Samir Kumar Hazra

A comparative study of lipid profile and autonomic functions in vegetarian and non-vegetarian postmenopausal women

Background: The prevalence of dyslipedaemia, autonomic dysfunction leading to cardiovascular diseases, increases with menopause and an ageing population. Autonomic dysfunction as measured by lower heart rate variability is an established risk factor for cardiac death. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases and are also linked to other cardiovascular risk factors. Objectives: To compare lipid profile and autonomic functions of postmenopausal women on vegetarian and non- vegetarian diet. Materials and Methods: 120 Postmenopausal women (menopausal duration and age-matched) without any gross systemic disease from an Industrial population were selected. Sixty women were on vegetarian diet and 60 on non-vegetarian diet. BMI and waist/hip ratios were calculated, lipid profile was analyzed, and autonomic function tests were carried out. A comparison was done between the two groups using Students t test. Pearsons correlation coefficient was calculated between the independent variable (lipid profile parameters) and the dependent variables (deep breath test, valsalva ratio, 30:15 ratio, OTT, IHG, CPT) to understand the effect of lipid profile on autonomic control of heart. Results : Significant increases in total cholesterol, triglyceride, LDL, cholesterol/HDL ratio were noticed in women on non-vegetarian diet. Results of autonomic function tests, i.e. valsalva ratio, deep breath test, 30: 15R-R intervals ratio, isometric hand grip test, cold pressor test, and orthostatic tolerance test were significantly worsened in postmenopausal women on non-vegetarian diet. Conclusion: Dietary factors may be an important cause of alteration of lipid metabolism. Increased cholesterol decreases heart rate variability and increased LDL cholesterol decreases baroreceptor sensitivity thereby worsening autonomic functions in postmenopausal women.

Correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of Eastern India

The theory that there is a possible correlation between blood types and personality characteristics, other diseases, neurological disorders have been prevalent for a long-time. Background/Aims: To find correlation of perceived stress with blood group A and O among medical students and its effect on lipid profile in a medical college of eastern India. Materials and Methods: This cross-sectional study was conducted in a time span of 6 months after taking approval from the institutional ethics committee and informed consent of the subjects. Stress level in the subjects was assessed according to the presumptive life event stress scale (PSLES). 465 subjects with scores above 200 were chosen for the study. Blood groups of the subjects were assessed (blood group O 185; A 95; B 150: AB 35 [total 465]). Lipid profiles of subjects with blood group O and A were analyzed following exposure to stress. The perceived stress scale (PSS) of Sheldon Cohen was used to measure perceived stress. Data were analyzed using SPSS version 16. Results: There was no significant difference in PSLES scores, body mass index, total cholesterol, triglyceride, high-density lipoprotein, very low-density lipoprotein between subjects of blood group O and A. PSS score was significantly higher in group O as compared to group A (22.4 ± 4.6 vs. 19.36 ± 4.9; P value 0.036*). Low-density lipoprotein-cholesterol (LDL-C) was significantly higher in group O (132.63 ± 19.43 vs. 115.59 ± 18.7; P value 0.004**). PSS scores were positively correlated with LDL with r value of 0.03 [P < 0.01]). Conclusions: The results of our study indicate that subjects with blood group perceived more stress as compared to subjects of blood group A and perceived stress significantly worsened LDL-C levels.

Comparative study of effect of progressive muscle relaxation and walking on stress and cardiovascular profile in young adults of health sector

Background: Stress has become a part and parcel of modern day life. Lifestyle modifications may be a cost-effective way to improve health and quality of life. Aims: To compare effects of progressive muscle relaxation (PMR) and walking on stress and cardiovascular profile in young adults working in the health sector. Materials and Methods: This pilot study was conducted at a tertiary care hospital of Eastern India after taking institutional ethical clearance and informed consent of the subjects. One hundred and twenty young adults from the health-care sector with the presumptive life event stress scale of more than 200 were selected for the study. Anthropometric measurements were carried out. Pulse and blood pressure were recorded. Perceived Stress Scale (PSS) scores were calculated, lipid profile analyzed, and isometric hand grip test, orthostatic tolerance test, and breath-holding test were done. Study subjects were divided into two groups G1 and G2. Group G1 was asked to practice PMR and Group G2 was advised to walk in the morning for 3 months. All parameters were re-evaluated after 3 months. The primary outcome measures from baseline to final follow-up were measured by blinded observers. Results: There was no difference in age, sex, PSS, cardiovascular profile, and dietary habits between the two groups before training. Ten subjects failed to attend follow-up clinic and were excluded. PSS, cardiovascular profile were significantly improved in both groups after the training session. PSS and cardiovascular profile improved equally in both groups. Conclusion: PMR and walking were equally effective in reducing stress and improving cardiovascular profile in young adults and may be used as a cost-effective way to improve health and quality of life.

To study effectiveness of progressive relaxation on balancing exercises in functional outcome of osteoarthritis knee in postmenopausal females

Background: Postmenopausal females with osteoarthritis (OA) of knee joint often report episodes of knee instability limiting their daily activities and this causes an added stress. Aims: To evaluate the effects of progressive muscle relaxation (PMR) on balancing exercises to improve functional ability in postmenopausal females with OA of knee. Materials and Methods: This interventional study was conducted on 60 postmenopausal females in a tertiary care hospital of Eastern India after taking Institutional Ethical Clearance and informed consent of the subjects. Perceived stress scores of the subjects were assessed. Patients were randomly allocated into two groups and they received either balancing exercises and PMR (Group A) or balancing exercises (Group B). Both of the groups received transcutaneous electrical nerve stimulation and treatment was given for 4 days a week for 4 weeks. The outcome measures were Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Results: After 4 weeks of treatment, significant reduction in the WOMAC score and VAS was found in both Groups. The results showed that improvement was more in Group A than Group B. Perceived stress scores significantly decreased in Group A (27.8 ± 1.95 vs. 20.16 ± 3.33; P < 0.000**) but the change was not significant in Group B (28.2 ± 1.4 vs. 27.46 ± 1.45; P value: 0.53). Perceived Stress Scale (PSS) was positively correlated with WOMAC and VAS scores at R value of 0.68 and 0.81, respectively. Conclusion: The results of the study indicates that balancing exercise when practiced along with stress relaxation exercises is more effective in improving the functional ability of OA knee.

To study impact of stress on education and health profile of newly admitted medical students in a medical college of Eastern India

Background: Medical education is inherently stressful and emotionally demanding training. Objectives: The objective was to assess the stress levels, its causes, and impact on health and education on first MBBS students. Materials and Methods: This cross-sectional pilot project was conducted in a Medical College in Eastern India during a time span of 2 months, after receiving approval from the Institutional Ethics Committee and informed consent from the subjects. One hundred and fifty MBBS students in the age group of 18–20 years under stress were chosen for the study. Stress level was assessed according to the Presumptive Life Event Stress Scale (PSLES) and categorized into two groups: 41–200: less/moderate stress; more than 200: severe stress. The Perceived Stress Scale (PSS) of Sheldon Cohen was also used. Scores around 13 were considered as average. Scores of 20 or higher were considered high stress. Baseline anthropometric measurements were done; body mass index and waist to hip ratio (WHR) were calculated. Resting pulse rate and blood pressure were measured. The results of internal assessment examinations conducted in this time period were recorded. The computer software Statistical Package for the Social Sciences version 16 was used for analysis of the data. Results: A total of 30 subjects had moderate PSLES scores (167.25 ± 26.67); 120 had high scores (373.86 ± 149.21; P < 0.000). We found statistically significant higher heart rate, diastolic blood pressure, WHR, and PSS scores (22.05 ± 5.02 vs. 19.25 ± 4.21; P 0.003) in subjects having high PSLES scores. No significant effect of stress scores were observed on systolic blood pressure. Examination results were significantly worse in the highly stressed group (64.3 ± 10.8 vs. 69.1 ± 9.6; P 0.019) as compared to subjects having moderate stress. Conclusions: These results indicated a negative impact of stress on health and education among MBBS students.

To Study Correlation of Body Fat and Blood Lipids with Autonomic Nervous System Activity in Postmenopausal Indian Women

Background: Obesity, physical inactivity, and altered estrogen metabolism play integrated role contributing to the disease risk profiles of postmenopausal women (PMW). Aim: To study the correlation of body fat and blood lipids with autonomic nervous system activity in PM Indian women. Subjects and Methods: A total of 60 PM sedentary women without any gross systemic disease were selected as a control group and 23 PMW, who were regularly doing morning walk for 1-year was selected as a study group. Body mass index (BMI), waist/hip (W/H) ratio were recorded; lipid profile analyzed, and conventional autonomic function tests were carried. Results were analyzed using SPSS version 16. Results: There was a significant difference in BMI, W/H ratio, lipid profile, autonomic function tests between the two groups. Aging and menopausal duration (MD) were positively correlated with pulse rate, systolic blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, orthostatic tolerance test (OTT), and negatively correlated with Valsalva ratio (VR), deep breath test (DBT), 30:15 relative risk (RR) intervals ratio, isometric hand-grip test (HGT), cold pressor test (CPT). BMI and W/H ratio were positively correlated with TC, triglyceride, LDL cholesterol, OTT, and negatively correlated with isometric HGT, CPT. TC and LDL were negatively correlated with VR, deep breath difference test, 30:15 RR interval ratios, isometric HGT, CPT, and positively correlated with OTT. Multiple regression analysis revealed LDL cholesterol as the only significant independent explanatory variable of DBT. LDL cholesterol and age were the significant independent explanatory variables of 30:15 RR interval ratios, CPT. TC, LDL cholesterol, and age were the significant independent explanatory variables of isometric HGT. Conclusions: Aging, MD, BMI, and W/H ratio all contribute significantly to worsening of autonomic functions and lipid profile. Multiple regression analysis revealed LDL cholesterol as the most significant contributor of worsening of autonomic functions in PM females and regular exercise can improve these parameters significantly.