Effect of Percutaneous Electric Stimulation with High Frequency Alternating Currents on the Sensory-Motor System of Healthy Volunteers

BackgroundFormer studies investigated the application, both transcutaneous and with implanted electrodes, of high frequency alternating currents (HFAC) in humans for blocking the peripheral nervous system. The present trial aimed to assess the effect of HFAC on motor response, somatosensory thresholds, and peripheral nerve conduction, when applied percutaneously with ultrasound-guided needles at frequencies of 10 kHz and 20 kHz in healthy volunteers. MethodsA parallel, placebo-controlled, double-blind, randomized clinical trial was conducted. Ultrasound-guided HFAC at 10 kHz and 20 kHz and sham stimulation were delivered to the median nerve of 60 healthy volunteers (n=20 per group) for 20 minutes. The main assessed variables were maximum isometric flexion strength (MFFS) of the index finger, myotonometry, pressure pain threshold (PPT), mechanical detection threshold (MDT), and antidromic sensory nerve action potential (SNAP). Measurements were recorded pre-intervention, during the intervention 15 minutes after its commencement, immediately post-intervention, and at 15 minutes post-intervention.ResultsA decrease in the MFFS was observed immediately post-intervention compared to baseline, both in the 10 kHz group [-8.5 %; 95% confidence interval (CI) -14.9 to -2.1] and the 20 kHz group (-12.0%; 95%CI -18.3 to -5.6). At 15 minutes post-intervention, the decrease in the MFFS was -9.5% (95%CI -17.3 to -1.8) and -11.5% (95%CI -9.3 to -3.8) in the 10 kHz and 20 kHz groups, respectively. No changes over time were found in the sham group. The between-group comparison of changes in MFFS showed a greater reduction of -10.8% (95%CI -19.8 to -1.8) immediately post-intervention in the 20 kHz compared to the sham stimulation group. Muscle tone increased over time in both the 10 kHz and 20 kHz groups, but not in the sham group. The intergroup comparison of myotonometry showed a superior effect in the 20 kHz (6.7%, 95%CI 0.5 to 12.9) versus the sham group. No significant changes were observed in the rest of the assessed variables. ConclusionsThe ultrasound-guided percutaneous stimulation applying 10 kHz and 20 kHz HFAC to the median nerve produced reversible reductions in strength and increases in muscle tone with no adverse effects.

Efficacy of Probiotic, Chlorhexidine, and Sodium Fluoride Mouthrinses on Mutans Streptococci in 8- to 12-Year-Old Children: A Crossover Randomized Trial

<b><i>Introduction:</i></b> The oral cavity is home to a diverse and distinct microbiome. While the role of oral bacteria in cariogenic and other dental diseases is irrefutable, their beneficial effects in the form of probiotics (PB) has been less studied, especially pertaining to oral diseases in children. This study compares the efficacy of a PB mouthrinse with 0.12% chlorhexidine (CHX) and 0.05% sodium fluoride (NaF) mouthrinse on the colony counts of mutans streptococci (MS) in children. <b><i>Methods:</i></b> A triple-blind crossover randomized trial between interventional groups was planned. Fifty-one children between 8 to 12 years of age were divided into three groups (I, II, and III) and were exposed to all three mouthrinses (A, B, and C) by randomized allocation for a period of two weeks with an inter-phase washout period of four weeks. Pre- and post-interventional MS counts (CFU/mL) were assessed, and the mean change was analysed using the <i>t</i> test (intragroup) and ANOVA (intergroup and crossover). <b><i>Results:</i></b> The mean changes in the colony counts obtained with the use of PB, CHX, and NaF mouthrinses were −1.0223 (−1.2201 to −0.8246), −0.9564 (−1.1503 to −0.7626), and −0.9511 (−1.1554 to −0.7467), respectively, which were statistically significant (<i>p</i> &#x3c; 0.0001). However, the intergroup comparison for the mean change in colony counts revealed no statistically significant differences (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> The study concluded that the PB mouthrinse was equally efficacious as compared to CHX and NaF mouthrinses against MS in 8- to 12-year-old children. However, further studies are recommended to strengthen the evidence.

Effect of Scapular Kinesiotaping as an Adjunct to Dynamic Neuromuscular Stabilization Exercises on Upper Extremity Functions in Stroke Patients

Background and Purpose: Stroke is one of the leading causes of death and disability in India. Upper extremities get more affected in Middle cerebral artery syndrome. Stroke patients have lack of functional ability of upper extremity due to scapular malalignment resulting from paralysis of the scapular muscles. Kinesiotape helps to realign the muscles and thus it becomes easy to activate or inhibit them. We hypothesised that Dynamic Neuromuscular Stabilisation exercises along with kinesiotape could improve upper extremity function. Methodology: Ethical clearance was obtained. Informed consent was taken. 30 patients were selected according to inclusion and exclusion criteria. 15 subjects were randomly divided into experimental and control group. Subjects were given Dynamic neuromuscular stabilisation exercises for scapular strengthening. The experimental group was given Kinesiotaping to the scapula using muscle technique. Pre and post treatment assessment was done using Upper Extremity Function Index, grip strength and scapular abduction position with MB ruler. Result: The intergroup comparison revealed a highly significant difference for upper extremity function index and grip strength whereas scapular abduction was not significant. Conclusion: The Scapular Kinesiotaping as an adjunct to Dynamic Neuromuscular Stabilization Exercises is significantly effective to improve upper extremity functions and grip strength in post stroke patients. Key words: Stroke, Upper Extremity Functions, Dynamic Neuromuscular Stabilization Exercises, Scapular Kinesiotaping.

Comparing the effect of statins on hepatic fibrosis induced by carbon tetrachloride in Wistar rats

Background: The clinical studies have shown contrary results regarding hepatoprotective effect of statins. However, antifibrotic properties of statins in in vitro and in vivo experimental models have been demonstrated. The purpose of this study was to assess and compare the effect of statins on serum liver enzymes and their antifibrotic effects.Methods: Forty two rats were divided into 7 groups (I to VII) (n=6). Liver toxicity was induced by injecting carbon tetrachloride (1 ml/kg). Control groups received corn oil (0.1 ml/100 gm) and carboxy methyl cellulose (0.50%) respectively. Group III to VII received carbon tetrachloride (CCl4) for 6 weeks and then groups IV, V, VI and VII received simvastatin (10 mg/kg), atorvastatin (15 mg/kg), rosuvastatin (2 mg/kg) and silymarin (50 mg/kg) for another 8 weeks respectively. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels were estimated in all the groups at baseline, 6 weeks and 14 weeks. At 14 weeks, histopathology of liver was done in all groups.Results: At 14 weeks, all the test groups (IV, V and VI) showed a significant decrease in serum ALT, AST and ALP levels as compared to control (p<0.05) and group III (p<0.05). On intergroup comparison, liver enzymes in rats in group VI (rosuvastatin) and group V (atorvastatin) were decreased more in comparison to group IV (simvastatin) but the difference was not statistically significant except for AST levels where the difference was significant between the statins. There was decrease in hepatic fibrosis by statins with rosuvastatin being superior followed by atorvastatin and simvastatin.Conclusions: In the present study statins decreased the serum AST, ALT and ALP levels and histopathological changes were reversed by statins in CCl4 induced hepatotoxic models.

Antibacterial Efficacy of Mouth Rinsing With 0.4% Syzygium Cumini Leaf Extract Against Streptococcus Mutans: A Randomized Controlled Trial

Syzygium cumini leaf extract possess a range of pharmacological properties such as anti-diabetic, anti-inflammatory, antiulcerogenic, cardioprotective, antidiarrheal, antimicrobial, antioxidant and hepatoprotective activities. Objective of the study was to evaluate and compare the antibacterial efficacy of 0.4% Syzygium cumini leaf extract and 0.2% chlorhexidine containing mouthwashes on salivary Streptococcus mutans among children aged 7-8 years in a hospital setting. Methods: Twenty-four school children aged 7-8 years, fulfilling the eligibility criteria, were randomized into two groups. Group 1: received 0.4% S. cumini leaf extract mouth wash and Group 2: received 0.2% chlorhexidine mouth wash. Saliva samples of the children were collected before and one hour after mouth rinsing with 10 ml of interventional mouthwash, for S. mutans count analysis. Results: The results of the study showed that there was significant reduction in salivary S. mutans counts in both the groups post mouth rinsing with interventional solutions (p=0.002). However, intergroup comparison reveled that in Chlorhexidine group there was significantly more reduction in Salivary S mutans counts compared to Syzygium cumini mouth rinsing group. (p=0.03) Conclusion: There was reduction in salivary S mutans counts after mouth rinsing with Syzygium cumini leaf extract. Hence, Syzygium cumini leaf extract mouthwash could be an effective aid for prevention and control of dental caries since it is safe, culturally acceptable and feasible.

Ex-Vivo evaluation of Nano-MgO in the elimination of Endodontic pathogen- E. faecalis

Magnesium oxide (MgO) nanoparticles due to their antimicrobial properties and ability to survive under harsh conditions have become an area of interest in the field of biomedical sciences. The aim of the study was to evaluate antimicrobial efficacy of Nano-MgO in the elimination of endodontic pathogen . Minimum inhibitory concentration (MIC) of Nano-MgO and sodium hypochlorite against was calculated using broth dilution method. The antibacterial efficacy of Nano-MgO in elimination of the pathogens was seen using an ex-vivo model of decoronated teeth which were experimentally infected. The antibiofilm activity of the tested antimicrobial agents on biofilms was determined quantitatively by counting the colonies on Mueller-Hinton agar plates and by evaluation under scanning electron microscopy (SEM). The data analysis was done using one way ANOVA and the intergroup comparison by student –t test. MIC concentration of Nano-MgO was observed at 10mg/ml for . Mean values of colony forming unit (CFU) count was maximum for normal saline, followed by Nano-MgO and sodium hypochlorite with a significant difference between all the three groups. The results of the study reveal that Nano-MgO has the potential to be used as an alternative irrigating solution in endodontic therapy.

Additional effects of Thoracic manipulation on pain, shoulder disability and range of motion in Adhesive Capsulitis

Aim: To determine the additional effects of thoracic manipulation on shoulder pain, shoulder range of motion (ROM) and disability in combination with conventional physical therapy exercises for individuals with adhesive capsulitis. Materials: A parallel, randomized controlled clinical trial was conducted. 32 patients (16 in each group), aged between 40‑60 years from both genders having shoulder pain, clinically diagnosed with adhesive capsulitis (Stage II and III), along with thoracic spine hypo mobility were included. Patients were randomized into conventional physiotherapy group (A) and thoracic manipulation group (B). Clinical trial was continued for two weeks with three sessions per week and a follow up was done at the end of 3rd week. Visual analogue scale (VAS), shoulder range of motion (ROM) and Disabilities of Arm Shoulder and Hand (DASH) score were used for outcomes measurement. Results: Intragroup comparison for shoulder ROM, DASH and VAS scores shows a significant (p value=≤0.001) for both groups. Intergroup comparison for shoulder ROM was improved significantly on post-intervention (p value=≤0.001). While intergroup comparison of baseline to end value for VAS showed insignificant result (p value=0.373). Conclusion: Additional effects of thoracic manipulation to conventional physical therapy underwent a greater improvement regarding shoulder range of motions and disability. Conventional physical therapy exercises and a combination of thoracic manipulation to conventional physical therapy exercises are equally effective for decreasing shoulder pain. Keywords: Adhesive Capsulitis, Pain, Frozen shoulder, Physical Therapy, Rehabilitation

Effect of orthodontic treatment on periodontal health of periodontally compromised patients: A randomized controlled clinical trial

ABSTRACT Objectives To evaluate the effect of fixed orthodontic treatment on periodontal parameters in periodontally compromised adult orthodontic patients. Materials and Methods This was a prospective, randomized, controlled clinical trial. Thirty-six periodontally compromised adult patients (mean age: 29.67 ± 4.8 years) were randomly allocated to either test (perio-ortho) or control group (perio). After periodontal stabilization in both groups, orthodontic treatment was started in the test group, whereas the control group remained on periodontal maintenance only. Evaluation and comparison of clinical parameters (plaque index [PI]; gingival index [GI]; bleeding on probing [BOP]; probing depth [PD]; clinical attachment level [CAL]) of both groups was assessed at three time intervals: T0 (base line), T1 (at start of orthodontic treatment), and T2 (1 year after start of orthodontic treatment). Radiological parameters (alveolar bone levels [ABL]) were recorded using CBCT at T1 and T2. Results Intragroup analysis showed statistically significant improvement in all clinical and radiological periodontal parameters in both groups (P ≤ .05). Intergroup comparison revealed improvement in the periodontal parameters was not statistically significant between the groups (P ≥ .05). Subgroup analysis showed reduction in the number of moderate and severe periodontitis sites in both groups with significant more gains in ABL in the test group compared to the control group. Conclusions Orthodontic treatment after periodontal stabilization does not have any detrimental effect on periodontal health in adult periodontally compromised orthodontic patients and may add to the benefits achieved by periodontal treatment alone.

COVID-19 versus Seasonal Influenza: Comparison of Profiles of Older Adults Hospitalized in a Short-Term Geriatric Ward in France

The objective was to compare the profile and outcomes of older adults admitted to a geriatric short-stay unit for COVID-19, to those of older adults admitted to the same unit for seasonal influenza infection. This was an observational study performed in a General Hospital in France. Patients ≥ 70 years admitted to a geriatric short-stay unit for COVID-19 between March 18 and November 15, 2020 were included. They were compared with patients of the same age group, admitted to the same geriatric short-stay unit for seasonal influenza infection over the periods January to March 2019 and January to March 2020. Data collection included demographic information, medical history, clinical signs and symptoms, outcomes, and hospital discharge patterns. Descriptive and intergroup comparison analyses were performed. In total, 153 patients were included in the study, 82 in the seasonal influenza group, and 71 in the COVID-19 group. The average age was 87.6 ± 4.8 and 87.6 ± 6.5 years in the COVID-19 and seasonal influenza groups, respectively. There was no difference between groups regarding the Charlson comorbidity index (3.4 ± 3.0 versus 3.4 ± 2.8). The seasonal influenza group more often had fever, cough, sputum, and renal failure, whereas the COVID-19 group more often experienced diarrhea, and death. The COVID-19 group was frequently living in collective housing. The profile at admission of older adults hospitalized for COVID-19 or seasonal influenza infection was similar. Although fever and respiratory signs were less common in the COVID-19 group, these patients experienced more complications (such as renal failure or oxygen therapy requirement) and higher mortality.

Effect of Ropivacaine-Loaded Magnetic Nanoparticles on Ankle Nerve Block in Rats

Aim. Our study is to determine the influence of ropivacaine-loaded magnetic nanoparticles (MNP/Rop) on ankle nerve block in rats. Materials and Methods. MNP/Rop was prepared and then injected intravenously into rats to evaluate its anesthetic effect on rat limbs. Mechanical pain thresholds paw withdrawal threshold (PWT) and paw withdrawal thermal latency (PWL) were employed for the assessment of ankle nerve block in rats. Results. PWT increased from T1 to T4 in each group ( P < 0.05 ). The intergroup comparison determined no distinct difference in the PWT value among the three series at T1 ( P > 0.05 ); however, PWT values at T2-T4 were higher in nerve block control group (NBCG) and MNP/Rop group than in blank group (BG), and they remained slightly higher in MNP/Rop group than in NBCG. The intragroup comparison revealed that from T1 to T4, PWL in each group showed a rising trend. The PWL at T1 showed no evident difference among the three series ( P > 0.05 ); however, PWL values at T2-T4 were higher in NBCG and MNP/Rop group than in BG, and they remained slightly higher in MNP/Rop group than in NBCG. In MNP/Rop group, both PWT and PWL increased with the increase of Fe3O4 load in MNP/Rop ( P < 0.05 ), while PWT and PWL remained unchanged when the load was 2.189%; moreover, PWT and PWL elevated as Rop concentration increased in MNP/Rop ( P < 0.05 ), while they kept unaltered under 40 μL 1% Rop. Conclusion. Intravenous injection of MNP/Rop into rats and inhalation of MNP into the ankle joint can effectively block ankle nerve conduction in rats.