Increased sample asymmetry and memory of cardiac time-series following endotoxin administration in cirrhotic rats

Sepsis, and other causes of acute systemic inflammation, can reduce heart rate variability (HRV) and increase cardiac cycle regularity in mammals. Thus, HRV monitoring has been used for early detection of sepsis in adults and neonates. Liver cirrhosis is associated with reduced basal HRV and the development of tolerance to the cardiac chronotropic effects of bacterial endotoxin. This may pose limitations on the use of heart rate monitoring in early detection of sepsis in this patient population. In a study to develop a physiomarker for the detection of sepsis in cirrhosis, we observed that endotoxin administration in adult cirrhotic rats leads to the development of transient heart rate decelerations, a phenomenon which has been reported in neonates with sepsis, and quantified using sample asymmetry analysis. In the present study, cirrhosis was induced by surgical ligation of the bile duct in rats. Cirrhotic rats were given intraperitoneal injections of either saline or endotoxin (1 mg kg(-1)). Changes in sample asymmetry and memory length of cardiac time-series were studied in conscious rats using implanted telemetric probes. Cirrhotic (but not control) rats exhibited increased sample asymmetry following endotoxin injection, which was consistent with the development of transient heart rate deceleration. Endotoxin administration in cirrhotic rats was associated with prolongation of memory length for observing decelerating perturbations in the cardiac rhythm. These findings may have application in the development of an HRV monitoring system for early detection of sepsis in cirrhosis

Body temperature fluctuation analysis in cirrhosis

We recently reported that patients with cirrhosis exhibit an abnormal pattern in their skin temperature variability, with complexity analysis of skin temperature fluctuations distinguishing inpatients from outpatients, despite similar mean temperature values [1]. Patients with cirrhosis also exhibit abnormalities in circadian rhythmicity, part of which are of central origin [2]. Therefore, we wondered if abnormalities in skin temperature fluctuations may reflect abnormalities in core body temperature (CBT) regulation in these patients. To test this hypothesis, we analysed CBT data that we had previously recorded in control rats and rats with cirrhosis [3]. This article is protected by copyright. All rights reserved

THE EFFECT OF Z-TRACK AND AIR - LOCK INJECTIONS ON THE INTENSITY OF PAIN IN PATIENTS REFERRING TO SABZEVAR HESHMATIYYAH CLINIC

Muscular injections are one of the most common medical procedures and nurses encounter the experience of pain in their patients and look for ways of reducing pain. This quasi-experimental research was conducted to study the effects of Z-track and air-lock injection methods on the intensity of pain. 585 women referring to Heshmatiyyah Clinic in Sabzevar, Iran for either of three injections (Penicillin, B-complex, Diclophenac) were randomly assigned into three groups of 195 members; in each group, 65 patients received Ztrack 65 air-lock and the last 65 routine methods of injection in lateral position. Visual scale was utilized for pain assessment. Findings revealed that in Z-track group, intensity of pain was 3.1; while it was 4.1 and 4.5 in air-lock and routine injection groups; the difference was found to be significant by one -way ANOVA. Severe pain was experienced by 4.1 in Ztrack group, 7.7 in air-lock and 14.4 in the routine injection methods; Chi-squre revealed a significant relationship between pain intensity and injection method (P<0.0001). However, no significant relationship was found to exist between intensity of pain and factors such as age, occupation, education, and BMI. Therefore, it is suggested that we make use of Z-track injection for the ease of patients

Malnutrition and anthropometric measurements among elderly people with cardiovascular diseases

Background: Aging is accompanied by physiologic changes that can negatively impact nutritional status. Progressive under nutrition during aging is associated with early death. Some food avoidance could complicate nutritional status during chronic diseases in elderly people. Objective: The aim of this study was to compare malnutrition among elderly people with and without cardiovascular diseases (CVDs). Method: This case-control study was conducted on 64 healthy elder subjects (as a control group) and 64 elderly patients with CVDs (as a case group) in Shiraz (2017). Demographic and mini nutritional assessment (MNA) questionnaires were completed for each participant. Anthropometric data (weight, BMI, waist, hip, arm and calf circumferences) were measured. Findings: Malnutrition distribution was significantly different between two groups based on MNA score (P<0.001) and 48 (75%) of healthy elderly participants and 18 (28.1%) of patients weren’t malnourished. Risk of malnutrition was 35 (54.7%) and 16 (25%) in unhealthy and healthy groups respectively. Only 11 (17.2%) of elderly patients with CVDs were malnourished. Conclusion: Malnutrition rate increased in elderly patients with CVDs compared to healthy old group. It seems that food avoidance of the disease is the cause of higher malnutrition rate. Attention to the balance and adequacy of macronutrient intake in a personal diet of CVDs patients can be a method to prevent progression of malnutrition in old patients

Designing of Anti keratin Antibody kit by Immuno fluorescent assay (IFA) and it's evaluation in Rheumatoid Arthritis (RA) pathients

Background and purpose: Rheumatoid Arthritis (RA) is a systemic auto immune Rheumatoid diseases. Auto antibodies are detected in this disease, with diagnostic and prognostic properties. One of them is AKA which reacts with the fibrous keratin in epiderm and the stratum corneum of rat esophageal epithelium. Hence at first AKA – IFA kit was designed, then its sensitivety and specificity was measured, and the titer of Anti body was evaluated in RA patients, and finaly the results of AKA were compared with that of RF test.Materials and method: AKA-IFA kit was designed with protein antigens in the stratum corneum of rat esophageal and anti human IgG conjugated to FITC.52 patients with RA (mean age 48.0 ±15.8) according to the American College of Rheumatology (ACR) criteria were selected for measuring the sensitivity and specificity. The results of AKA test in sera of RA patients were campared with 23 sera of patient control groupe (mean age 32.5 ±16.4) and 30 sera of healthy control groupe (mean age 32.1 ±16.9). Inter and intra assay method was used to determinig precision of AKA kit. RF test was also performed and it's results compared with result of designed AKA kit.Results: AKA were found in 75% of patients with RA (39/52), 13% of patient control groupe (3/23) and 3.3% of healthy control groupe .(YBO)The designed AKA kit by inter and intra assay method had 100% and 98% percision respectively. The sensitiviety and specificity of AKA in (1/10) serum dilution was 75% and 92.5% respectively but sensitiviety and specificity of RF was 88.5% , 86.8% respectively. Conclusion: According to the results, IFA– AKA test could be diagnostic and confirmative for RA , And AKA in (1/10)serum dilution has the best diagnostic Value for RA. (cut off)