Search results for: traumatic brain injury.

Authors: Valene J. Gresham, MA, Laura A. Brodie

Abstract:

For the last decade, statistics show traumatic brain injury (TBI) is a growing concern in our legal system. In an effort to obtain data regarding the influence of neuropsychological expert witness testimony in a criminal case, this study tested three hypotheses. H1: The majority of jurors will vote not guilty, due to mild head injury. H2: The jurors will give more credence to the testimony of the neuropsychologist rather than the psychiatrist. H3: The jurors will be more lenient in their sentencing, given the testimony of the neuropsychologist-s testimony. The criterion for inclusion in the study as a participant is identical to those used for inclusion in the eligibility for jury duty in the United States. A chisquared test was performed to analyze the data for the three hypotheses. The results supported all of the hypotheses; however statistical significance was seen in H1 and H2 only.

Keywords: Expert witness, jury decision, neuropsychology, traumatic brain injury.

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Authors: Y. J. Zhou, G. Lu

Abstract:

In this paper, an analytical study is made for the dynamic behavior of human brain tissue under transient loading. In this analytical model the Mooney-Rivlin constitutive law is coupled with visco-elastic constitutive equations to take into account both the nonlinear and time-dependent mechanical behavior of brain tissue. Five ordinary differential equations representing the relationships of five main parameters (radial stress, circumferential stress, radial strain, circumferential strain, and particle velocity) are obtained by using the characteristic method to transform five partial differential equations (two continuity equations, one motion equation, and two constitutive equations). Analytical expressions of the attenuation properties for spherical wave in brain tissue are analytically derived. Numerical results are obtained based on the five ordinary differential equations. The mechanical responses (particle velocity and stress) of brain are compared at different radii including 5, 6, 10, 15 and 25 mm under four different input conditions. The results illustrate that loading curves types of the particle velocity significantly influences the stress in brain tissue. The understanding of the influence by the input loading cures can be used to reduce the potentially injury to brain under head impact by designing protective structures to control the loading curves types.

Keywords: Analytical method, mechanical responses, spherical wave propagation, traumatic brain injury.

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Authors: Nicole S. McKinney

Abstract:

The purpose of the study was to determine if, among 32 brain injured adults in community rehabilitation programs, there is a statistically significant relationship between the degree of severity of brain injury and these adults- level of self-esteem and stress. The researcher hypothesized there would be a statistically significant difference and a statistically significant relationship in self-esteem and stress levels among and TBI adults. A Pearson product moment correlational analysis was implemented and results found a statistically significant relationship between self-esteem and stress levels. Future recommendations were suggested upon completion of research.

Keywords: anxiety, community recovery center, head-trauma persons, self-concept

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Authors: Wai Pan Chan, Minkyu Je

Abstract:

A precision CMOS chopping amplifier is adopted in this work to improve a CMOS temperature sensor high sensitive enough for intracranial temperature monitoring. An amplified temperature sensitivity of 18.8 ± 3*0.2 mV/oC is attained over the temperature range from 20 oC to 80 oC from a given 10 samples of the same wafer. The analog frontend design outputs the temperature dependent and the temperature independent signals which can be directly interfaced to a 10 bit ADC to accomplish an accurate temperature instrumentation system.

Keywords: Chopping, analog frontend, CMOS temperature sensor, traumatic brain injury (TBI), intracranial temperature monitoring.

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Authors: M. Sharanreddy, P. K. Kulkarni

Abstract:

Brain tumor is inherently serious and life-threatening disease. Brain tumor builds the intracranial pressure in the brain, by shifting the brain or pushing against the skull, and also damaging nerves and healthy brain tissues. This intracranial pressure affects and interferes with normal brain functionality, which results in generation of abnormal electrical activities from brain. With recent development in the medical engineering and instruments, EEG instruments are able to record the brain electric activities with high accuracy, which establishes EEG as a primary tool for diagnosing the brain abnormalities. Research scholars and general physicians, often face difficulty in understanding EEG patterns. This paper presents the EEG patterns associated with brain tumor by combing medicine theory and neurologist experience. Paper also explains the pros-cons of the EEG based brain tumor identification.

Keywords: Brain tumor, Electroencephalogram (EEG).

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Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

Abstract:

This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: Brain Computer Interface (BCI), gait trainer, Spinal Cord Injury (SCI), neurorehabilitation.

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Authors: Young-Seok Choi

Abstract:

It has been known that a characteristic Burst-Suppression (BS) pattern appears in EEG during the early recovery period following Cardiac Arrest (CA). Here, to explore the relationship between cortical and subcortical neural activities underlying BS, extracellular activity in the parietal cortex and the centromedian nucleus of the thalamus and extradural EEG were recorded in a rodent CA model. During the BS, the cortical firing rate is extraordinarily high, and that bursts in EEG correlate to dense spikes in cortical neurons. Newly observed phenomena are that 1) thalamic activity reemerges earlier than cortical activity following CA, and 2) the correlation coefficient of cortical and thalamic activities rises during BS period. These results would help elucidate the underlying mechanism of brain recovery after CA injury.

Keywords: Cortex, thalamus, cardiac arrest, burst-suppression.

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Authors: Young-Seok Choi

Abstract:

This work proposes a data-driven multiscale based quantitative measures to reveal the underlying complexity of electroencephalogram (EEG), applying to a rodent model of hypoxic-ischemic brain injury and recovery. Motivated by that real EEG recording is nonlinear and non-stationary over different frequencies or scales, there is a need of more suitable approach over the conventional single scale based tools for analyzing the EEG data. Here, we present a new framework of complexity measures considering changing dynamics over multiple oscillatory scales. The proposed multiscale complexity is obtained by calculating entropies of the probability distributions of the intrinsic mode functions extracted by the empirical mode decomposition (EMD) of EEG. To quantify EEG recording of a rat model of hypoxic-ischemic brain injury following cardiac arrest, the multiscale version of Tsallis entropy is examined. To validate the proposed complexity measure, actual EEG recordings from rats (n=9) experiencing 7 min cardiac arrest followed by resuscitation were analyzed. Experimental results demonstrate that the use of the multiscale Tsallis entropy leads to better discrimination of the injury levels and improved correlations with the neurological deficit evaluation after 72 hours after cardiac arrest, thus suggesting an effective metric as a prognostic tool.

Keywords: Electroencephalogram (EEG), multiscale complexity, empirical mode decomposition, Tsallis entropy.

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Authors: Sofia Matoug, Amr Abdel-Dayem

Abstract:

This paper presents a comprehensive survey of recent research studies to segment and classify brain MR (magnetic resonance) images in order to detect significant changes to brain ventricles. The paper also presents a general framework for detecting regions that atrophy, which can help neurologists in detecting and staging Alzheimer. Furthermore, a prototype was implemented to segment brain MR images in order to extract the region of interest (ROI) and then, a classifier was employed to differentiate between normal and abnormal brain tissues. Experimental results show that the proposed scheme can provide a reliable second opinion that neurologists can benefit from.

Keywords: Alzheimer, brain images, classification techniques, Magnetic Resonance Images, MRI.

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Authors: N. Fuad, M. N. Taib, R. Jailani, M. E. Marwan

Abstract:

In this paper, the comparison between k-Nearest Neighbor (kNN) algorithms for classifying the 3D EEG model in brain balancing is presented. The EEG signal recording was conducted on 51 healthy subjects. Development of 3D EEG models involves pre-processing of raw EEG signals and construction of spectrogram images. Then, maximum PSD values were extracted as features from the model. There are three indexes for balanced brain; index 3, index 4 and index 5. There are significant different of the EEG signals due to the brain balancing index (BBI). Alpha-α (8–13 Hz) and beta-β (13–30 Hz) were used as input signals for the classification model. The k-NN classification result is 88.46% accuracy. These results proved that k-NN can be used in order to predict the brain balancing application.

Keywords: Brain balancing, kNN, power spectral density, 3D EEG model.

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Authors: Amiel Satvedi, Richard Pyne

Abstract:

Injuries in professional sports occur on a regular basis. Some may be minor while others can cause huge impact on a player’s career and earning potential. In soccer, there is a high risk of players picking up injuries during game time. This research work seeks to help soccer players reduce the risk of getting injured by predicting the likelihood of injury while playing in the near future and then providing recommendations for intervention. The injury prediction tool will use a soccer player’s number of minutes played on the field, number of appearances, distance covered and performance data for the current and previous seasons as variables to conduct statistical analysis and provide injury predictive results using a machine learning linear regression model.

Keywords: Injury predictor, soccer injury prevention, machine learning in soccer, big data in soccer.

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Authors: Truong Quang Dang Khoa, Masahiro Nakagawa

Abstract:

Brain Computer Interface (BCI) has been recently increased in research. Functional Near Infrared Spectroscope (fNIRs) is one the latest technologies which utilize light in the near-infrared range to determine brain activities. Because near infrared technology allows design of safe, portable, wearable, non-invasive and wireless qualities monitoring systems, fNIRs monitoring of brain hemodynamics can be value in helping to understand brain tasks. In this paper, we present results of fNIRs signal analysis indicating that there exist distinct patterns of hemodynamic responses which recognize brain tasks toward developing a BCI. We applied two different mathematics tools separately, Wavelets analysis for preprocessing as signal filters and feature extractions and Neural networks for cognition brain tasks as a classification module. We also discuss and compare with other methods while our proposals perform better with an average accuracy of 99.9% for classification.

Keywords: functional near infrared spectroscope (fNIRs), braincomputer interface (BCI), wavelets, neural networks, brain activity, neuroimaging.

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Authors: Mridul Sharma, Praveen Saroha

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In today's world, everyone has become so busy in their to-do tasks and daily routine that they tend to ignore some of the basal components of our life, including exercise and diet. This comparative study analyzes the pathways of the relationship between exercise and brain plasticity and also includes another variable diet to study the effects of diet on learning by answering questions including which diet is known to be the best learning supporter and what are the recommended quantities of the same. Further, this study looks into inter-relation between diet and exercise, and also some other approach of the relation between diet and exercise on learning apart from through Brain Derived Neurotrophic Factor (BDNF).

Keywords: Basolateral amygdala, brain derived neurotrophic factor, brain plasticity, diet, exercise, mediterranean diet.

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Authors: E. Aboutaleb, R. Dinarvand

Abstract:

The purpose of this work was to inspect the potential of vincristine-dextran complex loaded solid lipid nanoparticles for drug delivery to the brain. The nanoparticles were stained with a fluorescence dye and their plasma pharmacokinetic and brain concentrations were investigated following injection to rats. The result revealed a significant improvement in the plasma concentration profile of the SLN injected animals as well as a sharp increased concentration in the brains.

Keywords: Brain, Coumarin-6, Nanoparticles, SLN.

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Authors: Rica Jell de Laza, Jose Alberto Fernandez, Andrea Marie Mendoza, Qristin Jeuel Regalado

Abstract:

This study investigates whether participants experience different levels of persuasion depending on the hemisphere of the brain and the tone of voice. The experiment was performed on 96 volunteer undergraduate students taking an introductory course in psychology. The participants took part in a 2 x 3 (Hemisphere: left, right x Tone of Voice: positive, neutral, negative) Mixed Factorial Design to measure how much a person was persuaded. Results showed that the hemisphere of the brain and the tone of voice used did not significantly affect the results individually. Furthermore, there was no interaction effect. Therefore, the hemispheres of the brain and the tone of voice employed play insignificant roles in persuading a person.

Keywords: Dichotic listening, brain hemisphere, tone of voice, persuasion.

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Authors: Mohamed Gouskir, Belaid Bouikhalene, Hicham Aissaoui, Benachir Elhadadi

Abstract:

In this paper, we present an application of Riemannian geometry for processing non-Euclidean image data. We consider the image as residing in a Riemannian manifold, for developing a new method to brain edge detection and brain extraction. Automating this process is a challenge due to the high diversity in appearance brain tissue, among different patients and sequences. The main contribution, in this paper, is the use of an edge-based anisotropic diffusion tensor for the segmentation task by integrating both image edge geometry and Riemannian manifold (geodesic, metric tensor) to regularize the convergence contour and extract complex anatomical structures. We check the accuracy of the segmentation results on simulated brain MRI scans of single T1-weighted, T2-weighted and Proton Density sequences. We validate our approach using two different databases: BrainWeb database, and MRI Multiple sclerosis Database (MRI MS DB). We have compared, qualitatively and quantitatively, our approach with the well-known brain extraction algorithms. We show that using a Riemannian manifolds to medical image analysis improves the efficient results to brain extraction, in real time, outperforming the results of the standard techniques.

Keywords: Riemannian manifolds, Riemannian Tensor, Brain Segmentation, Non-Euclidean data, Brain Extraction.

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Authors: Atanu K Samanta, Asim Ali Khan

Abstract:

Due to the acquisition of huge amounts of brain tumor magnetic resonance images (MRI) in clinics, it is very difficult for radiologists to manually interpret and segment these images within a reasonable span of time. Computer-aided diagnosis (CAD) systems can enhance the diagnostic capabilities of radiologists and reduce the time required for accurate diagnosis. An intelligent computer-aided technique for automatic detection of a brain tumor through MRI is presented in this paper. The technique uses the following computational methods; the Level Set for segmentation of a brain tumor from other brain parts, extraction of features from this segmented tumor portion using gray level co-occurrence Matrix (GLCM), and the Artificial Neural Network (ANN) to classify brain tumor images according to their respective types. The entire work is carried out on 50 images having five types of brain tumor. The overall classification accuracy using this method is found to be 98% which is significantly good.

Keywords: Artificial neural network, ANN, brain tumor, computer-aided diagnostic, CAD system, gray-level co-occurrence matrix, GLCM, level set method, tumor segmentation.

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Authors: Zhepeng Rui, Zhenyu Gu, Caitilin de Bérigny

Abstract:

In the current study, we designed an interactive meditation and brain painting application to cultivate users’ creativity, promote meditation, reduce stress, and improve cognition while attempting to learn a foreign language. User tests and data analyses were conducted on 42 male and 42 female participants to better understand sex-associated psychological and aesthetic differences. Our method utilized brain-computer interfaces to import meditation and attention data to create artwork in meditation-based applications. Female participants showed statistically significantly different language learning outcomes following three meditation paradigms. The art style of brain painting helped females with language memory. Our results suggest that the most ideal methods for promoting memory attention were meditation methods and brain painting exercises contributing to language learning, memory concentration promotion, and foreign word memorization. We conclude that a short period of meditation practice can help in learning a foreign language. These findings provide insights into meditation, creative language education, brain-computer interface, and human-computer interactions.

Keywords: Brain-computer interface, creative thinking, meditation, mental health.

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Authors: Muhammad Wajid Tahir, Rubina Kauser, Majid Ali Tahir

Abstract:

Pakistani doctors (MBBS) are emigrating towards developed countries for professional adjustments. This study aims to highlight causes and consequences of doctors- brain drain from Pakistan. Primary data was collected from Mayo Hospital, Lahore by interviewing doctors (n=100) through systematic random sampling technique. It found that various socio-economic and political conditions are working as push and pull factors for brain drain of doctors in Pakistan. Majority of doctors (83%) declared poor remunerations and professional infrastructure of health department as push factor of doctors- brain drain. 81% claimed that continuous instability in political situation and threats of terrorism are responsible for emigration of doctors. 84% respondents considered fewer opportunities of further studies responsible for their emigration. Brain drain of doctors is affecting health sector-s policies / programs, standard doctor-patient ratios and quality of health services badly.

Keywords: Brain Drain, Emigration, Remuneration, Politicalinstability, MBBS doctors

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Authors: K. Aloui, M. S. Naceur

Abstract:

The main objective of this paper is to provide an efficient tool for delineating brain tumors in three-dimensional magnetic resonance images. To achieve this goal, we use basically a level-sets approach to delineating three-dimensional brain tumors. Then we introduce a compression plan of 3D brain structures based for the meshes simplification, adapted for time to the specific needs of the telemedicine and to the capacities restricted by network communication. We present here the main stages of our system, and preliminary results which are very encouraging for clinical practice.

Keywords: Medical imaging, level-sets, compression, meshess implification, telemedicine.

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Authors: Terrence Chen, Thomas S. Huang

Abstract:

In this paper, we present the region based hidden Markov random field model (RBHMRF), which encodes the characteristics of different brain regions into a probabilistic framework for brain MR image segmentation. The recently proposed TV+L1 model is used for region extraction. By utilizing different spatial characteristics in different brain regions, the RMHMRF model performs beyond the current state-of-the-art method, the hidden Markov random field model (HMRF), which uses identical spatial information throughout the whole brain. Experiments on both real and synthetic 3D MR images show that the segmentation result of the proposed method has higher accuracy compared to existing algorithms.

Keywords: Finite Gaussian mixture model, Hidden Markov random field model, image segmentation, MRI.

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Authors: Mounira Rouaïnia, Mohamed Salah Medjram, Noureddine Doghmane

Abstract:

In Multiple Sclerosis, pathological changes in the brain results in deviations in signal intensity on Magnetic Resonance Images (MRI). Quantitative analysis of these changes and their correlation with clinical finding provides important information for diagnosis. This constitutes the objective of our work. A new approach is developed. After the enhancement of images contrast and the brain extraction by mathematical morphology algorithm, we proceed to the brain segmentation. Our approach is based on building statistical model from data itself, for normal brain MRI and including clustering tissue type. Then we detect signal abnormalities (MS lesions) as a rejection class containing voxels that are not explained by the built model. We validate the method on MR images of Multiple Sclerosis patients by comparing its results with those of human expert segmentation.

Keywords: EM algorithm, Magnetic Resonance Imaging, Mathematical morphology, Markov random model.

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Authors: K. Aloui, M. S. Naceur

Abstract:

The main objective of this paper is to provide an efficient tool for delineating brain tumors in three-dimensional magnetic resonance images and set up compression-transmit schemes to distribute result to the remote doctor. To achieve this goal, we use basically a level-sets approach to delineating brain tumors in threedimensional. Then introduce a new compression and transmission plan of 3D brain structures based for the meshes simplification, adapted for time to the specific needs of the telemedicine and to the capacities restricted by wireless network communication. We present here the main stages of our system, and preliminary results which are very encouraging for clinical practice.

Keywords: Medical imaging, level-sets, compression, meshessimplification, telemedicine, wireless transmission.

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Authors: Iman A. Elkiweri, Ph.D, Martha C. Tissot van Patot, Ph.D., Yan Ling Zhang, Ph.D., Uwe Christians, Ph.D., Thomas K. Henthorn, M.D.,

Abstract:

Verapamil has been shown to inhibit fentanyl uptake in vitro and is a potent P-glycoprotein inhibitor. Tissue partitioning of loperamide, a commercially available opioid, is closely controlled by the P-gp efflux transporter. The following studies were designed to evaluate the effect of opioids on verapamil partitioning in the lung and brain, in vivo. Opioid (fentanyl or loperamide) was administered by intravenous infusion to Sprague Dawley rats alone or in combination with verapamil and plasma, with lung and brain tissues were collected at 1, 5, 6, 8, 10 and 60 minutes. Drug dispositions were modeled by recirculatory pharmacokinetic models. Fentanyl slightly increased the verapamil lung (PL) partition coefficient yet decreased the brain (PB) partition coefficient. Furthermore, loperamide significantly increased PLand PB. Fentanyl reduced the verapamil volume of distribution (V1) and verapamil elimination clearance (ClE). Fentanyl decreased verapamil brain partitioning, yet increased verapamil lung partitioning. Also, loperamide increased lung and brain partitioning in vivo. These results suggest that verapamil and fentanyl may be substrates of an unidentified inward transporter in brain tissue and confirm that verapamil and loperamide are substrates of the efflux transporter P-gp.

Keywords: Efflux transporter, elimination clearance, partition coefficient, verapamil

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Authors: Sri Sumartiningsih

Abstract:

In elevating performance in competetive sports, an athlete must continously train in achieving maximum performance,but needs to pay attention to recovery therapy, that is to recover from fatigue as well as injury.The correct recovery therapy will assist in process of recovery and helps in the training in achieving better performace. Binahong (Anredera cordifolia) was proven empirically by the locals in assisting speedy recovery from an injury.Clinical research with lab animals receiving blunt trauma injury, microscopically shown signs of: 1) redness, 2) heatiness, 3) swelling and, 4) lack of activity. There is also microscopic indication of: 1) infiltration of inflame cells (migration of cells to the trauma area), 2) Cells necrosis, 3) Congestion (as a result of dead red blood cells), 4) uedema. On administration of Binahong for 3 days, there is a significant drop of 5% in cell inflammation, 2% increase of fibroblast (cell membrance) count.Conclutin: Binahong do assist in reducing cell inflammation and increase counts of cells fibroblast. Suggestion: In helping athlete's to recover from force injury, we need study about Binahong's roots to inflammation cell and healing of injuried cell.

Keywords: Binahong, sport injury, hematoma

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Authors: Yulia Irnidayanti, Win Darmanto, Agus Abadi

Abstract:

research goal was to determine the expression levels cDNA of brain embrio at gestation days 10 (GD-10). The Electroforesis DNA results showed that GAPDH, Fibronectin1, Ncam1, Tenascin, Vimentin, Neurofilament heavy, Neurofilament medium and Neurofilament low were 447 bp, 462 bp, 293 bp. 416 bp, 327 bp, 301 bp, 398 bp and 289 bp. Result of real-time RT-PCR on brain Embryo at gestation days 10 showed that the expression of copy gen Fibronectin 36 copies, Ncam 21,708 copies; Tenascin 24,505 copies; Vimentin 538,554 copies; Neurofilament heavy 2,419 copies; Neurofilament medium 92,928 copies; Neurofilament low 125,809 copies. Vimentin expressed gene copies is very high compared with other gene copies. This condition are caused by Vimentin, that contribute to proliferate of brain development. The vimentin role to cell proliferation of brain.

Keywords: GAPDH, Fibronectin, Ncam, Tenascin, vimentin, Neurofilamen heavy, Neurofilament medium, Neurofilamen low.

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Authors: Xiao Zhou, Kazuhiro Imai, Xiaoxuan Liu

Abstract:

Badminton is one type of racket sports that requires repetitive overhead motion, with the shoulder in abduction/external rotation and requires players to perform jumps, lunges, and quick directional changes. These characteristics could be stressful for body regions that may cause badminton injuries. Regarding racket players including badminton players, there have not been any studies that have utilized medical check-up to evaluate epidemiology and mechanism of injuries. In addition, epidemiology of badminton injury in school age badminton players is unknown. The first purpose of this study was to investigate the badminton injuries, physical fitness parameters, and intensity of shoulder pain using medical check-up so that the mechanisms of shoulder injuries might be revealed. The second purpose of this study was to survey the distribution of badminton injuries in elementary school age players so that injury prevention can be implemented as early as possible. The results of this study revealed that shoulder pain occurred in all players, and present shoulder pain players had smaller weight, greater shoulder external rotation (ER) gain, significantly thinner circumference of upper limbs and greater trunk extension. Identifying players with specific of these factors may enhance the prevention of badminton injury. This study also shows that there are high incidences of knee, ankle, plantar, and shoulder injury or pain in elementary school age badminton players. Injury prevention program might be implemented for elementary school age players.

Keywords: Badminton injury, epidemiology, medical check-up, school age players.

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Authors: N. Fuad, M. N. Taib, R. Jailani, M. E. Marwan

Abstract:

This paper discusses on power spectral density (PSD) characteristics which are extracted from three-dimensional (3D) electroencephalogram (EEG) models. The EEG signal recording was conducted on 150 healthy subjects. Development of 3D EEG models involves pre-processing of raw EEG signals and construction of spectrogram images. Then, the values of maximum PSD were extracted as features from the model. These features are analyzed using mean relative power (MRP) and different mean relative power (DMRP) technique to observe the pattern among different brain balancing indexes. The results showed that by implementing these techniques, the pattern of brain balancing indexes can be clearly observed. Some patterns are indicates between index 1 to index 5 for left frontal (LF) and right frontal (RF).

Keywords: Power spectral density, 3D EEG model, brain balancing, mean relative power, different mean relative power.

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Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

Abstract:

The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: Coronary artery disease, Percutaneous coronary intervention, Myocardial injury, Pharmacology.

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Authors: Kay-Anne Haykal, Issack Biyong

Abstract:

The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: Post-Traumatic Stress Disorder, diagnosis, co-morbidities, mental health disorders.

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