Cervical root stimulation in the diagnosis of radiculopathy

Cervical root stimulation (CRS) was compared with conventional EMG, nerve conduction, and late response studies in 34 patients with possible cervical radiculopathy. Cervical roots were stimulated by monopolar needles inserted into paraspinal muscles, recording compound muscle action potentials in biceps, triceps, and abductor digiti minimi muscles. In 18 patients with clinical evidence of radiculopathy, EMG was abnormal in 11 (61%), but CRS was abnormal in all 18. Of 16 patients with symptoms but no signs of radiculopathy, EMG was abnormal in 5 (31%) and CRS was abnormal in 9 (56%).     

Classification treesA possible method for iso-resource grouping in intensive care

Classification and grouping of clinical data into defined categories or hierarchies is difficult in intensive care practice. Diagnosis-related groups are used to categorise patients on the basis of diagnosis. However, this approach may not be applicable to intensive care where there is wide heterogeneity within diagnostic groups. Classification tree analysis uses selected independent variables to group patients according to a dependent variable in a way that reduces variation. In this study, the influence of three easily identified patient attributes on their length of intensive care unit stay was explored using classification analysis. Two thousand five hundred and forty-five critically ill patients from three hospitals were classified into groups so that the variation in length of stay within each group was minimised. In 23 out of 39 terminal groups, the interquartile range of the length of stay was ≤ 3 days.     

Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital, the National Trauma Registry of Iran

Purpose: Injuries are one of the leading causes of death and lead to a high social and financial burden. Injury patterns can vary significantly among different age groups and body regions. This study aimed to evaluate the relationship between mechanism of injury, patient comorbidities and severity of injuries. Methods: The study included trauma patients from July 2016 to June 2018, who were admitted to Sina Hospital, Tehran, Iran. The inclusion criteria were all injured patients who had at least one of the following: hospital length of stay more than 24 h, death in hospital, and transfer from the intensive care unit of another hospital. Data collection was performed using the National Trauma Registry of Iran minimum dataset. Results: The most common injury mechanism was road traffic injuries (49.0%), followed by falls (25.5%). The mean age of those who fell was significantly higher in comparison with other mechanisms (p < 0.001). Severe extremity injuries occurred more often in the fall group than in the vehicle collision group (69.0% vs. 43.5%, p < 0.001). Moreover, cases of severe multiple trauma were higher amongst vehicle collisions than injuries caused by falls (27.8% vs. 12.9%, p = 0.003). Conclusion: Comparing falls with motor vehicle collisions, patients who fell were older and sustained more extremity injuries. Patients injured by motor vehicle collision were more likely to have sustained multiple trauma than those presenting with falls. Recognition of the relationship between mechanisms and consequences of injuries may lead to more effective interventions.     

The Effect of Foot Reflexology on the Quality of Sexual Life in Hemodialysis Patients: A Randomized Controlled Clinical Trial

Sexuality and Disability - Sexual problems of hemodialysis patients are one of the most significant factors affecting their quality of life and families. On the other hand, an essential part of the...     

Abnormal single motor unit behavior in the upper motor neuron syndrome

We studied the discharge pattern of single motor units (SMUs) in the left and right biceps muscles from a patient with nonspastic weakness of the left arm. Detailed statistical analysis of the behavior of discharge patterns of 4 of 4 single motor units on the affected side showed abnormalities with characteristic features of an upper motor neuron lesion. Five out of 5 single motor units recorded from the right biceps were normal. An upper motor neuron lesion affecting the left arm, predicted by our results, was confirmed by magnetic resonance imaging (MRI), which showed a lesion in the right precentral gyrus. It appears that changes in single motor unit firing characteristics, caused by an upper motor neuron lesion, can be detected at a time when there is no evidence of increased "tone" and/or hyperreflexia (spasticity) in the affected extremity.     

Automated sleep staging of OSAs based on ICA preprocessing and consolidation of temporal correlations

An automated sleep staging based on analyzing long-range time correlations in EEG is proposed. These correlations, indicating time-scale invariant property or self-similarity at different time scales, are known to be salient dynamical characteristics of stage succession for a sleeping brain even when the subject suffers a destructive disorder such as Obstructive Sleep Apnea (OSA). The goal is to extract a set of complementary features from cerebral sources mapped onto the scalp electrodes or from a number of denoised EEG channels. For this purpose, source localization/extraction and noise reduction approaches based on Independent Component Analysis were used prior to correlation analysis. Feature extracted segments were then classified in one of the five classes including WAKE, STAGE1, STAGE2, SWS and REM via an ensemble neuro-fuzzy classifier. Some techniques were employed to improve the classifier’s performance including Scaled Conjugate Gradient Method to speed up learning the ANFIS classifiers, a pruning algorithm to eliminate irrelevant fuzzy rules and the 10-fold cross-validation technique to train and test the system more efficiently. The performance of classification for two strategies including (1) feature extraction from effective cerebral sources and (2) feature extraction from selected channels of denoised EEG signals was compared and contrasted in terms of training errors and test accuracies. The first and second strategies achieved 92.23 and 88.74% agreement with human expert respectively which indicates the effectiveness of the staging system based on cerebral sources of activity. Our results further indicate that the misclassification rates were almost below 10%. The proposed automated sleep staging system is reliable due to the fact that it is based on the underlying dynamics of sleep staging which is less likely to be affected by sleep fragmentations occurred repeatedly in OSA.     

Applicability of Universal Thermal Climate Index (UTCI) in occupational heat stress assessment: a case study in brick industries

The present study aimed to investigate the applicability of Universal Thermal Climate Index (UTCI) as an innovative and science-based index in public health researches, in occupational heat stress assessment. All indoor and outdoor workers (200 people) of Brick industries of Shahroud, Iran participated in the research. First, the environmental variables such as air temperature, wet-bulb temperature, globe temperature, air velocity and relative humidity were measured; then UTCI and WBGT (wet-bulb globe temperature) indices were calculated. Simultaneously, physiological parameters including systolic and diastolic blood pressure, oral temperature, skin temperature, tympanic temperature and heart rate of workers were measured. UTCI and WBGT indices were 34.2 ± 2°C, 21.8 ± 1.8°C in the outdoor environments and 38.1 ± 4.4°C, 24.7 ± 3.3°C at the indoor environments, respectively. There were the weak inverse relationships between UTCI and WBGT indices at the outdoor environments and physiological responses such as systolic blood pressure, and diastolic blood pressure. However, there were no similar results for indoor environments. The significant relationships were found between UTCI and WBGT at both indoor and outdoor environments. Both UTCI and WBGT indices are suitable for assessing the occupational heat stress. Although, UTCI index seems more appropriate for heat stress assessment in the environments with low humidity and air velocity.