Journal of Arak University of Medical Sciences

Enhancement and Denoising of ECG Signals using Adaptive Kalman Filter

Masoomeh Ashoorirad

Background: Electrocardiogram signal (ECG) is a graphical representation of the heart activity. Processing and analysis of these morphological changes can result in visual diagnosing some cardiac diseases. However, various types of noises and disturbances in ECG influence the visual recognition and feature extraction from it. The aim of this research is to eliminate different noises from ECG and to enhance its quality.

Materials and Methods: In this study, an adaptive Kalman filter is developed by using Bayesian model. Considering simplification and Gaussian distribution for measurement noise, complicated mathematical equations were converted to simple relations and therefore implementation was simplified.

Results: In this paper, by designing an adaptive Kalman filter, the signal to noise ratio (SNR) has increased to 21.46dB. Adaptive Kalman filter based on Beyesian framework could model dynamic variations of ECG signal by estimating covariance matrix for measurement noise.

Conclusion: In despite of Kalman filters that use parametric functions to model ECG signal, the adaptive Kalman filter introduced in this paper uses real ECG records for modeling. Parametric functions which could model dynamic variations of ECG need a lot of analytical functions and this decreases the time of filtering process but the adaptive Kalman filter proposed in this research has a high speed and could be used in real time applications.

Reducing the Morphine Induced Conditioned Place Preference Acquisition by Inhibition of Glial Cells in the Hippocampus

Narges Hosseinmardi

Background: Considering the increased activity of hippocampal glial cells due to chronic morphine administration and the involvement of hippocampus in restoration of the addictive drug-associated experience, the role of these cells on morphine induced conditioned place preference (CPP) was investigated.

Materials and Methods: In this experimental study, four groups of animals were evaluated. After habituation to CPP apparatus on the first day, conditioning was done by injection of morphine (5 mg/kg) or its vehicle (saline) during three consecutive days. On the fifth day, the time spent in each compartment of CPP cage and locomotor activity was recorded for 20 min. To investigate the role of hippocampal glial cells in CPP, these cels were inbibited by bilaterally injecting fluorocitrate (1nmol/1ml), before each morphine injection. CPP testing in this group and animals received fluorocitrate vehicle (Phosphate buffer saline) was done before morphine injection.

Results: Fluorocitrate pretreatment reduced morphine induced conditioned place preference acquisition, so that a significant decrease was observed in conditioning score (unpaired t-test, p<0.01) in this group (n=8) compared to animals received morphine (n=9). Neither morphine nor fluorocitrate pretreatment did not affect locomotor activity (ANOVA, p>0.05).

Conclusion: The results suggest that glial cells in the hippocampus are involved in morphine induced conditioned place preference.

Effect of Retention Suture on Emergent Abdominal Laparotomy Wound Dehiscence

Syamak Rakei Isfahani

Background: Despite advances in surgical techniques and risk management practices in recent years, wound dehiscence following abdominal laparotomy has still high prevalence. The purpose of this study is to evaluate the effect of retention sutures on wound dehiscence of emergent abdominal laparotomy.

Materials and Methods: In this randomized clinical trial study, 160 patients scheduled for emergency laparotomy for peritonitis or trauma were enrolled. Half of the patients randomly underwent retention suture and the other half underwent routine sutures. Finally, the amount of surgical wound dehiscence and complications were assessed.

Results: Three patients (3.7%) in retention group and 11 patients (13.7%) in the control group developed wound dehiscence which there was a significant difference between them (p=0.025). It was determined by multivariate logistic regression that wound dehiscence is correlated with hemodynamic status, type of trauma and injury to the abdominal organs, and sex. The incidence of wound dehiscence, early hemodynamic instability, penetrating abdominal trauma and damage to the intestines were higher in males.

Conclusion: In general, it seems that the preventive use of retention sutures in patients with multiple risk factors for postoperative wound dehiscence can be useful.

Comparison of the Efficacy of Castor Oil and Vaginal Misoprostol With Vaginal Misopostol Alone for Treatment of Missed Abortion

Mehri Jamilian

Background: Missed abortion refers to pregnancy products remain dead with age less than 20 weeks in the womb for several weeks. This study was designed to evaluate the efficacy of castor oil on cervical ripening in the treatment of abortion.

Materials and Methods: This triple blind clinical trial was done on 72 women with missed abortion who were divided into two groups of 36 patients based on odd or even numberd of cases. The case groups received 800 mg vaginal misoprostol and 60 ml castor oil mixed with fruit juice and control groups received 800 mg vaginal misoprostol and 60 ml placebo with fruit juice, respectively. In both groups, if needed, 3 doses of vaginal suppository 800 mg were repeated with at least 24 hours. After the disposal of pregnancy products, sonography and curettage were performed if necessary.

Results: During the intervening period, the time of the opening of the cervix in the intervention group was shorter than control group and there was a statistically significant difference (p=0.032). Also, the control group required a higher frequency of administration of misoprostol than intervention group and the difference was statistically significant (p = 0.037).

Conclusion: It seems that the castor oil can be effective on cervical ripening for treatment of abortion.

The Combined Effects of Pilates Training and Apium Graveolens Seed Supplement on the Levels of Inflammatory Monocyte Chemoattractant Protein -1 and C-Reactive Protein in Sedentary Women

Masoumeh Habibian

Background: Inflammation plays an important role in the pathogenesis of atherosclerosis and change in lifestyle represents a successful strategy to prevent cardiovascular disease. Therefore, the present study investigated the combined effects of regulae Pilates training and Apium Graveolens seed supplement on monocyte chemoattractant protein-1(MCP-1) and C-reactive protein (CRP) in sedentary women.

Materials and Methods: In this quasi-experimental study, 28 healthy sedentary woman with age average 31±5.5 years old are selected in a convenience sampling way and randomely divided into and control, exercise, supplement and exercise+supplement groups. Pilates exercise was consisted of exercise movements at 50% to 80% maximal heart rate in, 3 sessions per week for 8 weeks. Supplement and exercise+supplement groups consumed 1.3 gr Apium Graveolens seed capsule three times a day after meals. Fasting blood samples were collected before and 48 hours after the last interventions. MCP-1 and CRP levels were measured by ELISA method.

Results: Eight weeks of Pilates exercise, supplementation and the combined intervention were associated with a significant increase in MCP-1 and CRP levels (p<0.05). Furthermore Pilates exercise and combined intervention were associated with significantly greater increases in percent changes of the MCP-1 and CRP compared to supplement group (p<0.05).

Conclusion: These findings suggest that the protective effect of Pilates exercise and Apium Graveolens seed supplementation non-drug interventions might in part be due to suppression of the inflammatory processes.

Total Suspended Solids Removal from Leachate using Electrochemical, Fenton and Electro-Fenton Processes

Mohadeseh Mosayebi

Background: The growth of population, improvement of quality of life and the development of industries have led to increase in the rate of urban and industrial waste. As the leachate of the waste has a lot of pollution, influences harmfully human health and the environment. Researches have shown that the advanced oxidation processes (AOPs) such as Fenton and Fenton-related processes can reduce chemical oxygen demand (COD) of the leachate effectively.

Materials and Methods: In this paper, the rate of decrease in the total suspended solids (TSS) of leachate from a composting facility in Isfahan was studied using electrochemical, Fenton and electro-Fenton processes. These processes were conducted at reaction times 0, 20, 40, and 60 minutes, with the currents of 0.5, 1 and 1.5A and hydrogen peroxide dosages 1000, 2000, and 3000 mg/L.

Results: In the three mentioned processes, the most TSS removal was observed at the first 40 minute of the reactions. Among the studied processes, the electro-Fenton removed up to 92.4% of the TSS and was recognized as the most effective method. Furthermore, electrochemical and Fenton removed 41.7% and 60.3% of the TSS, respectively.

Conclusion: Therefore, decreasing the TSS of leachate could change its qualities and reduce the leachate pollution and the adverse environmental effects.

To Compare the Effect of Ultrasound Guided Local Injection of Dexamethasone with Dexamethasone Phonophoresis for Treatment of Lateral Epicondylitis (Tennis Elbow)

Farzaneh Johari

Background: Lateral epicondylitis may cause pain and functional disability in many daily activities. Steroid injection or phonophoresis are the recommended treatments in this regard. In this study, we aim to compare the effect of ultrasound guided local injection of dexamethasone with dexamethasone phonophoresis for treatment of lateral epicondylitis.

Materials and Methods: In this clinical trial, patients with lateral epicondylitis were randomely assigned to injection (n=18) and phonophoresis (n=18) groups. Three patients in phonophoresis group dropped out from the study. In injection group, dexamethasone with lidocaine was injected once with the guide of sonography at the base of common extensor tendon. Phonophoresis group received 5 minutes treatment with ultrasound using dexamethasone gel for 10 sessions. Patients’ pain in total and in specific and usual activities according to PRTEE questionnaire before, one and three months after treatment was calculated.

Results: Injection group compared to phonophoresis had significantly better improvement in pain (p=0.04), but there was no significant difference in serial changes of functional subscale and total score of PRTEE between groups. Injection group compared to phonophoresis had also better pain and total score one month after treatment (p=0.003 and p=0.01, respectively).

Conclusion: Dexamethasone injection compared to phonophoresis had significant improvement in patients’ pain which was more apparent one month after treatment, but the results were similar between groups three months after treatment.

The Effect of Quercetin on Skin Wound Healing in Dexamethasone-Treated Rats

Iran Goudarzi

Background: Corticosteroids as dexamethasone are used for treating non-specific inflammatory diseases, however, may result in delayed wound healing due to its catabolic effects in skin. Thus, the purpose of the present study was to investigate the effect of quercetin on delayed wound healing in dexamethasone-treated rats.

Materials and Methods: In this experimental study, 40 male Wistar rats were used. After dermal incisions within a distance of 1.5 mm to the spinal column (30 mm length), rats were treated with 0.17 mg/kg dexamethasone, 50 mg/kg quercetin or both until 21 days. Wound healing was evaluated by measuring surface area, percentage of healing, wound length, duration of healing, and wound tensile strength.

Results: Our results showed that the duration of wound healing was significantly increased in dexamethasone treated rats in comparison with control group. In contrast, the rate of healing and skin tensile strength in dexamethasone treated rats receiving quercetin was significantly greater than dexamethasone treated group. In addition, the duration of wound healing in the dexamethasone treated group receiving quercetin was less than dexamethasone group.

Conclusion: This study provides some evidence to support the use of quercetin to accelerating wound healing in dexamethasone treated animals. However, Further research is needed to determine the quercetin mechanisms in acceleration of wound healing.

The Effect of Probiotics on Prevention and Treatment of Metabolic Syndrome-Associated Disorders

Aziz Homayouni Rad

Background: Metabolic syndrome, a concurrence of overweight and abdominal fat distribution, disturbed glucose and insulin metabolism, mild dyslipidemia and hypertension is among the most important issues that man deals with, in today's world. Probiotics are live microorganisms which, when administered in adequate amounts, can confer a health benefit on the host. The aim of the present study was to review the clinical evidence available regarding the role of probiotics in improvement of disorders associated with metabolic syndrome.

Materials and Methods: In this research, clinical trials performed between 2000-2014 were searched in two databases, Pubmed and ScienceDirect. In both databases “Probiotics”, “metabolic syndrome” and each of its elements were used as the key words.

Results: Probiotics may reduce body weight through manipulating the gut flora. Through reducing inflammation and immune-regulation, probiotics decrease insulin resistance. They also improve lipid profile through reducing cholesterol absorption and producing short chain fatty acids, as well as deconjugating bile acids and converting cholesterol to coprostanol. Moreover, probiotics have been suggested to have a hypotensive effect through release of angiotensin-converting enzyme inhibitory peptides, through proteolytic action.

Conclusion: Although some clinical trials have failed to obtain beneficial effects of probiotics on metabolic syndrome related situations, a majority of the studies have shown positive results for these microorganisms in this regard. Thus, probiotics can be looked upon as a novel approach when either prevention or alleviation of metabolic syndrome is aimed.

Lack of Association between Nodular Throid Disease and rs1256049 Polymorphism of Estrogen Receptor Beta Gene in Women from Markazi Province

Abdorrahim Sadeghi

Background: Thyroid nodules are common. 4-7% of adults have a palpable nodule and up to 50-70% of nodules are detected in high-resolution sonography. Thyroid nodules in women are 4 times greater than men and the rate of thyroid cancer in women is 3:1 compared to men, and is the sixth most common cancer in women. Epidemiological findings and experimental evidences show that sex hormones, especially estrogen, may have effect on this gland and its neoplasm. The aim of this study was to investigate the association between rs1256049 polymorphism in the estrogen receptor beta gene with thyroid nodular disease.

Materials and Methods: In this case-control study, 146 Patients with nodular thyroid and 151 health individuals were referred to Amiralmomenin hospital of Arak were recruited in study. Diagnosis is based on by ultrasonography and was confirmed by an endocrinologist. Genomic DNA was extracted from EDTA treated whole blood .The genotypes were determined using tetra-amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) and analyzed by statistical methods.

Results: The frequency of CC, TC and TT genotypes in case group 136(93.2%), 10(6.8%) and 0(0%) and in the control group 139(92.1%), 12(7.9%) and 0(0%) were obtained respectively. No statistically significant association (p=0.72) was observed between nodular thyroid disease and rs1256049 polymorphism.

Conclusion: Our findings showed no significant association between rs1256049 polymorphism and nodular thyroid disease. For best deduction, it is recommended that this study be done in other populations.