UMIN-CTR Study Design: trial Number: R000016846.
The main objective of this research work is to develop an effective mathematical model of cardiac conduction system using a heterogeneous whole-heart model. The model is in the form of a system of modified Van der Pol and FitzHugh-Nagumo differential equations capable of describing the heart dynamics. The proposed model extends the range of normal and pathological electrocardiogram (ECG) waveforms that can be generated by the model. The effects of the respiratory sinus arrhythmia (RSA) and the Mayer waves (MW) are both incorporated to modulate the intrinsic frequency of the main oscillator that represents the sinoatrial node. Also, three pathological conditions are incorporated into the model. The heart rate variability (HRV) phenomenon is incorporated into the synthetic ECGs produced which yields valuable information about the cardiovascular health and the performance of the autonomic nervous system. The spectral analysis of the generated RR tachogram delivers power spectrums that resemble those obtained from real recordings. Also, the proposed model generates synthetic ECGs that characteristic the three considered pathological conditions, namely, the tall T wave, the ECG with U wave, and the Wolff-Parkinson-White syndrome. In general, the significance of this research work is in developing a mathematical model that represents the interactions between different pacemakers and allows analysis of cardiac rhythms. To show the effectiveness and the accuracy of the presented model, the results are compared to published results. The proposed model can be a useful tool to study the influences of different physiological conditions on the profile of the ECG. The synthetic ECG signals produced can be used as signal sources for the assessment of diagnostic ECG signal processing devices.
Background: This study aims to assess the levels of visfatin in children and adolescents with autoimmune thyroiditis (AIT) and its relationship with disease-related variables. Methods: The study included 84 children and adolescents with AIT and 84 healthy subjects. Measurements of fasting glucose, insulin, thyroid-stimulating hormone (TSH), free thyroxin (FT4), antithyroid peroxidase antibodies (TPOAb) and antithyroglobulin antibody (TgAb) were completed, with assessment of visfatin levels. Results: Overt hypothyroidism was diagnosed in 58 cases, while subclinical hypothyroidism was diagnosed in 26 of the studied patients. Total studied cases, overt and subclinical subgroups had significantly higher levels of TSH, HOMA-IR, TPOAb, TgAb and visfatin and significantly lower FT4 level compared with the control. Spearman correlation analysis revealed that visfatin was correlated positively with BMI, homeostasis model assessment (HOMA-IR), TSH and TPOAb, while inversely correlation with FT4. In logistic regression analysis, visfatin was correlated only with TPOAb. Conclusions: This preliminary study provides evidence of significantly higher level of visfatin in children and adolescents with AIT. Visfatin might have a potential role in the pathogenesis of AIT, which needs to be validated by measuring immunological responses in children and adolescents with AIT.
Objectives: To assess serum anti-Müllerian hormone (AMH) levels as an ovarian reserve marker in adolescent girls with autoimmune thyroiditis (AIT) and explore the relationship of this marker with autoimmunity and thyroid function biomarkers. Subjects and methods: This study included 96 adolescent girls with newly diagnosed AIT and 96 healthy, age-and sex-matched controls. All participants were evaluated with detailed history taking and physical examination, thyroid ultrasound, and measurement of levels of thyroid-stimulating hormone (TSH), free thyroxin (FT4), free triiodothyronine (FT3), antithyroid peroxidase antibodies (TPOAb), antithyroglobulin antibody (TGAb), estradiol, total testosterone, and anti-Müllerian hormone (AMH) levels. The LH/FSH ratio was also calculated. Among 96 patients evaluated, 78 were overtly hypothyroid and 18 were euthyroid. AMH levels were significantly lower in participants with overt hypothyroidism and euthyroidism compared with controls. Results: Serum levels of AMH correlated negatively with age, body mass index (BMI) standard deviation score (SDS), and TPOAb, TGAb, and TSH levels but positively with FT4 levels. In multivariate analysis, AMH levels correlated significantly with age (odds ratio [OR]
Background: Chronic low backache is a commonly affecting problem in our population; it has an economic impact due to the consumption of health expenses in its treatment and rehabilitation. Backache interferes with daily activities of life without discriminating age, gender or race, etc. Our study aimed to determine the role of vitamin B-12 in relieving chronic low backache. Methodology: A comparative study was conducted at Baqai University and Fatima Hospital, Karachi, from May 2019 to April 2020. A total of 496 patients were enrolled and divided into two groups; group I was treated with vitamin B-12 (n=256), and group II (n=240) did not receive vitamin B-12 treatment. Pre-treatment Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) scores were evaluated. Group II was given calcium supplements and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for one month, while group I was given intramuscular injections of vitamin B-12 (500 mcg) on an alternate day for a month along with calcium supplements and NSAIDs. Results: Pre-treatment mean VAS and ODI scores were 6.68 ± 1.45 and 30.11 ± 12.7, while post-treatment VAS and ODI scores were subsequently 3.50 ± 2.07 and 17.73 ± 12.7, respectively. At the end of treatment, a remarkable decrease in ODI and VAS scores was observed after treatment with vitamin B-12 (p<0.05). Conclusion: Concurrent use of vitamin B-12 in the treatment of chronic backache had a better impact in relieving backache symptoms than those treated without vitamin B-12.
Objectives: Dipping tobacco is highly prevalent worldwide and in Sudan among adult males and is associated with cardiovascular hazards. The main objective of this study was to determine the effects of ‘tombak’ (local name for dipping tobacco in Sudan) dipping on heart rate variability and autonomic functions among adult males. Methods: Blood pressure and heart rate variability were recorded in 60 male tombak users (study group) at least 5 hours before using the tombak and after 30 minutes of use. Forty male non- users of tombak or any other tobacco products were included as a control group. Results: Measurements 5 hours before tombak dipping revealed statistically significant decrease in high frequency power in tombak users. Acute responses to tombak dipping included statistically significant increase in diastolic blood pressure, increase mean arterial pressure, decrease mean NN and decreased square root of the mean squared differences of successive NN intervals. Conclusions: the study results indicated disturbances in the sympatho-vagal balance with domination of sympathetic effects in the regulation of the cardiac activity and peripheral resistance in tombak users.
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