Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5

Search results for: Manjusha R. Vagal

5 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions

Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

Abstract:

Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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4 Thermodynamic Analyses of Information Dissipation along the Passive Dendritic Trees and Active Action Potential

Authors: Bahar Hazal Yalçınkaya, Bayram Yılmaz, Mustafa Özilgen

Abstract:

Brain information transmission in the neuronal network occurs in the form of electrical signals. Neural work transmits information between the neurons or neurons and target cells by moving charged particles in a voltage field; a fraction of the energy utilized in this process is dissipated via entropy generation. Exergy loss and entropy generation models demonstrate the inefficiencies of the communication along the dendritic trees. In this study, neurons of 4 different animals were analyzed with one dimensional cable model with N=6 identical dendritic trees and M=3 order of symmetrical branching. Each branch symmetrically bifurcates in accordance with the 3/2 power law in an infinitely long cylinder with the usual core conductor assumptions, where membrane potential is conserved in the core conductor at all branching points. In the model, exergy loss and entropy generation rates are calculated for each branch of equivalent cylinders of electrotonic length (L) ranging from 0.1 to 1.5 for four different dendritic branches, input branch (BI), and sister branch (BS) and two cousin branches (BC-1 & BC-2). Thermodynamic analysis with the data coming from two different cat motoneuron studies show that in both experiments nearly the same amount of exergy is lost while generating nearly the same amount of entropy. Guinea pig vagal motoneuron loses twofold more exergy compared to the cat models and the squid exergy loss and entropy generation were nearly tenfold compared to the guinea pig vagal motoneuron model. Thermodynamic analysis show that the dissipated energy in the dendritic tress is directly proportional with the electrotonic length, exergy loss and entropy generation. Entropy generation and exergy loss show variability not only between the vertebrate and invertebrates but also within the same class. Concurrently, single action potential Na+ ion load, metabolic energy utilization and its thermodynamic aspect contributed for squid giant axon and mammalian motoneuron model. Energy demand is supplied to the neurons in the form of Adenosine triphosphate (ATP). Exergy destruction and entropy generation upon ATP hydrolysis are calculated. ATP utilization, exergy destruction and entropy generation showed differences in each model depending on the variations in the ion transport along the channels.

Keywords: ATP utilization, entropy generation, exergy loss, neuronal information transmittance.

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3 Heart Rate Variability in Responders and Non- Responders to Live-Moderate, Train-Low Altitude Training

Authors: Michael J. Hamlin, Apiwan Manimmanakorn, Gavin R. Sandercock, Jenny J. Ross, Robert H. Creasy, John Hellemans

Abstract:

The aim of this study was to compare the effects of an altitude training camp on heart rate variability and performance in elite triathletes. Ten athletes completed 20 days of live-high, train-low training at 1650m. Athletes underwent pre and post 800-m swim time trials at sea-level, and two heart rate variability tests at 1650m on the first and last day of the training camp. Based on their time trial results, athletes were divided into responders and non-responders. Relative to the non-responders, the responders sympathetic-toparasympathetic ratio decreased substantially after 20 days of altitude training (-0.68 ± 1.08 and -1.2 ± 0.96, mean ± 90% confidence interval for supine and standing respectively). In addition, sympathetic activity while standing was also substantially lower post-altitude in the responders compared to the non-responders (-1869 ± 4764 ms2). Results indicate that responders demonstrated a change to more vagal predominance compared to non-responders.

Keywords: parasympathetic predominance, poor performance, triathlon, 800-m swim

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2 Adaptive Filtering of Heart Rate Signals for an Improved Measure of Cardiac Autonomic Control

Authors: Desmond B. Keenan, Paul Grossman

Abstract:

In order to provide accurate heart rate variability indices of sympathetic and parasympathetic activity, the low frequency and high frequency components of an RR heart rate signal must be adequately separated. This is not always possible by just applying spectral analysis, as power from the high and low frequency components often leak into their adjacent bands. Furthermore, without the respiratory spectra it is not obvious that the low frequency component is not another respiratory component, which can appear in the lower band. This paper describes an adaptive filter, which aids the separation of the low frequency sympathetic and high frequency parasympathetic components from an ECG R-R interval signal, enabling the attainment of more accurate heart rate variability measures. The algorithm is applied to simulated signals and heart rate and respiratory signals acquired from an ambulatory monitor incorporating single lead ECG and inductive plethysmography sensors embedded in a garment. The results show an improvement over standard heart rate variability spectral measurements.

Keywords: Heart rate variability, vagal tone, sympathetic, parasympathetic, spectral analysis, adaptive filter.

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1 Detection and Correction of Ectopic Beats for HRV Analysis Applying Discrete Wavelet Transforms

Authors: Desmond B. Keenan

Abstract:

The clinical usefulness of heart rate variability is limited to the range of Holter monitoring software available. These software algorithms require a normal sinus rhythm to accurately acquire heart rate variability (HRV) measures in the frequency domain. Premature ventricular contractions (PVC) or more commonly referred to as ectopic beats, frequent in heart failure, hinder this analysis and introduce ambiguity. This investigation demonstrates an algorithm to automatically detect ectopic beats by analyzing discrete wavelet transform coefficients. Two techniques for filtering and replacing the ectopic beats from the RR signal are compared. One technique applies wavelet hard thresholding techniques and another applies linear interpolation to replace ectopic cycles. The results demonstrate through simulation, and signals acquired from a 24hr ambulatory recorder, that these techniques can accurately detect PVC-s and remove the noise and leakage effects produced by ectopic cycles retaining smooth spectra with the minimum of error.

Keywords: Heart rate variability, vagal tone, sympathetic, parasympathetic, wavelets, ectopic beats, spectral analysis.

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