The presence of abnormal sounds in one cardiac cycle, provide valuable information on various diseases.Early detection of various diseases is necessary; it is done by a simple technique known as: phonocardiography. The phonocardiography, based on registration of vibrations or oscillations of different frequencies, audible or not, that correspond to normal and abnormal heart sounds. It provides the clinician with a complementary tool to record the heart sounds heard during auscultation. The advancement of intracardiac phonocardiography, combined with signal processing techniques, has strongly renewed researchers’ interest in studying heart sounds and murmurs. This paper presents an algorithm based on the denoising by wavelet transform (DWT) and the Shannon energy of the PCG signal, for the detection of heart sounds (the first and second sounds, S1 and S2) and heart murmurs. This algorithm makes it possible to isolate individual sounds (S1 or S2) and murmurs to give an assessment of their average duration.

BACKGROUND: There have been previous studies detailing the variables involved in readmissions in patients with a primary admission diagnosis of infective endocarditis – however those studies were done prior to the 2015 change in AHA guidelines and introduction to ICD-10 codes. OBJECTIVES: The aim of this study was to describe the frequency, causes, factors, and costs associated with infective endocarditis encounters. METHODS: Utilizing the 2017 national readmission database (NRD), we identified all patients that were admitted with infective endocarditis. These patients were evaluated for the rates, predictors, and costs of unplanned 30 days readmissions. Weighted analysis was performed to obtain nationally representative data. RESULTS: 56,357 patients were identified to have been admitted with a diagnosis of infective endocarditis of whom 13,004 patients (23%) were readmitted within 30 days of the index discharge. The most common causes of readmission were septicemia (15.1%), endocarditis and endocardial disease (10.5%), heart failure (9.5%), and complication of the cardiovascular device, implant or graft, initial encounter (5.6%). Data showed that there were certain comorbidities that resulted in a higher risk of being readmitted, these include chronic kidney disease, COPD, tobacco use, and hepatic failure. Cost of readmissions per patient was approximately $22,059 (IQR $11,630 - $49,964). CONCLUSIONS: Thirty-day unplanned readmissions remain a significant issue affecting nearly 1 in 6 patients with infective endocarditis. This is associated with significant mortality and financial burden. A multi-disciplinary approach may help decrease readmissions, reduce complications, and improve overall outcomes as well as the overall quality of life of our patients.

Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of mortality worldwide, is a highly incapacitating irrevocable health problem, with pulmonary and extra-pulmonary manifestations. According to Suzanne Hurd and Claude Lenfant, it is “the only chronic disease for which the finger of blame can be pointed to a single risk factor – tobacco smoking”. However, only 15-20% of smokers are afflicted. Whereas smoking is far from being the only cause, substantial proportion of COPD cases cannot be explained by smoking alone. The visibility of distressing and frightening physical manifestations of symptoms leads to serious ‘‘observable’’ consequences, such as disability or lack of control, public use of oxygen and rescue inhalers. As a result “they are disqualified from full social acceptance”. However, the stigma is not the only factor responsible for the miseries of those with COPD. In fact, there are many misconceptions in this scenario which have been discussed. The need of a huge awareness campaign for the public to improve their understanding of lung diseases (notably COPD) has been highlighted. The patient, healthcare professionals and the health services should be prepared to play their new role in the management of a chronic disease like COPD “requiring “ongoing management over a period of years or decades”. The importance of a self-management strategy has been emphasised.

Background: Diabetes mellitus is a complex concept for a spectrum of disorders characterized by hyperglycemia and a variety of complications, comprising metabolic and cellular disturbances that lead to vascular complications. The objective of this project was to correlate type 2 diabetes patients to healthy controls in aspects of hematological indices and their association with demographic data. Materials and Methods: From May to September 2016, a case-control analysis has been performed in Khartoum, Sudan. 154 participants were enrolled in this study. 104 participant were diabetic type 2 and 50 were apparently healthy as control group to find out any variations in hematological parameters HbA1C and CBC: (Hb, WBCs & differential, RBCs& indices and PLTs, hematocrit (HCT) among type 2 diabetic patients. Blood was gathered in EDTA containers. HbA1C measured using i-CHROMATM and complete blood count using the Sysmex® Kx21-N hematological analyzer. Before samples collection, each participant gave their informed consent, which had been approved by the Ministry of Health ethical committee. The Statistical Package for Social Sciences (SPSS) SPSS version 20 was used. The meaning of the discrepancies was assessed using the Crosstab test. the p-Value is significant at P< 0.05. Results: T2DM patients had a statically significant in white blood cells, neutrophils, and lymphocytes as a comparison to the control group P<0.05. There was no considerable difference in red blood cell count, Hb, Hct, MCV, MCH, MCHC, RDW, Platelets count, MPV, and PDW between the two classes P> 0.05. Conclusion: T2DM patients had relatively increased levels of white blood cells, neutrophils, and lymphocytes than the control group (P<0.05).

In studies, the alkaloid 1-(2-Chloro-4,5-methylenedioxyphenyl)-2-hydroxyethyl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinoline (N-14) had a negative inotropic effect on the activity of the papillary muscle contraction of the rat heart detected. Ca2+ ions from SR play an important role in the process of contraction of the heart muscle. With this in mind, the negative inotropic effect of the N-14 alkaloid was investigated with the modification of the accumulation processes of Ca2+ ions to SR. To clarify this, we examined the effects of the alkaloid being studied on SERCA2a and RyR2. To do this, the inhibitor of SERCA2a - cyclopiazonic acid (CPA) and RyR activator caffeine, which provide the accumulation of Ca2+ ions in SR, were used.