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 Yoga to Combat and Prevent COVID-19 <p>The COVID-19 pandemic is a global crisis. The rapid spread of COVID-19 around the world and subsequent lockdown in almost all countries have resulted the entire population being forced into confinement. Along with isolation due to lockdown, financial deficiency in the family, business slowdown, job insecurity, salary cut-down, the fear of acquiring infection and uncertainty of children education and their future during COVID have culminated in a life full of tremendous stress. Combining work while living in the family and working at home has thrown up challenges hitherto unnoticed and undocumented. While it will take time to gauge the gravity of the impact on society’s mental and emotional health, exercise, yoga, music, dance and art are the disciplines that have offered promises on how to maintain one’s physical and emotional equilibrium. <strong>Read More...</strong></p> Gopal Krushna Pal ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 46 47 10.5530/ijcep.2020.7.2.12 Exercise-Induced Hypertension: A Review of Plausible Mechanisms and Clinical Significance <p>This literature review is aimed to present the effect of exercise on blood pressure. More specifically it addresses the pathophysiological mechanisms as to how exaggerated blood pressure is occurring following experimental exercise and its predictive power for future new onset hypertension. Literatures searched using key words; ‘Cardiovascular diseases’, ‘Exercise’, ‘hypertension’, ‘Hypertensive Response to Exercise (HRE)’, ‘Hemodynamic Changes’ from search engines including PubMed, Cochrane Database and Google scholar. Blood pressure (BP) is the lateral pressure exerted on the wall of elastic arteries and it is critical for distribution of blood to metabolic tissues in need of oxygen and nutrients. Elevated BP or hypertension is often considered as a silent killer and is a risk factor for cardiac, neuronal and renal insults. A systolic BP of ≥ 210mmHg in males and ≥ 190 mmHg in females to exercise testing is defined the term exercise-induced hypertension. An exaggerated increase in BP to exercise is a good predictor for the incidence of hypertension in other wise normotensive individuals. A hyperactivity of the sympathetic nervous system along with activation of renin-angiotensin system, a pre-existed endothelial dysfunction associated with a defect in release of nitric oxide, arterial stiffness and concurrent metabolic syndrome are the putative factors involved in exaggerated BP response to exercise. An exaggerated BP response to exercise in normotensives is a predictor for new onset hypertension and target organ damage. Therefore, early detection is paramount to prevent the complication and economic cost of hypertension.</p> Ayechew Adera Getu ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 48 51 10.5530/ijcep.2020.7.2.13 Heart Rate Variability During an Internal Family Systems Approach to Self-Forgiveness <p><strong>Background and Aim:</strong> Self-recrimination is a stress-inducing cognitive process, so there is a strong need for evidence-based effective self-forgiveness interventions. Most individuals, and particularly those in professions with high occupational stress, can suffer damaging bouts of self-recrimination, leading to depression, burnout and/or suicide. Unfortunately, useful frameworks for developing self-forgiveness skills appear limited. <strong>Methods:</strong> We designed a guided imagery session, based on the internal family systems therapeutic model, to facilitate the process of self-forgiveness. We used surveys and ECG recordings to 1) determine the effectiveness of the self-forgiveness imagery, 2) collect baseline psychometric data on forgiveness, particularly self-forgiveness, 3) collect ECG data during baseline, self-critical rumination and self-forgiveness periods and 4) correlate the psychometric and physiological data.<strong> Results:</strong> Together, our outcomes indicate the intervention is highly effective and that the self-forgiveness state produces high parasympathetic tone. <strong>Conclusion:</strong> A single, relatively short guided imagery session can facilitate significant self-forgiveness which is associated with reduced physiological stress.</p> Kyle W. Eaton Thomas M. Ferrari ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 52 57 10.5530/ijcep.2020.7.2.14 Correlation of Sympathovagal Imbalance with Disease Activity and Inflammatory Markers in South Indian Patients with Rheumatoid Arthritis <p><strong>Background and Aim:</strong> Rheumatoid arthritis (RA) patients have higher risk of cardiovascular disease and mortality and that is not linked to traditional cardiovascular risk factors. Altered sympathovagal balance is associated with cardiovascular disease. In RA sympathovagal balance and inflammatory markers were reported to be increased, but there is inadequacy of data on its assessment and association with disease activity. This study was conducted to find the correlation of sympathovagal balance with disease activity and inflammatory markers in South Indian patients with RA. <strong>Methods:</strong> RA patients (diagnosis of RA made as per 2010 ACR/EULAR classification criteria) were enrolled from Department of Clinical Immunology, JIPMER. Participants were sub grouped as low disease activity (LDA), moderate disease activity (MDA) and severe disease activity (HDA) using disease activity score 28 with ESR. Frequency and time domain parameters of heart rate variability and inflammatory markers like Interleukin-1α (IL-1α), Interleukin-6 (IL-6), tumor necrosis factor-α (TNFα) and cortisol were measured for all the participants. <strong>Results:</strong> A total of 143 RA patients (23 in LDA group, 69 in MDA group and 51 in HDA group) were assessed during the study. LF-HF ratio (ratio of low frequency power to high frequency power) a marker of sympathovagal balance showed significant increase in MDA and HDA group compared to LDA group. LF-HF ratio correlated positively with DAS28 (r=0.473, <em>p</em>&lt;0.001), cortisol (r=0.363, <em>p</em>&lt;0.001), IL -1α (r=0.379, <em>p</em>&lt;0.05). <strong>Conclusion:</strong> Sympathovagal imbalance was significantly increased in the MDA and HDA group compared to LDA group and positively correlated with disease activity, IL-1α and cortisol in the patients of RA. Assessment of sympathovagal balance may help to find the autonomic dysfunction and cardiovascular risk in RA.</p> Selvakumar Ganesan Vir Singh Negi Girwar Singh Gaur Vivek Kumar Sharma Gopal Krushna Pal ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 58 62 10.5530/ijcep.2020.7.2.15 Effects of Acute Supplementation of Panax ginseng on Endurance Performance in Healthy Adult Males of Kolkata, India <p><strong>Background and Aim:</strong> Panax ginseng C. A. Meyer (PG), a worldwide renowned “adaptogen”, is believed to combat stress and augment endurance performance. Studies available regarding chronic supplementation of PG revealed contradictory findings. This study, for the first time, was conducted to examine the effects of acute supplementation of PG on endurance performance in healthy sedentary male university students of Kolkata, India. <strong>Methods:</strong> In this placebo controlled double blind study, effects of acute supplementation (1hr before endurance exercise) of 200 mg PG on endurance exercise was examined in healthy males (<em>n</em>=12), age ranging from 20 to 24 years. Endurance time, heart rate and rate of perceived exertion (RPE) were recorded. Blood samples were drawn just before supplementation and at the time of exhaustion for biochemical analysis of glucose, insulin, lactic acid, free fatty acid, lipid peroxidase, catalase, superoxide dismutase and total thiol. Data were analyzed by paired t-test, one-way ANOVA with post-hoc test. <strong>Results:</strong> Endurance time was significantly higher (<em>p</em>&lt;0.001) in PG-trial (96.17±1.19 min) compared to placebo (PL) trial (92.42±1.24 min). Heart-rate and RPE at the time of exhaustion in PL-trial were significantly greater (<em>p</em>&lt;0.05) than PG-trial. Post-exercise values of lactic acid, free fatty acid, lipid peroxidase were significantly greater (<em>p</em>&lt;0.05) in placebo trial than PG trial while post-exercise values of glucose (78.96±1.67 mg/dl), insulin (3.13±0.56 μU/ml), catalase (78.02±1.38 μmol of H2O2/min/mg of protein), superoxide-dismutase (22.41±1.24 nmol/mg of protein) and total thiol (23.42±1.09 μmol/L) of PG-trial were significantly greater (<em>p</em>&lt;0.05) than that of PL trial (75.33±1.5 mg/dl, 1.71±0.34 μU/ml, 75.84±0.92 μmol of H<sub>2</sub>O<sub>2</sub>/min/mg of protein, 19.36±1.45 nmol/mg of protein and 18.85±1.25 μmol/L respectively). <strong>Conclusion:</strong> Thus, acute supplementation of 200 mg PG has ergogenic effect in studied population.</p> Ishita Bhattacharjee Amit Bandyopadhyay ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 63 68 10.5530/ijcep.2020.7.2.16 A Single 10k Run Session does not Change neither Skinfold Thickness nor Body Circumferences <p><strong>Background and Aim:</strong> In everyday practice, the anthropometric assessment including measures of skinfolds and body girths must be performed avoiding previous physical exercise. However, few studies are conducted using situations with ecological validity. Thereby, this study aimed to compare if 10k treadmill run alters skinfold measures and body girths of runners. <strong>Methods:</strong> Eighteen runners of both sexes and levels (34 ± 6 years old with 8 ± 7 years of run practice and 63.6 ± 8.8 ml*kg-1*min-1 of VO2max) underwent body girths, skinfolds thickness and body weight assessments before and after the 10k run. The anthropometric parameters were compared by Student’s t-Test dependent for paired samples and correlations between body weight reduction and anthropometric parameters were compared by Pearson’s correlation coefficient with α= 5%. <strong>Results:</strong> The 10k run reduces 1.4% of body weight. However, no significant changes were observed in the sum and neither of skinfold thickness nor body girths. The percentage of body weight reduction also not correlated with the exercise-induced changes in skinfold thickness and body girths. <strong>Conclusion:</strong> Therefore, although 10k run causes a body weight reduction, the skinfold thickness and body girths were not altered by previously exercise and not correlates with body weight reductions. In this way, the use of these anthropometric assessment techniques can occur both before and after a conventional training session in runners.</p> João Gabriel da Silveira-Rodrigues Camila Cristina Melo Rúbio Sabino Bruzzi André Gustavo Pereira de Andrade ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 69 72 10.5530/ijcep.2020.7.2.17 Association of Hemoglobin during First Trimester and its Relation to Pregnancy-Induced Hypertension in Indian Women <p><strong>Background and Aim:</strong> Globally, prevalence of pregnancy-induced hypertension (PIH) is 3-5% and in India it is around 5-15%. PIH is one of the major factors responsible for abnormal pregnancy outcome along with high maternal and perinatal morbidity and mortality. Role of hemoglobin is the key factor for pregnancy outcome and development of hypertension during pregnancy. This study was done with aim to check the relation of maternal hemoglobin with blood pressure and development of PIH in Indian women of 20 to 30 years of age group. <strong>Methods:</strong> A cross sectional multicentric study was done after approval of Institutional Ethics Committee. A total 200 pregnant female visiting to antenatal clinics in age group of 20 to 30 years were enrolled after their written voluntary consent. Participant’s body weight, hemoglobin, along with pulse rate, systolic blood pressure and diastolic blood pressure were done during 1<sup>st</sup> antenatal visit at first trimester, during next visit at 2<sup>nd</sup> trimester between 20th to 24<sup>th</sup> weeks and between 25<sup>th</sup> to 28<sup>th</sup> weeks during third trimester. During 1<sup>st</sup> antenatal visit participants were categorized into two groups with hemoglobin less than 10 gm% and hemoglobin more than 10 gm% comprising 100 participants in each group. Progress of pregnancy was documented very well during subsequent next visit. All participants had visited antenatal clinic till delivery as per instructions given to them. Pregnancy outcomes were documented very well up to 6 week of delivery. <strong>Results:</strong> In participants of both groups, progressive increases in weight, hemoglobin, heart rate, systolic blood pressure, diastolic blood pressure were seen. A statistical significant difference in weight was seen in both groups during all trimester. A statistical significant difference in diastolic blood pressure was seen in both groups during 2<sup>nd</sup> trimester. Total 17 participants developed PIH, out of which 10 participants were from group 1, i.e. hemoglobin less than 10 gm% and 7 from group 2 with haemoglobin more than 10 gm%. <strong>Conclusion:</strong> In the present study, role of maternal hemoglobin in development of pregnancy induced hypertension is not seen.</p> Kamini Gajjar Anil Gajjar Hasmukh Shah ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 73 76 10.5530/ijcep.2020.7.2.18 Link of Oxidative stress to Pulmonary Functions Contributed by Matrix Metalloproteinase in South Indian Population-An Observational Study <p><strong>Background and Aim:</strong> Oxidative stress plays a key role in the etiopathogenesis of several disease conditions and most commonly pulmonary diseases. Pulmonary tissues are susceptible to oxidative stress from ambient air pollution. Serum Malondialdehyde is a sensitive biomarker of oxidative stress. Oxidants also enhance proteinase mediated lung injury. In the current study we have aimed at correlating the serum Malondialdehyde levels with pulmonary functions and serum Matrix mettaloproteinase-9 levels in south Indian population. <strong>Methods</strong>: This was a cross sectional study conducted among healthy volunteers of age group 18 to 45 years. Pulmonary function tests of the subjects were recorded using computerised spirometry (SPIROLAB III). Serum malondialdehyde levels were estimated using Thiobarbituric acid Reactive Substances assay and serum Matrix metalloproteinase-9 levels were estimated by Enzyme linked Immunosorbent Assay.<strong> Results:</strong> Significant negative correlation was found between Malondialdehyde and FEV1/FVC ratio and significant positive correlation was found between serum malondialdehyde levels and Matrix metalloproteinase-9 levels. Individual link of Malondialdehyde levels and FEV1/FVC ratio, malondialdehyde levels and Matrix metalloproteinase-9 levels were established by linear regression analysis.<strong> Conclusion:</strong> Our results state that increased oxidative stress directly affects pulmonary functions and it also increases MMP-9 levels, which again lead to decline in pulmonary functions.</p> Jothi Marie Feula Dhanalakshmi Y Gopal Krushna Pal Sandhiya S ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 77 80 10.5530/ijcep.2020.7.2.19 Assessment of Work Related Musculoskeletal Disorders among House Maids of Kolkata, India <p><strong>Background and Aim:</strong> Work related musculoskeletal disorders (WMSDs) are common problems among the workers engaged in unorganised sector. Working as a house maid is a very old profession. The objective of the present study was to evaluate the prevalence of WMSDs in house maids of Kolkata. <strong>Methods:</strong> Ninety-four house maids (age range of 20–60 years) engaged in different household works for minimum 3 years of duration were recruited in this study by random sampling method from different parts of Kolkata, India. They were divided into four groups based on their age and years of working. Physical parameters, assessment of musculoskeletal disorders and analysis of posture were done by using standard methods and procedures. <strong>Results:</strong> The study revealed different grades of pain in different parts of the body, maximum being the prevalence of low back pain. The intensity and localisation of pain varied in different age groups showing significant relationship with working experiences and daily working hours. Body part wise pain varied during work, rest and sleep times. <strong>Conclusion:</strong> WMSDs and pain experienced by the house maids were due to their constrained and awkward working postures for longer duration which need to be corrected with immediate interventions.</p> Piyali Mukherjee Anindita Singha Roy Amit Bandyopadhyay Somnath Gangopadhyay ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 81 86 10.5530/ijcep.2020.7.2.20 Vagus Nerve Stimulation could also Alleviate Respiratory Infections as Part of its Anti-inflammatory Property <p>Dear Sir,</p> <p>I read very attentively your recent Editorial on the “Vagus Nerve: The Key Integrator of Anti-inflammatory reflex” published in IJCEP 2020;7(1):1-2 and I found it to be a very useful article with insights deep into the anti-inflammatory role of vagus nerve. Thank you for enlightening us on the topic. I am happy to share my observation on the topic.</p> <p>The vagus nerve is the longest nerve of the body that innervates thoracic and many visceral organs. The role of the vagus nerve in anti-inflammatory reflex has opened the opportunity for the scientists to study ANS mediated anti-inflammatory responses. Apart from the immediate significance of the term anti-inflammatory reflex, the biological and clinical consequences of this immune system hyperactivity are by far less known, making it worthwhile to be overviewed. I would like to add further that excessive uncontrolled inflammatory response results in cytokine storms syndrome which is nothing but fatal hyper-cytokinemia associated with multiorgan failure. This response is observed recently in pneumonia /ARDS in the severe COVID-19 positive cases. Other like viruses of n-corona stimulating cytokine storm syndrome mimic the components of the chemokine system by producing molecules that are very similar to chemokines and can interact with their receptor. Some chemokines play a direct anti-viral effect by inducing an array of phenomena that lead cells to determine an “anti-viral state’’. These phenomena include activation of apoptosis or direct killing of infected cells by activated immune cells. Few studies demonstrated that chemokine CXCL10 levels, as evaluated in serum, bronchial-alveolar washing fluid, or nasal secretions, consistently correlate with the severity and duration of acute respiratory tract infection due to viral infections. <strong>Read More ....</strong></p> Satish Dipankar ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 87 87 10.5530/ijcep.2020.7.2.21 Early Recovery from Anosmia and Ageusia of COVID-19 by Practice of Slow Breathing of Pal’s Pranayama Schedule: A Case Report <p>Though 80% of coronavirus disease 2019 (COVID-19) patients recover without much medical intervention, the process of recovery is delayed in few patients with continuation of myalgia, headache, weakness and loss of taste and smell sensations. Reports indicate improvement of cardiorespiratory, neuromuscular and sensory functions following practice of yoga, especially slow pranayamas. Therefore, a case study was conducted to assess if practice of slow breathing exercise of Pal’s pranayama schedule can facilitate recovery from anosmia and ageusia in COVID-19 illness.</p> Uttareshwar Pachegaonkar Duraisamy Rathinam Rajesh ##submission.copyrightStatement## 2020-09-25 2020-09-25 7 2 1 3 10.5530/ijcep.2020.7.3.29 Guidelines for Healthcare Workers for Prevention of COVID-19 <p><strong>1. Personal Protective Equipments (PPE) - Mask/ Goggle/ Face shield </strong></p> <p>• Use PPE to avoid direct contact with patient’s blood, body fluids, secretions (including respiratory secretions) and non-intact skin.</p> <p>• Wear mask at all times; wear goggle, face shield as needed.</p> <p>• Perform hand hygiene before putting on.</p> <p>• Place the mask carefully, ensuring it covers the mouth and nose, adjust to the nose bridge, and tie it securely to minimize any gaps between the face and the mask.</p> <p>• Avoid touching them while wearing it.</p> <p>• Remove them using the appropriate technique: do not touch the front of the mask but untie it from behind.</p> <p>• After removal or whenever a used mask/ goggles/ face shield are inadvertently touched, clean hands with an alcohol-based handrub, or soap and water if hands are visibly dirty.</p> <p>• Replace masks as soon as they become damp with a new clean, dry mask.</p> <p>• Discard single-use masks after each use and dispose them immediately upon removal. <strong>Read more.....</strong></p> IJCEP Office ##submission.copyrightStatement## 2020-07-03 2020-07-03 7 2 88 88