scholarly journals Adaptive neuromodulation in the treatment of spasticity

2020 ◽  
Author(s):  
Barassi Giovanni ◽  
Giannuzzo Giuseppe ◽  
De Santis Romano ◽  
Dragonetti Antonella
Keyword(s):  
Cerebral Palsy ◽  
Operative Procedure ◽  
Lower Limbs ◽  
Rheological Parameters ◽  
Therapeutic Approaches ◽  
Single Session ◽  
Group A ◽  
Analysis Of Results ◽  
Group B

This research has the purpose to evaluate the immediate effects on spasticity of lower limbs of a single session of two different therapeutic approaches in patients affected by cerebral palsy. A total of 30 patients, with an age between and 10-40 years old and affected by cerebral palsy associated to spastic para/tetra paresis, were recruited and equally and randomly divided into 3 groups: group A has was treated with hydrokinesitherapy (HKT). Group B was treated with adaptive electro neuromodulation (ENM). Group C underwent a sham approach respecting the operative procedure of Group B with the device not operating. All patients were evaluated, before (T0) and after (T1) the single session of treatment, through myometric evaluation of muscular rheological parameters. The analysis of results underlined that both HKT and ENM resulted effective in reducing muscu-lar hypertone associated to spasticity, while in Group C no significant results were detected. We can affirm that both ENM and HKT approach can be good alternatives for the treatment of spasticity in patients affected by cerebral palsy.

The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

2021 ◽  
Vol 15 (10) ◽  
pp. 2712-2714
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Asif ◽  
Imran Yousaf ◽  
Muhammad Faheem Anwer ◽  
Muhammad Waseem Anwar
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Recovery Time ◽  
Mesh Repair ◽  
Operative Procedure ◽  
Total Extraperitoneal ◽  
Outcome Comparison ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

scholarly journals Effects of Swiss ball exercise and Pilates exercise on core muscle strengthening in college cricketers

Biomedicine ◽  
2020 ◽  
Vol 40 (3) ◽  
pp. 377-380
Author(s):  
K. Kamatchi ◽  
B. Arun ◽  
G. Tharani ◽  
G. Yuvarani ◽  
G. Vaishnavi ◽  
...  
Keyword(s):  
Mean Value ◽  
Terminal Segment ◽  
Core Stability ◽  
Lower Limbs ◽  
Age Group ◽  
Mean Values ◽  
Muscle Strengthening ◽  
Group A ◽  
Group B ◽  
Swiss Ball

Introduction and Aim: Cricket is one of the most popular game in India played by men and women of all ages. Core stability is defined as the ability to control the position and movement of the trunk over the pelvis to allow optimum production, transfer and control of force and movement to the terminal segment. Major muscles involved are pelvic floor muscles, Transverse abdominis, multifidus, internal and external obliques, and rectus abdominis. Core is used to stabilize the thorax and the pelvis during dynamic movement. The study helps to compare the effectiveness of Swiss ball exercise and Pilates exercise on gaining core muscle strength. The aim of the study is to compare the effect of Swiss ball exercise and Pilates exercise on core muscle strengthening in college cricketers. Materials and Methods: The design of the study is comparative type. The study was carried out in faculty of Physiotherapy, Dr.M.G.R. Educational and Research Institute. The study sample of 30 male college cricketers between the age group of 18 to 25 years are included in the study. Individuals with associated neuromuscular conditions, any injuries to lower limbs and any spinal injuries have been excluded in the study. Swiss ball and Pilates mat are the materials used. Sphygmomanometer is the outcome measure.30 male individuals between the age group of 18 to 25 years were divided into two groups, group A and group B. Individuals in the group A (n=15) received the Swiss ball exercise and group B (n=15) received Pilates exercise for 4 session/ week for 6 weeks. Results: On comparing the mean values of group A and group B on double leg lowering test (DLLT), it shows significant decrease in the post test mean values but (group B- Pilates exercise) shows (30.60) which has the lower mean value is more effective than (group A- Swiss ball exercise) (46.80) at P ? 0.001. Hence, null hypothesis is rejected. Conclusion: The study concluded that both the group was effective but while comparing Pilates exercise showed the potential treatment option than swiss ball exercise. Hence, Pilates exercise was effective on core muscle strengthening in college cricketers. Keywords: Swiss ball; Pilates mat; core muscle; sphygmomanometer.

scholarly journals Androgen versus erythropoietin for the treatment of anemia in hemodialyzed patients: a prospective study.

1996 ◽  
Vol 7 (1) ◽  
pp. 140-144
Author(s):  
J L Teruel ◽  
R Marcen ◽  
J Navarro-Antolin ◽  
A Aguilera ◽  
G Fernandez-Juarez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Recombinant Human Erythropoietin ◽  
Dry Weight ◽  
Pressure Control ◽  
Therapeutic Approaches ◽  
Human Erythropoietin ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
A Prospective Study

According to this facility's protocol for the treatment of anemia in hemodialyzed patients, androgens were administered to male patients aged over 50 yr and recombinant human erythropoietin was administered to male patients below 50 yr of age and to female patients. In the study presented here, both therapeutic approaches have been prospectively analyzed. Patients were divided into two groups. Group A was composed of 18 patients, aged 62 +/- 12 yr, treated with nandrolone decanoate (200 mg/wk im) for 6 months; Group B was composed of 22 patients (6 men, 16 women) aged 47 +/- 15 yr, treated with subcutaneous recombinant human erythropoietin (initial dose, 6000 IU/wk) for 6 months. The increases of hemoglobin were similar in both groups; Group A, from 7.3 +/- 0.8 to 10.8 +/- 1.7 g/dL (P < 0.001), and Group B, from 7 +/- 0.6 to 10.4 +/- 1 g/dL (P < 0.001). In Group A, increases of triglycerides (159 +/- 71 versus 267 +/- 153 mg/dL, P < 0.001), serum albumin (3.9 +/- 0.3 versus 4.2 +/- 0.3 g/dL, P < 0.05), and dry weight (62.1 +/- 9.8 versus 64.9 +/- 10.1 kg, P < 0.001) were observed, which remained unmodified in Group B. Blood pressure control worsened in one patient (6%) from Group A, and in ten patients (45%) from Group B (P < 0.05). In conclusion, androgens produced an improvement in anemia in selected patients, similar to that achieved by use of recombinant human erythropoietin but at a lower cost. Androgens also have an appreciable anabolic effect and did not increase the blood pressure.

scholarly journals Treatment of Chronic Venous Ulcers Using New Four Layers Compressive Bandage Dressing

2015 ◽  
Vol 53 (199) ◽  
pp. 156-161 ◽  
Author(s):  
Kaushal K Tiwari ◽  
Krishna G Shrestha ◽  
Bijay Sah ◽  
D.Jaypal Reddy
Keyword(s):  
Compression Therapy ◽  
Venous Ulcer ◽  
Term Treatment ◽  
Lower Limbs ◽  
High Morbidity ◽  
Current Standard ◽  
Venous Ulcers ◽  
Long Term Treatment ◽  
Group A ◽  
Group B

Introduction: Lower-extremity ulcers represent the largest group of ulcers presenting to an outpatient department. It is a cumbersome, difficult to treat disease, which causes high morbidity and huge cost for the patient and healthcare system. Current standard treatment includes compression therapy. However, majority of patients need long term treatment with minimal efficacy. Aim of our study is to evaluate efficacy of four layers compressive bandages for the management of chronic venous ulcers. Methods: In Group A, we have prospectively included 20 patients with chronic venous ulcers on lower limbs for four layers hosiery bandage using Velfour bandage. Other 15 patients, Group B, were treated with conventional wound dressing. Velfour and crepe bandage were done once weekly for three weeks. Results: DVT was cause of chronic venous ulcer in 70% patient in group A and in 73.3% in Group B. Majority of patients were having left sided chronic venous ulcers. The mean duration of the ulcers was 15.6 vs 10.86 months (group A vs. group B). At the end of 3rd week, in 55% wounds in Group A were healed except few big and deep wounds remained. Most of these wounds also became smaller with minimal discharge. Size of wounds significantly decreased in Group A vs. Group B patients (0.7±0.81 cm vs. 1.73±0.77 cm, p<0.00031). However, cost of treatment in group A remained higher than group B. Conclusions: Our study has shown that four layer compressive bandage using Velfour is an easy, effective, and reproducible method of treatment for the chronic venous ulcer.  Keywords: compression bandage; treatment; venous ulcer.

VENOGRAPHY (VG) OF THE LOWER LIMBS IN THE MANAGEMENT OF PATIENTS WITH SUSPECTED PULMONARY EMBOLISM (PE)

1987 ◽  
Author(s):  
W H J Kruit ◽  
A K Sing ◽  
G J H den Ottolander ◽  
A C de Beor ◽  
J J C Jonker
Keyword(s):  
Pulmonary Embolism ◽  
Impedance Plethysmography ◽  
Lower Limbs ◽  
Surgical Patients ◽  
Additional Patient ◽  
Suspected Pulmonary Embolism ◽  
X Ray ◽  
Group A ◽  
Group B

In a prospective cohort study, we evaluated X-ray VG in the management of non-surgical patients with clinically suspected PE. Thusfar follow up is available on 131 consecutive patients with suspected PE. In all patients a perfusion lungscan (PS) was carried out within 24 hours. In case of a normal PS (group A, n=32), no anticoagulant (AC) therapy was given. In case of an abnormal PS, AC therapy was started (heparin) and a bilateral ascending VG was carried out within 72 hours. In 46 patients (group C) venous thrombosis (DVT) was demonstrated by VG, and these patients were treated with AC for 6 months. In 53 patients with suspected PE and an abnormal lungscan, bilateral VG did not show DVT (group B). AC therapy was discontinued in these patients These patients were then screened for 14 days with fibrinogen legscanning and impedance plethysmography (IPG), followed by IPG alone every 2 months for at least 1 year. In group B, 6 patients died in the follow up period. None of the patients had signs of PE at autopsy. One additional patient in group B developed DVT documented by repeat VG, 6 months after entry into the trial. According to these preliminary data, it seems safe to base the decision whether or not to treat a patient with suspected PE with AC, on the presence or absence of DVT in the lower limbs as demonstrated by VG

Residual Vein Thrombosis Improves Screening for Occult Cancer: Results On 537 Patients with Idiopathic Deep Vein Thrombosis.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3999-3999
Author(s):  
Sergio Siragusa ◽  
Alessandra Malato ◽  
Fabio Fulfaro ◽  
Giorgia Saccullo ◽  
Domenica Caramazza ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Early Detection ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Occult Cancer ◽  
Group A ◽  
Group B ◽  
Deep Vein ◽  
Related Mortality

Abstract Abstract 3999 Poster Board III-935 Background Clinical advantage of extensive screening for occult cancer in patients with idiopathic Deep Vein Thrombosis (DVT) is unknown. We have demonstrated that the Residual Vein Thrombosis (RVT)-based screening for occult cancer improves early detection as well as cancer-related mortality (Siragusa S et al. Blood 2007;110(699):OC). Here we report on final analysis of 537 patients over a period of 8 years. Objective of the study We conducted a prospective study evaluating whether a RVT-based screening for cancer is sensitive and influences cancer-related mortality. Study design Prospective with two cohorts of DVT patients: the first cohort was monitored for clinical overt cancer only (Group A), while the second (Group B) received complete screening for occult neoplasm and subsequent surveillance. Materials and methods Consecutive patients with a first episode of DVT who presented RVT after 3 month of anticoagulation and without signs and/or symptoms for overt cancer. Screening for occult cancer was based on: ultrasound and/or CT scan of the abdomen and pelvis, gastroscopy, colonoscopy or sigmoidoscopy, hemoccult, sputum cytology and tumor markers. These tests were extended with mammography and Pap smear for women and ultrasound of the prostate and total specific prostatic antigen (PSA) for men. All investigations had to be completed within four-weeks from the assessment of RVT. All patients were followed-up for at least 2 years. Incidence and cancer-related mortality was compared between the two groups by survival curves (Kaplan-Mayer) and related Breslow test for statistics. Results Over a period of 8 years, 537 patients were included in the analysis: first cohort included 346 patients (Group A), second cohort 191 (Group B). Clinical characteristics between groups were homogenous. During the follow-up, 8.3% of patients developed overt cancer in group A; in group B, 7.8% of patients had diagnosed cancer at the moment of extensive screening while 2 new cases (0.7%) occurred during the follow-up (Table). The sensitivity of this approach was 92.1% (95% confidence intervals 75.2-104.2). Cancer-related mortality was 7.5% in group A and 3.6% in group B (p< 0.001). Conclusions The RVT-based screening for occult cancer is highly effective for improving early detection as well as cancer-related mortality in a cohort of 537 patient with DVT of the lower limbs. Disclosures: Off Label Use: Hydroxyurea use in myelofibrosis.

scholarly journals Correlation of distance from skin to lumbar epidural space with age and height of patients

2020 ◽  
Vol 7 (12) ◽  
pp. 1846
Author(s):  
Manju Bala ◽  
Monica Chhikara ◽  
Deepika . ◽  
Kiranpreet Kaur ◽  
Teena Bansal ◽  
...  
Keyword(s):  
Epidural Space ◽  
Standard Technique ◽  
Epidural Block ◽  
Lower Limbs ◽  
Correct Identification ◽  
Epidural Catheter Placement ◽  
Group A ◽  
Group B ◽  
Lower Lumbar ◽  
Group D

Background: Epidural block is a popular and versatile procedure with applications as sole anaesthetic, as an analgesic adjuvant to general anaesthesia and for post-operative analgesia in procedures involving lower limbs, perineum, pelvis, abdomen and thorax. However, success of the epidural technique depends upon the correct identification of epidural space. The knowledge of distance from skin to epidural space can help in better identification of epidural space and epidural catheter placement with fewer incidences of complications. We conducted a study to find the distance from skin to the epidural space and its correlation with patient height and age to improve the success rate.  Methods: Seventy-four patients scheduled to undergo lower lumbar surgeries where epidural block was required as anaesthetic or analgesic, were included in the study. These patients were randomly divided into four different groups of 37 patients each according to their age (group A and group B) and height (group C and group D). In these patient’s epidural block was given by standard technique according to the need of surgery and epidural depth measured. Obtained results were compared among group A, B and group C, D depending on their age and height respectively.  Results: In group A (age 20-30 years), mean epidural depth was 3.96±0.4 cm while in group B (age 30-40 years) mean epidural depth was 4.05±0.5 centimeters. In group C (height 155-169 cm) mean epidural depth was 3.88±0.4 centimeters while it was 4.13±0.5 centimeters in group D (height 170-184 cm).Conclusions: There was increase in epidural depth with increase in height of patients but there was no correlation between age of patients and epidural depth.

scholarly journals Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

2021 ◽  
Vol 11 (9) ◽  
pp. 1189
Author(s):  
Tasneem Karim ◽  
Mohammad Muhit ◽  
Israt Jahan ◽  
Claire Galea ◽  
Catherine Morgan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cerebral Palsy ◽  
Early Intervention ◽  
Intervention Program ◽  
Community Based ◽  
Children With Cerebral Palsy ◽  
Functional Measure ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

scholarly journals Analysis of surgical treatment of duodenal ulcers with multiple combined complications

2021 ◽  
pp. 10-12
Author(s):  
Pavlo Ivanchev ◽  
Maxim Bilyachenko ◽  
Anton Kurbanov ◽  
Oleksii Lissov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Mortality ◽  
Bleeding Complications ◽  
Duodenal Ulcers ◽  
The Third ◽  
Number Of Patients ◽  
Group A ◽  
Analysis Of Results ◽  
Surgical Tactics ◽  
Group B

The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients. Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %). Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.

The Effects of Multi-Slice Helical Computed Tomography and Phlebography on Edema Regression Nursing of Lower Limbs Varicosis

2020 ◽  
Vol 10 (9) ◽  
pp. 2124-2129
Author(s):  
Jinmei Zu ◽  
Ruyue Chen ◽  
Jia Kang ◽  
Yaru Han ◽  
Gaixin Zhang
Keyword(s):  
Computed Tomography ◽  
Lower Limb ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Helical Computed Tomography ◽  
High Ligation ◽  
Gabor Filtering ◽  
Operation Rate ◽  
Group A ◽  
Group B

Objective: To explore the effects of multi-slice helical computed tomography (MSCT) and phlebography on edema regression nursing of lower limbs varicosis, and to analyze the values of MSCT and phlebography on the diagnosis and treatment of lower limb varicosis. Methods: A total of 193 patients with lower limb varicosis treated in the Vascular Surgery Department were included as the research objects. According to different examination methods, the included patients were divided into the MSCT group, and the MSCT combined with the phlebography group, Then, patients in both groups received joint treatment of high ligation and varicectomy. The Gabor filtering-based algorithm and the Mean-Variance Efficient Frontier (MVEF) algorithm were used to smoothen the obtained images. Also, the operation rates and contradiction compositions of patients in both groups were analyzed. Patients who received surgical treatment were followed up for three months to one year; whether the deep vein thrombosis (DVT) occurred in them were observed, as well as the edema regression. Results: As for gender, grading, disease history, duration of disease, and onset age of both groups, no statistical significance was found (P > 0.05). Compared to group A, the positive detection rate of postoperative DVT was lower in group B, so did the operation rate. In group A, 32 cases of edema regressed significantly, and the disease condition was relieved. In group B, 35 cases of edema were regressed. Conclusion: Compared with MSCT, phlebography had a higher screening rate for indications of lower limb varicosis, which could effectively reduce the probability of DVT after operations and relieve the symptoms of edema in patients. In addition, although the sensitivity of MSCT was relatively low, it could be used for the primary screening diagnosis of lower limb varicosis.

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