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Ahuja H, Badhwar S, Edgell H, Litoiu M, Sergio LE. Machine learning algorithms for detection of visuomotor neural control differences in individuals with PASC and ME. Front Hum Neurosci 2024; 18:1359162. [PMID: 38638805 PMCID: PMC11024369 DOI: 10.3389/fnhum.2024.1359162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
The COVID-19 pandemic has affected millions worldwide, giving rise to long-term symptoms known as post-acute sequelae of SARS-CoV-2 (PASC) infection, colloquially referred to as long COVID. With an increasing number of people experiencing these symptoms, early intervention is crucial. In this study, we introduce a novel method to detect the likelihood of PASC or Myalgic Encephalomyelitis (ME) using a wearable four-channel headband that collects Electroencephalogram (EEG) data. The raw EEG signals are processed using Continuous Wavelet Transform (CWT) to form a spectrogram-like matrix, which serves as input for various machine learning and deep learning models. We employ models such as CONVLSTM (Convolutional Long Short-Term Memory), CNN-LSTM, and Bi-LSTM (Bidirectional Long short-term memory). Additionally, we test the dataset on traditional machine learning models for comparative analysis. Our results show that the best-performing model, CNN-LSTM, achieved an accuracy of 83%. In addition to the original spectrogram data, we generated synthetic spectrograms using Wasserstein Generative Adversarial Networks (WGANs) to augment our dataset. These synthetic spectrograms contributed to the training phase, addressing challenges such as limited data volume and patient privacy. Impressively, the model trained on synthetic data achieved an average accuracy of 93%, significantly outperforming the original model. These results demonstrate the feasibility and effectiveness of our proposed method in detecting the effects of PASC and ME, paving the way for early identification and management of the condition. The proposed approach holds significant potential for various practical applications, particularly in the clinical domain. It can be utilized for evaluating the current condition of individuals with PASC or ME, and monitoring the recovery process of those with PASC, or the efficacy of any interventions in the PASC and ME populations. By implementing this technique, healthcare professionals can facilitate more effective management of chronic PASC or ME effects, ensuring timely intervention and improving the quality of life for those experiencing these conditions.
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Affiliation(s)
- Harit Ahuja
- School of Information Technology, York University, Toronto, ON, Canada
| | - Smriti Badhwar
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Marin Litoiu
- School of Information Technology, York University, Toronto, ON, Canada
- Lassonde School of Engineering, York University, Toronto, ON, Canada
| | - Lauren E. Sergio
- School of Information Technology, York University, Toronto, ON, Canada
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Patel C, Deepak KK. Differential role of central and peripheral arterial stiffness in determining brachial artery resting retrograde flow in patients with ischemic heart disease vs healthy subjects. J Hum Hypertens 2023; 37:803-812. [PMID: 36224323 DOI: 10.1038/s41371-022-00762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 11/09/2022]
Abstract
Retrograde flow in endothelial cell cultures has been shown to induce a pro-atherogenic phenotype. Despite its potential role as a pathophysiological link between cardiovascular risk factors and atherosclerotic disease, resting retrograde flows between patients with cardiovascular disease and healthy subjects have not been compared. Further, the vascular characteristics governing retrograde flow in human arteries have not been systematically investigated. Association of central and peripheral vascular characteristics with retrograde flow profile was investigated in 32 healthy subjects and 47 patients with ischemic heart disease. Endothelial dysfunction was assessed by brachial ultrasound-based calculation of flow-mediated dilation (FMD) and sub-clinical atherosclerosis was estimated from carotid-intima media thickness (CIMT). Retrograde blood flow velocity (RBFV) and shear rate were comparable between the two groups (RBFV 1.82(0.97-3.32) vs 1.78(1.24-2.65) cm/s p = 0.79). Augmentation index was a significant determinant of retrograde flow in both patients and healthy subjects. Carotid artery incremental elastic modulus was an independent determinant of retrograde flow patterns in healthy subjects while ejection fraction, cf/cr PWV ratio and forearm vascular conductance emerged as independent determinants in patients. Retrograde flow patterns were also associated with FMD (RBFV r = -0.43, p = 0.004) and CIMT (r = 0.30, p = 0.041) in patients. The results of the study suggest a difference in the determinants of retrograde flow in patients and healthy subjects, with central arterial stiffness being a major contributor in healthy subjects while interaction between central, peripheral, and cardio-arterial factors influence retrograde flow in patients with ischemic heart disease.
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Affiliation(s)
- Smriti Badhwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Ashok K Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chetan Patel
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Banodhe GK, Badhwar S, Sharma HB, Deepak KK. Assessment of baroreflex sensitivity during isometric handgrip exercise and oscillatory lower body negative pressure. J Taibah Univ Med Sci 2023; 18:868-875. [PMID: 36852235 PMCID: PMC9957788 DOI: 10.1016/j.jtumed.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/10/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
Objectives Baroreflex sensitivity (BRS) is an estimate of autonomic control of cardiovascular system via the baroreflex arc. It has been suggested that exercise pressure reflex and muscle metaboreflex override baroreflex during exercise to decrease baroreflex gain, which facilitates the simultaneous rise in blood pressure (BP) and heart rate during the exercise. This study investigated the effects of isometric handgrip exercise (IHE) on baroreflex gain and frequency dependence of baroreflex sensitivity while fluctuations in arterial BP were generated. Methods Thirteen healthy men performed IHE at 20% and 30% of their maximum voluntary contraction (MVC), while oscillatory lower body negative pressure (OLBNP) of 40 mmHg was applied in 0.1 and 0.25 Hz frequencies. Results Compared to the OLBNP at 0.25 Hz frequency alone, the baroreflex gain for diastolic BP (DBP) was significantly reduced with the addition of IHE at 20% and 30% of MVC in the high frequency band. At rest (without IHE and OLBNP) the baroreflex gain was significantly more in the high frequency band for DBP, but the baroreflex gain for DBP was not significantly different when IHE + OLBNP were applied at 20% and 30% of MVC in both frequencies. Conclusions The significant reduction of DBP baroreflex gain with the addition of graded IHE might indicate that exercise pressure reflex and muscle metaboreflex override baroreflex during exercise to decrease baroreflex gain at a high frequency band (0.25 Hz). The frequency-dependent phenomenon of BRS was altered when IHE and OLBNP were applied, meaning that the frequency dependence of BRS was nullified during IHE.
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Affiliation(s)
- Gagan K. Banodhe
- Department of Physiology, All India Institute of Medical Science, Room no. 3106, Tatibandh, Raipur, Chhattisgarh 492001, India,Corresponding address: Department of Physiology, AIIMS, Raipur, India.
| | - Smriti Badhwar
- Women's Cardiovascular Health Lab, York University, Toronto, Canada
| | | | - Kishore K. Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Patel C, Deepak KK. Brachial Artery "Low-Flow Mediated Constriction" Is Associated with Myocardial Perfusion Defect Severity and Mediated by an Altered Flow Pattern during Occlusion. Pulse (Basel) 2022; 9:99-108. [PMID: 35083176 DOI: 10.1159/000519558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/08/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction The relationship between low flow-mediated constriction (LFMC), a new proposed measure of endothelial function, with cardiovascular disease severity and its hypothesized stimulus, that is, low flow, has not been comprehensively evaluated. The study evaluated association between change in brachial artery diameter during constriction with severity of myocardial perfusion defect (PD) and alterations in different components of flow profile. Methods Brachial artery responses to occlusion were assessed in 91 patients and 30 healthy subjects. Change in anterograde and retrograde blood flow velocities (delta anterograde blood flow velocity and retrograde blood flow velocity), anterograde shear rate and retrograde shear rate (delta ASR and RSR, respectively), and oscillatory shear index (delta) during forearm occlusion at 50 mm Hg above systolic pressure, from baseline was calculated. Myocardial perfusion was evaluated in patients using exercise single positron emission computed tomography and % myocardial PD was calculated from summed stress score. Results LFMC emerged as independent predictor of defect severity after correcting for age and gender (p = 0.014). Sixty-seven patients (73.6%) and 15 healthy subjects (50%) showed constriction during occlusion. In stepwise backward regression analysis, RSR contributed 35.5% and ASR contributed 20.1% of the total 63.9% variability in artery diameter during occlusion. Conclusion The results suggest that LFMC is independently associated with myocardial perfusion severity and is "mediated" by an altered flow profile during occlusion.
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Affiliation(s)
- Smriti Badhwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok K Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chetan Patel
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Talapatra K, Chadha P, Deshpande M, Mistry R, Vadgaonkar R, Mhatre V, Pilakkal S, Goyle S, Limaye S, Shaikh I, Badhwar S. PO-0827: Hypofractionated image guided re-irradiation in head - neck cancers; an Indian experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00844-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Srivastava P, Badhwar S, Chandran DS, Jaryal AK, Jyotsna VP, Deepak KK. Improvement in Angiotensin 1-7 precedes and correlates with improvement in Arterial stiffness and endothelial function following Renin-Angiotensin system inhibition in type 2 diabetes with newly diagnosed hypertension. Diabetes Metab Syndr 2020; 14:1253-1263. [PMID: 32688242 DOI: 10.1016/j.dsx.2020.06.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM Studies in cell cultures and animal models have revealed the possible pathophysiological factors associated with vascular endothelial dysfunction. However, the same in human subjects has not been clearly established. The current study uses a novel approach to identify the factors associated with endothelial function and arterial function by altering these vascular parameters using Angiotensin-Converting-Enzyme (ACE) inhibition. METHODS Diabetic patients with newly diagnosed hypertension (n = 60) were recruited for the study. Flow-mediated-dilation (FMD), carotid-femoral (cf), carotid-radial (cr) Pulse-wave-velocity (PWV), Augmentation-Index, Carotid-Intima-Media-Thickness (CIMT), serum levels of Renin, Angiotensin II (AngII), Angiotensin-Converting-Enzyme2 (ACE2), Angiotensin1-7 (Ang1-7), E-selectin, Vascular-Cell-Adhesion-Molecule-1 (VCAM-1), Highly-sensitive-C-Reactive-Protein (hsCRP) and Interleukin-10 were measured at baseline (V1), after 1 week (V2) and 3 months (V3) of ACE inhibition in patients of diabetes with newly diagnosed hypertension. The amplitude of change after 1 week (V2-V1) and 3 months (V3-V1) for the clinical and various parameters were correlated with the change in endothelial function and arterial stiffness. RESULTS Carotid radial-PWVV2-V1 (p = 0.001) and Ang1-7V2-V1 (p = 0.01) emerged as independent predictors of FMDV2-V1. ReninV2-V1 and VCAM-1V2-V1 independently predicted E-selectinV2-V1 [(p = 0.01) and (p = 0.001), respectively]. ACE 2V2-V1 was the only independent predictor of cf-PWVV2-V1. The same parameters remained as independent predictors of the respective vascular factors after 3 months of ACE inhibition. CONCLUSION The study highlights the role of AngII/Ang1-7 balance in alteration of endothelial function and central arterial stiffness in humans in addition to identifying the interrelationship between the renin-angiotensin-aldosterone-system components and clinically ascertainable parameters.
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Affiliation(s)
- Prachi Srivastava
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Badhwar
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Viveka P Jyotsna
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
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Badhwar S, Chandran D, Jaryal A, Narang R, Patel C, Deepak KK. P10 Oscillatory Flow Patterns in Peripheral Conduit Artery are Related to Central Arterial Stiffness in Healthy Subjects. Artery Res 2020. [DOI: 10.2991/artres.k.191224.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Badhwar S, Chandran D, Jaryal A, Narang R, Patel C, Deepak KK. P.02 Differential ‘Mediators’ of Low-Flow ‘Mediated’ Constriction in Healthy vs Patients of Ischemic Heart Disease. Artery Res 2020. [DOI: 10.2991/artres.k.201209.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Singh A, Badhwar S, Chandran D, Jaryal A, Deepak KK. P.10 Distal Arterial Occlusion at Different Grades of Supra-Systolic Pressures Differentially Modulates Flow Velocity and Shear Rates in Radial Artery. Artery Res 2020. [DOI: 10.2991/artres.k.201209.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Badhwar S, Chandran D, Jaryal A, Narang R, Patel C, Deepak KK. 2.5 Differential Association of Central and Peripheral Arterial Compliance with Resting and Recruitable Endothelial Function in Healthy Human Subjects. Artery Res 2020. [DOI: 10.2991/artres.k.191224.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Srivastava P, Badhwar S, Chandran DS, Jaryal AK, Jyotsna VP, Deepak KK. Imbalance between Angiotensin II - Angiotensin (1-7) system is associated with vascular endothelial dysfunction and inflammation in type 2 diabetes with newly diagnosed hypertension. Diabetes Metab Syndr 2019; 13:2061-2068. [PMID: 31235137 DOI: 10.1016/j.dsx.2019.04.042] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/22/2019] [Indexed: 12/30/2022]
Abstract
AIM Diabetes is associated with Renin-angiotensin-aldosterone-system (RAAS) activation. Protective role of Angiotensin (1-7) has been recently identified. The study aims to identify associations between imbalance in RAAS components with vascular endothelial dysfunction and inflammation in diabetics with newly diagnosed hypertension. METHODS Brachial Flow-mediated-dilation (FMD), Carotid Intima-media-thickness (CIMT), pulse-wave-velocity (PWV), Serum E-selectin, Vascular-Cell-Adhesion-Molecule-1 (VCAM-1), high-sensitivity C-Reactive Protein (hsCRP), Interleukin-10 (IL-10), Renin, AngiotensinII, Angiotensin-Converting-Enzyme 2 (ACE2) and Angiotensin1-7 were measured in 60 diabetic patients with newly diagnosed hypertension. Patients with AngiotensinII/Angiotensin1-7 ratio <1 were classified as Favourable-Axis (FA) group (n = 22) and those with ratio >1 were classified as Unfavourable-Axis (UA) group (n = 38). RESULTS hsCRP was higher [9.52 (4.64-16.19) vs 3.62 (1.77-13.09) (mg/l), p = 0.04], IL-10 was lower [2.26 (1.34-12.05) vs 10.98 (4.44-17.78) (pg/ml),p = 0.006], %FMD was lower [(5.51 ± 2.97) vs (7.66 ± 3.38) (%), p = 0.01] and CIMT was higher in UA compared to FA group [0.7 (0.55-0.79) vs 0.51 (0.49-0.65) (mm), p = 0.001]. Renin correlated positively with pressure, PWV, E-selectin and VCAM-1, opposing associations were obtained for Angiotensin1-7 and ACE2. CONCLUSION Imbalance between AngiotensinII - Angiotensin1-7 is associated with increased inflammation and vascular dysfunction in diabetics and can contribute to development of hypertension in these patients.
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Affiliation(s)
- Prachi Srivastava
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Badhwar
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Ashok Kumar Jaryal
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Viveka P Jyotsna
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Autonomic & Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Badhwar S, Chandran D, Jaryal A, Narang R, Patel C, Deepak KK. Uncoupling of Feedforward Control on Blood Pressure by Heart Rate in Patients with Recent Myocardial Infarction. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.885.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Smriti Badhwar
- PhysiologyAll India Institute of Medical SciencesNew DelhiNew DelhiIndia
| | - Dinu Chandran
- PhysiologyAll India Institute of Medical SciencesNew DelhiNew DelhiIndia
| | - Ashok Jaryal
- PhysiologyAll India Institute of Medical SciencesNew DelhiNew DelhiIndia
| | - Rajiv Narang
- CardiologyAll India Institute of Medical SciencesNew DelhiNew DelhiIndia
| | - Chetan Patel
- Nuclear MedicineAll India Institute of Medical SciencesNew DelhiNew DelhiIndia
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Deepak KK. Regional arterial stiffness in central and peripheral arteries is differentially related to endothelial dysfunction assessed by brachial flow-mediated dilation in metabolic syndrome. Diab Vasc Dis Res 2018; 15:106-113. [PMID: 29283006 DOI: 10.1177/1479164117748840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The interrelationship between endothelial function and arterial stiffness may be different for central and peripheral arteries due to their structural and functional differences. The study aims to assess the interrelationship between central and peripheral vascular function and haemodynamics in metabolic syndrome. Thirty-seven patients [63.0 (57.5-66.0) years, 68.4% males] of metabolic syndrome (National Cholesterol Education Program - Adult Treatment Panel-III criteria) were studied. Carotid-femoral, carotid-radial pulse wave velocity and augmentation index (AIx@75) were assessed using applanation tonometry. Endothelial function was evaluated by brachial flow-mediated dilation using B-mode ultrasonography. Central and peripheral pressures were measured by radial tonometry and sphygmomanometer, respectively. Carotid-radial pulse wave velocity correlated significantly with peripheral diastolic blood pressure ( r = 0.33, p = 0.04) and inversely with flow-mediated dilation ( r = -0.61, p = 0.0001). AIx@75 correlated significantly with carotid-femoral pulse wave velocity ( r = 0.35, p = 0.03) and with aortic pulse pressure ( r = 0.43, p = 0.01). In principal component analysis, an inverse relationship was observed between flow-mediated dilation and carotid-radial pulse wave velocity but not with carotid-femoral pulse wave velocity. Regional arterial stiffness assessed by pulse wave velocity in central-elastic and peripheral-muscular arteries differentially relates to endothelial dysfunction. The central arteries might be predominantly influenced by endothelial dysfunction-induced structural changes, while the peripheral arteries are majorly affected by functional alterations.
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Affiliation(s)
- Smriti Badhwar
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- 2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- 1 Autonomic and Vascular Function Lab, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Yadav K, Singh A, Badhwar S, Jaryal AK, Coshic P, Chatterjee K, Deepak KK. Decreased Spontaneous Baroreflex Sensitivity as an Early Marker for Progression of Haemorrhage. High Blood Press Cardiovasc Prev 2017; 24:275-281. [PMID: 28497338 DOI: 10.1007/s40292-017-0205-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/28/2017] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Blood donation provides an ideal setup for assessment of cardiovascular responses to mild hypovolemia for understanding the underlying mechanisms. AIM To evaluate cardiovascular responses in time and magnitude by estimating the spontaneous baroreflex sensitivity (BRS) during and after donation of 450 ml of blood. METHODS Continuous beat-to-beat blood pressure and lead II ECG was recorded before, during and after blood donation in 54 healthy volunteers (age 34.7 ± 5.08 years; weight 77.9 ± 8.20 kg), followed by offline analyses of baroreflex sensitivity. RESULTS The systolic, diastolic or mean blood pressures did not change during or after the blood donation. Decrease in pulse pressure and increase in heart rate was observed post donation. The spontaneous BRS decreased during [8.68 (6.038-12.69) ms/mmHg] and after blood donation [9.401 (6.396-11.59) ms/mmHg] as compared to the baseline [12.83 (6.884-18.18) ms/mmHg] with a significant decrease in α-HF on spectral analysis. CONCLUSION Mild blood loss (450 ml) results in non-hypotensive haemorrhage with a decrease in spontaneous BRS before the rise of heart rate during blood donation.
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Affiliation(s)
- Kavita Yadav
- Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India
| | - Akanksha Singh
- Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India
| | - Smriti Badhwar
- Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India
| | - Ashok Kumar Jaryal
- Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India.
| | - Poonam Coshic
- Department of Transfusion Medicine (Blood Bank), All India Institute of Medical Sciences, Ground Floor, Main Blood Bank Unit 1, Ansari Nagar, New Delhi, India
| | - Kabita Chatterjee
- Department of Transfusion Medicine (Blood Bank), All India Institute of Medical Sciences, Ground Floor, Main Blood Bank Unit 1, Ansari Nagar, New Delhi, India
| | - K K Deepak
- Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching Block, Second Floor, Ansari Nagar, New Delhi, India
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Garg P, Badhwar S, Jaryal AK, Kachhawa G, Deepak KK, Kriplani A. The temporal trend of vascular function in women with gestational diabetes. Vasc Med 2017; 22:96-102. [DOI: 10.1177/1358863x16678479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Priyanka Garg
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Badhwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Alka Kriplani
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
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Talapatra K, Deshpande M, Goyle S, Majumder D, Badhwar S, Mistry R. Nimotuzumab and Intensity Modulated Radiation Therapy (IMRT) in the Concurrent Setting of Locally Advanced Head and Neck Cancers: Early Results of a Prospective Trial in India. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Affiliation(s)
| | - S Badhwar
- Classified Specialist (Otolaryngology/Head and Neck Oncosurgery), INHS Asvini, Colaba, Mumbai
| | - J D'Souza
- Classified Specialist (Radiodiagnosis and Interventional Radiology), INHS Asvini, Colaba, Mumbai
| | - I K Indrajit
- Classified Specialist (Radiodiagnosis and Imaging), INHS Asvini, Colaba, Mumbai
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18
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DE Sylva P, Rajpathak SD, Borgohain BN, Badhwar S, Srivastava P. MULTIPLE CRANIAL NERVE INVOLVEMENT IN HERPES ZOSTER (A Case Report). Med J Armed Forces India 1998; 54:51-52. [PMID: 28775414 PMCID: PMC5531236 DOI: 10.1016/s0377-1237(17)30410-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Plk DE Sylva
- Classified Specialist (Derm & Ven), Colaba, Mumbai
| | - S D Rajpathak
- Sr Adv (Derm & Ven), Dept of Dermatology, Colaba, Mumbai
| | | | - S Badhwar
- Graded Specialist (ENT), Dept of ENT, INHS Asvini, Colaba, Mumbai
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19
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Uppal SS, Badhwar S, Ganguly S, Agnihotri V, Boparai MS, Suri RK. Chloroquine resistant falciparum malaria in the Andamans. J Assoc Physicians India 1995; 43:103-5. [PMID: 9282672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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20
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Uppal SS, Agnihotri V, Ganguly S, Badhwar S, Shetty KJ. Clinical aspects of centipede bite in the Andamans. J Assoc Physicians India 1990; 38:163-4. [PMID: 2380137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Clinical aspects of centipede bite as seen in the Andamans are reported. Centipede bite produces excruciating local pain and burning. Local bleeding is common but transient. Occasionally local infection or necrosis develops. Constitutional upset occurs in a small minority. Centipede bites are never fatal and pain-relief is the cornerstone of treatment.
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Affiliation(s)
- S S Uppal
- INHS Dhanvantari, Port Blair, Andamans
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