International Journal of Clinical and Experimental Physiology <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> EManuscript Technologies en-US International Journal of Clinical and Experimental Physiology 2348-8832 Slow and deep breathing pranayamas facilitate recovery from COVID-19 <p>Though 80% of Corona Virus Disease 2019 (COVID -19) patients recover without much medical intervention, the morbidities and mortality in the in the second wave of COVID-19 have been reported to be more. Though COVID-19 mortality is mostly due to acute pneumonia and acute respiratory distress syndrome (ARDS), it has also been reported that cardiac problems and cardiovascular (CV) risks are not less in this disease.<sup>[1]</sup> Even after recovery, patients are dying due to cardio-respiratory complications in the post-recovery period. To date, there is no evidence of any effective treatment for COVID-19. In India alone at the peak of second wave, daily new cases reported were more than 4 lakhs and daily deaths were about 4000. Practice of yoga is known to improve cardiac and pulmonary functions.<sup>[2]</sup> Among yoga techniques, pranayamas (controlled breathings) are more effective in promoting cardio-respiratory functions.<sup>[3]</sup> Among different types of pranayamas, the chandranadi pranayama (left-nostril breathing) and anulom-vilom pranayama (alternate-nostril breathing) have been demonstrated to have maximum beneficial effects on autonomic and cardiopulmonary functions, especially if they are practiced in a single session of pranayama schedule.<sup>[4,5]</sup> Recently, a slow and deep pranayama schedule integrating both these pranayamas has been reported to facilitate early recovery from COVID-19.<sup>[6] </sup><strong>Read More ...</strong></p> Gopal Krushna Pal ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 47 48 10.5530/ijcep.2021.8.2.12 Clinical and Research Opportunities for Budding Physiologists in India <p>There has been increased awareness about choosing the field and career progress in Physiology and its related branches. In spite of the many available resources, there exists a need for proper mentoring and guidance that is required to build up a good career as a physiologist. There is a high demand for physiologists in various fields with the advances in translational research in today’s world and young academic Physiologists are stimulated to get them involved in such research activities. These research works not only bring them forward in their careers but also collective efforts from various such research projects help to improve the health conditions and overall well-being of Physiologists. There is increased opportunity both in India and abroad for the young Physiologists to obtain grants, establish laboratory and collaborate with clinicians, epidemiologists and basic scientists to perform quality research. In this review, we will summarize various subdivisions of the major field of physiology and also discuss on the research opportunities, jobs in academic, industry and other scientific fields. Ultimately, the research works and collaboration of physiologists with pharmacologists, physicians, dietitians, fitness coaches, zoologists, clinicians and academicians would hopefully provide lots of satisfaction to the successful investigators, enhanced academic environment and output of the academic institutions ultimately resulting in improvement of overall health of humanity.</p> Kaviraja Udupa Mrudula Kambhampati Talakad N. Sathyaprabha ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 49 54 10.5530/ijcep.2021.8.2.13 Rehabilitation of Stroke-Induced Spastic Paralysis using Stretching-resisting Modality Combined with LFEA (Low-Frequency Electric Acupuncture) Stimulation <p><strong>Background and Aim:</strong> In order to establish the method of rehabiliting the stroke-induced spastic paralysis, we tried stretching-resisting modality, combining with LFEA (low-frequency electric acupuncture) stimulation on the muscle. <strong>Methods:</strong> A total of 137 patients were devided into two groups-trial group (n=75) and compared group (n=62). Two groups of patients were given stretching-resisting modalities on paralysed muscles respectively, and LFEA (low-frequency electric acupuncture) stimulation was combined in the trial group, but not in the compared group. We have evaluated the paralysis using well-known scores as Ashworth Scales and Barthel Indices (BI) in the early days of admission and after we have finished the treatment. Then, we compared improved variances of the measures between two groups statistically. <strong>Results:</strong> We found that Ashworth Scale in trial group significantly reduced than in compared group, and more quickly reduced. Barthel Indice were significantly changed in both groups, but total BI and 2 BI items (transferring between bed and wheelchair, mobility on surface level) were increased significantly in trial group than in combined group. <strong>Conclusion:</strong> The combination of LFEA stimulation might increase the therapeutic effects for rehabilitation of stroke-induced spastic paralysis than simple stretching-resisting modality, and reduces the length of time to recovery. And the mostly changed ADLs (activities of daily life) might be transferring between bed and wheelchair and mobility on surface level.</p> Un-Sung Paek Se-Il Song ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 55 58 10.5530/ijcep.2021.8.2.14 Sympathovagal imbalance, cardiometabolic risks and hypertension status are linked to depression in women having risk factors for pregnancy-induced hypertension <p><strong>Background and Aim:</strong> Pregnancy is a physiological state in which there are cardiovascular, autonomic, hemodynamic and psychological changes. Increase in incidence of stress and depression in antenatal period has been reported. Autonomic changes in pregnancy-induced hypertension (PIH) and its dysfunction in depression are well documented. However, there is no report of contribution of sympathovagal imbalance (SVI) and cardiometabolic alterations to stress and depression in PIH. <strong>Methods:</strong> In this case-control study, we assessed and analyzed cardiovascular autonomic functions including heart rate variability (HRV) and cardiometabolic risks (CMR) between pregnant women having risks of PIH (n=62) and normal healthy pregnant women (n=68). The perceived stress scale (PSS-10) and Quality of Life (QoL) were used to evaluate depressive symptoms and perceived stress. The HRV and CMR parameters were correlated with PSS. Multiple regression analysis was performed individually to study their association with PSS. Logistic regression was done to determine the prediction of hypertension/prehypertension status by PSS. <strong>Results:</strong> There was increase in heart rate and blood pressure, decreased HRV and increased markers of insulin resistance, atherogenic lipid profile, markers of inflammation, oxidative stress and vascular endothelial dysfunction in PIH risk subjects compared to control subjects. Parameters of SVI and decreased cardiovagal modulation and CMR were significantly correlated and associated with PSS. PSS had independent prediction of prehypertension/hypertension status in the study group. <strong>Conclusion:</strong> Findings of the present study indicate that there is considerable SVI and CMR in PIH. It appears that depression is the major cause of SVI and decreased cardiovagal modulation in PIH, and retrograde inflammation and vascular endothelial dysfunction could be the potential mechanisms of depression mediated SVI in PIH.</p> Gopal Krushna Pal Syed Habeebullah Manivannan Subha Pravati Pal ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 59 64 10.5530/ijcep.2021.8.2.15 Electrophysiological Study on the Influence of the Morphine Microiontophoresis on Firing Activity of Neurons in Nuclei Related to Acupuncture Analgesia <p><strong>Background and Aim:</strong> Many nuclei such as periaqueductal central gray (PAG), raphe magnus nucleus (RMG) and gigantocellular reticular nucleus (Gi) are related in acupuncture analgesia. The aim of this study is to find the analgesic characteristics when dorsolateral periaqueductal gray (DLPAG), ventrolateral periaqueductal gray (VLPAG), RMG and Gi were individually stimulated in rat. <strong>Methods:</strong> Wistar rats (200~230g) were used in experiments. Rats were put in a small plastic box except the tail when the tail of a rat was stimulated by using radiant heat, tail flick latency (TFL), threshold of the painful response on account of the radiant heat was determined. The stimulus experiments were performed 3 to 5 days after inserting the electrodes. The current intensity for microiontophoresis is 30nA and time is 20s. <strong>Results:</strong> When DLPAG was locally stimulated in rats, the analgesia gradually appeared. Its characteristics resembled those of electroacupuncture at ST36 point. And then the analgesic effect appeared only in the period when VLPAG, RMG and Gi were individually stimulated in rats, but didn’t appear after cessation of stimulation. The rates of the excited neurons in the VLPAG, RMG and Gi were increased by microiontophoresis of morphine. <strong>Conclusion:</strong> There are mechanisms inhibiting the painful impulse in input of spinal cord by influence of endogenous morphine-type substance affecting neurons in VLPAG, RMG, and Gi among the mechanisms of electroacupuncture analgesia on ST36 point.</p> Won Jong Myong Hui Kim ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 65 69 10.5530/ijcep.2021.8.2.16 Study of Severity of Syndrome-X on Lung Function Impairment in Indian Population <p><strong>Background and Aim:</strong> Syndrome-X and impaired lung functions both have been associated with an increased jeopardy of coronary heart disease (CHD) in the middle aged Indian population. The aim of present study was to investigate the Severity of Syndrome-X on Lung Function Impairment in Indian Population. <strong>Methods:</strong> This cross sectional study was done among 200 syndrome-X patients at C. U. Shah Medical College, Gujarat, India for the period of three years from July 2012 to June 2015. They were divided into three groups on basis of presence of numbers of components of Syndrome-X. Syndrome-X was defined, National cholesterol Education Program’s-Adult Treatment Panel III Criteria. Anthropometric measurements, blood pressure and lung functions were measured. Fasting blood samples were analyzed to measured glucose, triglyceride and high-density lipoprotein (HDL-c) cholesterol. Statistical analysis was done by SPSS windows version 20.0 software. <strong>Results:</strong> The prevalence of components in syndrome-X patients was 48.5% with 3, 33.5% with 4 and 18% with 5 components of syndrome-X. The lung functions variables (FVC; P&lt;0.05, FEV1; P&lt;0.001, FEV3; P&lt;0.05, FEFR; P&lt;0.001 and FEF25-75%; P&lt;0.0001) were significantly decreases in patients having 4 or 5 components of syndrome-X as compared to patients having 3 components. <strong>Conclusion:</strong> It is concluded from present study that the frequency of components of syndrome-X was significantly associated with lung functions impairment. Therefore, this study suggests that lung function test may be useful as an additional evaluation for the syndrome–X in a clinical practice.</p> Prema Ram Choudhary Munna Lal Jaipal ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 70 73 10.5530/ijcep.2021.8.2.17 Solitary and Synergistic Influences of Eugenol and Curcumin against Induced Bronchial Asthma in Male Rats <p><strong>Background and Aim:</strong> Asthma crosstalk has recently gained growing scientific attention, especially in the terrifying existence of COVID-19 that affected specifically the function of the respiratory system and led to death. Thus, this study aimed to determine how and if natural products as eugenol (Eug) and curcumin (Cur) can appoint the promising recovery and treatment of induced bronchial asthma. <strong>Methods:</strong> Forty male albino rats were included and randomly divided into five groups: Group I (control group), Group II (asthma group), Group III (Eug+Asthma group), Group IV (Cur+Asthma group), and Group V (Eug+Cur+Asthma group). Complete blood count (CBC) and biochemical estimation of serum urea, creatinine, and blood urea nitrogen (BUN) levels, lipid profile, and high-sensitivity C-reactive protein (hs-CRP) and pulmonary tissue homogenate levels were performed to evaluating inflammatory markers (IL‑1β, IL‑4, and TNF‑α). <strong>Results:</strong> Eug and Cur significantly improve urea, creatinine, and BUN levels and lipid profile. Moreover, restoring the normal levels of CBC and inflammatory markers (hs-CRP, IL‑1β, IL‑4, and TNF‑α) ameliorates the stress of asthma on the function of the respiratory system. <strong>Conclusion:</strong> Solitary and synergistic therapeutic effects of Eug and Cur on experimental induced asthma model owes principally to promoting the improvement of kidney and pulmonary functions by reducing inflammatory stress.</p> Hani M. Abdelsalam ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 74 81 10.5530/ijcep.2021.8.2.18 Evaluation of Autonomic Function in Polycystic Ovary Syndrome with Hypothyroidism <p><strong>Background and Aim:</strong> Polycystic ovary syndrome (PCOS) and thyroid disorders are commonest endocrine disorders; both of these disorders have profound effect on reproductive function in women’s. An increase in ovarian volume and cystic changes in ovaries have been reported in hypothyroidism. Recent studies reveal that PCOS might be associated with cardiovascular autonomic dysfunction and the thyroid hormone also influences the autonomic nervous system. So the aim of the study was to first, evaluate and compare autonomic function in PCOS as well as in PCOS with hypothyroidism, second, correlation between thyroid stimulating hormone (TSH) and autonomic function tests (AFT) in both the groups and third, study also provided further exploration in autonomic function in PCOS in presence of hypothyroidism. <strong>Methods:</strong> Total 43 newly diagnosed not on medications subjects were recruited, these subjects were divided into group A PCOS (n=33) and group B PCOS with hypothyroidism (n=10). Anthropometric measurements were taken from all the participants and autonomic function tests for assessing parasympathetic function (such as heart rate response to immediate standing and standing to lying ratio) and sympathetic function (such as blood pressure response to immediate standing and mental arithmetic stress test) were employed, then measurements was taken according to the respective scoring procedures. <strong>Results:</strong> In our studied population PCOS as well as PCOS with hypothyroidism showed autonomic dysfunction but no significant difference was found between them. No correlation and significance was found between TSH and AFT in both the groups. <strong>Conclusion:</strong> Our study concluded that the presence of hypothyroidism did not further affect autonomic function in PCOS and TSH was unrelated to AFT.</p> Gulafshan Iqbal Jyoti Ganai Nahid Khan Arifa Anwar Ramsha Iqbal ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 82 87 10.5530/ijcep.2021.8.2.19 ‘Weighing up the Load’ – A Comparison of Cardiac Magnetic Resonance Methods to Assess Valvulo-Arterial Load in Patients with Aortic Stenosis <p><strong>Background and Aim:</strong> The left ventricle (LV) faces a dual afterload in patients with aortic stenosis (AS) – both from the valve and vasculature. Together they form the global LV load. Two cardiac magnetic resonance (CMR) techniques have been described to quantify global LV load: (1) valvulo-arterial impedance instantaneous (ZVA-INS) and (2) valvulo-arterial load (VAL). The purpose of this study was to evaluate concordance (if any) between ZVA-INS and VAL. <strong>Methods:</strong> Twenty AS patients were compared (80 ± 9 years; 12 males; 80% severe). Aortic flow velocity data was obtained during breath-hold using through-plane PC Qflow imaging. ZVA-INS was determined as the relationship of aortic pressure and maximum aortic valve (AV) gradient to ascending aorta flow velocity in the time domain. VAL was determined as the relationship of aortic pressure to ascending aorta flow velocity in the frequency domain. Values from both methods were compared against total arterial compliance (TAC). <strong>Results:</strong> Global LV load was significantly higher when assessed by ZVA-INS (3990±1795 dynes.s.cm³) than VAL (946±318 dynes.s.cm³) (R=0.941; R²=0.886; F=109.2; P&lt;0.01) due to the addition of maximum AV gradient. VAL was linearly related to TAC with no significant difference (R=0.313; R²=0.098; F=1.413; P=0.256). <strong>Conclusion:</strong> This study presents the first direct comparison of CMR methods to assess global LV load in patients with AS. We conclude a significant difference between ZVA-INS and VAL, but not between VAL and TAC. This relationship is most likely due to the addition of maximum AV gradient.</p> Sara Hungerford Audrey Adji Nicole Bart Linda Lin Michael O'Rourke Andrew Jabbour Christopher Hayward David Muller Natasha Gorrie ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 88 94 10.5530/ijcep.2021.8.2.20 The Hypertension among Women with Diabetes Mellitus Patients of Single Ethnicity within 10 Years of Treatment <p><strong>Background and Aim:</strong> Hypertension is often prevalent among diabetes patients. However, the risk factors of hypertension are mostly affected by age, gender, and ethnicity, which are non-modifiable. Therefore, in the present study, we have analyzed the prevalence of hypertension and various risk factors associated with it among women with diabetes mellitus from Tamilian community. <strong>Methods:</strong> We conducted a cross-sectional survey of type 2 diabetes mellitus patients in our Institute hospital. We recruited female patients with Tamil origin of three generations. The case history and personal history and basal demographic parameters were noted down. Five ml of fasting blood was collected for routine analysis. Plasma was stored for estimation of osteoprotegerin (OPG) and insulin. <strong>Results:</strong> Hypertension was associated with family history of cardiovascular disease (CVD), abdominal obesity, dyslipidemia and higher rate pressure product. <strong>Conclusion:</strong> Diabetes women of Tamil community and with family history of CVD may benefit from weight loss, lifestyle modification and monitoring of blood pressure in early part of life.</p> Ayalasomayajula Naga Sailaja Nivedita Nanda Bettadpura Shamanna Suryanarayana Gopal Krushna Pal ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 95 99 10.5530/ijcep.2021.8.2.21 The Birth of first JIPMER “ICSI” Baby <p>Assisted reproductive techniques are becoming more and more essential for human life in the Society. Worldwide more than 5 million babies were born out of this technology after the birth of first baby Louis Brown and second Durga (India) in 1978. It is a boon for the couple in despair to have a child especially when it is provided by Govt Institutions for the less affordable people of the Society. It is essential to share provider’s experiences and expectations of the public in a fast growing biomedical field like ART. The techniques of IVF and ICSI have undergone a sea change since the initial technique of natural cycles to ovarian hyper stimulation and stem cell research. A 29 year old lady, Type I Diabetic with hirsutism, PCOS, failed IUI underwent ICSI following ovarian stimulation employing antagonist protocol after 8 years of married life. The husband is also diabetic for 13 years and suffered from post-polio residual paralysis and had asthenospermia. Frozen Embryo transfer of cleavage stage embryos was done on 31.7.2019 after endometrial preparation employing HRT. Her β HCG was HCG 387 on 14.8.2019 and intrauterine pregnancy was confirmed by transvaginal scan. Pregnancy and Diabetes were managed with progesterone support and Insulin therapy respectively. An alive male baby was delivered by emergency Caesarean section on 28.3.2020 at 12.34 PM for breech presentation in labour during lockdown for COVID 19. Both mother and baby were discharged home in healthy condition and the baby is one year old at the time of writing this report.</p> Papa Dasari Manjula Gopalakrishnan, Dr ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 100 103 10.5530/ijcep.2021.8.2.22 Physiology Practicals by Health Science Students in COVID-19 Pandemic <p><strong>Sir,</strong></p> <p>The coronavirus disease (COVID-19) is a pandemic. This has spread to many countries in the world, The hACE2 is an essential gene and the entire human population is susceptible to SAR-CoV-2 infection.[1] The Government of India has taken actions to control the spread of COVID-19. The central and state governments are taking several measures for the control of spread of Infection. <strong>Read More ...</strong></p> Yashoda Ravindra Kattimani Mahantayya Veerabhadrayya Math Rita Manoj Khadkikar ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 104 105 10.5530/ijcep.2021.8.2.23 Rheumatoid Arthritis: The Problems Beyond the Joints <p>An autoimmune disease is defined as a clinical syndrome resulted from instigation of both T cell and B cell or individually, in the absence of any present infection or any sort of distinguishable cause. Rheumatoid arthritis is chronic and systemic autoimmune response to multiple joints with unknown etiology, progressive disability, systemic complications, early death and high socioeconomic costs. Rheumatoid arthritis is characterised by hyperplastic synovium, production of cytokines, chemokines, autoantibodies like rheumatoid factor (Rf) and anticitrullinated protein antibody (ACPA), osteoclastogenisis, angiogenisis and systemic consequences like cardiovascular, pulmonary, psychological and skeletal disorders. Cytokines a diverse group of polypeptides, play critical role in the pathogenesis of Rheumatoid arthritis. Their involvement in autoimmune disease is a rapidly growing area of biological and clinical research. Pharmacotherapy should target the balance between the pro and anti-inflammatory cytokines that is believe to be the central dogma in the pathogenesis of rheumatoid arthritis.<sup>[1]</sup> Elevated sympathetic and parasympathetic nervous system activities are expected to occur as a consequence of inflammatory stress.<sup>[2]</sup> For this we need to explore new treatment modalities to find the answers for unresolved etiology of autoimmune disease and to provide a quality of life to the patients suffering from rheumatoid arthritis. <strong>Read More ...</strong></p> Hariprasad R ##submission.copyrightStatement## 2021-07-29 2021-07-29 8 2 106 106 10.5530/ijcep.2021.8.2.24