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Introduction: Mitral Valve Replacement (MVR), an important treatment for rheumatic mitral valve disease, is being widely promoted worldwide. MVR using the total leaflet preservation technique can produce good results; however, patient-specific factors and anatomical considerations must be taken into account when selecting the appropriate surgical approach. Aim: To investigate the benefits of Posterior Leaflet Preservation (PLP) in MVR in individuals with severe mitral stenosis. Materials and Methods: The current prospective interventional study included patients with Rheumatic Heart Disease (RHD) who had severe mitral valve stenosis and/or regurgitation and underwent MVR between December 2019 and December 2021 in the Department of Cardiothoracic and Vascular Surgery at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. The study included 50 patients with MVR (PLP) to preserve the posterior leaflets and 50 patients with classic MVR (no PLP). Left Ventricular Ejection Fraction (LVEF), Left Ventricular End-Systolic Diameter (LVESD), and Left Ventricular End-Diastolic Diameter (LVEDD) were measured before surgery, one, three, and six months after surgery. Results: The majority of patients in the present study were between 23 and 46 years old. The PLP group consisted of 17 men and 33 women, while the non-PLP group had 16 men and 34 women. The difference in cross-clamp time between Group-A and B was significant (p=0.0001). Cardiopulmonary Bypass (CPB) time was significantly different between Group-A and B (p=0.001). Only 4 (8%) patients in Group-A had low cardiac output syndrome, compared with 8 (16%) of patients in Group-B. Comparison of LVEF between groups over time revealed no significant difference (p=0.05). The mean change in LVEF from pre-operative to six months in Group-A was significant (p=0.004), but there was no significant change in Group-B (p=0.25). Conclusion: PLP had no improved beneficial outcome on left ventricular performance in cases with rheumatic stenosis during the six-month follow-up. Even after long-term follow-up, haemodynamic valve properties do not alter with adequate PLP. [ABSTRACT FROM AUTHOR]

Introduction: In a normal healthy adult, sympathetic and parasympathetic system should be in synergy. Measuring resting heart rate is a one of the methods to assess health condition. It can be affected by different factors such as exercise, mental health, any disease, etc. Normal subjects with reduced heart rate are associated with better cardiovascular health. Physical inactivity is associated with high level of inflammatory markers. Increased inflammatory markers are related to inflammation and chronic diseases. C-Reactive Protein (CRP) is a biomarker of inflammatory diseases. High CRP level is a potent risk factor for obesity, diabetes, atherosclerosis, etc. Aim: To study the effect of short-term endurance and resistance exercises in healthy young adults on resting heart rate, CRP body mass index and also to compare the changes between two exercise groups. Materials and Methods: A cross-sectional study was conducted from May 2019 to May 2020 in the Department of Physiology at King George's Medical University, Lucknow, Uttar Pradesh, India. The study included 60 healthy young subjects with normal Body Mass Index (BMI) (18.5-24.9 kg/m2) and age between 18-25 years participated. Subjects were equally divided into endurance (group I) and resistance exercise (group II) groups. Subjects did moderate intensity exercise (based on maximum heart rate) for five days in a week for eight weeks. Endurance group did jogging. Resistance group did pushup, pull-up and squats. Target heart rate during moderate intensity of activities is 64-76% of maximum heart rate. Heart rate measurement was done before the start of exercise and after five to seven minutes of exercise when it reached 64-76% of maximum heart rate. It was measured by pulse oximeter. Follow-up was done after eight weeks of exercise training in both the groups. Evaluation was done by comparing resting heart rate and CRP level before the start of training and after the completion of training programme. Statistical analysis was done using student t-test and paired t-test. Results: Mean age of subjects of group I was found to be higher (19.98±1.26 years) as compared to group II (19.97±0.98 years). Mean pre-intervention BMI of both the groups was found to be similar (21.97±1.78 kg/m2). No statistically significant change in resting heart rate was found in both resistance group (p-value=0.096) and endurance group (p-value=0.326) after exercise training. Statistically significant increase in CRP was found in resistance group (p-value<0.001) and endurance group (p-value<0.001). The increment in CRP was more in endurance group (55.04%) than resistance group (35.34%). Conclusion: Short duration of exercises increase inflammation but no significant effect on resting heart rate was seen. [ABSTRACT FROM AUTHOR]

Introduction: In many Human Papilloma Virus (HPV) negative women, the Squamous Intraepithelial Lesions (SIL) of cervix often show persistence or progression of the lesion on followup which shows involvement of other risk factors of carcinoma cervix. Aim: The aim of the study was to evaluate the different risk factors of cervical cancer in persistent, progressed and regressed cases of SIL to identify the prominent ones among them. Materials and Methods: The study had been of a screening type for early detection of cervical cancer and it was done in the women population of west Lucknow, Uttar Pradesh, India (May, 2013-February, 2020). Cervical smears were collected in 2949 women attending the camps whose cytological examination revealed 498 cases of SIL and follow-up was available in 254 of them done through home visits after 1-4 years. Persistence of SIL was seen in 60 women on follow-up while in the remaining 194, the SIL had regressed to normal. The percentage of different risk factors seen with the persistence or regression of SIL was studied. Results: Among the different risk factors identified, prominent were of young age between 16-30 years with vaginal discharge and their percentage were insignificantly higher with persistence of SIL than in the regression group. Multiparity was also highly associated with both persistence and regression of SIL. The erosion of cervix was significantly associated with SIL persistence while associated inflammation was insignificantly higher in persistent than in the regression group. The percentage of all these factors except erosion of cervix was found higher in HPV- positive than in the HPV negative women. Conclusion: It appears that all the identified risk factors are present both in persistent and regression group but their percentage is higher with persistence of SIL. Hence, presence of any of these factors in these two groups should be viewed with caution to rule out any progression/recurrence of SIL. [ABSTRACT FROM AUTHOR]

Introduction: There is likelihood of development of premalignant changes in the cervix in the teenagers due to early sexual activity. This assumes importance under rural conditions in India where majority of marriage of girls are performed at young age below 20 years. Aim: The present cytological study was carried out in the three cohorts of rural girls- adolescents (16-20 years), young adult girls (21-25 years) and adult women (26-30 years) to see the effect of early increasing sexual exposure. Materials and Methods: The study cases were derived from the cervical cancer screening which is in progress in the rural population of Lucknow, Uttar Pradesh, India. Of the 1185 study cases, 97 were adolescents, 338 young adult girls and remaining 750 were adult women. Results: The Atypical Squamous Cell Changes of Unknown Significance (ASCUS) were found higher in the adolescents than in young adult girls and adult women while Squamous Intraepithelial Lesions of cervix (SIL) rate was almost equal in the three cohorts. Follow-up revealed progression of ASCUS to Low grade SIL (LSIL) almost equal in the three groups while the persistence of SIL was higher in the young adult girls and adult women. The gynaecological symptoms especially vaginal discharge was more common in the last two groups than in adolescents but the SIL rate was higher with all symptoms in the adolescents. The cervical lesions were more common in the young girls and adult women and SIL rate was higher with different cervical lesions. The majority of adolescents were nulliparous with high SIL rate while in the young adult girls and adult women, the SIL incidence showed rising trend with increasing parity. Conclusion: The study highlights the importance of cytological screening of all the rural young girls and adult women specially who reveal cervical lesions or are symptomatic. This will yield large number of pre-cancerous cases, timely treatment of which will check the progression of SIL to malignancy. [ABSTRACT FROM AUTHOR]

Background: Hypertension is the most common disorder which is encountered in outdoor patients. The existing data suggests that there is an increase in the prevalence of pre-hypertension and hypertension in India. The prevalence of hypertension will increase even further, unless broad and effective preventive measures are implemented. The main objective of this study was to find out the prevalence of hypertension amongst the adult outdoor patients of an urban health centre of Lucknow district. Materials and Methods: This observational, Out Patients Department based study involved a survey on 306 male and 1203 female respondents who were aged 18 years, who attended the Urban Health Training Centre of the Department of Community Medicine, Era's Lucknow Medical College and Hospital, Lucknow, India. A structured, pretested schedule was used to collect the data with regards to the demographic characteristics and the blood pressure pattern. The Chi- square test and ANOVA were used to analyze the data. Results: The prevalence of hypertension was found to be 44.46%. The proportion of hypertension showed an increasing trend with age. The mean systolic as well as diastolic blood pressure patterns were found to be higher, with an increase in age. Conclusion: Hypertension was found to be highly prevalent among the outdoor patients of an urban health centre of Lucknow. An early detection of hypertension can be facilitated by periodically screening people regularly. [ABSTRACT FROM AUTHOR]