Correction of Pulmonary Arteriovenous Malformation Using Image-Based Surgical Planning

The objectives of this study were to develop an image-based surgical planning framework that 1) allows for in-depth analysis of pre-operative hemodynamics by the use of cardiac magnetic resonance and 2) enables surgeons to determine the optimum surgical scenarios before the operation. This framework is tailored for applications in which post-operative hemodynamics are important. In particular, it is exemplified here for a Fontan patient with severe left pulmonary arteriovenous malformations due to abnormal hepatic flow distribution to the lungs. Patients first undergo cardiac magnetic resonance for 3-dimensional anatomy and flow reconstruction. After analysis of the pre-operative flow fields, the 3-dimensional anatomy is imported into an interactive surgical planning interface for the surgeon to virtually perform multiple surgical scenarios. Associated hemodynamics are predicted by the use of a fully validated computational fluid dynamic solver. Finally, efficiency metrics (e.g., pressure decrease and hepatic flow distribution) are weighted against surgical feasibility to determine the optimal surgical option

Assessment of cutaneous parameters and sympathetic skin response as a non-invasive complementary diagnostic tool in psoriasis: An exploratory study

Background: Various diagnostic tools are used to assess cutaneous psoriasis, but most of it were subjective. Sympathetic skin response (SSR), skin PH and temperature objectively measure the skin barrier functions that could aid clinicians to evaluate accurately and predict skin disease incidence even before the onset of clinical symptoms. Aim and Objectives: The study's objective was to assess the utility of cutaneous parameters (skin temperature and pH) and SSRs influencing psoriatic patients' diagnosis management and treatment compared to controls. Materials and Methods: A total of 40 healthy participants and 40 psoriasis patients aged 18 to 65 years were recruited for this study. SSR, skin temperature and pH were assessed. The psoriasis disability index (PDI) was recorded from all the patients. Data analysis was carried out using SPSS version 20.0. Results: The results shows significantly increased skin temperature, prolonged SSR latency (bilaterally) and decreased SSR amplitude (bilaterally) among patients affected with psoriasis compared to control subjects. There is a positive correlation between SSR latency with PDI and a negative correlation between SSR amplitude and PDI in psoriasis patients. Conclusion: SSR reveals sympathetic sudomotor dysfunction and increased skin temperature in psoriasis. Furthermore, there is a link between increased SSR latency and PDI, which shows that local nervous system impairment significantly contributes to the inflammatory process in psoriasis. Thus, SSR can be used as a complementary tool for the early identification and assessment of epidermal barrier integrity in psoriasis patients, along with the clinician's standard protocols

Effect of yoga intervention on short-term heart rate variability in children with autism spectrum disorder

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interactions, communication, restricted, and repetitive behaviors. Evidence-based treatment options for ASD are limited. Yoga is practiced by over 20 million people worldwide, and multiple studies have investigated yoga as a possible effective intervention for children with ASD. Aim: The aim of this study is to investigate the effect of yoga intervention on short-term heart rate variability (HRV) in children with ASD. Methodology: In this study, 50 children (38 boys and 12 girls) with ASD were recruited from Swabhimaan Trust, Palavakkam, Chennai. They were randomly grouped into ASD with yoga intervention group (n = 25) and ASD without yoga intervention group (n = 25) by simple lottery method. Yoga group children underwent yoga training for 3 months, and the control group did not receive any such training. For short-term HRV, 15 min electrocardiogram recording in sitting posture was recorded in lead II using a simple analog amplifier. Results: In HRV, time domain parameters such as mean RR interval (0.72 [0.74] to 0.94 [0.92]), standard deviation of the NN intervals (52.04 [54.23] to 74.48 [72.80]), and root of the mean squared differences of successive NN interval (32.60 [34.40] to 40.83 [42.90]) significantly increased in ASD children after yoga intervention. In frequency-domain parameters, high frequency (HF) in n. u (48.08 [47.24] to 58.37 [59.22]) shows a significant increase and low frequency (LF) in n. u (52.4 [51.82] to 40.51 [40.12]), and LF/HF ratio (1.29 [1.31] to 0.78 [0.79]) shows a significant decrease in ASD with yoga intervention group children after 3 months of yoga training. Conclusion: Yoga interventions have been successful in bringing parasympathetic dominance in ASD children, and the greater advantage is being a noninvasive way of intervention to support children with ASD and help them to achieve physiological as well as psychological balance