Search results for: myofascial pain syndrome

Authors: Mesih Kocamuftuoglu, Gonca Ozan, Enver Ozan, Nalan Kaya, Sema Temizer Ozan

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Metabolic Syndrome, one of the common metabolic disorder, occurs with co-development of insulin resistance, obesity, dislipidemia and hypertension problems. Insulin resistance appears to play a pathogenic role in the metabolic syndrome. Also, there is a relationship between insulin resistance and infertility as known. Turmeric (Curcuma longa L.) a polyphenolic chemical is widely used for its coloring, flavoring, and medicinal properties, and exhibits a strong antioxidant activity. In this study, we assess the effects of turmeric on rat uterine tissue in metabolic syndrome model induced by high fructose diet. Thirty-two adult female Wistar rats weighing 220±20 g were randomly divided into four groups (n=8) as follows; control, fructose, turmeric, and fructose plus turmeric. Metabolic syndrome was induced by fructose solution 20% (w/v) in tap water, and turmeric (C.Longa) administered at the dose of 80 mg/kg body weight every other day by oral gavage. After the experimental period of 8 weeks, rats were decapitated, serum and uterine tissues were removed. Serum lipid profile, glucose, insülin levels were measured. Uterine tissues were fixed for histological analyzes. The uterine tissue sections were stained with hematoxylin-eosin (H & E) stain, then examined and photographed on a light microscope (Novel N-800Mx20). As a result, fructose consumption effected serum lipids, insulin levels, and insulin resistance significantly. Endometrium and myometrium layers were observed in normal structure in control group of uterine tissues. Perivascular edema, peri glandular fibrosis, and inflammatory cell increase were detected in fructose group. Sections of the fructose plus turmeric group showed a significant improvement in findings when compared to the fructose group. Turmeric group cell structures were observed similar with the control group. These results demonstrated that high-fructose consumption could change the structure of the uterine tissue. On the other hand, turmeric administration has beneficial effects on uterine tissue at that dose and duration when administered with fructose.

Keywords: metabolic syndrome, rat, turmeric, uterus

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Uswah Ahmad Khan, Muhammad Moazam Fraz, Humayoon Shafique Satti, Qasim Aziz

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Approximately 10-14% of the global population experiences a functional disorder known as irritable bowel syndrome (IBS). The disorder is defined by persistent abdominal pain and an irregular bowel pattern. IBS significantly impairs work productivity and disrupts patients' daily lives and activities. Although IBS is widespread, there is still an incomplete understanding of its underlying pathophysiology. This study aims to help characterize the phenotype of IBS patients by differentiating the comorbidities found in IBS patients from those in non-IBS patients using machine learning algorithms. In this study, we extracted samples coding for IBS from the UK BioBank cohort and randomly selected patients without a code for IBS to create a total sample size of 18,000. We selected the codes for comorbidities of these cases from 2 years before and after their IBS diagnosis and compared them to the comorbidities in the non-IBS cohort. Machine learning models, including Decision Trees, Gradient Boosting, Support Vector Machine (SVM), AdaBoost, Logistic Regression, and XGBoost, were employed to assess their accuracy in predicting IBS. The most accurate model was then chosen to identify the features associated with IBS. In our case, we used XGBoost feature importance as a feature selection method. We applied different models to the top 10% of features, which numbered 50. Gradient Boosting, Logistic Regression and XGBoost algorithms yielded a diagnosis of IBS with an optimal accuracy of 71.08%, 71.427%, and 71.53%, respectively. Among the comorbidities most closely associated with IBS included gut diseases (Haemorrhoids, diverticular diseases), atopic conditions(asthma), and psychiatric comorbidities (depressive episodes or disorder, anxiety). This finding emphasizes the need for a comprehensive approach when evaluating the phenotype of IBS, suggesting the possibility of identifying new subsets of IBS rather than relying solely on the conventional classification based on stool type. Additionally, our study demonstrates the potential of machine learning algorithms in predicting the development of IBS based on comorbidities, which may enhance diagnosis and facilitate better management of modifiable risk factors for IBS. Further research is necessary to confirm our findings and establish cause and effect. Alternative feature selection methods and even larger and more diverse datasets may lead to more accurate classification models. Despite these limitations, our findings highlight the effectiveness of Logistic Regression and XGBoost in predicting IBS diagnosis.

Keywords: comorbidities, disease association, irritable bowel syndrome (IBS), predictive analytics

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Authors: Ghada M. R. Koura, Mohamed N. Mohamed, Ahmed M. F. El Shiwi

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Chronic mechanical Low back dysfunction (CMLBD) is the most common problem of the working-age population in modern industrial sociaty; it causes a substantial economic burden due to the wide use of medical services and absence from work. Aim of work: the aim of this study was to investigate the effect of positional release technique on patients with chronic mechanical low back pain. Materials and Methods: Thirty two patients from both sexes were diagnosed with CMLBP, aged 20 to 45 years and were divided randomly into two equal groups; sixteen patients each; group A (control group) received therapeutic exercises that include (Stretch and Strength exercises for back and abdominal muscles). Group B (experimental group) received therapeutic exercises with positional release technique; treatment was applied 3 days/week for 4 weeks. Pain was measured by Visual Analogue Scale, Lumbar range of motion was measured by Inclinometer and Functional disability was measured by Oswestry disability scale. Measurements were taken at two intervals pre-treatment and post-treatment. Results: Data obtained was analyzed via paired and unpaired t-Test. There were statistical differences between the 2 groups, where the experimental group showed greater improvement than control group. Conclusion: Positional release technique is considered as an effective treatment for reducing pain, functional disability and increasing lumbar range of motion in individuals with chronic mechanical low back pain.

Keywords: chronic mechanical low back pain, traditional physical therapy program, positional release technique, randomized controlled trial

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

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Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Mohamed Gomaa Mohamed

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Background and purpose: Ideal posture involves a minimal amount of stress or strain on various body segments which are aligned and worked in harmony to protect the body from injury or progressive deformity. One of most common faulty posture encountered in clinical setting is forward head posture (FHP) that was considered one of the main predictors for neck pain. Furthermore, FHP may predispose to thoracic outlet syndrome, temporomandibular joint dysfunction, shoulder pain and headache. The large financial burden related to neck disorders management raises the need to improve the quality of assessment and rehabilitation of FHP. So, the purpose of the study is to compare between measurements of FHP as indicated with craniovertebral (CVA) and gaze angles assessed from dominant and non-dominant sides in football players who extensively use their dominant side and non-athletic subjects. Participants: Twenty-four subjects were divided into 12 football players and 12 non-athletic subjects. Methods: CVA and gaze angles were assessed through photogrammetric method. Photos were taken from dominant and non-dominant sides of the subjects while assuming standing position. Paired t-test was used to assess angles differences between dominant and non-dominant sides of the subjects. Since there were no statistical differences between CVA and gaze angles measured from dominant and non-dominant sides in each group, we pooled data together to become 24 measurements for each group (12 from dominant and 12 from non-dominant). Independent t-test was used to assess angles differences between football players and non-athletic subjects. Results: No significant differences were found between CVA and gaze angles measured from dominant and non-dominant sides of both groups (P>0.05). Also, there were no significant differences between CVA and gaze angles measured from football players and non-athletic subjects (P>0.05). Conclusion: FHP can be assessed from dominant or non-dominant sides interchangeably either in football players or non-athletic subjects. Furthermore, playing football has no impact on measurements of FHP when compared to non-athletic subjects.

Keywords: dominant side, forward head posture, football players, non-dominant side

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

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Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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Authors: Mohammad Javaherian, Siamak Bashardoust Tajali, Monavvar Hadizadeh

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Objective: This systematic review study was conducted to evaluate the effects of Pulsed Electromagnetic (PEMF) and Static Magnetic Fields (SMG) on pain relief and functional improvement in patients with musculoskeletal Low Back Pain (LBP). Methods: Seven electronic databases were searched by two researchers independently to identify the published Randomized Controlled Trials (RCTs) on the efficacy of pulsed electromagnetic, static magnetic, and therapeutic nuclear magnetic fields. The identified databases for systematic search were Ovid Medline®, Ovid Cochrane RCTs and Reviews, PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE from 1968 to February 2016. The relevant keywords were selected by Mesh. After initial search and finding relevant manuscripts, all references in selected studies were searched to identify second hand possible manuscripts. The published RCTs in English would be included to the study if they reported changes on pain and/or functional disability following application of magnetic fields on chronic musculoskeletal low back pain. All studies with surgical patients, patients with pelvic pain, and combination of other treatment techniques such as acupuncture or diathermy were excluded. The identified studies were critically appraised and the data were extracted independently by two raters (M.J and S.B.T). Probable disagreements were resolved through discussion between raters. Results: In total, 1505 abstracts were found following the initial electronic search. The abstracts were reviewed to identify potentially relevant manuscripts. Seventeen possibly appropriate studies were retrieved in full-text of which 48 were excluded after reviewing their full-texts. Ten selected articles were categorized into three subgroups: PEMF (6 articles), SMF (3 articles), and therapeutic nuclear magnetic fields (tNMF) (1 article). Since one study evaluated tNMF, we had to exclude it. In the PEMF group, one study of acute LBP did not show significant positive results and the majority of the other five studies on Chronic Low Back Pain (CLBP) indicated its efficacy on pain relief and functional improvement, but one study with the lowest sessions (6 sessions during 2 weeks) did not report a significant difference between treatment and control groups. In the SMF subgroup, two articles reported near significant pain reduction without any functional improvement although more studies are needed. Conclusion: The PEMFs with a strength of 5 to 150 G or 0.1 to 0.3 G and a frequency of 5 to 64 Hz or sweep 7 to 7KHz can be considered as an effective modality in pain relief and functional improvement in patients with chronic low back pain, but there is not enough evidence to confirm their effectiveness in acute low back pain. To achieve the appropriate effectiveness, it is suggested to perform this treatment modality 20 minutes per day for at least 9 sessions. SMFs have not been reported to be substantially effective in decreasing pain or improving the function in chronic low back pain. More studies are necessary to achieve more reliable results.

Keywords: pulsed electromagnetic field, static magnetic field, magnetotherapy, low back pain

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Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici

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Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome

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Authors: Angelis P. Barlampas

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Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.

Keywords: fahr disease, fahr syndrome, CT, brain calcifications

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Authors: Jonathan de Rothewelle

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Heeled shoes are notoriously bad for physical health. The vast majority of Americans have suffered lower extremity pain at some point in their lives; women have been in pain for centuries. More recently, however, with an increase in number due to cultural shifts in acceptability, more men wear heeled shoes. Men who wear heels (MWWH) also suffer lower limb pain. In my hypothesis, their pathologies should be treated as unique due to males’ difference in body mass, center of gravity, posture, gait, and foot anatomy when compared with their female counterparts. These differences alone warrant a closer examination of the pathologies associated with the wearing of heeled shoes among male populations. This research performs a broad literature review on the differences between male and female anatomy and discusses implications on heel wearing. This research discusses the need for further inquiry and makes recommendations for future study.

Keywords: heeled shoes, gait, pathologies, biological sex

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

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The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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Authors: Giulia Bonaldo, Alberto Vaccheri, Ottavio D'Annibali, Domenico Motola

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The Human Papilloma Virus (HPV) was shown to be the cause of different types of carcinomas, first of all of the cervical intraepithelial neoplasia. Since the early 80s to today, thanks first to the preventive screening campaigns (pap-test) and following to the introduction of HPV vaccines on the market; the number of new cases of cervical cancer has decreased significantly. The HPV vaccines currently approved are three: Cervarix® (HPV2 - virus type: 16 and 18), Gardasil® (HPV4 - 6, 11, 16, 18) and Gardasil 9® (HPV9 - 6, 11, 16, 18, 31, 33, 45, 52, 58), which all protect against the two high-risk HPVs (6, 11) that are mainly involved in cervical cancers. Despite the remarkable effectiveness of these vaccines has been demonstrated, in the recent years, there have been many complaints about their risk-benefit profile due to Adverse Events Following Immunization (AEFI). The purpose of this study is to provide a support about the ongoing discussion on the safety profile of HPV vaccines based on real life data deriving from spontaneous reports of suspected AEFIs collected in the Vaccine Adverse Events Reporting System (VAERS). VAERS is a freely-available national vaccine safety surveillance database of AEFI, co-administered by the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA). We collected all the reports between January 2007 to December 2017 related to the HPV vaccines with a brand name (HPV2, HPV4, HPV9) or without (HPVX). A disproportionality analysis using Reporting Odds Ratio (ROR) with 95% confidence interval and p value ≤ 0.05 was performed. Over the 10-year period, 54889 reports of AEFI related to HPV vaccines reported in VAERS, corresponding to 224863 vaccine-event pairs, were retrieved. The highest number of reports was related to Gardasil (n = 42244), followed by Gardasil 9 (7212) and Cervarix (3904). The brand name of the HPV vaccine was not reported in 1529 cases. The two events more frequently reported and statistically significant for each vaccine were: dizziness (n = 5053) ROR = 1.28 (CI95% 1.24 – 1.31) and syncope (4808) ROR = 1.21 (1.17 – 1.25) for Gardasil. For Gardasil 9, injection site pain (305) ROR = 1.40 (1.25 – 1.57) and injection site erythema (297) ROR = 1.88 (1.67 – 2.10) and for Cervarix, headache (672) ROR = 1.14 (1.06 – 1.23) and loss of consciousness (528) ROR = 1.71 (1.57 – 1.87). In total, we collected 406 reports of death and 2461 cases of permanent disability in the ten-year period. The events consisting of incorrect vaccine storage or incorrect administration were not considered. The AEFI analysis showed that the most frequently reported events are non-serious and listed in the corresponding SmPCs. In addition to these, potential safety signals arose regarding less frequent and severe AEFIs that would deserve further investigation. This already happened with the referral of the European Medicines Agency (EMA) for the adverse events POTS (Postural Orthostatic Tachycardia Syndrome) and CRPS (Complex Regional Pain Syndrome) associated with anti-papillomavirus vaccines.

Keywords: adverse drug reactions, pharmacovigilance, safety, vaccines

Procedia PDF Downloads 137

Authors: Greg Zimmerman

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Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.

Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence

Procedia PDF Downloads 80

Authors: Mengestie Mulugeta Belay, Serebe Abay Gebrie, Biruk Lambbiso Wamisho, Amare Worku

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Background: Low back pain (LBP) related to nursing profession, is a very common public health problem throughout the world. Various risk factors have been implicated in the etiology and LBP is assumed to be of multi-factorial origin as individual, work-related and psychosocial factors can contribute to its development. Objectives: To determine the prevalence and to identify risk factors of LBP among nurses working in Addis Ababa City Public Hospitals, Ethiopia, in the year 2015. Settings: Addis Ababa University, Black-Lion (‘Tikur Anbessa’) Hospital-BLH, is the country’s highest tertiary level referral and teaching Hospital. The three departments in connection with this study: Radiology, Pathology and Orthopedics, run undergraduate and residency programs and receive referred patients from all over the country. Methods: A cross-sectional study with internal comparison was conducted throughout the period October-December, 2015. Sample was chosen by simple random sampling technique by taken the lists of nurses from human resource departments as a sampling frame. A well-structured, pre-tested and self-administered questionnaire was used to collect quantifiable information. The questionnaire included socio-demographic, back pain features, consequences of back pain, work-related and psychosocial factors. The collected data was entered into EpiInfo version 3.5.4 and was analyzed by SPSS. A probability level of 0.05 or less and 95% confidence level was used to indicate statistical significance. Ethical clearance was obtained from all respected administrative bodies, Hospitals and study participants. Results: The study included 395 nurses and gave a response rate of 91.9%. The mean age was 30.6 (±8.4) years. Majority of the respondents were female (285, 72.2%). Nearly half of the participants (n=181, 45.8% (95% CI (40.8%- 50.6%))) were complained low back pain. There was statistical significant association between low back pain and working shift, physical activities at work; sleep disturbance and felt little pleasure by doing things. Conclusion: A high prevalence of low back pain was found among nurses working in Addis Ababa Public Hospitals. Recognition and preventive measures like providing resting periods should be taken to reduce the risk of low back pain in nurses working in Public hospitals.

Keywords: low back pain, risk factors, nurses, public hospitals

Procedia PDF Downloads 275

Authors: A. Aceranti, L. Moretti, S. Vernocchi, M. Colorato, P. Caristia

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Irritable bowel syndrome (IBS) is the association between abdominal pain, abdominal distension and intestinal dysfunction for recurring periods. About 10% of the world's population has IBS at any given time in their life, and about 200 people per 100,000 receive an initial diagnosis of IBS each year. Persistent pain is recognized as one of the most pervasive and challenging problems facing the medical community today. Persistent pain is considered more as a complex pathophysiological, diagnostic and therapeutic situation rather than as a persistent symptom. The low efficiency of conventional drug treatments has led many doctors to become interested in the non-drug alternative treatment of IBS, especially for more severe cases. Patients and providers are often dissatisfied with the available drug remedies and often seek complementary and alternative medicine (CAM), a unique and holistic approach to treatment that is not a typical component of conventional medicine. Osteopathic treatment may be of specific interest in patients with IBS. Osteopathy is a complementary health approach that emphasizes the role of the musculoskeletal system in health and promotes optimal function of the body's tissues using a variety of manual techniques to improve body function. Osteopathy has been defined as a patient-centered health discipline based on the principles of interrelation between body structure and function, the body's innate capacity for self-healing and the adoption of a whole person health approach. mainly by practicing manual processing. Studies reported that osteopathic manual treatment (OMT) reduced IBS symptoms, such as abdominal pain, constipation, diarrhea, and improved general well-being. The focus in the treatment of IBS with osteopathy has gone beyond simple spinal alignment, to directly address the abnormal physiology of the body using a series of direct and indirect techniques. The topic of this study was chosen for different reasons: due to the large number of people involved who suffer from this disorder and for the dysfunction itself, since nowadays there is still little clarity about the best type of treatment and, above all, to its origin. The visceral component in the osteopathic field is still a world to be discovered, although it is related to a large part of patient series, it has contents that affect numerous disciplines and this makes it an enigma yet to be solved. The study originated in the didactic practice where the curiosity of a topic is marked that, even today, no one is able to explain and, above all, cure definitively. The main purpose of this study is to try to create a good basis on the osteopathic discipline for subsequent studies that can be exhaustive in the best possible way, resolving some doubts about which treatment modality can be used with more relevance. The path was decided to structure it in such a way that 3 types of osteopathic treatment are used on 3 groups of people who will be selected after completing a questionnaire, which will deem them suitable for the study. They will, in fact, be divided into three groups where: - the first group was given a visceral osteopathic treatment. - The second group was given a manual osteopathic treatment of neurological stimulation. - The third group received a placebo treatment. At the end of the treatment, questionnaires will be re-proposed respectively one week after the session and one month after the treatment from which any data will be collected that will demonstrate the effectiveness or otherwise of the treatment received. The sample of 50 patients examined underwent an oral interview to evaluate the inclusion and exclusion criteria to participate in the study. Of the 50 patients questioned, 17 people who underwent different osteopathic techniques were eligible for the study. Comparing the data related to the first assessment of tenderness and frequency of symptoms with the data related to the first follow-up shows a significant improvement in the score assigned to the different questions, especially in the neurogenic and visceral groups. We are aware of the fact that it is a study performed on a small sample of patients, and this is a penalizing factor. We remain, however, convinced that having obtained good results in terms of subjective improvement in the quality of life of the subjects, it would be very interesting to re-propose the study on a larger sample and fill the gaps.

Keywords: IBS, osteopathy, colon, intestinal inflammation

Procedia PDF Downloads 78

Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Manikandan S. P., Sharmila N.

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Pain in the neck, intermediate and anterior, and even low back may occur in one or more locations. Numerous factors can lead to back discomfort, which can manifest into sensations in the other parts of your body. Up to 80% of people will have low back problems at a certain stage of their lives, making spine-related pain a highly prevalent ailment. Roughly twice as commonly as neck pain, low back discomfort also happens about as often as knee pain. According to current studies, using digital devices for extended periods of time and poor sitting posture are the main causes of neck and low back pain. There are numerous monitoring techniques provided to enhance the sitting posture for the aforementioned problems. A sophisticated technique to monitor the extended sitting position is suggested in this research based on this problem. The system is made up of an inertial measurement unit, a T-shirt, an Arduino board, a buzzer, and a mobile app with cloud services. Based on the anatomical position of the spinal cord, the inertial measurement unit was positioned on the inner back side of the T-shirt. The IMU (inertial measurement unit) sensor will evaluate the hip position, imbalanced shoulder, and bending angle. Based on the output provided by the IMU, the data will be analyzed by Arduino, supplied through the cloud, and shared with a mobile app for continuous monitoring. The buzzer will sound if the measured data is mismatched with the human body's natural position. The implementation and data prediction with design to identify balanced and unbalanced posture using a posture monitoring t-shirt will be further discussed in this research article.

Keywords: IMU, posture, IOT, textile

Procedia PDF Downloads 53

Authors: Rahul Magazine, Shobitha Rao

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The aim of this study was to study the prescribing pattern of drugs in patients with ARDS (Acute Respiratory Distress Syndrome) managed at a tertiary care hospital. This observational study was conducted at Kasturba Hospital, Karnataka, India. Data of patients admitted from January 2010 to December 2012 was collected. A total of 150 patients of ARDS were included. Data included patients’ age, gender, clinical disorders precipitating ARDS, and prescribing pattern of drugs. The mean age of the study population was 42.92±13.91 years. 48% of patients were less than 40 years of age. Infection was the cause of ARDS in 81.3% of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3%. 41.3% were prescribed corticosteroids, 39.3% diuretics and 89.3% intravenous fluids. Infection was the commonest etiology for ARDS, and beta-lactams were the commonest antibiotics prescribed. Corticosteroids and diuretics were prescribed in a significant number of patients. Most of the patients received intravenous fluids.

Keywords: acute respiratory syndrome, beta lactams, corticosteroids, Acute Respiratory Distress Syndrome (ARDS)

Procedia PDF Downloads 349

Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

Procedia PDF Downloads 56

Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

Procedia PDF Downloads 273

Authors: Faezeh Jahanpour, Shahin Dezhdar, Saeedeh Firouz Bakht, Afshin Ostovar

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Objective: The hospitalized premature babies often undergo various painful procedures such as venous sampling. The Kangaroo mother care (KMC) method is one of the pain reduction methods, but as mother’s presence is not always possible, this research was done to compare the effect of swaddling and KMC method on venous sampling pain on premature neonates. Methods: In this randomized clinical trial 90 premature infants selected and randomly alocated into three groups; Group A (swaddling), Group B (the kangaroo care), and group C (the control). From 10 minutes before blood sampling to 2 minutes after that in group A, the infant was wrapped in a thin sheet, and in group B, the infant was under Kangaroo care. In all three groups, the heart rate and arterial oxygen saturation in time intervals of 30 seconds before, during, 30-60-90, and 120 seconds after sampling were measured and recorded. The infant’s face was video recorded since sampling till 2 minutes and the videos were checked by a researcher who was unaware of the kind of intervention and the pain assessment tools for infants (PIPP) for time intervals of 30 seconds were completed. Data analyzed by t-test, Q square, Repeated Measure ANOVA, Kruskal-Wallis, Post-hoc and Bonferroni test. Results: Findings revealed that the pain was reduced to a great extent in swaddling and kangaroo method compared to that in control group. But there was not a significant difference between kangaroo and swaddling care method (P ≥ 0.05). In addition, the findings showed that the heart rate and arterial oxygen saturation was low and stable in swaddling and Kangaroo care method and returned to base status faster, whereas, the changes were severe in control group and did not return to base status even after 120 seconds. Discussion: The results of this study showed that there was not a meaningful difference between swaddling and kangaroo care method on physiological indexes and pain in infants. Therefore, swaddling method can be a good substitute for kangaroo care method in this regard.

Keywords: Kangaroo mother care, neonate, pain, premature, swaddling, venipuncture,

Procedia PDF Downloads 191

Authors: Mohd Fadzly Yahya, Matthew Teo Yong Chang

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Globally, the increasing life expectancy of human beings has brought more issues with non-communicable diseases, especially work-related musculoskeletal disorders (WMDs). WMSD also is one of the leading causes of health-related absence from work restricted work time in Malaysia. WMDs are cumulative disorders, resulting from repeated exposure to high or low-intensity loads over a long period. Evidence from a previous study showed that office workers in government and private sectors were showing high WRMDs prevalence in Malaysia. The objectives of this study were to determine the prevalence of MSDs among Malaysian office workers in Klang Valley and to identify the association between MSDs pain and working experience among office workers. This is a cross-sectional study focusing on officer workers in the Klang Valley area. The questionnaires consisted of the subject’s demographics, Nordic Musculoskeletal Questionnaire, and The Numeric Pain Rating Scale were distributed online via google forms to all consenting participants. The data were analyzed for descriptive analysis, parametric test, and student T-test using IBM SPSS Statistics Version 27. From a total of 244 participants, 95 (38.9%) were male and 149 (61.1%) were female. 57.8% of the total samples were government staff while private-sector workers were 42.2%. The highest MSDs prevalence was neck pain during the last 12 months which contributed to 69.3% (n=169) of total participants, which is male 38.5% (n=65) and female 61.5% (n=104). Our study revealed that female office workers have a higher prevalence of WMDs and there is a significant difference in elbow pain, wrist, and hands pain, and lower back pain across four different working experience groups. Office workers in this study were highly exposed to MSDs due to poor ergonomics implementation at the workplace. It is crucial to advocate preventative measures to employers such as workplace ergonomics and changes to work practices to reduce the incidence of MSDs cases in office settings.

Keywords: musculoskeletal disorders, pain, prevalence rate, office workers, risks

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

Procedia PDF Downloads 317

Authors: Dipanshu Sur, Ratnabali Chakravorty

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Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

Procedia PDF Downloads 286

Authors: Maria Do Carmo Baracho De Alencar

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Back pain is considered a worldwide public health problem and has led to numerous work-related absence from work and public spending on rehabilitation, as well as difficulties in the process of professional rehabilitation and return to work. Also, the rehabilitation of workers is one of the great challenges today and for the field of Workers' Health in Brazil. Aim: To investigate the procedures related to the professional rehabilitation of insured workers affected by chronic low back pain, based on the perceptions of professional counselors. Methods: A list of related professional counselors was obtained from the Professional Rehabilitation Coordination of the Baixada Santista (SP) region, and from the Social Security National Institute of Brazil, and in which cities they worked. Semistructured and individual interview was scheduled, based on a pre-elaborated script, containing questions about procedures, experiences at work and feelings. The interviews were recorded and transcribed in full for content analysis. Results: Ten (10) professional counselors of both genders and from nine (9) cities from the Baixada Santista region participated in the study. Aged between 31 and 64 years, and time in service between 4 and 38 years. Only one of the professionals was graduaded in Psychology. Among the testimonies emerged the high demand of work, the lack of interest of companies, medical authority, the social helplessness after rehabilitation process, difficulty in assessing invisible pain, and suffering, anguish, and frustration at work, between others. Conclusion: The study contributes to reflections about the importance of interdisciplinary actions and the Psychology in the processes of professional rehabilitation and readaptation in the process of return to work.

Keywords: low back pain, rehabilitation, work, occupational health

Procedia PDF Downloads 110