Gender comparison of cardiac autonomic functions as measured by heart rate variability in a tertiary care hospital

Background: Medical students experience immense mental stress while understanding and retaining new terms, drug names and mechanisms and eventually generating a concept. Such stress, in long run, may affect their cardiovascular health. This can be assessed by heart rate variability, a reliable non-penetrating tool to determine the cardiac autonomic tone. Material and methods: Thirty healthy young male medical students of BPKIHS, Nepal of age 21.03 ± 1.73 years, and BMI 20.83 ± 2.07 kg/m2 were recruited for the present study. Their resting BP, HR, RR, and short-term heart rate variability (HRV) were recorded in sitting position. Each subject was given a mental stress for 5 min. Their BP, HR, and RR were recorded at 5th min of mental stress. HRV of 5 min was also recorded simultaneously during mental stress. Results: Mental stress increased SBP (p=0.001), DBP (p= 0.001), PR (p= 0.005) and RR (p= 0.042) in young male medical students. Time domain measures of HRV viz; RMSSD (p= 0.001), NN50 (p= 0.001) and PNN50 (p=0.001), which are markers of parasympathetic activity, were significantly decreased during mental stress. Conclusion: Acute mental stress increases BP and HR by withdrawing parasympathetic nervous control in young, healthy male medical students.

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Anesthesia with mask free sleep inducing balloon in pediatric patients; A tertiary care hospital experience

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v39i1.50449 ◽

2020 ◽

Vol 39 (1) ◽

pp. 19-23

Author(s):

Abul Kalam Azad ◽

Mozibul Haque ◽

Aminul Islam

Keyword(s):

Heart Rate ◽

Oxygen Saturation ◽

Behavioral Problems ◽

Induction Time ◽

Pediatric Patients ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Function Of Sleep ◽

Mean Heart Rate

Introduction: Children are habitually frightened and become combative during the induction of anesthesia. It is challenging for pediatric anesthesiologists to minimize psychological upset by reducing scaring environment of operating room and to facilitate a smooth induction of anesthesia. Use of force to handle severely anxious and scared children may lead to postoperative behavioral problems. Purpose: There is an immense need to develop a simple device to ensure mask free and stress-less induction for children. Sleep Inducing Balloon is the mask-free and stress-less anesthesia delivery system designed for children which is not only fulfilling the criteria of ideal breathing system but also replaces anxiety with amusement and fear with fun! Methods: A study was conducted among 100 children between 6 months to 7 years of age, during the period of Apr 2018 to Dec 2018 to find out the induction time of Sleep Inducing Balloon who were scheduled for elective short surgical procedure under general anaesthesia having ASA grading I and II. While doing so, children receive constant gas mixture of 5L oxygen mixed with 5% sevoflurane till fall asleep. Results: A total 100 patients were included in this study to record induction time, heart rate and oxygen saturation to validate the function of Sleep Inducing Balloon. Mean age of the children was 3.50±1.04 years, mean weight was 10.7±3.24 Kgs and mean heart rate was 120±8.3/min. Most of the children had ASA grade-I (96%) and oxygen saturation was 99%. Induction time was 60-80 seconds in 26% patients, and 81-100 seconds in 45% of the children. In 24% children the induction time was 101-120 seconds, 5% children took more than two minutes for induction. There was no failure and adverse events were easy to manage. Conclusion: Mask free sleep inducing balloon is a safe and successful way of anesthetic induction in pediatric patients. The procedure ensures a stress-free peaceful event in frightened children. J Bangladesh Coll Phys Surg 2021; 39(1): 19-23

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Evaluation of role of heart rate variability with holter monitoring in chronic kidney disease

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202264 ◽

2020 ◽

Vol 8 (6) ◽

pp. 2188

Author(s):

Naveen Reddy Avula ◽

Tusahr Dighe ◽

Atul Sajgure ◽

Charan Bale ◽

Pavan Wakhare

Keyword(s):

Chronic Kidney Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Kidney Disease ◽

Kidney Diseases ◽

Tertiary Care ◽

Holter Monitoring ◽

Stage Iii ◽

Care Hospital ◽

Ckd Stage

Background: Chronic kidney disease is prevalent disease even in absence of diabetes and hypertension in 12% adults over 65 yrs of age. Autonomic imbalance is not studied in detail which could be a risk factor for chronic kidney disease.Methods: This Study was observational study in a tertiary care Hospital in pune, india and was conducted for a period of 1 year with sample size of 52. All subjects were known cases of chronic kidney disease from stage III to VD. All individuals of age >18yrs and eGFR ≤60ml/min/1.73m2 according to CKD- EPI equation were included in the study and who were not giving consent were excluded. 24 hrs Holter monitoring was done in stages from ckd stages III to V, for ckd stage VD on both Hemodialysis day and Non hemodialysis. Analysis was done using SPSS version 20 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The paired t test, analysis of variance (ANOVA) and Chi-square test were used. Level of significance was set at p≤0.05.Results: In this study when Heart rate variability (HRV) parameters were compared in different stages of ckd from stage III to VD (on Hemodialysis day) SDNN, SDNN Index were found to be statistically significant and on non Hemodialysis day SDNN Index was found to be statistically significant. In each subgroup of ckd stage V when diabetic subjects were compared with non-diabetic subjects, HRV parameters like ratio of P/S which was found to be low and significant in ckd stage V diabetic subjects.Conclusions: Chronic kidney disease itself can affect the HRV parameters. Causal relationship between HRV and chronic kidney diseases can be vice versa and further needs larger and prospective studies.

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Screening autonomic functions in patients with restless legs syndrome: A case-control study in a tertiary care hospital

Autonomic Neuroscience ◽

10.1016/j.autneu.2021.102924 ◽

2021 ◽

pp. 102924

Author(s):

Sehnaz Basaran ◽

Erhan Akıncı

Keyword(s):

Restless Legs Syndrome ◽

Case Control Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Control ◽

Care Hospital ◽

Autonomic Functions ◽

Restless Legs ◽

Control Study

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Impact of shorter MDR tuberculosis regimen drugs on heart rate variability in MDR tuberculosis patients at tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212378 ◽

2021 ◽

Vol 10 (7) ◽

pp. 813

Author(s):

Disha S. Patel ◽

Chetankumar R. Acharya

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Nervous System ◽

Repeated Measures ◽

Tertiary Care ◽

Low Frequency ◽

Care Hospital ◽

Active Pulmonary Tuberculosis ◽

Significant Difference ◽

Mdr Tb

Background: Tuberculosis is major cause of death in India. Analysis of heart rate variability is one of the most popular methods of autonomic nervous system evaluation. Shorter MDR-TB regimen drugs affect both central nervous system as well as peripheral nervous system. Existing research suggests that active pulmonary tuberculosis causes ANS dysfunction. So, by HRV measurement impact of shorter MDR-TB regimen drugs on autonomic dysfunction can be correlated. Aim of the current investigation was to evaluate effect of shorter MDR-TB regimen drugs on cardiac autonomic regulation in MDR-TB patients with respect to heart rate variability as a parameter.Methods: Fifty newly diagnosed MDR-TB patients of either gender on shorter MDR- TB regimen were enrolled in this study after taking consent. After 20 minutes rest, ECG was taken by “physiopac digital polygraph” software for 5 minutes. Two follow-up HRV assessments were done on 2nd month and 4th or 6th month of treatment. HRV was calculated by root mean square deviation of successive differences between adjacent RR intervals (RMSSD) and low frequency and high frequency ratio.Results: Repeated measures ANOVA showed no statistically significant difference in HRV parameters between baseline, 2 months and 6 months groups. So, sympathetic and parasympathetic modulation in terms of HRV remains unchanged during treatment of MDR-TB with shorter MDR-TB regimen drugs.Conclusions: Shorter MDR-TB regimen drugs don’t have any significant impact on HRV in MDR- TB patients, No correlation was observed between HRV and heart rate in MDR-TB patients.

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