Search

Background: Uncertainty prevails regarding the patterns of autonomic dysfunction in patients with idiopathic Parkinson's disease (IPD). This study was undertaken with the aim of assessing the complete spectrum of cardiovascular autonomic function tests (CAFTs) and blood pressure variability patterns in IPD patients while comparing the same with age-matched controls. Methods: Patients with IPD presenting to the Christian Medical College and Hospital from December 2016 to November 2018 along with age-matched controls were prospectively evaluated using CAFTs. The IPD patients also underwent ambulatory blood pressure (BP) monitoring (ABPM), and the diurnal systolic BP differences were used to classify into dippers (10-20%), non-dippers (0–10%), reverse dippers (<0%), and extreme dippers (>20%). Results: Autonomic dysfunction (AD) was prevalent in 41 (68.3%) IPD patients even in early disease (median (inter-quartile range) symptom duration 2 (1–4) years, mean Hoehn and Yahr (H&Y) stage 2 (1.5–2.8). Both sympathetic and parasympathetic parameters were impaired among IPD patients when compared to healthy controls. (E: I ratio 1.17 ± 0.12 vs 1.26 ± 0.14 (P < 0.001), Valsalva ratio (VR) 1.33 ± 0.27 vs 1.55 ± 0.25 (P < 0.001), PRT100 9.6 ± 8.0 vs 3.1 ± 1.8 (P < 0.001), tilt-up SBPAvg change 8.8 (4.2–13.8) vs 1.8 (−2.9–6.1) (P < 0.001), tilt-up HRAvg change 4.8 (2.2–8.2) vs 1.9 (−0.7–5.1) (P < 0.001). BP variability was demonstrated in 47 (79.7%) of IPD patients, with reverse dipping pattern in 28 (47.5%) seen more frequently in this cohort. Conclusions: Timely detection of AD may be helpful not only in recognizing IPD in its pre-motor stages but also in optimizing management for this population of patients. BP variability and abnormal dipping patterns on ABPM can be a potential marker of dysautonomia. [ABSTRACT FROM AUTHOR]

Background: Normative data for autonomic function tests (AFT) is not available for Indian population. Objective: The aim of the study was to establish normative data in AFT and its correlation with age, gender, and body mass index. Material and Methods: The study was done on 254 healthy subjects of age ≥18 years. All AFTs were done in autonomic laboratory at the Department of Neurology, Christian Medical College and Hospital, Ludhiana. Cardiovascular tests (heart rate response to deep breathing, HR changes in Valsalva maneuver and head-up tilt test (HUT)) and quantitative sudomotor axon reflex testing (QSART) were performed in all the subjects. Fifty subjects underwent thermoregulatory sweat test (TST). Results: The mean age (SD) of study participants was 43 (16.0) years (range 20--84), and 129 (50.8%) were men. The normative value range (2.5--97.5 percentile) for HR difference, E: I ratio, and Valsalva ratio (VR) was 3.5--47.0, 1.05--1.93, and 1.11--2.64, respectively, for all the subjects. HR difference and E: I ratio showed an significant inverse relation with age (r = -0.623 and r = -0.584, respectively). VR also showed an inverse relation with age (r = -0.575, P =< 0.001), and female had a lower value than male (1.63 vs 1.78, P =< 0.001). In QSART, mean (SD) sweat volume was higher in males 0.630 (0.230) compared to females 0.513 (0.132) for all sites, P < 0.001, and similar trend was noticed for sweat area in TST. Discussion and Conclusion: Normative AFT data has been established for Indian population for the first time. The values are comparable to previously published studies. [ABSTRACT FROM AUTHOR]

The antioxidant activity of the callus ofPhyllanthus emblicawas tested by using DPPH− radical scavenging, reducing power, superoxide anion, and metal chelating scavenging models. Digallic acid was the major compound in quantity bothin vivo(2.61 ± 0.887%) and in vitro (2.89 ± 0.997%) in 6-week-old cell cultures. Digallic acid demonstrated maximum antioxidant activity against the antioxidant systems, while other compounds exhibited mild-to-moderate antioxidant activity. Among the isolated phytochemicals, putranjivain-A showed maximum activity againstEscherichia coli(85 μg.mL−1) andRhizoctonia phaseoli(70 μg.mL−1). [ABSTRACT FROM AUTHOR]

A letter to the editor on blood donors in regional blood transfusion center of North India is presented.