Pulse Rate Research Articles

A Longitudinal Cohort Assessing the Carotid Intima-Media Thickness Progression and Cardiovascular Risk Factors in a Rural Black South African Community

Background: Diabetes mellitus [DM) is a fast-increasing non-communicable disease in South Africa, with a prevalence of 11.3%. The present study aimed to longitudinally investigate the association of carotid intima-media thickness [CIMT) progression and cardiovascular risk factors in the T2DM and non-DM rural black population of South Africa. Methods: This population-based retrospective cohort study was conducted in the Dikgale Mamabolo Mothiba Surveillance area between 2014 and 2023 by the Africa Wits INDEPTH Partnership for Genomic Research (AWI-Gen). The IBM Statistical Package for the Social Sciences version 27 was used to analyze data. The paired T-test was used to determine the mean differences between baseline and follow-up. Longitudinal estimates of the association of CIMT with CVD risk factors in the T2DM and non-DM groups were analyzed using linear mixed models. Results: The baseline mean age was 51.64 years. There was a significant increase in CIMT (left and mean CIMT), low-density lipoprotein-cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate in the T2DM and non-DM groups. In the T2DM group, there was a strong significant association between age (2.20 mm), LDL-C (4.30 mm), SBP (4.57 mm), and waist/hip ratio (0.24 mm) with CIMT progression. The non-DM group revealed a significant association between LDL-C (0.001 mm), SBP (1.41 mm), and CIMT progression. Conclusion: CIMT was associated with other main CVD-related risk factors (age, LDL-C, LDL-C/HDL-C ratio, TC/HDL-C ratio, waist/hip ratio, and SBP). CIMT progression was more pronounced in the T2DM group than non-DM, suggesting a higher risk of atherosclerosis and cardiovascular complications in T2DM individuals.

Effects of Gait Rehabilitation Robot Combined with Electrical Stimulation on Spinal Cord Injury Patients’ Blood Pressure

Background: Orthostatic hypotension can occur during acute spinal cord injury (SCI) and subsequently persist. We investigated whether a gait rehabilitation robot combined with functional electrical stimulation (FES) stabilizes hemodynamics during orthostatic stress in SCI. Methods: Six intermediate-phase SCI patients (five males and one female; mean age: 49.5 years; four with quadriplegia and two with paraplegia) participated. The participants underwent robotic training (RT), with a gait rehabilitation robot combined with FES, and tilt table training (TT). Hemodynamics were monitored using a laser Doppler flowmeter for the earlobe blood flow (EBF) and non-invasive blood pressure measurements. The EBF over time and the resting and exercise blood pressures were compared between each session. Adverse events were also evaluated. Results: The EBF change decreased in TT but increased in RT at the 0.5-min slope (p = 0.03). Similarly, the pulse rate change increased in TT but decreased in RT at the 1-min slope (p = 0.03). Systolic and mean blood pressures were slightly higher in RT than in TT but not significantly (p = 0.35; 0.40). No adverse events occurred in RT, but two TT sessions were incomplete due to dizziness. Conclusions: RT with FES can reduce symptoms during orthostatic stress in intermediate-phase SCI. Future studies require a larger number of cases to generalize this study.

Development of a Multi-Functional Human Health Monitoring System

Abstract: Today, in flow of innovations, the specialists are always looking for advanced electronic device to help in diagnosing abnormalities of the body. Next-generation structures in healthcare monitoring devices are due to the Internet of Things, which becoming an exciting development area. Load cells, ultrasonic, LM 35 sensor and pulse oximeter (MAX30100) are incorporated in the STM32F401CDU6 black pill development board (MCU) in this research work to design a muilti-functional human health monitoring system. A web based server (using HTML, CSS, JavaScript and PHP application) will be present and will get data from the device and also the body mass index of the patient and the body temperature, pulse rate and SpO2 level in the blood will be measured. The human data produced will be displayed on an LCD for initial analysis and also transferred over an ESP8266 WIFI module. All the data compiled for each patient can also be viewed from the web server for further study and evaluation. This device, however, will be quite useful in rural or remote areas it will enable nearby clinics to consult with city hospitals about the health conditions of their patients. The device will also enable people to have a normal checkup of their health which is very important in improving the standard and quality of the health sector.

The Relations Between Sensory Modulation, Hyper Arousability and Psychopathology in Adolescents with Anxiety Disorders

Background: Sensory modulation may play a significant role in psychiatric conditions, including anxiety, and explain arousability levels, behavioral disorders, and functional deficits. Yet, studies about sensory modulation in adolescents with anxiety disorders are scarce. Purpose: To profile the prevalence of sensory modulation difficulties (SMDs) in adolescents with anxiety and examine their relations to arousability and psychopathology. The study compared adolescents with anxiety disorders to healthy controls using physiological measures and self-reports that reflect daily life scenarios. Then, the study examined the relationship between SMDs, arousability, and psychopathological severity in the study group. Method: Participants were 106 adolescents, aged 10.5–18 years and their parents. The study group included 44 participants diagnosed with anxiety disorder by psychiatrists. The control group included 62 healthy participants matched by age and gender to the study group. Parents completed the demographic questionnaire and the Child Behavior Checklist (CBCL). The adolescents completed The Revised Children’s Manifest Anxiety Scale (RCMAS) and the Adolescent/Adult Sensory Profile (AASP) and underwent the electrodermal activity (EDA) and pulse rate tests while listening to extreme sensory stimuli of auditory startles. Results: Based on AASP, the study group had a higher prevalence of SMDs expressed in lower sensory seeking, difficulties in registering sensory stimuli, and higher sensory sensitivity and avoidance. The study group presented higher arousability while listening to the startles as manifested in higher heart rate and EDA responses. The physiological results correlated with SMD levels measured by the AASP self-reports. SMDs correlated with psychopathological severity. Conclusions: SMDs may characterize adolescents with anxiety disorders and impact their arousability, symptoms severity, and daily functioning. Therefore, sensory modulation should be evaluated using both self-reports (to reflect implications in real life from patients’ own voices) along with objective measures to explain daily behaviors by underlying physiological mechanisms. This may focus intervention towards better health, function, and development.

Comparison of Efficacy, Haemodynamic and Oxygen Saturation Variability by Using 4% Articaine Hydrochloride and 2% Lignocaine Hydrochloride During Periodontal Flap Surgery: A Double-blind, Split-mouth and Randomised Controlled Trial

Abstract Introduction: Periodontitis is a progressive oral disease that can lead to tooth loss and systemic health issues. Periodontal flap surgery is an essential treatment for advanced periodontitis. Effective pain control during surgery is crucial and often achieved through local anaesthesia. This study compares the efficacy, haemodynamic changes and oxygen saturation (SpO2) variability between 4% articaine hydrochloride and 2% lignocaine hydrochloride. The study compares the efficacy, haemodynamic effects and SpO2 changes between 4% articaine hydrochloride and 2% lignocaine hydrochloride during periodontal flap surgery. Materials and Methods: This double-blind, split-mouth, randomised controlled trial involved 22 patients with bilateral symmetrical sites requiring periodontal flap surgery. Each patient received both anaesthetics in separate sittings. The onset of anaesthesia, pain perception using a Visual Analogue Scale (VAS), haemodynamic changes (blood pressure and heart rate) and SpO2 variability were recorded and analysed. Results: There was no statistically significant difference in the onset of anaesthesia between the two groups. The VAS scores were significantly lower in the articaine group, indicating better pain management. Haemodynamic parameters such as blood pressure changes and SpO2 variability showed no significant differences between the groups, except for pulse rates, which were higher in the lignocaine group. Conclusion: Both anaesthetics are effective for periodontal flap surgery, but articaine hydrochloride offers advantages in pain management and pulse rate stability. Individualised consideration for optimal anaesthesia selection is recommended based on patient preferences and clinical circumstances.

An efficient medical data encryption scheme using selective shuffling and inter-intra pixel diffusion IoT-enabled secure E-healthcare framework

Security in e-healthcare applications such as Telemedicine is crucial in safeguarding patients’ sensitive data during transmission. The proposed system measures the patient’s health parameters, such as body temperature and pulse rate, using LM35 and pulse sensors, respectively. The sensor data and the patient’s medical image are encrypted in the Raspberry Pi 3 B + processor using Python’s proposed text and medical image encryption scheme. The encrypted data is transmitted via the Thing Speak cloud and received by another Raspberry Pi at the receiver to decrypt the cipher data. The flask webserver can view the decrypted data by the doctor at the other end. This IoT implementation of secure Electronic Health Record (EHR) transmission employs text and medical image encryption schemes using a Combined Chaotic System (CCS). The CCS generates the chaotic key sequences to shuffle the medical image row-wise and column-wise. Then, selective shuffling between the cut-off points breaks the statistical relationship between the neighbouring pixels. Finally, the intra and inter-pixel diffusion is carried out using bit permutation and bit-wise XOR operation to create a highly random cipher image. The initial seed for inter-pixel diffusion is obtained from the hash of intra-pixel diffused images to resist chosen plain text and cipher text attacks. The efficiency of the developed medical image encryption algorithm is tested against various attack analyses. The results and the security analyses validate the effectiveness of the proposed scheme.

Comparison of the Effectiveness of Two Different Methods of Alleviating Pain and Anxiety during Local Anaesthesia Administration in Children: A Split-mouth Study

Abstract Introduction: This study aimed to compare the effectiveness of two different methods, a custom-designed mucosal vibrator and topical benzocaine gel, in alleviating pain and anxiety during local anaesthesia (LA) administration in paediatric patients. Materials and Methods: A randomised, split-mouth controlled trial was conducted with 30 paediatric patients aged 5–10 years. Each child received LA with a custom-designed mucosal vibrator in one session and with topical benzocaine gel in another. Pain perception and anxiety were assessed using the Wong-Baker FACES Pain Rating Scale, Sound–Eye–Motor Scale and pulse rate measurements. The sequence of interventions was randomised using the sequentially numbered, opaque, sealed envelope technique. Results: The study found that the custom-designed mucosal vibrator significantly reduced pain perception compared to the benzocaine gel, as evidenced by both subjective and objective pain scores (P < 0.05). However, the two methods showed no significant difference in anxiety levels, as indicated by similar pulse rate changes (P > 0.05). Conclusion: The custom-designed mucosal vibrator offers a cost-effective and efficient alternative to topical benzocaine for reducing pain during LA in children, though it does not significantly alter anxiety levels. This device could be a valuable tool for paediatric dental practitioners to improve the comfort of their patients during dental procedures.

Immediate effect of electrical vestibular stimulation on autonomic and respiratory parameters and reaction time in patients with Parkinson’s disease

Background: Both the electrical and natural vestibular stimulation were reported to alter both the blood pressure and motor output of respiration. After a thorough review of the literature, the studies observed the immediate effect of vestibular stimulation on autonomic and respiratory functions is sparse. Hence, the present study was undertaken. Aims and Objectives: The present study was undertaken to observe the immediate effect of electrical vestibular stimulation on autonomic and respiratory parameters in patients with Parkinson’s disease (PD). Materials and Methods: The present study recruited 30 patients with PD after obtaining written informed consent. After recording the baseline values, a single session of stimulation was administered to the participants and soon after recorded the participants. Blood pressure was recorded by Diamond BPDG 141 Deluxe Multicolor LED Mercury Free BP Monitor. Pulse rate and respiratory rate were recorded manually. Auditory and visual reaction times were recorded using the RT apparatus. Results: There was a significant decrease in the systolic (P=0.011) and diastolic blood pressure (P=0.002) after the stimulation. The pulse rate was decreased significantly (P=0.071) followed by the vestibular stimulation. No change in the respiratory rate was observed followed by the vestibular stimulation. There was a significant decrease in the visual reaction time for red (P=0.0087) and green light (P=0.0007), as a result of the intervention. Auditory reaction time for low pitch (P=0.0056) was significantly decreased followed by the intervention. Conclusion: The study results support that a single session of electrical vestibular stimulation has beneficial effects on blood pressure and reaction time in patients with PD. Further detailed studies are recommended with long-term administration of electrical stimulation to recommend the use of electrical vestibular nerve stimulation in the management of non-motor symptoms in PD patients.

Effectiveness of 12 weeks of listening to Gayatri Mantra in the management of non-motor symptoms in patients with Parkinson’s disease: A pilot study

Background: Parkinson’s patients experience non-motor symptoms along with motor symptoms that include autonomic deregulation, insomnia, decline in cognition, and psychological distress. Although it is known that mantra chanting offers multiple beneficial effects, the scientific studies related to these are limited. Aims and Objectives: The present study aimed to observe the effectiveness of listening to the Gayatri Mantra in managing non-motor symptoms in patients with Parkinson’s disease. Materials and Methods: The present pilot study recruited 20 patients with Parkinson’s disease. The patients acted as self-controls. After recording the baseline values, the participants were asked to listen to the Gayatri Mantra 108 chanting twice a day for 12 weeks. After 12 weeks of listening, post-intervention values were recorded and analyzed. Sleep quality was assessed using the insomnia severity index. Stress levels were assessed using the perceived stress scale. Spatial and verbal memory tests were used to assess the memory scores. Blood pressure was recorded using the Diamond Original Mercurial Regular BP Monitor (Multicolor). The pulse rate was recorded manually in the radial artery. Results: There was a significant decrease in the perceived stress scores followed by the intervention (P<0.01). Sleep quality was improved in the participants followed by listening to the Gayatri Mantra chanting. There was an improvement in the spatial and verbal memory scores. Systolic and diastolic pressure was decreased and remained within normal limits followed by the intervention. The pulse rate was significantly decreased followed by the intervention. Conclusion: The study results provide preliminary evidence that listening to the Gayatri Mantra has positive effects on the management of the non-motor symptoms of Parkinson’s disease patients. However, there is a need for more studies with higher sample sizes to recommend the implementation of the Gayatri Mantra in the management of Parkinson’s disease.

Safety of Shear Wave Elastography as Evidenced From Carotid Artery Strain and Strain Rate Induced by Acoustic Radiation Force Impulse and Arterial Pulsations

Safety of Shear Wave Elastography as Evidenced From Carotid Artery Strain and Strain Rate Induced by Acoustic Radiation Force Impulse and Arterial Pulsations

A comparative study of analgesic effect between ultrasound-guided posterior vis-a-vis lateral transversus abdominis plane block in patients undergoing total abdominal hysterectomy with bilateral salpingo-oophorectomy under spinal anesthesia

Background: Transversus abdominis plane (TAP) block is used to reduce pain after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO). Two important approaches are ultrasound-guided lateral and posterior approaches. Ultrasound-guided blocks help in the correct localization of the plane and proper deposition of drugs. Aims and Objectives: This study was done to compare the analgesic effect of posterior TAP block and lateral TAP block in TAH+BSO.Materials and Methods: A double-arm observational study was conducted on eighty patients (ASA 1 and 2) posted for TAH+BSO under spinal anesthesia. They were randomly divided into two equal groups, 40 each (Groups L and P). Ultrasound-guided lateral TAP block and posterior TAP block were administered bilaterally with 20 mL 0.25% bupivacaine in the L group and P group, respectively, on each side of the abdomen after skin closure at the end of the operation. The intensity of post-operative pain was evaluated by a 10 cm Visual Analog Scale (VAS) Score at 1, 3, 6, 9, 12, and 24 h. If VAS was more than 4, 1 g paracetamol infusion was given. Duration of analgesia, total rescue analgesic requirement, and hemodynamic changes by measuring mean arterial pressure and pulse rate were also observed. Results: VAS score was significantly less in Group P than in Group L (P<0.05). The time of first rescue analgesia requirement was longer in Group P compared to Group L. Total analgesic requirement in 24 h was less in Group P compared to Group L. Hemodynamic changes were comparable in both groups. Conclusion: Posterior TAP block provides better post-operative analgesia than lateral TAP block with stable hemodynamics in patients undergoing TAH BSO operation under spinal anesthesia.

EFFECTS OF NORMOBARIC HYPOXIA AND HIGH-INTENSITY INTERVAL TRAINING ON HEMODYNAMICS

https://youtu.be/Jm8BVwM0X54 INTRODUCTION The purpose of this study was to evaluate the effects of high-intensity interval training (HIIT) at normobaric hypoxia (NH) on measures of hemodynamics. METHODS Ten active adults aged 23±1 years volunteered to complete a HIIT intervention at a randomized condition (sea level (SL); low NH (900m); moderate NH (2500m), high NH (4300m)) separated by 72 hours. After acclimating to the condition for 45 minutes (Rest), participants completed a HIIT intervention consisting of six bouts of high-intensity cycling separated by three minutes and 30 seconds of active recovery (AR). Hemodynamic variables included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and rate pressure product (RPP). They were assessed at Rest, during the final AR (AR6), and five minutes following the final bout of exercise (Post). A two-way repeated analysis of variance (ANOVA) was used to analyze the effects of condition (SL, 900m, 2500m, 4300m) across the repeated factor of time (Rest, AR6, Post) in response to HIIT. RESULTS There was a significant (p≤0.05) main effect of time for HR, SBP, DBP, MAP, PP, and RPP. At all conditions, HR (SL: Rest: 62±9bpm; AR6: 156±21bpm; Post: 104±15bpm; 900m: Rest: 61±10bpm; AR6: 161±10bpm; Post: 109±19bpm; 2500m: Rest: 64±11bpm; AR6: 167±14bpm; Post: 104±14bpm; 4300m: Rest: 67±14bpm; AR6: 171±11bpm; Post: 111±19bpm) increased following Rest, and AR6 was greater than Post. Additionally, at all conditions, SBP (SL: Rest: 116±7mmHg; AR6: 154±16mmHg; Post: 134±13mmHg; 900m: Rest: 119±8mmHg; AR6: 152±10mmHg; Post: 133±13mmHg; 2500m: Rest: 120±10mmHg; AR6: 153±12mmHg; Post: 136±14mmHg; 4300m: Rest: 116±10mmHg; 4300m AR6: 149±15mmHg; Post: 136±14mmHg) increased following Rest. More so, MAP at Rest was lower than AR6 and Post at SL (Rest: 66±5mmHg; AR6: 69±7mmHg; Post: 60±2mmHg) and 900m (Rest: 68±5mmHg; AR6: 70±8mmHg; Post: 68±7mmHg). At AR6, MAP was higher than Post at 900m. Similarly, PP (SL: Rest: 50±7mmHg; AR6: 85±15mmHg; Post: 64±15mmHg; 900m: Rest: 51±7mmHg; AR6: 82±10mmHg; Post: 63±11mmHg; 2500m: Rest: 48±6mmHg; AR6: 85±14mmHg; Post: 66±10mmHg; 4300m: Rest: 44±6mmHg; AR6: 77±14mmHg; Post: 63±11mmHg) was augmented following Rest at all conditions, and AR6 was higher than Post at SL, at 900m. Finally, RPP (SL: Rest: 71±13mmHg; AR6: 216±42mmHg; Post: 139±21mmHg; 900m: Rest: 73±15mmHg; AR6: 204±34mmHg; Post: 145±28mmHg; 2500m: Rest: 78±17mmHg; AR6: 202±30mmHg; Post: 141±22mmHg; 4300m: Rest: 79±21mmHg; AR6: 208±30mmHg; Post: 152±31mmHg) increased following Rest, and Post was lower than AR6, at all conditions. No other significant main effects, conditions, or interactions were observed. CONCLUSIONS While both NH and HIIT increase measures of hemodynamics, combining HIIT and NH does not further augment such variables. Thus, engaging in HIIT at NH does not increase cardiovascular stress or the risk of experiencing a cardiovascular event compared to HIIT at SL.

Depicting "arms race" of Rhipicephalus microplus and its host on a single frame platform.

To improve our knowledge on host-parasite interaction, the study was undertaken on Rhipicephalus microplus infestation in cross breed cattle. This tick, being a voracious blood sucker, remains attached to the skin for prolonged period and inoculates saliva during blood feeding. Biomolecules present in the saliva have detrimental effects on host system. The present study deals with the effects of R. microplus in artificially infected nine months old cattle for a period of 21days. There was physiological alteration during tick infestation in terms of body temperature, pulse, and respiration rate. There was drop in haemoglobin gram percentage, platelet count, total red and white blood cell count. Thrombocytopenia in infested animals was suggestive of iron deficient anaemia after artificial infestation. R. microplus infestation was found to induce stress in experimental animals. Our study on peripheral blood gene expression was suggestive of Th2 polarization since there was increased IL-4 response. Increased IL-6 response indicated skin damage due to R. microplus infestation and we further correlate eosinophilia with up-regulation of IL-6 and IL-8 responses. Increased IL-10 response and decreased IFN-γ response were suggestive of immunosuppressive and anti-inflammatory properties of tick saliva.

THE EFFECT OF ACE’S ON PHYSIOLOGICAL MEASURES OF HEALTH

https://youtu.be/RzKWRGm-J34 BACKGROUND The aim of this study was to determine if Adverse Childhood Experiences (ACE’s) are related to physiological measures of health. ACE’s are associated with an increase in the inflammatory response. Chronic inflammation is linked to diseases such as heart disease, lung disease, and cancer as well as immunologic conditions. Lifestyle choices such as exercise and dietary habits may potentially counteract those inflammatory changes related to higher ACE’s due to the anti-inflammatory properties associated with those choices. METHODS Participants visited the Exercise Physiology Lab and first completed an informed consent. Following that, participants were given the two survey instruments: ACE’s assessment and Simple 7 assessment. Participants were to complete each survey assessment and place the completed assessments in a sealed manilla envelope. After completing the survey instruments, participants had resting blood pressure, height, weight and body composition (Tanita body fat scale) measurements completed. Following the resting measures participants put on a Polar telemetry strap and started a self-selected warm-up on the treadmill. After a 5-min warm-up, participants started a Bruce Protocol treadmill test that was terminated at 80% of age-predicted maximum heart rate or a request to stop or for any reason signifying cardiopulmonary distress . A correlational analysis was conducted using SPSS v30. RESULTS In total12 participants (8 female, 4 male) were analyzed. Body mass index (BMI) and age of first occurrence for the ACE’s assessment were correlated, p = 0.045, r = -0.587. Other correlations were trending towards significance but due to a smaller sample size, significance was not achieved. ACE’s and stage RPE (p = 0.084, r = 0.519), heart rate at test termination (p = 0.054, r = 0.568) and resting arterial pulse pressure (p = 0.097, r = -0.502) were not significantly correlated. ACE’s assessment part 2 regarding support systems had a trending correlation with resting mean arterial pressure (p = 0.097, r = -0.501). CONCLUSIONS ACE’s may have a long-term physiological impact from psychological stress at a younger age. Data showed those with an earlier age of adverse experiences, correlated with a higher BMI. High BMI is associated with many chronic diseases such as heart disease, lung disease, metabolic diseases and cancer. With other data trending toward significance, further investigation into ACE’s and health values should be explored to determine the long-term impact of psychological damage from childhood.

Binaural auditory beats vs music of choice as audio distraction behaviour guidance technique among children: A randomized controlled trial.

Binaural beat is created by presenting two different pure-tone sine waves with less than a 30Hz difference dichotically. In dental settings, children listening to familiar music during treatments gain control over the anxiety caused by tools like the airotor or syringe, creating a comforting, familiar environment. To evaluate and compare anxiety level during restorative treatment using No Music, Music of choice and Binaural Auditory Beats as Audio distraction behaviour guidance technique in children aged 6-12 years. In-vivo, double-blind, three-arm, parallel-group randomized study was conducted in the department of pediatric and preventive dentistry where 75 participants were allocated into 3 groups. The teeth with Class I cavity in primary and permanent molars were prepared and restored. Anxiety was measured pre- and post-intervention using Pulse oximeter and Venham's picture test. Children who were treated with Binaural beats and Music of choice showed reduction in anxiety levels as indicated by lower anxiety scores in Venham picture test and pulse rate values as compared to the control group. Binaural auditory beats and Music of choice can be used effectively as a non-invasive treatment modality to reduce anxiety in apprehensive pediatric patients.

Number of Readmissions and Its Determinants Among Patients With Heart Failure at Referral Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study Using Zero-Inflated Negative Binomial Model, 2023.

Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia. This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023. A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity. Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; p < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; p < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; p < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; p < 0.004) was linked with a higher likelihood of remaining in the "always-zero" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; p < 0.036). The mortality rate among readmitted patients was 11.39%. This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.

Health Monitoring System

Healthcare is given extreme importance by each country since the covid pandemic had taken place. The health monitoring system is the best solution for tracking our health regularly. The system has wearable sensors to measure vital signs such as Blood Pressure, Pulse rate, Oxygen Level, Body Temperature in a single system. The speciality of this system is that we can track patient’s health from a far distance also since the system can be connected wirelessly to our mobile , laptop etc through Bluetooth or wifi. This system has the potential to reduce hospital visits and then individuals can take control of their health as well. This system ensures data privacy and security. We can store the patient’s data in the server utilizing Wi-fi module. Thus Patient health monitoring system based uses internet to effectively monitor patient health and helps the user monitoring their loved ones from work and saves lives.

Simultaneous Isotropic Omnidirectional Hypersensitive Strain Sensing and Deep Learning-Assisted Direction Recognition in a Biomimetic Stretchable Device.

Omnidirectional strain sensing and direction recognition ability are features of the human tactile sense, essential to address the intricate and dynamic requirements of real-world applications. Most of the current strain sensors work by converting uniaxial strain into electrical signals, which restricts their use in environments with multiaxial strain. Here, the first device with simultaneous isotropic omnidirectional hypersensitive strain sensing and direction recognition (IOHSDR) capabilities is introduced. By mimicking the human fingers from three dimensions, the IOHSDR device realizes a novel heterogeneous substrate that incorporates the involute of a circle, resulting in isotropic behavior in the radial direction and anisotropic property in the involute direction for hypersensitive strain sensing. With the assistance of a deep learning-based model, the IOHSDR device accomplishes an impressive accuracy of 99.58% in recognizing 360° stretching directions. Additionally, it exhibits superior performance in the typical properties of stretchable strain sensors, with a gauge factor of 634.12, an ultralow detection limit of 0.01%, and outstanding durability exceeding 15000 cycles. The demonstration of radial artery pulse and throat vibration applications highlights the IOHSDR's unique characteristics of isotropic omnidirectional sensing and precise direction detection unleashing new classes of wearable health monitoring devices.

Challenge case of ventricular arrhythmia in young women

Background: Torsade de pointes (TdP) and ventricular fibrillation can cause rapid mortality. The etiological cause the ventricular arrhythmia must be detected and treated early, especially in the ER. Objective: We report a patient with severe hypokalemia and TdP following the administration of Amiodarone in QT-interval prolongation Case Report: A 32-year-old girl with diarrhea and vomiting for two days arrived to the ED with a seizure with her hand flexed and leg straight down. Her family reported she didn't take prescriptions regularly. She was GCS 224, hemodynamically stable, typical ECG showed extended QTc and her head CT was normal. During observation at the ED, she had seizure and the monitor revealed a Torsade de Pointes (TdP) ) with a pulse rate of 160-180 bpm. She was given Amiodarone and peroral Bisoprolol 5 mg. She returned to sinus rhythm with PVC bigeminy and was admitted to the ICU Laboratory data showed hypokalemia (1.9) improved (2.9) after treatment. Eight hours later, she experienced a TdP without pulse palpability for less than 1 minute, then Ventricular Fibrillation, began CPR, and the doctor in charge gave her a defibrillation operation once. She returned with sinus tachycardia 110-130 bpm. The next day, she was having recurring TdP episodes without a pulse. The doctor conducted CPR and defibrillation and returned with 120-130 bpm sinus tachycardia. The patient consulted a cardiologist and was prescribed lidocaine 1 mg/hour and continued Bisoprolol 5 mg for long QT problem. Observation The seizure ended 12 hours later, the patient was alert, GCS 456, and the ECG showed sinus rhythm with extended QTc. Over the days before discharge, electrocardiography demonstrated reduced QT-interval prolongation. Conclusion: Life-threatening ventricular arrhythmia in a young female can be caused by QT-interval prolongation. It must be diagnosed and treated immediately to avoid mortality. Keywords: Torsade de Pointes (TdP), ventricular fibrillation, prolonged QT, hypokalemia, amiodarone

Polyarteritis Nodosa with Tubercular Pericardial Effusion: A Rare Coexistence of Childhood Vasculitis and Infectious Disease

Polyarteritis nodosa (PAN) is a systemic vasculitis that affects medium-sized arteries, resulting in inflammation and damage to multiple organs. PAN may develop following bacterial or viral infections representing a post-infectious autoimmune response. Tuberculosis (TB) can affect any organ of the body and it is one of the most important causes of pericardial effusion in developing countries. This case report presents a young girl with a rare co-occurrence of PAN and tubercular pericardial effusion having a history of fever, polyarthritis, weight loss, digital gangrene, and respiratory distress. On examination, the patient had signs of heart failure, pericardial effusion, and diminished peripheral pulsation in both anterior and posterior tibial arteries and arteria dorsalis pedis. The patient improved dramatically after receiving combined immunosuppressive and anti-tubercular therapy. This case was a unique coexisting situation where the patient presented with unusual presentations and also demonstrated the complex interplay between autoimmune and infectious diseases which needs a comprehensive diagnostic and treatment approach. J Bangladesh Coll Phys Surg 2025; 43: 85-88