Comparative analysis of ANN performance of four feature extraction methods used in the detection of epileptic seizures.

Epilepsy, a prevalent neurological disorder characterized by disrupted brain activity, affects over 70 million individuals worldwide, as reported by the World Health Organization (WHO). The development of computer-aided diagnosis systems has become vital in assessing epilepsy severity promptly and initiating timely treatment. These systems enable the detection of epileptic seizures by analyzing the electrical activity in the EEG recordings of the patients. In addition, it helps doctors to choose suitable treatment by quickly determining the type, duration, and characteristics of seizures and increases the patient's quality of life. The proposed computer-aided diagnosis system in this study comprises three modules: preprocessing, feature extraction, and classification. The initial module employs a low-pass Chebyshev II filter to eliminate noise artifacts from signal recordings. The second module involves deriving feature vectors using Bispectrum Analysis, Empirical Mode Decomposition, Discrete Wavelet Transform, and Wavelet Packet Analysis. The third module employs the Artificial Neural Networks method for epileptic seizure detection. This study not only enables the comparison of feature extraction efficacy among Bispectrum Analysis, Empirical Mode Decomposition, Discrete Wavelet Transform, and Wavelet Packet Analysis techniques, but it also reveals that Bispectrum Analysis and Empirical Mode Decomposition yield the highest accuracy rate. The method achieves 100% accuracy in detecting epileptic seizures. Additionally, sensitivity analysis has been conducted to enhance the success of Discrete Wavelet Transform and Wavelet Packet Analysis methods and to identify significant features.

Evaluation of electrocardiographic parameters in patients with epileptic seizure.

The aim of the study is to evaluate the changes in electrocardiographic parameters, including QTc dispersion (QTcd), Tpeak-Tend (Tp-e)/QTc ratio and P-wave dispersion (Pd), during the period without seizure activation in patients, presented to the emergency department (ED) with epileptic seizures. This prospective case-control study was conducted between January 2017 and January 2018. Patients, over 18 years old and presented to the ED with epileptic seizure, were consecutively included in the study. Interictal period ECGs of patients were obtained at least 2 hours after the end of the postictal period. ST-segment changes, QT interval, corrected QT interval (QTc), QTd, Pd, Tp-e, Tp-e dispersion (Tp-ed), Tp-e/QTc ratio and arrhythmias were evaluated in interictal ECGs. A total of 103 epileptic patients and 31 control cases were included in the study. Heart rate, QTc, QTcd, Pd, Tp-ed and Tp-e/QTc ratio were significantly higher in the epilepsy group than in the control group (p < 0.05 for all values). No statistically significant difference in those parameters was observed between the patients with known epilepsy and the patients who had seizure for the first time. There was also no statistically significant difference between patients who had recurrent seizures during the observation period and who did not. The patients with epileptic seizures had increased Pd, QTd, QTcd, Tp-ed and Tpe/QTc ratio during interictal period compared to healthy subjects. These electrocardiographic changes might be associated with an increased risk of dysrhythmia. However, prospective large cohorts with short- and long-term follow-up are needed for clinical reflections.

Effects of 20-degree spinal immobilization on respiratory functions in otherwise healthy volunteers with android-type obesity.

AIM: The aim of the study was to assess whether spinal immobilization with long back board (LBB) and semi-rigid cervical collar (CC) at 20° instead of 0° conserves pulmonary functions in obese volunteers, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. METHODS: The study included adult volunteer subjects with android-type obesity who were otherwise healthy. First, pulmonary functions were tested in a seated position to obtain baseline levels, than volunteers were immobilized with LBB and CC at 0-degree and measurements repeated at 0th and 30th minute of immobilization. Next day, same procedures were repeated with the trauma board at 20-degree. Changes over time in FEV1, FVC values and FEV1/FVC ratios during spinal immobilization at 0° and 20° were compared to baseline levels. RESULTS: Study included 30 volunteers. Results showed a significant decline in all values for both situations following spinal immobilization (p < .001). We also compared the decrease over time in those values (ΔFEV1, ΔFVC, and ΔFEV1/FVC ratio) during spinal immobilization at 0° and 20°. The decrease in pulmonary functions was similar in both groups (p > .05). CONCLUSION: The present findings confirm that spinal immobilization reduces pulmonary functions in obese volunteers, and that 20-degree immobilization has no conservative effect on these values when compared to the traditional 0-degree immobilization. It may be that 20° is insufficient to decrease the negative effect of abdominal obesity on pulmonary functions.

Value of Leucine-rich alpha-2-glycoprotein-1 (LRG-1) on diagnosis of acute appendicitis in female patients with right lower-quadrant abdominal pain.

OBJECTIVE: To assess the diagnostic usefulness of leucine-rich alpha-2-glycoprotein-1 in female patients with acute abdominal pain on right lower-quadrant and acute appendicitis. METHODS: The prospective, cross-sectional study was conducted at the emergency department of Kecioren Training and Research Hospital, Ankara, Turkey, during a two-month period in 2014, and comprised patients with acute abdominal pain in right lower-quadrant, and control subjects. Female patients aged 18-60 years who were admitted to the hospital's emergency department were included. The control group consisted of healthy females without acute or chronic diseases. Venous blood was obtained from all the subjects to measure leucine-rich alpha-2-glycoprotein-1. RESULTS: Of the 160 participants, 80(50%) were patients and 80(50%) were control subjects. The mean value of leucine-rich alpha-2-glycoprotein-1 level in the patient and control groups were 6.78±2.21mg/ml and 6.59±2.37mg/ml, respectively (p>0.05). Among the cases, 32(40%) patients were diagnosed with acute appendicitis, whereas 48(60%) with non-acute appendicitis. The mean leucine-rich alpha-2-glycoprotein-1level was 6.96±2.76mg/ml in patients diagnosed with acute appendicitis, and 6.66±1.78mg/ml in those diagnosed with non-acute appendicitis (p>0.05). CONCLUSIONS: Plasma leucine-rich alpha-2-glycoprotein-1 levels were not useful in diagnosing acute appendicitis in female patients with acute abdominal pain in right lower-quadrant.

Copeptin levels in carbon monoxide poisoning.

BACKGROUND/AIM: The aim of this study is to identify the copeptin levels in patients presenting with carbon monoxide (CO) poisoning to the emergency department and to investigate its correlation with the neurological effects. MATERIALS AND METHODS: The study group consisted of patients presenting with CO poisoning and carboxyhemoglobin levels >10%. Blood samples for copeptin levels were obtained twice, first at presentation then at the fourth hour of observation. The data were analyzed using SPSS 16 for Windows. RESULTS: The median copeptin levels of the patient group were identified as 0.63 (0.39-1.06) ng/mL at hour 0 and 0.41 (0.31-0.49) at hour 4. The copeptin levels of the control group were 0.34 (0.25-0.42) ng/mL and were significantly lower than those of the patient group (P < 0.000). According to our results, 0.345 ng/mL for plasma copeptin level as the best cut-off level may be used with sensitivity of 94.0% and specificity of 60%. The copeptin levels at hour 0 were statistically significantly higher in the neurologically affected patients than those not affected (P < 0.001). CONCLUSION: In this study it was shown that blood copeptin levels increase in patients presenting to the emergency department with CO poisoning.

Isolated basal ganglia hemorrhage due to blast injury.

Bilateral traumatic hemorrhage of the basal ganglia is an extremely rare neuropathologic entity. Bilateral basal ganglia hemorrhage secondary to blast injury has not described before. We report a case with bilateral basal ganglia hemorrhage secondary to explosion.

Cerebral infarction caused by traumatic carotid artery dissection.

Traumatic carotid artery dissection, if not diagnosed and treated early, is a serious problem with permanent neurological deficit and a high mortality rate of up to 40%. We present a case with delayed diagnosis of traumatic carotid artery dissection in a 21-year-old female. While there were no ischemic infarct findings on the admission cerebral computerized tomography (CT), such findings were observed on two cerebral CTs taken because of the left hemiplegia noticed seven days later when the patient regained consciousness. The patient was referred to our emergency service, and definitive diagnosis was achieved with arterial Doppler ultrasonography, cerebral magnetic resonance imaging (MRI), diffusion MRI, and MR angiography. We did not consider invasive treatment since the neurological damage was permanent and dissection grade was IV according to angiography findings. The case was discharged within a week and physiotherapy was advised. Despite the advances in diagnostic methods, diagnosis of traumatic carotid artery dissection is still missed or delayed, as in the case presented here. Early diagnosis can ameliorate permanent neurological damage or even prevent it. However, the vital factors for early diagnosis are the obtained anamnesis leading to appropriate radiological examinations, detailed physical examination and high clinical suspicion.