International Journal of Clinical and Experimental Physiology 2021-04-19T11:20:12+00:00 IJCEP Editorial Office Open Journal Systems <p><strong>Aim and Scope</strong></p> <p>The aim of International Journal of Clinical and Experimental Physiology (IJCEP) is to publish quality research papers in Physiology that have clinical application in medicine or the papers with experimental evidences having future perspective of application in medicine. As Physiology is the mother-subject of all branches of medicine, the ‘Clinical Physiology’ component will include in addition to the research data in ‘Clinical Physiology’, the research papers from all branches of clinical medicine such as diabetes, hypertension, heart disease, endocrine disorders, neurological dysfunctions, pulmonary diseases, gastrointestinal disorders etc., explaining the pathophysiological basis of the diseases and the physiological basis of management and prevention of the diseases. The ‘Experimental Physiology’ component will include reports on all experimental physiology research and the experimental models of diseases that facilitate understanding the pathophysiologic processes and management of diseases. However, the works in ‘Applied Physiology’ or the works in ‘Basic Research in Physiology’ intending to have application in clinical physiology and medicine will be considered for publication in IJCEP. Also, ‘Preventive Physiology’ such as role of nutrition, relaxation therapy, yoga, exercises etc. in health promotion will be published in this journal.</p> <p><strong>Subjects Covered</strong></p> <p>Physiology (Basic, Experimental, Applied and Clinical), Clinical Medicine, Endocrinology, Neurophysiology, Cardiovascular Physiology and Medicine, Gastrointestinal Physiology and Medicine, Pulmonary Physiology and Medicine, Clinical Biochemistry, Exercise Physiology, Nutrition, Sports Physiology and Medicine, Aviation Physiology and Medicine, Behavioural Physiology and Medicine, Reproductive Physiology and Medicine, Ophthalmic Physiology and Medicine, Physiology and Medicine related to ear, nose and throat, Orthopedic Physiology and Medicine, Pathophysiology of Lifestyle and Stress Disorders, Clinical Pharmacology, Physiology of Metabolism and Metabolic disorders and Physiology of Yoga.</p> Integration of Microbiota-Gut-Brain Axis: Significance of Autonomic Neural Influence 2021-04-19T11:15:19+00:00 Gopal Krushna Pal <p>The Gut-brain Axis (GBA) is the bidirectional communication between the brain and the enteric nervous system of the gut, linking emotional and cognitive centers of the brain with peripheral intestinal functions. Gut microbiota profoundly influences these interactions. The interaction between microbiota and GBA is made bidirectional by signalling from gut-microbiota to brain and from brain to gut-microbiota through neural, endocrine, immune, and humoral communications. Hence, this bidirectional relationship between gut and the brain is more precisely called as microbiota-gut-brain axis (microbiota-GBA).<sup>[1]</sup> Microbiota-GBA is closely associated with many functions and dysfunctions in health and diseases in human beings. However, most of the data on GBA have been acquired using germ-free animal models, probiotics, antibiotics, and infection studies in experimental models. In clinical medicine, data on functions of microbiota- GBA are derived mainly from the association of dysbiosis with central nervous disorders, especially in autism and anxiety-depressive behaviours and from functional gastrointestinal disorders. Especially, irritable bowel syndrome is considered as a prototype of the disruption of this complex relationship of microbiota-GBA.<sup>[2]</sup>&nbsp;<strong>Read more...</strong></p> 2021-04-19T06:10:36+00:00 ##submission.copyrightStatement## Physiological Facets of Jet Lag: Melatonin is the Key Ruler 2021-04-19T11:20:12+00:00 Aparna Mulgund Nagaraja Puranik <p>It’s the most exciting thing to move around from one section of the globe to the other part, swiftly. However, Jet lag is the most frustrating component of such long journeys. Jet lag happens when our internal clock is desynchronized by travelling across several time zones in a short time. Jet lag is not a badge of honour, but a significant modern problem. Hence, it’s worth understanding the means to handle Jet lag without counting on sleeping pills. Melatonin has proven to be a better and safer treatment for Jet lag. This review is a general topic of interest and talks over the causes, and implications of Jet lag. It also gives special emphasis on the method to use judiciously timed exogenous melatonin to conquer the jet lag.</p> 2021-04-19T00:00:00+00:00 ##submission.copyrightStatement## Association of Body Mass Index, Menstrual Flow, Socio-economic and Educational Status with Psychological Stress Levels in Young Age Students 2021-04-19T11:15:20+00:00 Panneerselvam Periasamy V. Suganthi Ponmurugan Karuppiah Senthilkumar Subramanian Sasikala Gunasekaran Ramamoorthy Easwaarisiva <p><strong>Background and Aim:</strong> To determine the role of factors linked to the presence of perceived stress in students, after evaluating different aspects of mental health in college students. To evaluate and understand the psychological discomfort and reduce burden of it among young aged students. <strong>Methods:</strong> A total of 291 students fulfilling the inclusion criteria were recruited and Ethical approval was obtained from the institution. Written consent was obtained and all the participants were assured that their identity would be kept confidential. The study participants were asked to complete a questionnaire anonymously consisting of menstrual problems, socio-economic status, educational status and perceived stress scale. <strong>Results:</strong> Among 291 respondents of this study, 27.15% students are medical students and 31.62% are nursing students, 23.02% of the students are physiotherapy students and 18.21% are Art and science students. 53.26% are 1st and 2nd year students. 27.15% of the students have their family income between Rs. 20,000 – 49,999 and 24.4% of the students have their family income between Rs.10,000-19,999. 27.15% of the student’s head of their families are graduates and majority of the head of their families (67.35%) are self-employed. <strong>Conclusion:</strong> This study reveals the relationship between socio-economic status (SES), Body Mass Index (BMI), menstrual problems and psychological stress, which can explain partly due to emotional eating as a coping strategy to overcome the psychological stress.</p> 2021-04-19T07:48:51+00:00 ##submission.copyrightStatement## Cardiovascular Responses to Submaximal Exercise Stress Test in Adolescents with High Visceral Fatness 2021-04-19T11:15:21+00:00 Shweta Parikh Sushil Kumar Singh Hasmukh Shah <p><strong>Background and Aim:</strong> Visceral adiposity per se was associated with risk of developing hypertension in future. There is escalating trend of visceral obesity in Indian adolescents. Nonetheless, the Asian Indian population is known to have an affinity for central fat deposition than peripheral fat. Meanwhile, the association of visceral adiposity and cardiovascular response to exercise in Indian adolescents of 18-19 years’ age group has not been well described so far. Therefore, the present study was undertaken.<strong> Methods:</strong> A Cross-sectional study was conducted on 120 non-athletes’ (60 males and 60 females) late Indian Adolescents of 18-19 years’ age group. Visceral Fat (VF) and Other Body composition were measured by Bioelectrical Impedance technique using Omron HBF 302 body fat analyzer. The participants were customized into two groups based on their Visceral Fat Level (0-9: Normal VF group; &gt; 9: High VF group). Exercise Testing was done by treadmill exercise test following standard Bruce protocol. Cardiovascular reactivity (Heart Rate, Systolic and Diastolic Blood Pressure) was checked at the end of each stage of Bruce Protocol. <strong>Results:</strong> Increased SBP and DBP responses to treadmill exercise tests at different stages were seen in high VF groups in both the genders. However, no abnormal reactivity was observed in high VF groups of both the genders. <strong>Conclusion:</strong> During treadmill exercise stress test, high blood pressure reactivity was seen in high visceral fat adolescents as compared to normal visceral fat adolescents, which was primarily due to their high resting blood pressure. Adolescents with normal visceral fat were competent to cross more number of Bruce stages than high visceral fat Indian adolescents. Visceral fat had a stronger influence on baseline cardiovascular parameters like systolic and diastolic blood pressure as well as blood pressure parameter during exercise than total body fat.</p> 2021-04-19T08:53:15+00:00 ##submission.copyrightStatement## Improvement in Fetomaternal Outcomes and Cardiovascular Health in Gestational Diabetes Mellitus following a Short-course Yoga Therapy 2021-04-19T11:15:21+00:00 Manoharan Renugasundari Gopal Krushna Pal Latha Chaturvedula Nivedita Nanda KT Harichandrakumar Lakshmanan Vidyalakshmi <p><strong>Background and Aim:</strong> Though the effects of yoga on fetomaternal outcomes in GDM have been assessed earlier, a complete cardiometabolic profile and fetomaternal outcomes have not been studied yet. Also, there is no report of practice of a short course yoga therapy administered prior to parturition in GDM patients. Therefore, in the present study, effects of a structured short-course yoga module on cardiometabolic risks, fetomaternal outcomes and psychophysical health in GDM were assessed. <strong>Methods:</strong> A total of 21 pregnant women diagnosed to have GDM, admitted to Obstetrics Ward of tertiary care hospital prior to their delivery were recruited for the study. Anthropometric indices such as height, weight and BMI were calculated. Cardiometabolic risk (CMR) parameters such as heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded, and rate pressure product (RPP) was calculated. The psychophysical health was assessed by using two questionnaires such as Perceived Stress Scale (PSS) scoring and Quality of Life (QoL) scoring. The participants were provided yoga therapy consisting of basic asanas and slow pranayamas daily and the schedule continued till their delivery. Yoga therapy was administered for a minimum of seven days and maximum of ten days. All the parameters before and after yoga were compared. Correlation of RPP, the marker of myocardial work stress was done with various parameters to assess the association of stress and metabolic status with the cardiovascular (CV) risk. <strong>Results:</strong> There was a significant decrease (P=0.000) in BHR, SBP, DBP, RPP after yoga intervention when compared to the pre-yoga assessment. There was also a significant decrease (P=0.001) in blood glucose after yoga intervention. The comparison of PSS and QoL before and after yoga intervention revealed a significant reduction in stress level (P=0.000) and improvement in QoL (P=0.000) after yoga intervention. RPP was significantly correlated with PSS. <strong>Conclusion:</strong> Practice of yoga for about one week consisting of basic asanas and slow pranayama significantly decreases blood glucose and stress levels and improves fetomaternal outcomes in GDM patients. The myocardial work stress in GDM patients could be linked to the psychological stress in them.</p> 2021-04-19T09:12:23+00:00 ##submission.copyrightStatement## Serum Copeptin Level and High-Sensitivity C-Reactive Protein in Centrally Obese Middle-Aged Male Subjects 2021-04-19T11:15:22+00:00 Kyi Kyi Myint Aung Khaing Mya Mya Thwin <p><strong>Background and Aim:</strong> Copeptin, a surrogate marker of Arginine Vasopressin, has been recently used as stress related neuroendocrine marker. In addition, chronic psychosocial stress had an association with increased inflammatory cytokines. Moreover, obesity has been recognized as high inflammatory status. Thus, it has been generated an interest whether centrally obese with high copeptin level have higher inflammatory status comparing to those with low copeptin level or not. <strong>Methods:</strong> Eighty-seven centrally obese male subjects between 40-60 years were recruited for this study. Anthropometric measurements such as height, weight, BMI and waist circumference were measured. Blood sample was collected to measure copeptin and hsCRP. <strong>Results:</strong> 29 subjects (33.33%) had low copeptin level (&lt;5 pmol/L) and 58 subjects (66.67%) had high copeptin level (≥5 pmol/L). Median hs-CRP levels were 2.86 mg/L (IQR: 1.63-6.7) and 3.42 mg/L (IQR: 2.44-5.46) in obese with low copeptin level and obese with high copeptin level respectively. There was no significant difference in hs-CRP levels between these two study groups (p=0.7). <strong>Conclusion:</strong> In the study population of the present study, there was no correlation found between copeptin and inflammatory status.</p> 2021-04-19T09:26:43+00:00 ##submission.copyrightStatement## Effect of Home Based Yoga on Blood Pressure and Quality of Life in Patients with Hypertension 2021-04-19T11:15:22+00:00 Shweta Parikh Priyanka Mahida Nirav Vaghela Hasmukh Shah <p><strong>Background and Aim:</strong> Hypertension is one of the major growing global problems. Management of hypertension by medicine, diet and exercise is not enough and alternative therapy is need of time. Yoga is one such substitute healthcare practice assumed to improve blood pressure control and quality of life in hypertensive. A prospective intervention was designed to check the effect of home based yoga exercise on blood pressure and quality of life in hypertensives. <strong>Methods:</strong> A total 74 hypertensive participants were recruited for the present study after following inclusion and exclusion criteria. Participants were divided into two groups, study group (n=39) who have done home based yoga and control group (n=35) who have not done home based yoga. Detailed methodology of home based yoga; their advantage and disadvantage were explained to the study group very well. Study group have done their home based yoga for three months and control group did not have done the home based yoga. Cardiovascular parameters like systolic blood pressure, diastolic blood pressure and pulse rate were recorded after following all standard precautions at the time of initiation of study and at end of every month till completion of study. Participants were also assessed for their quality of life, health and other areas of life by World Health Organization Quality of Life questionnaire at the time of beginning of the study and at every month till completion of study. <strong>Results:</strong> Significant decrease in systolic blood pressure from 130.60 ± 4.06 to 124.20 ± 0.60 mm of Hg and diastolic blood pressure from 85.62 ± 5.55 to 79.21 ± 0.73 mm of Hg were seen in study group. In control group, blood pressure reduction was not seen. Self rated score of quality of life was improved in study group as compared to control group. <strong>Conclusion:</strong> A short term home-based yoga program in hypertensive patients have shown to reduce blood pressure as well as positive effect on self-rated quality of life compared to controls. A simple 12-weeks duration home based yoga exercise program may be useful as supplementary therapy in addition to antihypertensive drugs in hypertensive patients.</p> 2021-04-19T09:46:48+00:00 ##submission.copyrightStatement## Evaluation of Improvement in Clinical and Left Ventricular Systolic Functions after Cardiac Resynchronization Therapy in Patients with Heart Failure in the Indian Population 2021-04-19T11:15:22+00:00 Shaikh Saiful Haque Zahed Naushi Mujeeb <p><strong>Background and Aim:</strong> Heart Failure (HF) is a chronic progressive disease associated with substantial morbidity and mortality. It is a major and growing global public health problem affecting millions of people worldwide. Despite optimal pharmacological therapy, many patients may still have significant symptoms affecting their functional capacity and quality of life. This study was conducted to determine the efficacy of Cardiac Resynchronization Therapy (CRT) in improving clinical and systolic echocardiographic parameters of the Left Ventricle in patients with heart failure in the Indian population.<strong> Methods:</strong> This is a non-randomized prospective observational study conducted at the Department of Cardiology, Fortis Escorts Heart Institute, New Delhi, from 1<sup>st</sup> September 2014-31<sup>st</sup> December 2015. A total of 70 cases eligible for CRT based on inclusion and exclusion criteria were included in the study. Echocardiographic parameters for Left ventricular systolic functions were measured pre CRT implantation, 3 months and 6 months post CRT implantation. Data were analyzed using standard statistical tests. <strong>Results:</strong> Present study showed statistically significant improved values (P ≤ 0.0001) for the clinical response measured in terms of New York Heart Association (NYHA) class and Echocardiographic response measured by Left Ventricular systolic functions (LVEF, LVESV, and LVESDs) in patients treated with CRT, measured at 3 months and 6 months post CRT implantation. <strong>Conclusion:</strong> This study supports the efficacy of CRT for the treatment of Heart Failure in the population studied in terms of improving patient’s clinical and echocardiographic Left Ventricular Systolic Functions.</p> 2021-04-19T10:08:52+00:00 ##submission.copyrightStatement## Increased High Frequency Compared to Low Frequency Power in Heart Rate Variability in Parkinsonism 2021-04-19T11:15:23+00:00 Rajani Bala Jasrotia Pramita Dubey Arvind Kanchan Nitin Ashok John <p>Heart rate variability (HRV) decreases in Parkinson’s disease which could be a consequence of reduced motor activity besides being a marker of cardiovascular dysautonomia. The diurnal low frequency power and high frequency power decrease in advanced Parkinsonism. In this case, there is decreased low frequency (LF) but high frequency (HF) is found to be very high compared to LF, which needs explanation. Multiple lobed pattern on Poincare plot in this case increases SD1, which has an analogy to HF, therefore HF is increased. If we remove premature beats from the recording while analysing, and then frame Poincare plot, it would be a normal torpedo pattern and HF value will be decreased in this case like LF, as is normally found in Parkinsonism, which would truly reflect the HRV values due to autonomic effects. HRV report should be interpreted for autonomic dysfunction when Poincare plot is torpedo pattern as other patterns may signify some intrinsic disease of heart.</p> 2021-04-19T10:25:49+00:00 ##submission.copyrightStatement## Adrenergic Storm Induced Warburg Effect in COVID-19 2021-04-19T11:15:23+00:00 Natesan Vasanthakumar <p>At present, there is no treatment option available for COVID-19 condition and most importantly the underlying pathophysiology in COVID-19 is not known. In this article, I had given a viewpoint that explains the underlying pathophysiology in COVID-19 and based on it proposed treatment options for COVID-19. I propose that the adrenergic storm-induced Warburg effect (aerobic glycolysis) may be the underlying mechanism in the COVID-19 condition. I propose alpha1 adrenergic blockers in the early phase and beta-adrenergic blockers in the late phase of COVID-19 to inhibit the adrenergic storm and reverse the Warburg effect in COVID-19 condition.</p> 2021-04-19T10:38:52+00:00 ##submission.copyrightStatement## News and Views 2021-04-19T11:15:24+00:00 Editor’s Office <p>Increase in blood glucose during pregnancy is known as gestational diabetes mellitus (GDM). The main feature of GDM is insulin resistance, which resembles type 2 diabetes mellitus (T2DM).<sup>[1]</sup> Generally, GDM occurs in the 2<sup>nd</sup> trimester of pregnancy and the blood glucose usually reverts to normal following delivery. In few cases, the blood glucose does not return to normal after delivery and continues as T2DM if not adequately managed. However, many GDM women develop diabetes later in life postpartum, if diabetes is not managed vigorously during pregnancy. The management of GDM involves medical nutrition therapy (MNT), metformin / insulin therapy.<sup>[2]</sup> Nevertheless, as GDM is the disease of pregnancy, usually medicines are avoided to protect the health of the fetus. The various alternative therapeutic options available for GDM include dietary management, which is considered to be the first treatment of choice.<sup>[2]</sup>&nbsp;<strong>Read more...</strong></p> 2021-04-19T00:00:00+00:00 ##submission.copyrightStatement## Instructions to the Authors 2021-04-19T10:59:33+00:00 Gopal Krushna Pal <p><strong>About the Journal </strong></p> <p>International Journal of Clinical and Experimental Physiology (IJCEP), a is a peer‑reviewed online and print journal with quarterly (March, June, September, December) publications on demand, compilation of issues published. The journal allows free access (Open Access) to its contents and permits authors to self‑archive final accepted version of the articles on any OAI‑compliant institutional / subject‑based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.</p> <p><strong>Abstracting and Indexing Information </strong></p> <p>The journal is registered with the following abstracting partners: Baidu Scholar, CNKI (China National Knowledge Infrastructure), EBSCO Publishing’s Electronic Databases, Ex Libris – Primo Central, Google Scholar, Hinari, Index Copernicus, Infotrieve, National Science Library, ProQuest, TdNet, Wanfang Data. <strong>Read more...</strong></p> 2021-04-19T00:00:00+00:00 ##submission.copyrightStatement##