Abstract:Background: Obesity is one of the health problems and the association of autonomic nerve dysfunction with certain cardiovascular disorders may exist in obese subjects. Objective: To observe the status of autonomic nerve function activity in order to detect the presence of autonomic neuropathy in obese persons. Methods: This study was conducted in Physiology department of Bangabandhu Sheikh Mujib Medical University during July 2006-June 2007. 40 apparently healthy obese subjects of both sexes with BMI >25 were included. Age and sex matched 40 nonobese subjects with BMI range 18.5-22.9 were also included for comparison(control). 5 noninvasive cardiovascular reflexes tests were done and scoring of autonomic neuropathy was also detected. Unpaired Student 't' test was used for statistical analysis. Results: Mean values of all cardiovascular reflex tests were significantly lower in obese subjects. Autonomic neuropathy in its early involvement stage was found in 22.5% of the obese subjects. Conclusion: The results of this study indicate that autonomic neuropathy though in early stage may be silently present in otherwise healthy obese person.J Bangladesh Soc Physiol. 2011 June; 6(1): 5-9For author affiliations, see end of text.http://www.banglajol.info/index.php/JBSP besity is a common and significant health hazard 1 . It is a risk factor for a variety of cardiovascular conditions parasympathetic activity was significantly associated with increasing percentage of body weight 7 .There are various controversial reports on autonomic nervous activity in obese persons. Some report showed hypoactivity of parasympathetic and associated hyperactivity of sympathetic nerve function 8 . Some showed both reduced sympathetic and parasympathetic nerve activity 7,9 . Again, an increased parasympathetic activity with a decreased sympathetic activity had also been reported by a group of investigators but in animal model 6 . Minor impairments of autonomic nervous system were found in obesity, changes in parasympathetic division of autonomic nervous system were found in most cases; which is likely to analogus to the early stages of autonomic neuropathy in diabetes mellitus 10 .including hypertension, ischemic heart disease and stroke 2 . Obesity is a condition in which the body fat stores are increased to an extent which impairs health and leads to serous health consequences. Body mass index (BMI) provides the most useful measure of overweight and obesity in adult individuals. The cut off point for overweight (23 to 24.9) and for obese (e"25) are lower for Asians 3 than the WHO standards (overweight and obesity are indicated by BMI >25 and e"30 respectively) 3,4.A complex interaction among different factors like endocrine, nervous, metabolic factors maintain constant energy storage 5 . Autonomic nervous system is vital for the coordination of different factors 6 . Depression in sympathetic and O Article

Background: Urethroplasty is the treatment of choice for long segment anterior urethral stricture. Various types of graft can be used as substitution, but now a day Buccal Mucosal Graft (BMG) is more popular with very promising results. This study was conducted to compare the outcome between dorsolateral free BMG graft and traditional staged reconstruction technique.   Materials and methods: This was a hospital based quasi experimental study done prospectively on 64 patients, dividing in two groups, dorsolateral onlay BMG Urethroplasty (Group A) and Johanson’s staged Urethroplasty (Group B) from January 2016 to June 2018 for long segment (3080mm) anterior urethral stricture with a minimum 06 months follow-up. Two patients were failed to attened at follow up clinic were excluded from the study. Data were analyzed by student’s t test, and chi-square test where appropriate.   Results: Total 62 patients were included in results (2 lost in follow-up) 32 patients with BMG (Group A) and 30 patients with Johanson’s urethroplasy (Group B) in 6 months follow-up where success rate of group A was 90.7% and group B 63.3% which is statistically significant. At the end of six months 22 patients (68.8%) in Group A had peak urnary flow rate more than 15 ml/sec, whereas only nine patients (33.3%) had had such flow rate in B group. Post operative complications were significantly higher in Group B. Eight patients (26.7%) in Group B had developed fistula and eleven patients (36.7%) had recurrence in Group B which is significantly higher then Group A.   Conclusions: Dorsolateral onlay BMG urethroplasty is comparatively an effective technique with excellent functional outcome for long segment an- terior urethral stricture and feasible with good short term success. JCMCTA 2020 ; 31 (1) : 31-37

Objectives: To study treatment outcome of positional vertigo in adult patients of 15-40 years of age. Place and duration of study: This study was conducted at ENT department of Chaudhary Muhammad Akram Teaching & Research Hospital, Lahore and Kuwait Teaching Hospital, Peshawar from June 2019 to June 2020. Material and Methods: 50 patients with diagnosis of benign positional vertigo were included in the study. Patients were treated and their outcomes were analyzed. Results: 50 patients of age between 15-40 years were included in the study. The analysis of treatment outcome showed that 35 patients (70%) showed maximum improvement in vertigo with medical treatment, 10 patients (20%) showed improvement in their symptoms with positional exercises and 5 patients (10%) showed improvement by combined treatment. Conclusion: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and presents as brief, episodic, positional provoked vertigo. The diagnosis can be made through clinical history along with diagnostic maneuvers and it can have a considerable impact on the quality of life. The medical treatment with vestibular dilators and vestibular suppressant is best option, with particle repositioning maneuver (Epley maneuver) for resistant and recurrent patients. Key words: Vestibular exercises, Dizziness, Positional vertigo, Dis equilibrium

Background: Chronic obstructive pulmonary disease (COPD) is a chronic progressive obstructive airway disease which is often associated with cardiovascular diseases. Sympathetic dysfunction may complicate the cardiovascular diseases which may in turn increase the morbidity and mortality in COPD patients. Objective: Aim of this study was to evaluate sympathetic cardiovascular function status of COPD patients to reduce the cardiovascular complication in those patients. Methods: This comparative cross-sectional study was carried out at the department of Physiology and department of Medicine, Rajshahi Medical College, Rajshahi from July 2013 to June 2014. Results: A total number of 80 subjects aged 40-55 years were selected, among which 40 were clinically diagnosed COPD patients (case) and 40 were age, sex and BMI matched apparently healthy persons for comparison (control group). To observe sympathetic cardiovascular function status resting pulse rate, resting systolic BP, resting diastolic BP, decline of systolic BP in response to standing from lying position (orthostatic test) and rise of diastolic BP in response to sustained hand grip for 5 minutes (isometric exercise test) were measured. For statistical analysis Independent sample t-test, and Pearson’s correlation coefficient test were performed.  In this study resting pulse rate, systolic BP, diastolic BP and rise of diastolic blood pressure in isometric exercise test were significantly increased in COPD than in healthy control group. On the other hand, decline of systolic blood pressure in orthostatic test was significantly decreased in COPD than in control group. Conclusion: This study concludes that sympathetic cardiovascular function is overactive in COPD and sympathetic over activity correlates with severity of the disease.

Background: In acute abdominal conditions, chronic duodenal ulcer  perforation is a very common surgical emergency that overwhelm the surgical ward throughout the year. Especially in the tropics and more in our country, peptic ulcer disease causes a major health problem. Objectives: To assess the usefulness of the prognostic factors in terms of morbidity and mortality in the treatment of perforated duodenal ulcer patient. Methods: This was a prospective study during the period from January 2003 to December 2003 in M.A.G. Osmani Medical College Hospital, Sylhet. The study included 100 cases of perforated chronic duodenal ulcer. Patients were randomly collected from all surgical units of SOMCH, Sylhet. Operation was done by simple closure with omental graft in all cases. Data analyzed by appropriate statistical method (Mean, SD & l2 test). Results: Highly significant relationship was found between increased age (>50 years) of patients with perforated duodenal ulcer and mortality (p<0.001). Lethality rate was higher in patients operated after 24 hours of onset of symptom in relation to patients operated within 24 hours of onset of symptom, (p<0.05). Different postoperative complications were prevalent in patients operated after 24 hours of onset of symptom, on the other hand complication rate was low in patients operated within 24 hours (p<0.001). There was also longer hospital stay in lately operated patients (more above median) than patients operated within 24 hrs (p<0.001). Mortality was higher in cases of purulent peritoneal fluid, where as it was nil in case of billous and serosanguinous fluid (p<0.001). More complications were developed in patients with purulent peritoneal fluid in comparison to billous and serosanguinous nature (p<0.001). There was more mortality in patients with preoperative shock in comparison with no features of shock (p<0.001). More complications were noted in patients with preoperative shock than in patients with no features of shock (p<0.01). Conclusion: Delayed operation, preoperative shock, more age and gross peritoneal sepsis bear a direct relationship with outcome of treatment chronic duodenal ulcer perforation patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21060