Effectiveness and Safety of Physical Therapy Intervention in Adult Dermatomyositis: A Case Report and Review

BACKGROUND The evidence for positive effects of exercise is insufficient in dermatomyositis. This article aims to outline the effects of physical exercise with regard to structure (Disease activity, inflammation, metabolic milieu and muscle structure) as well as clinical outcome in terms of impairment, activity limitation, participation restriction according to the ICF; and QOL in an adult patient with dermatomyositis. CASE DESCRIPTION A 47-years old female diagnosed with definite DM since last 10 months was referred by a Rheumatologist for physical therapy intervention. INTERVENTION 12 weeks (Three days a week) of Physiotherapy (Moderate intensity, individualized, closely monitored) along with a structured home exercise program (Low intensity, 5 days - 6 days a week). OUTCOME MEASURES Assessment of muscular pain, muscle strength, endurance, balance, functional evaluation, and QOL along with serological investigations. RESULTS Effectiveness Patient continued to show meaningful and clinically significant improvement on standardized outcome measures: 1. A major clinical response (total improvement score of 77) on IMAC S core set measures. 2. Improvement across all domains of ICF viz. muscle strength; endurance; movement coordination; balance; aerobic endurance; confidence and performance in activities of daily living; participation in social activities. 3. Probable disease-modifying effect: Progressively tapering dose of prescribed corticosteroids medication and improvement in disease-specific biochemical markers. 4. Patient reported measures: Reduction in muscular pain, shortness of breath & fatigue; and improvement in Healthrelated QOL. SAFETY (As evident clinically and from the investigations): 1. No adverse reaction to exercises or physical activity. 2. Remained in remission - stable disease activity. CONCLUSION Moderate intensity of physiotherapy intervention along with home exercise program is effective and safe in improving functional outcomes for dermatomyositis in a stable disease activity state. This case report enhances our understanding of the effects of physical exercise and may improve treatment and outcome in patients with dermatomyositis.

Innovative Medicines & Medical Practice during COVID at MENA Region

Medical practice during COVID -19 pandemic faced many challenges one of the major challenges is adaptation of treatment protocols for achieving following objectives.

Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

BACKGROUND The study aimed to analyze the complications following cementless arthroplasty surgery where original sphericity was not obtained and screw-cap system was required. METHOD The study inclusion criteria were met by 39 patients aged 47 - 90 and the mean follow-up period was 54 months. Patients were operated in a lateral position, through the posterolateral or minimal posterior approach.To assess postoperative functionality, Harris Hip Score and Hoos questionnaire were applied. RESULTS According to the Harris Hip Score, 64.3% of the scores were very good and good and the mean score was 96 according to the Hoos questionnaire. The incision type, BMI and the type of cutaneous suture had no impact on the functional outcome, incidence of complications and a pain rate in the groin. Scar esthetics received highest scores from the patients operated through the minimal posterior approach and treated with a running intra-cutaneous suture. Yet a lateral position during the surgery made any intraoperative assessment of the limb length considerably more difficult. Consequently, 30% of the operated patients reported different limb lengths, which significantly (p = 0.036) lowered a functional outcome measured according to the HOOS and Harris Hip Score. The functional outcomes demonstrate a considerably negative correlation with age but not with gender although men are more vulnerable to the postoperative complications (p = 0.18). CONCLUSION Despite a relatively large number of complications following the surgery using a screw-cap system, 75% of the patients declared they would not mind another surgery using such system.

Fear is Stress that causes Weakening of the Immune System

The immune system protects the human body from pathogens like viruses and bacteria. People need to maintain a strong immune system during the COVID-19 pandemic. Unfortunately, the fearmongering news reports on death rates increase fear. This could become a health risk because fear could weaken the immune system by in creasing the release of corticosteroid in the body. Modern medicine includes the mind, body, and soul strengthening the immune system.

Emotions, Stressors, Coping Strategies, and Motivational Factors in Private Higher Education Institutions amid COVID-19 Pandemic

Private school teachers among Higher Education Institutions (HEIs) continue to strive to sustain quality education despite the psychological impact of the COVID-19 crisis. This study aimed to assess the emotions, stressors, coping strategies, and motivational factors of private HEI's teachers in Southern Philippines. Both negative and positive teachers' emotions were observed. Low salary scheme was the primary teachers' stressor. But, teachers utilized helpful strategies to cope with stress. Several motivational factors were seen as significant steps for their institutions to implement and follow. The high level of stressors of teachers during the pandemic influences the emotions towards the community and work situations. As they increasingly practice varied coping strategies and augment motivation to continue to work despite the situation, the better emotional state with lesser adverse feelings they will have. Government support is needed to aid private schools to continue the quality delivery of higher education. It is necessary to address stress-related problems of teachers during the pandemic, and help them strengthen their coping practices and motivation at work.

Pandemic Control COVID 19: The Results of Analytical Studies of Ten Health Systems in the Word. Scopus Review

OBJECTIVES Description of the epidemiological situation of COVID-19 and analyze and compare between ten-health systems control epidemic around the word for use in public health system settings. METHODS This study was a descriptive, exploratory analysis of all cases of COVID-19 in the world especially in the ten countries. We conducted a Scopus review of the literature. Thirty articles are been recolted. RESULTS The estimates of human transmissibility (R0) range from 2 to 3. Pre-symptomatic transmission has been reported. The Incubation period is 5.1 days; the overall global case fatality rate is currently approximately 6%. The countries are characterized into three categories of pandemic control: excellent level of control fo r Germany, South Korea, Hong Kong and turkey a medium level for China, Morocco and a low level for the USA, France, Spain and Italy. CONCLUSION The present descriptive, exploratory analysis offers important new information to the international community on the Corona virus Pandemic in world. Important questions remain including determination of infectiousness period, identification of transmission routes, and effective treatment and prevention methods including further test development, drug development, and vaccine development.

Epilepsy Management during the COVID-19 Pandemic in Epilepsy Monitoring Unit

Coronavirus disease 2019 (COVID-19) is a rapidly spreading infectious disease caused by the novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The Impact of Covid 19 Quarantine on the Intellectually Disabled

The COVID-19 quarantine is creating a threat to the intellectually disabled community. There is a need for community outings to sustain the psychological wellbeing of the intellectually disabled. This is why their caregivers include community outings in their care. However, during the COVID-19 quarantine this is suddenly missing in their lives. Therefore, this is causing an increase in psychosis for the intellectually disabled. Mental health professionals must proceed with caution when providing medication to ensure the holistic wellbeing of the patients is met.

Trichoblastoma Complicating Jadassohn's Sebaceous Hamartoma

Jadassohn's Sebaceous Hamartoma (HSJ) is a complex congenital dysembryoplasia. The tumor transformation occurs in adulthood, often in a benign form.