Search results for: combined modality therapy

Authors: Ramesh Chandra Patra, Ajay P. Gautam, Patitapaban Mohanty

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Headache disorders are one of the 10 most disabling conditions for men and women. Headache that originated from upper cervical spine and refereed to the one side of the head and/or face is known as cervicogenic headache (CH) which constitute15% to 20% among all the headaches. In our best knowledge manual therapy is often advocated for managing CH, but very little focus given on muscle system although it is a musculoskeletal disorder. In this study, 75 patients with CH were selected and divided into two groups Group A: Manual therapy and Group B: dry needling along with manual therapy group. Assessment was done using NPRS (0-10) for pain, wide spread pressure pain threshold using an algometer at the beginning and end of the study. There is a consistent reduction in pain and tenderness in both the group but significant improvement was shown in combined group. Outcome of the study has explored that the effectiveness of dry needling along with Mulligan is more beneficial in patients with cervicogenic headaches.

Keywords: cervicogenic headaches, dry needling, NPRS, pressure point threshold

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Authors: Rui Sang, Fei Deng, Alexander Engel, Ewa M. Goldys, Wei Deng

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In this study, we brought together X-ray induced photodynamic therapy (X-PDT) and chemo-drug (5-FU) for the treatment on colorectal cancer cells. This was achieved by developing a lipid-polymer hybrid nanoparticle delivery system (FA-LPNPs-VP-5-FU). It was prepared by incorporating a photosensitizer (verteporfin), chemotherapy drug (5-FU), and a targeting moiety (folic acid) into one platform. The average size of these nanoparticles was around 100 nm with low polydispersity. When exposed to clinical doses of 4 Gy X-ray radiation, FA-LPNPs-VP-5-FU generated sufficient amounts of reactive oxygen species, triggering the apoptosis and necrosis pathway of cancer cells. Our combined X-PDT and chemo-drug strategy was effective in inhibiting cancer cells’ growth and proliferation. Cell cycle analyses revealed that our treatment induced G2/M and S phase arrest in HCT116 cells. Our results indicate that this combined treatment provides better antitumour effect in colorectal cancer cells than each of these modalities alone. This may offer a novel approach for effective colorectal cancer treatment with reduced off-target effect and drug toxicity.

Keywords: pdt, targeted lipid-polymer nanoparticles, verteporfin, colorectal cancer

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Authors: Joana Portia Sakyi

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The uniqueness of auxiliary verbs and their contribution to grammar as constituents, which act as preverbs to supply additional grammatical or functional meanings to clauses, are well established. Functionally, they relate clauses to tense, aspect, mood, voice, emphasis, and modality, along with the main verbs conveying the appropriate lexical content. There has been an issue in Akan grammar vis-à-vis the status of auxiliary verbs, in terms of whether Akan has auxiliaries or not and even which forms are to be regarded as auxiliaries. We investigate the syntactic, semantic, and pragmatic components of expressions and claim that Akan has auxiliary verbs that contribute the functional or grammatical meaning of modality, tense/aspect, etc., to clauses they occur in. Essentially, we use a self-created corpus data to consider the affix bέ- ‘may’, ‘must’, ‘should’; the form tùmí ‘can’, ‘be able to’; mà ‘to let’, ‘to allow’, ‘to permit’, ‘to make’, or ‘to cause’ someone to do something; the multi-word forms ὲsὲ sέ ‘must’, ‘should’ or ‘have to’ and ètwà sέ ‘must’, ‘should’ or ‘have to’, and assert that they are legitimate modal auxiliaries conveying epistemic, deontic, and dynamic modalities, as well as other meanings in the language.

Keywords: Akan, modality, modal auxiliaries, semantics

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Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

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Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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Authors: Matthew Montebello

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The way e-learning effectiveness has been notoriously measured within an academic setting is by comparing the e-learning medium to the traditional face-to-face teaching methodology. In this paper, a simple yet innovative comparison methodology is introduced, whereby the effectiveness of next generation e-learning systems are assessed in contrast not only to the face-to-face mode, but also to the classical e-learning modality. Ethical and logistical issues are also discussed, as this three-way approach to compare teaching methodologies was applied and documented in a real empirical study within a higher education institution.

Keywords: e-learning effectiveness, higher education, teaching modality comparison

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Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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Authors: Auj-E Taqaddas

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The use of proton beam therapy is increasing globally. It seems to offer dosimetric advantages, especially in paediatric central nervous system (CNS) and brain tumours. A short E-survey was conducted to assess the clinical, technical, and educational resources and strategies employed in the state of the art proton beam therapy (PBT) centres in the USA to determine the current status of proton beam therapy. The study also aimed at finding out which PBT skills are in demand as well as what improvements are needed to ensure efficient treatment planning, delivery, and dosimetry. The study resulted in identifying areas for future research and development and in identifying cancers for which PBT is most suitable compared to other modalities to facilitate the implementation and use of PBT in clinical settings for cancer treatment.

Keywords: cancer, intensity modulated proton therapy, proton beam therapy, single field uniform scanning

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Authors: Eva Kirzner

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Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

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Authors: Faith Fang Xi Ooi, Kam-Fong Lee

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Headlines are generally the summary of the content of news articles. With the added influence of hectic lifestyles, readers may rely solely on the headlines for information. In the media, what is reported concerning health issues are government responses and community involvement. There is a need for a call to action to curb health issues and not just reporting on what the government is doing about these health-related issues. In other words, linguistic elements of persuasive communicative function should be realized when reporting on health issues. Hence, this paper aims at identifying and analyzing the transitivity, Mood and Modality systems in two hundred news headlines from two Malaysian online news portals, namely The Star Online and New Straits Times. This study employs the purposive sampling method to obtain the news headlines on healthy eating using the search keyword ‘healthy eating’ and is based on Halliday’s Systemic Functional Linguistics (SFL) framework. The results show that the Material process dominates the process types along with its participants of Scope and Goal. The mood type that constitutes most of the headlines in the two newspapers is the declarative mood. Moreover, for Modality, the median Probability constitutes the highest in the headlines on healthy eating. This study contributes to the implications of being a source of reference for news writers and producers in constructing news headlines and for health campaign strategists to realize the persuasive appeals to influence behaviors and attitudes of the public towards healthy eating.

Keywords: healthy eating, modality, mood, news headlines, SFL

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Authors: Siamak Samani, Nadereh Sohrabi

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Psychological nano-therapy is a new method based on systems theory. According to the theory, systems with severe dysfunctions are resistant to changes. Psychological nano-therapy helps the therapists to break this ice. Two key concepts in psychological nano-therapy are nano-functions and nano-behaviors. The most important step in psychological nano-therapy in family therapy is selecting the most effective nano-function and nano-behavior. The aim of this study was to check the effectiveness of psychological nano-therapy for family therapy. One group pre-test-post-test design (quasi-experimental Design) was applied for research. The sample consisted of ten families with severe marital conflict. The important character of these families was resistance for participating in family therapy. In this study, sending respectful (nano-function) text massages (nano-behavior) with cell phone were applied as a treatment. Cohesion/respect sub scale from self-report family processes scale and family readiness for therapy scale were used to assess all family members in pre-test and post-test. In this study, one of family members was asked to send a respectful text massage to other family members every day for a week. The content of the text massages were selected and checked by therapist. To compare the scores of families in pre-test and post-test paired sample t-test was used. The results of the test showed significant differences in both cohesion/respect score and family readiness for therapy between per-test and post-test. The results revealed that these families have found a better atmosphere for participation in a complete family therapy program. Indeed, this study showed that psychological nano-therapy is an effective method to make family readiness for therapy.

Keywords: family therapy, family conflicts, nano-therapy, family readiness

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Authors: Farnaz Dehkhoda

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This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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Authors: Sachinkumar Patil, Sonali Patil, Shitalkumar Patil

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Nanoparticles played important role in the biomedicine. New advanced methods having great potential apllication in the diagnosis and therapy of cancer. Now a day’s magnetic nanoparticles used in cancer therapy. Cancer is the major disease causes death. Magnetic nanoparticles show response to the magnetic field on the basis of this property they are used in cancer therapy. Cancer treated with hyperthermia by using magnetic nanoparticles it is unconventional but more safe and effective method. Magnetic nanoparticles prepared by using different innovative techniques that makes particles in uniform size and desired effect. Magnetic nanoparticles already used as contrast media in magnetic resonance imaging. A magnetic nanoparticle has been great potential application in cancer diagnosis and treatment as well as in gene therapy. In this review we will discuss the progress in cancer therapy based on magnetic nanoparticles, mainly including magnetic hyperthermia, synthesis and characterization of magnetic nanoparticles, mechanism of magnetic nanoparticles and application of magnetic nanoparticles.

Keywords: magnetic nanoparticles, synthesis, characterization, cancer therapy, hyperthermia, application

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Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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Authors: Yu Chen

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Auricular-magnet therapy is the development of auricular acupuncture. It is a powerful, convenient, and quick result-achieving therapeutic method. This therapy works by using magnetic discs to be placed on acupuncture points on the ears to treat diseases and improve health. In this study, the fundamental principles, indications, and contraindications of this therapy are discussed. Five examples, including reducing blood glucose levels, healing gangrene for diabetes patients, and treating Bell's palsy, are presented. Auricular-magnet therapy is a powerful development in acupuncture.

Keywords: auricular-magnet therapy, Bell’s palsy, diabetes mellitus, food craving, insomnia, nausea, obesity

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Authors: Myriam Rousseau, Marie-Hélène Poulin, Suzie McKinnon, Jacinthe Bourassa

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Context: There is a growing demand for effective training programs for parents of children with autism spectrum disorders. While traditional in-person training is effective, it can be difficult for some parents to participate due to distance, time, and cost. Telepractice, a form of distance education, could be a viable alternative to address these challenges. Research objective: The objective of this study is to explore the experiences of parents of children with autism who participated in a training program offered by telepractice in order to document: 1) the experience of parents who participated in a program telepractice training program for autistic children, 2) parental satisfaction with the telepractice modality, and 3) potential benefits of using telepractice to deliver training programs to parents of autistic children. Method: This study followed a qualitative research design, and Braun and Clarke's six-step procedure was used for the thematic analysis of the comments provided by parents. Data were collected through individual interviews with parents who participated in the project. The analysis focused on identifying patterns and themes in the comments in order to better understand parents' experiences with the telepractice modality. Results: The study revealed that parents were generally satisfied with the telepractice modality, as it was easy to use and enabled a better balance between work and family. This modality also enabled parents to share and receive mutual support. Despite the positive results, it is still relevant to offer training in different modalities to meet the different needs of parents. Conclusion: The study shows that parents of children with autism are generally satisfied with telepractice as a training modality. The results suggest that telepractice can be an effective alternative to traditional face-to-face training. The study highlights the importance of taking parents' needs and preferences into account when designing and implementing training programs.

Keywords: parents, children, training, telepractice

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Mohammed M. Mahdy Tawfeek

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Objective: The aim of this work is to compare the outcome of photoactivated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) alone with combined PACK-CXL WA and standard anti-microbial therapy (SAT) for the treatment of infectious keratitis. Patients and Methods: This is a randomized prospective comparative clinical trial. Thirty eyes with clinically suspected infectious keratitis were randomly assigned into two equal groups of 15 eyes each: Group (A) was treated by PACK-CXL WA alone and group (B) was treated by PACK-CXL WA combined with SAT. Identification of organisms was made by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT). Written informed consent was obtained from all participants and the study was approved by the research ethics committee of the Faculty of Medicine, Zagazig University. The work has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results: Complete healing and resolution (Successful treatment) were observed in 10 eyes (66.7%) of a group (A) and 14 eyes (93.3%) of group (B) and failure was observed in 5 eyes (33.3%) of a group (A) and one eye (6.67%) of group (B). They were statistically significant (P =0.042 and 0.003) in a comparison between both groups regarding success and failure of treatment, respectively. Complete corneal healing was reported in the third month postoperatively in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B). Complications were absent in 12 patients (80%) in group (A) and 14 patients (93.3%) of group (B); however, perforation and impending perforation were found in 3 patients of group (A) and only one patient of group (B). Conclusion: PACK-CXL is a promising, non-invasive treatment option for infectious keratitis, especially when performed with the window absorption (WA) technique, either alone or combined with SAT. It has a synergistic effect with a standard antimicrobial treatment that gives good outcome results in the treatment of infectious keratitis. Also, it avoids the antibiotics resistance that has become rapidly spreading worldwide.

Keywords: corneal cross linking, infectious keratitis, PACK-CXL, window absorption

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Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

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The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

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Authors: Maha Saliba Foster

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Speech perception has been recognized as a bi-sensory process involving the auditory and visual channels. Compared to the auditory modality, the contribution of the visual signal to speech perception is not very well understood. Studying how the visual modality affects speech recognition can have pedagogical implications in second language learning, as well as clinical application in speech therapy. The current investigation explores the potential effect of speech visual cues on the perception of Arabic emphatics (AEs). The corpus consists of 36 minimal pairs each containing two contrasting consonants, an AE versus a non-emphatic (NE). Movies of four Lebanese speakers were edited to allow perceivers to have partial view of facial regions: lips only, lips-cheeks, lips-chin, lips-cheeks-chin, lips-cheeks-chin-neck. In the absence of any auditory information and relying solely on visual speech, perceivers were above chance at correctly identifying AEs or NEs across vowel contexts; moreover, the models were able to predict the probability of perceivers’ accuracy in identifying some of the COIs produced by certain speakers; additionally, results showed an overlap between the measurements selected by the computer and those selected by human perceivers. The lack of significant face effect on the perception of AEs seems to point to the lips, present in all of the videos, as the most important and often sufficient facial feature for emphasis recognition. Future investigations will aim at refining the analyses of visual cues used by perceivers by using Principal Component Analysis and including time evolution of facial feature measurements.

Keywords: Arabic emphatics, machine learning, speech perception, visual speech perception

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Authors: T. Hennedige

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Imaging plays a crucial role in the evaluation of the extent of peritoneal disease, which in turn determines prognosis and treatment choice. Despite advances in imaging technology, assessment of the peritoneum remains relatively challenging secondary to its large surface area, complex anatomy, and variety of imaging modalities available. This poster will review the mechanisms of spread, namely intraperitoneal dissemination, directly along peritoneal pathways, haematogeneous dissemination, and lymphatic spread. This will be followed by a side-by-side pictorial comparison of the detection of peritoneal deposits using CT, MRI, and PET/CT, depicting the advantages and shortcomings of each modality. An imaging selection framework will then be presented, which may aid the clinician in selecting the appropriate imaging modality for the malignancy in question.

Keywords: imaging, CT, malignancy, MRI, peritoneum, PET

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Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Eman Tadros, Natasha Finney

Abstract:

The following case study involving a high-conflict, Children’s Services Bureau (CSB) referred couple is analyzed and reviewed through an integrated lens of structural family therapy and dialectical behavior therapy. In structural family therapy, normal family development is not characterized by a lack of problems, but instead by families’ having developed a functional structure for dealing with their problems. Whereas, in dialectical behavioral therapy normal family development can be characterized by having a supportive and validating environment, where all family members feel a sense of acceptance and validation for who they are and where they are in life. The clinical case conceptualization highlights the importance of conceptualizing how change occurs within a therapeutic setting. In the current case study, the couple did not only experience high-conflict, but there were also issues of substance use, health issues, and other complicating factors. Clinicians should view their clients holistically and tailor their treatment to fit their unique needs. In this framework, change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures.

Keywords: couples, dialectical behavior therapy, high-conflict, structural family therapy

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Authors: M. Krishna

Abstract:

The study was intended to identify if scalp cooling therapy is effective on preventing chemotherapy-induced hair loss among cancer patients. Critical literature of non-randomized controlled trials was used to investigate whether scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. The review identified that scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. Most of the patients receiving chemotherapy experience alopecia. It is also perceived as the worst effect of chemotherapy. This may be severe and lead the patients to withdraw the chemo treatment. The image disturbance caused by alopecia will make the patient depressed and will lead to declined immunity. With the knowledge on effectiveness of scalp cooling therapy on preventing chemotherapy-induced alopecia, patient undergoing chemotherapy will not be hesitant to undergo the treatment. Patients are recommended to go through scalp cooling therapy every chemo cycle and the proper therapy duration is 30 minutes before, during chemo. The suggested duration of the scalp cooling therapy is 45-90 minutes for an effective and positive outcome. This finding is excluding other factors of alopecia such as menopause, therapeutic drugs, poor hair density, liver function problems, and drug regimes.

Keywords: alopecia, cancer, chemotherapy, scalp cooling therapy

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Authors: Rachel Matar, Maxime Merheb

Abstract:

Chemical drugs have been used for many centuries as the only way to cure diseases until the novel gene therapy has been created in 1960. Gene therapy is based on the insertion, correction, or inactivation of genes to treat people with genetic illness (1). Gene therapy has made wonders in Parkison’s, Alzheimer and multiple sclerosis. In addition to great promises in the healing of deadly diseases like many types of cancer and autoimmune diseases (2). This method implies the use of recombinant DNA technology with the help of different viral and non-viral vectors (3). It is nowadays used in somatic cells as well as embryos and gametes. Beside all the benefits of gene therapy, this technique is deemed by some opponents as an ethically unacceptable treatment as it implies playing with the genes of living organisms.

Keywords: gene therapy, genetic disease, cancer, multiple sclerosis

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Authors: Jiwon Oh, Hyunjoo Oh, Seungwon Shin, Junghee Yoo, Euiju Lee

Abstract:

Background and Aims: This systematic review aimed at briefly exploring how effective pharmacoacupuncture therapy for dizziness is. Methods: We searched publications in Medline, EMBASE, Cochrane Library, KoreaMed, China National Knowledge Infrastructure (CNKI), Cinii, DBpia, KSI, Kiss, KMbase, NDSL and RISS. We included randomized controlled trials and well-designed non-randomized controlled trials that compared the effects of only pharmacoacupuncture or pharmacoacupuncture and usual therapies with any controls for dizziness. Results: The risk of bias was assessed using the Cochrane tool. Three studies have been included with eligibility criteria. The prevalence of "unclear" ratings in the risk assessment results is predominantly due to the included studies reporting their findings inadequately. This review found evidence that pharmacoacupuncture therapy was effective as an add-on therapy to acupoint therapy physiotherapy and had additional benefits in increasing CER for cervical vertigo. Also, it was recommended that pharmacoacupuncture therapy was effective as an add-on therapy to Western medicine and had additional benefits in increasing CER for vasovagal syncope. Conclusions: Pharmacoacupuncture therapy had additional benefits as an add-on therapy for cervical vertigo and vasovagal syncope. However, further studies are required to overcome the limitations of the lack of study qualities.

Keywords: pharmacoacupuncture therapy, dizziness, systematic review, traditional Korean medicine

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Authors: P. S. Jagadeesh Kumar, Mingmin Pan, Xianpei Li, Yanmin Yuan, Tracy Lin Huan

Abstract:

Researchers are doing enchanting research into the inherited features of Alzheimer’s disease and probable consistent therapies. In Alzheimer’s, memories are extinct in reverse order; memories formed lately are more transitory than those from formerly. Reminiscence therapy includes the conversation of past actions, trials and knowledges with another individual or set of people, frequently with the help of perceptible reminders such as photos, household and other acquainted matters from the past, music and collection of tapes. In this manuscript, the competence of reminiscence therapy for Alzheimer’s disease is measured using logistic regression based linear bootstrap aggregating. Logistic regression is used to envisage the experiential features of the patient’s memory through various therapies. Linear bootstrap aggregating shows better stability and accuracy of reminiscence therapy used in statistical classification and regression of memories related to validation therapy, supportive psychotherapy, sensory integration and simulated presence therapy.

Keywords: Alzheimer’s disease, linear bootstrap aggregating, logistic regression, reminiscence therapy

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Authors: Sarah Elsayed Mohammed, Lamiaa Ahmed Ahmed, Mahmoud Mohammed Khattab

Abstract:

Aim: The aim of the present study was to investigate whether combined nicorandil and bone marrow-derived mesenchymal stem cells (BMDMSC) treatment could offer an additional benefit in ameliorating isoproterenol (ISO)-induced heart failure in rats. Methods: ISO (85 and 170 mg/kg/day) was injected subcutaneously for 2 successive days, respectively. By day 3, electrocardiographic changes were recorded and serum was separated for determination of CK-MB level for confirmation of myocardial damage. Nicorandil (3 mg/kg/day) was then given orally with or without a single i.v. BMDMSC administration. Electrocardiography and echocardiography were recorded 2 weeks after beginning of treatment. Rats were then sacrificed and ventricles were isolated for estimation of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) contents, caspase-3 activity as well as inducible nitric oxide synthase (iNOS) and connexin-43 protein expressions. Moreover, histological analysis of myocardial fibrosis was performed and cryosections were done for estimation of homing of BMDMSC. Results: ISO induced a significant increase in ventricles/body weight ratio, left ventricular end diastolic (LVEDD) and systolic dimensions (LVESD), ST segment and QRS duration. Moreover, myocardial fibrosis as well as VEGF, TNF-α and TGF-β contents were significantly increased. On the other hand, connexin-43 protein expression was significantly decreased, while caspase-3 and iNOS protein expressions were significantly increased. Combined therapy provided additional improvement compared to cell treatment alone towards reducing cardiac hypertrophy, fibrosis and inflammation. Furthermore, combined therapy induced significant increase in angiogenesis and BMDMSC homing and prevented ISO induced changes in iNOS, connexin-43 and caspase-3 protein expressions. Conclusion: Combined nicorandil/BMDMSC treatment was superior to BMDMSC alone towards preventing ISO-induced heart failure in rats.

Keywords: fibrosis, isoproterenol, mesenchymal stem cells, nicorandil

Procedia PDF Downloads 498