Comparing the Effects of Virtual Reality Breathing Exercise and Incentive Spirometry Exercise on Improving Pulmonary Function in Children with Spastic Diplegic Cerebral Palsy.

INTRODUCTION: Children with cerebral palsy (CP) have a higher incidence of respiratory dysfunction than healthy children. Virtual reality breathing therapy is an assistive technology that is becoming popular in the rehabilitation of children with CP. METHODS: This experimental study included a total of 32 children with spastic diplegic CP who were divided into two groups: the virtual reality breathing training (VRBT) group and the incentive spirometry (IST) group. Individuals classified as levels I to III on the gross motor function classification system (GMFCS) were recruited using the simple random sampling method. RESULT: The results of comparing the values of forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and the ratio of FVC/FEV1 showed a significant difference between groups. A significant difference was found in the VRBT group compared to the IST group, except for the peak expiratory flow (PEF) values, which showed a nonsignificant difference between the groups. CONCLUSION: There were significant differences in FVC and FEV1 between the VRBT and IST groups. It has been concluded that VRBT has additional benefits in improving pulmonary functions.

A programmable microscopic stage: Design and development.

Microscopes have become a significant part of pathological study. Currently, motorized microscopes are enabled with horizontal and vertical movements, with the facility of fast response in acquiring images or videos from the slide. During microbial screening, viewing the specimen needs following a directional path viz., zig-zag, inward spiral, meander, and so forth. Even though the motorized movements are built-in, human intervention is required while screening. This leads to time delay in the scanning process and may leave some portions of the specimen unattended. In this proposed system, a programmable framework to define the scanning direction for the specimen and a firmware to control the microscopic stage is implemented, to enable customization of the scanning pattern without any human intervention during complete course of screening. The user can define the customized scanning pattern using two-dimensional (2D) graphics drawing primitives. The final drawing is converted into preparatory codes through a micro-computer numeric controlled software, which extracts the address information relating to the movement and direction of the stage. These X, Y directional information are fed into the machine control unit for activating the linear driving system, which has servo drives and motors to power the spindle for precise microscopic stage movement. The proposed system is cost effective and reduces the reliance on technicians in examining the whole slide. The system is also portable and can be attached to any conventional or fluorescence microscope. Some pre-defined scanning patterns have been tested for the stage movements and validated in this work.

Abnormal signal-averaged electrocardiogram (SAECG) in obesity.

OBJECTIVE: The occurrence of small high-frequency electrocardiogram (ECG) potentials (1 to 20 microV) seen at the end of the QRS complex and into the ST segment have been correlated with increased risk for ventricular arrhythmias and sudden cardiac death. Computer-assisted analysis of these "late potentials" by signal-averaged electrocardiography (SAECG) has been studied and utilized to predict the likelihood of ventricular arrhythmias in various clinical states. Obesity is associated with significant cardiovascular morbidity and sudden death. Ventricular arrhythmias are postulated causes. We studied the occurrence of late potentials in a randomly selected group of obese patients and healthy volunteers. RESEARCH METHODS AND PROCEDURES: We performed SAECG on 105 subjects. Of these, 62 were obese ambulatory patients with body mass index (BMI) of >30 kg/m2, whereas 43 were healthy asymptomatic volunteers with a BMI of <30 kg/m2. Patients with a history of clinical heart disease and pulmonary disease, electrolyte abnormalities, recent hospitalizations, or abnormal screening ECG or taking medications known to alter the QRS interval were excluded. At least 250 beats were analyzed with a noise level of <0.50 microV. Criteria of a late potential include QRS duration >114 ms, high-frequency low amplitude >38 ms, and root-mean-square voltage <20 microV. Patients were divided into four subgroups based on BMI values. The prevalence of SAECG abnormalities in each BMI subgroup was studied. We utilized multiple logistic regression analysis to study the effect of obesity, hypertension, and diabetes mellitus on abnormal SAECG results. RESULTS: Compared to age- and sex-matched healthy volunteers with BMI of <30 kg/m2, obese patients with BMI of >30 kg/m2 had significantly more abnormalities on SAECG (4.6% vs. 55%). In the obese group, the prevalence and number of abnormalities increased with increase in BMI (35% in the BMI 31 to 40 kg/m2 subgroup, 86% in the BMI 41 to 50 kg/m2 subgroup, and 100% in patients with BMI of >50 kg/m2). Multiple logistic regression analysis shows that BMI is an independent predictor variable of abnormal SAECG results in obese patients (n = 62) with BMI of >30 kg/m2 as well as in all study subjects (n = 105). BMI also predicts abnormality of each abnormal SAECG criterion in both obese and all subjects. Hypertension was found to influence the QRS duration alone in obese and all subjects. DISCUSSION: Obesity is associated with increased occurrence of abnormal SAECG results. These abnormalities are found both in obese patients with and without hypertension and/or diabetes. Obesity is an independent predictor variable of abnormal SAECG results. A history of hypertension predicts abnormality of QRS duration only.