Browsing by Author "Mahotra, NB"
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Publication Impact of Adolescent’s Obesity in Cardiac Function: An Association of Cardiac Structural and Metabolic Risk Factors with Physical Fitness(Kathmandu University, 2023) Yadav, RL; Yadav, LK; Mahotra, NB; Sharma, DABSTRACT Background Elderly obese results metabolic, cardiac structural and functional derangements. However, such alterations including physical fitness in early age obesity are still controversial. Objective To evaluate physical fitness, cardiac structural, functional and metabolic remodeling and their association with obesity markers in adolescents. Method This cross-sectional comparative study included 90 adolescents with median age -14(2) years were grouped into Normal weight (NW) and Overweight/Obese (OW/OB) based on the BMI percentile for age and sex. International Diabetes Federation criteria for adolescents selected for lipid profiles, fasting sugar, systolic (SBP) and diastolic blood pressure (DBP). Echocardiographic standard 2-dimensional measurements for cardiac structures, percent ejection fraction (EF%) were performed with standard procedure. Physical fitness index (PFI) was graded using the modified Harvard step test. The data compared with Mann Whitney U test and Spearman’s Rank correlation test used to find association among study variables. Result Compared to normal weight adolescents, overweight/obese individuals exhibited significantly higher cardiac function parameters, including heart rate, systolic and diastolic blood pressure. Within the realm of cardio-metabolic parameters, it was observed that individuals exhibited diminished levels of high-density lipoproteins and elevated levels of low-density lipoproteins. Notably, these individuals manifested cardiac structural remodeling characterized by augmented left atrial wall and aortal base thickness, and increased left ventricular end-diastolic diameter, concomitant with a markedly decreased percentage of left ventricular ejection fraction. Cardiac structural and functional parameters revealed adverse correlation with obesity markers. Conclusion The onset of obesity in early age has been ascertained to exert profound ramifications, encompassing not solely metabolic and biochemical parameters, but also extending to the structural integrity of the cardiovascular system. These outcomes synergistically contribute to a notable attenuation in overall physical fitness. KEY WORDS Adolescent’s obesity, Body mass index percentile, Cardiac structure, Lipid profile, Physical fitnessPublication Prolonged QT dispersion in Subclinical Hypothyroid Females: A Study in University Teaching Hospital in Central Nepal(Kathmandu University, 2019) Kandel, S; Rana, BSJB; Prasad, PN; Mahotra, NB; Shrestha, TMABSTRACT Background QT dispersion is a simple index derived from 12 lead ECG; its prolongation has been shown to be associated with increased arrhythmia risk. Increased cardiovascular risks, particularly occurrence of the malignant arrhythmias are a common finding in patients with subclinical hypothyroidism. This increased arrhythmia risk is found to be higher mainly in patients with TSH level more than 10 milli international unit per liter. Objective To assess QT dispersion among subclinical hypothyroid and euthyroid Nepalese females aged 20-59 years attending general practice out patient department of centrally located University Teaching Hospital from November 2016 to April 2017. Method Forty-three newly detected subclinical hypothyroid females and forty-one euthyroid females were enrolled. Resting electrocardiogram (ECG) was performed. QT dispersion was analyzed from ECG and corrected for heart rate using Framingham correction formula. Independent sample t-test was applied to compare mean QT dispersion between two groups. Pearson correlation test was used to examine the association between QT dispersion and TSH level. Result Mean QT dispersion for sub-clinical hypothyroid group was 75.35 ± 43.82 whereas mean QT dispersion for euthyroid group was 59.51 ± 22.13, with p value 0.041. A weak association between QT dispersion and TSH level was seen with correlation factor of 0.23. Conclusion The result showed prolongation of QT dispersion in sub-clinical hypothyroid group and weak positive correlation between TSH level and QT dispersion suggesting arrhythmia risk in subclinical hypothyroid females. KEY WORDS Arrhythmia risk, QT dispersion, Sub-clinical hypothyroidismPublication The Postural Effects on Electrical Activities of Heart in Apparently Healthy Young Adults(Kathmandu University, 2021) Chaudhary, S; Ranamagar, R; Shrestha, L; Pun, DB; Karmacharya, P; Mahotra, NBABSTRACT Background The electrical activities of heart recorded as electrocardiogram (ECG) are mostly done in supine postures. The body postural changes have effects in these electrical activities in heart which needs to be properly recognized. Objective To find the variations in electrocardiogram during postural changes from supine to upright i.e. sitting and standing postures among apparently healthy young adults. Method A cross sectional study was carried out in Manipal College of Medical Sciences after the institutional ethical clearance. The apparently healthy 30 Nepalese male medical students between 18-25 years of age were enrolled. The electrocardiography was elicited in supine, sitting and standing postures in the participants after 5 minutes’ interval between each procedure in each participant. Result The highest mean amplitudes of Q wave were seen in sitting postures (0.12±0.04 mm), R wave in standing postures (1.46±0.55 mm) and S wave also in standing postures (0.23±0.2 mm). The mean amplitudes of Q and S waves showed statistically significant difference when compared between supine and upright postures. The maximum QRS duration was found while sitting (0.08±0.01 ms)and maximum heart rate in standing posture (82.43±10.59/min). The mean comparison of heart rate was statistically highly significant when compared between supine and standing postures. The mean QRS frontal axis was comparatively increased while standing (64.30±39.29). Conclusion The electrical activities of heart vary during postural changes among apparently healthy young adults. These changes are most prominent when compared between supine and standing postures which urges for careful interpretation of electrocardiogram if it is done in upright postures. KEY WORDS Electrocardiogram, Heart, Postures