Fibromyalgia is a multi-symptomatic disorder characterized by generalized pain. The pathophysiology of fibromyalgia is supposedly an interplay between central nervous system hyper-responsiveness, autonomic dysfunction, and peripheral pain. In this cross-sectional study, the objective was to assess central sensitization and autonomic activity in patients with fibromyalgia compared with control. Fifty adults diagnosed with fibromyalgia by the modified American College of Rheumatology 2010 criteria and an equal number of age-and sex-matched controls participated in the study in an urban tertiary care hospital. Central sensitization was assessed by history and by evidence of increased prefrontal cortical activity as measured by cortical oxygenation using functional near-infrared spectroscopy. Autonomic activity was assessed by heart rate variability, electrodermal activity, and deep breathing test in three physiological states: rest, sympathetic stress (cold pressor test), and deep breathing. Mann-Whitney U-test, paired t-test, Wilcoxon test, and Friedman test with Bonferroni a priori were used to analyze the data. Cortical activity was significantly higher in the fibromyalgia group than control. There was no significant difference in autonomic activity between the fibromyalgia and control groups. In the fibromyalgia group, variable degrees of sympathetic hyperactivity and normal parasympathetic activity were observed. Central sensitization may be playing a primary role in the pathophysiology of generalized pain in fibromyalgia.

AimsTo objectively characterize and mathematically justify the observation that vectorcardiographic QRS loops in normal individuals are more planar than those from patients with ST elevation myocardial infarction (STEMI). MethodsVectorcardiograms (VCG) were constructed from three simultaneously recorded quasiorthogonal leads, I, aVF and V2 (sampled at 1000 samples/sec). The planarity of these QRS loops was determined by fitting a surface to each loop. Goodness of fit was expressed in numerical terms. Results15 healthy individuals aged 35 -65 years (73% male) and 15 patients aged 45 -70 years (80% male) with diagnosed acute STEMI were recruited. The spatial-QRS loop was found to lie in a plane in normal controls. In STEMI patients, this planarity was lost. Calculation of goodness of fit supported these visual observations. ConclusionsThe degree of planarity of the VCG loop can differentiate healthy individuals from patients with STEMI. This observation is compatible with our basic understanding of the electrophysiology of the human heart.

No abstract

No abstract

This observational cross-sectional Study was done in the Institute of Cardiovascular Sciences in R. G. Kar Medical College and Hospital from February, 2015 to December 2016. Atotal of 220 hypertensive patients were included through simple random sample selection. Patients who full the inclusion and exclusion criteria were enrolled for the study after getting written informed consent. This study was carried out using the echocardiogram as the gold standard for the diagnosis of LVH. The new score proposed here, of which cutoff for the diagnosis of LVH was arbitrarily set at 2800mm-ms, is easily applicable in clinical practice and presented the best correlation with the LVMI, when compared to some classic electrocardiographic criteria.

Pain, a protective mechanism turns into a pathologic response when it becomes chronic. Recent evidences are pointing towards neuroplastic brain changes as the primary factor for the persisting pain in chronic nonspecific low back pain (cLBP). To summarise the previous fMRI studies, a coordinate-based ALE meta-analysis of resting functional brain imaging studies is carried out to identify the clusters activated in the brain in cLBP. Literature survey: PubMed, Scopus and Sleuth were searched for studies with resting functional whole-brain imaging in cLBP. Till October 2020; 258, 238, and 7 studies were found respectively after search. The activity pattern was documented in without stimulation and with stimulation groups. The risk of bias was assessed by Joanna Briggs Institute critical appraisal checklist for analytical cross-section studies. Total seven (224 cLBP patients, 110 activation foci) and six studies (106 cLBP patients, 66 activation foci) were selected among 277 studies for metanalysis in the without stimulation and with stimulation group respectively. In the without stimulation group 8 statistically significant clusters were found. The clusters are distributed in the prefrontal cortex, primary somatosensory cortex, and primary motor cortex, anterior cingulate cortex, insular cortex, putamen, claustrum, amygdala, and associated white matters in both hemispheres. On the other group, 3 statistically significant clusters were found in the frontal cortex, Parietal cortex, and Insula. In the with stimulation group, significant lateralization was observed and most of the clusters were in the right hemisphere. The white matter involvement was more in the with stimulation group (78.62% Vs 38.21%). The statistically significant clusters found in this study indicate a probable imbalance in GABAergic modulation of brain circuit and dysfunction in descending pain modulation system. This disparity in pain neuro-matrix is the source of spontaneous and persisting pain in cLBP.

No abstract

No abstract