Displaying publications 81 - 100 of 269 in total

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  1. Shariat A, Cleland JA, Danaee M, Alizadeh R, Sangelaji B, Kargarfard M, et al.
    Work, 2018;60(4):549-554.
    PMID: 30103362 DOI: 10.3233/WOR-182762
    BACKGROUND: There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist.

    OBJECTIVE: The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training.

    METHODS: The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined.

    RESULTS: Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P 

    Matched MeSH terms: Heart Rate/physiology
  2. Aimie-Salleh N, Malarvili MB, Whittaker AC
    Med Biol Eng Comput, 2019 Jun;57(6):1229-1245.
    PMID: 30734153 DOI: 10.1007/s11517-019-01958-3
    Adverse childhood experiences have been suggested to cause changes in physiological processes and can determine the magnitude of the stress response which might have a significant impact on health later in life. To detect the stress response, biomarkers that represent both the Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenal (HPA) axis are proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA axis. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analyzed separately. Therefore, the objective of this study is to propose a fusion of ANS and HPA axis biomarkers in order to classify the stress response based on adverse childhood experience. Electrocardiograph, blood pressure (BP), pulse rate (PR), and salivary cortisol (SCort) measures were collected from 23 healthy participants; 11 participants had adverse childhood experience while the remaining 12 acted as the no adversity control group. HRV was then computed from the ECG and the HRV features were extracted. Next, the selected HRV features were combined with the other biomarkers using Euclidean distance (ed) and serial fusion, and the performance of the fused features was compared using Support Vector Machine. From the result, HRV-SCort using Euclidean distance achieved the most satisfactory performance with 80.0% accuracy, 83.3% sensitivity, and 78.3% specificity. Furthermore, the performance of the stress response classification of the fused biomarker, HRV-SCort, outperformed that of the single biomarkers: HRV (61% Accuracy), Cort (59.4% Accuracy), BP (78.3% accuracy), and PR (53.3% accuracy). From this study, it was proven that the fused biomarkers that represent both ANS and HPA (HRV-SCort) able to demonstrate a better classification performance in discriminating the stress response. Furthermore, a new approach for classification of stress response using Euclidean distance and SVM named as ed-SVM was proven to be an effective method for the HRV-SCort in classifying the stress response from PASAT. The robustness of this method is crucial in contributing to the effectiveness of the stress response measures and could further be used as an indicator for future health. Graphical abstract ᅟ.
    Matched MeSH terms: Heart Rate/physiology*
  3. Aminuddin A, Tan I, Butlin M, Avolio AP, Kiat H, Barin E, et al.
    PLoS One, 2018;13(11):e0207301.
    PMID: 30485318 DOI: 10.1371/journal.pone.0207301
    Finger photoplethysmography (PPG) is a noninvasive method that measures blood volume changes in the finger. The PPG fitness index (PPGF) has been proposed as an index of vascular risk and vascular aging. The objectives of the study were to determine the effects of heart rate (HR) on the PPGF and to determine whether PPGF is influenced by blood pressure (BP) changes. Twenty subjects (78±8 years, 3 female) with permanent cardiac pacemakers or cardioverter defibrillators were prospectively recruited. HR was changed by pacing, in a random order from 60 to 100 bpm and in 10 bpm increments. At each paced HR, the PPGF was derived from a finger photoplethysmogram. Cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) were derived from the finger arterial pressure waveform. Brachial blood pressure (BP) was measured by the oscillometric method. This study found that as HR was increased from 60 to 100 bpm, brachial diastolic BP, brachial mean BP and CO were significantly increased (p<0.01), whilst the PPGF and SV were significantly decreased (p<0.001). The effects of HR on the PPGF were influenced by BP, with a decreasing HR effect on the PPGF that resulted from a higher BP. In conclusion, HR was a significant confounder for PPGF and it must be taken into account in analyses of PPGF, when there are large changes or differences in the HR. The magnitude of this effect was BP dependent.
    Matched MeSH terms: Heart Rate*
  4. Malik AA, Williams CA, Weston KL, Barker AR
    J Sports Sci Med, 2019 03;18(1):1-12.
    PMID: 30787646
    High-intensity interval exercise (HIIE) may not elicit prominent unpleasant feelings even with elevated perceived exertion and physiological stress in adolescents. However, the influence of different HIIE work intensities on the affective experience and cardiorespiratory responses is unknown. This study examined the acute affective, enjoyment, perceived exertion and cardiorespiratory responses to HIIE with different work intensities in adolescents. Participants (n = 16; 8 boys; age 12.0 ± 0.3 years) performed, on separate days, HIIE conditions consisting of 8 x 1-minute work-intervals at 70%, 85%, or 100% peak power separated by 75 seconds recovery at 20 W. Affect, enjoyment and rating of perceived exertion (RPE) were recorded before, during, and after HIIE. Heart rate (HR) and oxygen uptake were collected during HIIE. Affect declined in all conditions (p < 0.01) but 100%HIIE elicited significantly lower affect than 70%HIIE and 85%HIIE at work-interval 8 (all p < 0.02, ES > 1.74; 70%HIIE = 2.5 ± 0.8; 85%HIIE = 1.1 ± 1.5; 100%HIIE = -1.5 ± 1.4 on feeling scale). Similar enjoyment was evident during and after all conditions (all p > 0.44). RPE was significantly higher during 100%HIIE than 70%HIIE and 85%HIIE across all work-intervals (all p < 0.01, ES > 1.56). The majority of the participants attained ≥90%HRmax during 85%HIIE (87%) and 100%HIIE (100%), but not during 70%HIIE (6%). Affect responses during HIIE are dependent on the intensity of the work-interval and are not entirely negative (unpleasant feelings). Despite similar enjoyment, positive affect experienced during 70%HIIE and 85%HIIE could serve as a strategy to encourage exercise adoption and adherence in adolescents, but only 85%HIIE elicits sufficient HR stimulus to facilitate potential health benefits.
    Matched MeSH terms: Heart Rate/physiology
  5. Md Lazin Md Lazim MR, Aminuddin A, Chellappan K, Ugusman A, Hamid AA, Wan Ahmad WAN, et al.
    PMID: 32290168 DOI: 10.3390/ijerph17072591
    Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers.
    Matched MeSH terms: Heart Rate/physiology*
  6. Wolkow AP, Rajaratnam SMW, Wilkinson V, Shee D, Baker A, Lillington T, et al.
    Sleep Health, 2020 06;6(3):366-373.
    PMID: 32340910 DOI: 10.1016/j.sleh.2020.03.005
    OBJECTIVES: This study examined the influence of a wrist-worn heart rate drowsiness detection device on heavy vehicle driver safety and sleep and its ability to predict driving events under naturalistic conditions.

    DESIGN: Prospective, non-randomized trial.

    SETTING: Naturalistic driving in Malaysia.

    PARTICIPANTS: Heavy vehicle drivers in Malaysia were assigned to the Device (n = 25) or Control condition (n = 34).

    INTERVENTION: Both conditions were monitored for driving events at work over 4-weeks in Phase 1, and 12-weeks in Phase 2. In Phase 1, the Device condition wore the device operated in the silent mode (i.e., no drowsiness alerts) to examine the accuracy of the device in predicting driving events. In Phase 2, the Device condition wore the device in the active mode to examine if drowsiness alerts from the device influenced the rate of driving events (compared to Phase 1).

    MEASUREMENTS: All participants were monitored for harsh braking and harsh acceleration driving events and self-reported sleep duration and sleepiness daily.

    RESULTS: There was a significant decrease in the rate of harsh braking events (Rate ratio = 0.48, p 

    Matched MeSH terms: Heart Rate/physiology*
  7. Jahan I, Begum M, Akhter S, Islam Z, Haque M, Jahan N
    J Popul Ther Clin Pharmacol, 2020 06 11;27(2):e68-e77.
    PMID: 32543162 DOI: 10.15586/jptcp.v27i2.675
    Alternate nostril breathing (ANB) is one of the best and easiest breathing exercises. ANB exercise has beneficial effects on cardiac function in healthy and diseased people. The objectives of this study were to assess the effects of ANB exercise on cardiac physiology among healthy medical students. This was a prospective interventional study that was conducted in the Department of Physiology, Chittagong Medical College (CMC), Chattogram, Bangladesh, from July 2017 to June 2018. A total of 100 research participants (RPs) aged 18-20 years, Year-I medical students of CMC, were selected. A simple random sampling method was adopted. The selection was done after the inclusion and exclusion criteria were applied. The age and body mass index (BMI) of the RPs were analogous in both the control and experimental groups. Cardiac parameters, like pulse and blood pressure (BP), were measured. The initial baseline data were recorded for both groups and after 4 weeks. The research respondents of the experimental group performed ANB exercise for 4 weeks. The mean value pulse and BP were significantly (p < 0.001) changed after breathing exercise, compared to the values before the breathing exercise. The results of this study suggest that cardiac function significantly improves after the breathing exercise. Therefore, ANB can be recommended for increasing cardiac efficiency.
    Matched MeSH terms: Heart Rate/physiology
  8. Husain R, Cheah SH, Duncan MT
    Singapore Med J, 1996 Aug;37(4):398-401.
    PMID: 8993142
    The investigation examined the possibility that observance of Ramadan by Moslems in Malaysia is associated with modification of circulatory parameters. Cardiovascular reactivity was investigated employing the cold hand immersion test as the stressor stimulus. Resultant data showed increased blood pressures and vascular resistance during Ramadan in the absence of cold stimulus while the magnitude of the maximal cardiac and vascular response to the applied stressor which served as indicators of reactivity was not affected by the Ramadan situation.
    Matched MeSH terms: Heart Rate/physiology
  9. Khoo KL, Tan H, Liew YM, Sambhi JS, Aljafri AM, Hatijah A
    Med J Malaysia, 2000 Dec;55(4):439-50.
    PMID: 11221155
    The paper presents the results of a health screening programme conducted in 10 major centers in Malaysia--Kuala Lumpur, Penang, Ipoh, Johor Bahru, Alor Star, Kuala Terengganu, Malacca, Kota Bahru, Kuching and Kota Kinabalu during the National Heart Weeks, 1995-1997. There were 6,858 participants of both sexes aged between 6 years to 81 years old. The parameters involved in the screening programme were body mass index, blood pressure, heart rate, cholesterol and glucose. The following are the results of the study:- 1. The mean and standard deviation for the body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC) and non fasting (random) blood glucose (GL) of the volunteers studied were 24.3 +/- 4.0 kg/m2, 128.3 +/- 21.1 mmHg, 79.6 +/- 11.9 mmHg, 77.2 +/- 12.1 bpm, 5.33 +/- 1.37 mmol/l and 5.11 +/- 1.97 mmol/l respectively. 2. There was a rising trend for BMI, SBP, DBP, TC and GL with age. The HR was higher in the younger age group of those below 20 years. Males tended to have higher mean values than females except for HR which was similar in both sexes. 3. The Malays, Chinese and Indians seemed to have closely similar mean values for SBP, DBP and HR but the Indians possessed the highest BMI (25.62 +/- 3.90 kg/m2), TC (5.61 +/- 1.48 mmol/l) and GL (5.41 +/- 2.43 mmol/l) among the three major ethnic groups. While the Ibans had highest TC (6.07 + 1.09 mmol/l), their GL level was the lowest (4.76 +/- 1.15 mmol/l). The Kadazans had the lowest TC level (4.94 +/- 1.39 mmol/l) among all the ethnic groups. 4. Among the participants screened, 31.9% were overweight (BMI > or = 25), 7.6% were obese (BMI > or = 30); 26.8% had raised SBP (> or = 140 mmHg) and 19.3% had raised DBP (> or = 90 mmHg); 13.6% of the participants had increased HR (> or = 90 bpm), 22% had raised TC (> or = 6.20 mmol/l) and 2% had raised GL (> or = 11.00 mmol/l). There was a higher prevalence for abnormal values with increasing age until between the ages of 60 or 70 years, when the values began to fall. 5. Age was positively correlated with SBP (r = 0.41***, df = 4351), DBP (r = 0.27***, df = 4351), TC (r = 0.22***, df = 3303) and GL (r = 0.16***, df = 2442) but negatively correlated with HR (r = -0.13***, df = 4351). The BMI was positively correlated with SBP (r = 0.29***, df = 2769), DBP (r = 0.31***, df = 2769), TC (r = 0.16***, df = 2137) and GL (r = 0.11**, df = 1637) but there was no correlation with HR (r = 0.03NS, df = 2771). The SBP and DBP were highly correlated with each other (r = 0.75***, df = 4351) and they also showed highly significant positive correlation (r = 0.08***-0.13***, df = 2441-3301) with TC and GL. TC was positively correlated with GL (r = 0.05* df = 2319) but only at the 5% probability level.
    Matched MeSH terms: Heart Rate*
  10. Chin KW, Chin NM, Chin MK
    Med J Malaysia, 1994 Jun;49(2):142-8.
    PMID: 8090093
    Three millilitres of plain 0.5% bupivacaine were injected intrathecally at two different spinal interspaces (L2/3 and L4/5) and at two different speeds (15 and 30 sec) in four groups of ten patients. Injection at L2/3 over 15 sec produced a significantly higher mean maximum spread of analgesia (T6.4) when compared to injection at L4-5 over 15 sec (T10.3) (P < 0.05). Over the same interspace L2/3, injection over 15 sec also produced a higher level of spread as compared to the 30 sec group (p < 0.05). At 15 min there was a greater fall in blood pressure in the L2/3 15 sec group when compared to the other groups (p < 0.01). There was a further decrease in the blood pressure in L2/3 15 sec and L4/5 30 sec groups after 30 minutes of blockade (p < 0.01). Therefore close monitoring of cardiovascular parameters must be continued for at least 30 min in spinal anaesthesia with bupivacaine.
    Matched MeSH terms: Heart Rate/drug effects
  11. Abdul-Kadir NA, Mat Safri N, Othman MA
    Int J Cardiol, 2016 Nov 01;222:504-8.
    PMID: 27505342 DOI: 10.1016/j.ijcard.2016.07.196
    BACKGROUND: The feasibility study of the natural frequency (ω) obtained from a second-order dynamic system applied to an ECG signal was discovered recently. The heart rate for different ECG signals generates different ω values. The heart rate variability (HRV) and autonomic nervous system (ANS) have an association to represent cardiovascular variations for each individual. This study further analyzed the ω for different ECG signals with HRV for atrial fibrillation classification.

    METHODS: This study used the MIT-BIH Normal Sinus Rhythm (nsrdb) and MIT-BIH Atrial Fibrillation (afdb) databases for healthy human (NSR) and atrial fibrillation patient (N and AF) ECG signals, respectively. The extraction of features was based on the dynamic system concept to determine the ω of the ECG signals. There were 35,031 samples used for classification.

    RESULTS: There were significant differences between the N & NSR, N & AF, and NSR & AF groups as determined by the statistical t-test (p<0.0001). There was a linear separation at 0.4s(-1) for ω of both databases upon using the thresholding method. The feature ω for afdb and nsrdb falls within the high frequency (HF) and above the HF band, respectively. The feature classification between the nsrdb and afdb ECG signals was 96.53% accurate.

    CONCLUSIONS: This study found that features of the ω of atrial fibrillation patients and healthy humans were associated with the frequency analysis of the ANS during parasympathetic activity. The feature ω is significant for different databases, and the classification between afdb and nsrdb was determined.

    Matched MeSH terms: Heart Rate/physiology*
  12. Rajikin MH
    Med J Malaysia, 1980 Sep;35(1):46-52.
    PMID: 6973059
    Seven non-anthletes [21-26 yrs] and five athletes [23-29 yrs] have participated in the study of cardiovascular and metabolic responses to 15 minutes isometric leg exercise at 15% of each of their maximal voluntary contraction force [MVC]. Oxygen consumption [V02 ]. heart rate [HR] and blood pressure (BP]. were measured during resting. exercise and recovery! periods. The results show that there were a significant increase in V02. HR and BP of the two groups studied during exercise, but no significant difference between groups has been found. This study indicates that although cardiovascular response between the rwo groups was not significantly different, 15 minutes isometric leg exercise at 15% MVC has challenged this system in a such a way to fulfill the metabolic requirement of the
    working muscle ill both groups. This finding was
    discussed in light of the available literatures.
    Matched MeSH terms: Heart Rate*
  13. Chang P, Koh YK, Geh SL, Soepadmo E, Goh SH, Wong AK
    J Ethnopharmacol, 1989 Apr;25(2):213-5.
    PMID: 2747255
    Matched MeSH terms: Heart Rate/drug effects
  14. Poznanski RR, Cacha LA, Al-Wesabi YMS, Ali J, Bahadoran M, Yupapin PP, et al.
    Sci Rep, 2017 May 31;7(1):2746.
    PMID: 28566682 DOI: 10.1038/s41598-017-01849-3
    A model of solitonic conduction in neuronal branchlets with microstructure is presented. The application of cable theory to neurons with microstructure results in a nonlinear cable equation that is solved using a direct method to obtain analytical approximations of traveling wave solutions. It is shown that a linear superposition of two oppositely directed traveling waves demonstrate solitonic interaction: colliding waves can penetrate through each other, and continue fully intact as the exact pulses that entered the collision. These findings indicate that microstructure when polarized can sustain solitary waves that propagate at a constant velocity without attenuation or distortion in the absence of synaptic transmission. Solitonic conduction in a neuronal branchlet arising from polarizability of its microstructure is a novel signaling mode of electrotonic signals in thin processes (<0.5 μm diameter).
    Matched MeSH terms: Heart Rate/physiology
  15. Jahan I, Begum M, Akhter S, Islam MZ, Jahan N, Samad N, et al.
    Ann Afr Med, 2021 7 3;20(2):69-77.
    PMID: 34213471 DOI: 10.4103/aam.aam_114_20
    Introduction: Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.

    Materials and Methods: This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.

    Results: Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females' PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001-0.028) and females (P < 0.001-0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.

    Conclusion: The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.

    Matched MeSH terms: Heart Rate/physiology*
  16. Ahmad AA, Douay G, Low MR, Fabbri S, Chen HC
    Vet Anaesth Analg, 2021 May;48(3):380-387.
    PMID: 33827780 DOI: 10.1016/j.vaa.2021.02.003
    OBJECTIVE: To assess the efficacy of butorphanol-azaperone-medetomidine (BAM) and butorphanol-midazolam-medetomidine (BMM) protocols for immobilization of wild common palm civets (Paradoxurus musangus) with subsequent antagonization with atipamezole.

    STUDY DESIGN: Prospective, randomized, blinded clinical trial.

    ANIMALS: A total of 40 adult wild common palm civets, 24 female and 16 male, weighing 1.5-3.4 kg.

    METHODS: The civets were randomly assigned for anesthesia with butorphanol, azaperone and medetomidine (0.6, 0.6 and 0.2 mg kg-1, respectively; group BAM) or with butorphanol, midazolam and medetomidine (0.3, 0.4 and 0.1 mg kg-1, respectively; group BMM) intramuscularly (IM) in a squeeze cage. When adequately relaxed, the trachea was intubated for oxygen administration. Physiological variables were recorded every 5 minutes after intubation. Following morphometric measurements, sampling, microchipping and parasite treatment, medetomidine was reversed with atipamezole at 1.0 or 0.5 mg kg-1 IM to groups BAM and BMM, respectively. Physiological variables and times to reach the different stages of anesthesia were compared between groups.

    RESULTS: Onset time of sedation and recumbency was similar in both groups; time to achieve complete relaxation and tracheal intubation was longer in group BAM. Supplementation with isoflurane was required to enable intubation in five civets in group BAM and one civet in group BMM. All civets in group BAM required topical lidocaine to facilitate intubation. End-tidal carbon dioxide partial pressure was lower in group BAM, but heart rate, respiratory rate, rectal temperature, peripheral hemoglobin oxygen saturation and mean arterial blood pressure were not different. All civets in both groups recovered well following administration of atipamezole.

    CONCLUSIONS AND CLINICAL RELEVANCE: Both BAM and BMM combinations were effective for immobilizing wild common palm civets. The BMM combination had the advantage of producing complete relaxation that allowed intubation more rapidly.

    Matched MeSH terms: Heart Rate/drug effects
  17. Yusof S, Ismail A, Alias MS
    Mar Pollut Bull, 2014 Aug 30;85(2):494-8.
    PMID: 24731878 DOI: 10.1016/j.marpolbul.2014.03.022
    Glyphosate is globally a widely used herbicide, yet there is little information on their toxicity to marine fishes. Java medaka, a small tropical fish native to coastal areas in several Southeast Asian countries, is viewed as a suitable candidate for toxicity test and thus was used for this study. Java medaka adults were cultured in the laboratory and the fertilized eggs of the F2 generation were exposed to different concentrations of glyphosate-based herbicide (100, 200, 300, 400 and 500 ppm) until they hatched. The survival and hatching rates of the embryos, changes in the heart rate and morphological impairments were recorded. Generally, survival and hatching percentage decreased as glyphosate concentration increased. Absence of pectoral fin(s) and cornea, permanently bent tail, irregular shaped abdomen, and cell disruption in the fin, head and abdomen are among the common teratogenic effects observed. Furthermore, risk factor also increased with the increased in glyphosate concentrations.
    Matched MeSH terms: Heart Rate/drug effects
  18. Yussof SJM, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH
    Med J Malaysia, 2012 Aug;67(4):406-11.
    PMID: 23082451
    INTRODUCTION: The importance of early recognition and treatment of sepsis and its effects on short-term survival outcome have long been recognized. Having reliable indicators and markers that would help prognosticate the survival of these patients is invaluable and would subsequently assist in the course of effective dynamic triaging and goal directed management.
    STUDY OBJECTIVES: To determine the prognosticative value of Shock Index (SI), taken upon arrival to the emergency department and after 2 hours of resuscitation on the shortterm outcome of severe sepsis and septic shock patients.
    METHODOLOGY: This is a retrospective observational study involving 50 patients admitted to the University of Malaya Medical Centre between June 2009 and June 2010 who have been diagnosed with either severe sepsis or septic shock. Patients were identified retrospectively from the details recorded in the registration book of the resuscitation room. 50 patients were selected for this pilot study. The population comprised 19 males (38%) and 31 females (62%). The median (min, max) age was 54.5 (17.0, 84.0) years. The number of severe sepsis and septic shock cases were 31 (62%), and 19 (38%) respectively. There were 17 (34%) cases of pneumonias, 13 (26%) cases of urological sepsis, 8 (16%) cases of gastro intestinal tract related infections and 12 (24%) cases of other infections. There were a total of 23 (46%) survivors and 27 (54%) deaths. The value of the shock index is defined as systolic blood pressure divided by heart rate was calculated. Shock Index on presentation to ED (SI 1) and after 2 hours of resuscitation in the ED (SI 2). The median, minimum and maximum variables were tested using Mann-Whitney U and Chi square analysis. The significant parameters were re-evaluated for sensitivity, specificity and cut-off points. ROC curves and AUC values were generated among these variables to assess prognostic utility for outcome.
    RESULTS: Amongst all 7 variables tested, 2 were tested to be significant (p: < 0.05). From the sensitivity, specificity and ROC analysis, the best predictor for death was (SI 2) with a sensitivity of 80.8%, specificity of 79.2%, AUC value of 0.8894 [CI 95 0.8052, 0.9736] at a cut-off point of > or = 1.0.
    CONCLUSION: (SI 2) may potentially be utilized as a reliable predictor for death in patients presenting with septic shock and severe sepsis in an emergency department. This parameters should be further analyzed in a larger scale prospective study to determine its validity.
    Matched MeSH terms: Heart Rate*
  19. Wong KI, Ho MM
    PMID: 19162703 DOI: 10.1109/IEMBS.2008.4649200
    Extended patient monitoring has become increasingly important for detection of cardiac conditions, such as irregularities in the rhythms of the heart, while patient is practicing normal daily activity. This paper presents a design of a single lead wireless cardiac rhythm interpretive instrument that capable of capture the electrocardiogram (ECG) in digital format and transmitted to a remote base-station (i.e. PC) for storage and further interpretation. The design has achieved high quality of ECG and free of interference in the presence of motion.
    Matched MeSH terms: Heart Rate/physiology*
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