Search results for: nerve locator

Authors: P.J. Jiji, B.V. Murlimanju, Latha V. Prabhu, Mangala M. Pai

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Background: The lunate bone dislocation can lead to the compression of the median nerve and subsequent carpal tunnel syndrome. The dislocation can interrupt the vasculature and would cause avascular necrosis. The objective of the present study was to study the morphology and number of the nutrient foramina in the cadaveric dried lunate bones of the Indian population. Methods: The present study included 28 lunate bones (13 right sided and 15 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the lunate bones. The foramen ranged between 2 and 10. The foramina were more in number over the dorsal surface (average number 3.3) in comparison to the palmar surface (average number 2.4). Conclusion: We believe that the present study has provided important data about the nutrient foramina of the lunate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the lunatomalacia and Kienbock’s disease.

Keywords: avascular necrosis, foramen, lunate, nutrient

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Authors: Anat Achiron

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Background: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system in young adults. It involves the immune system attacking the protective covering of nerve fibers (myelin), leading to inflammation and damage. MS can result in various neurological symptoms, such as muscle weakness, coordination problems, and sensory disturbances. Seizures are not common in MS, and the frequency is estimated between 0.4 to 6.4% over the disease course. Objective: Investigate the frequency of seizures in individuals with multiple sclerosis and to identify associated risk factors. Methods: We evaluated the frequency of seizures in a large cohort of 5686 MS patients followed at the Sheba Multiple Sclerosis Center and studied associated risk factors and comorbidities. Our research was based on data collection using a cohort study design. We applied logistic regression analysis to assess the strength of associations. Results: We found that younger age at onset, longer disease duration, and prolonged time to immunomodulatory treatment initiation were associated with increased risk for seizures. Conclusions: Our findings suggest that seizures in people with MS are directly related to the demyelination process and not associated with other factors like medication side effects or comorbid conditions. Therefore, initiating immunomodulatory treatment early in the disease course could reduce not only disease activity but also decrease seizure risk.

Keywords: epilepsy, seizures, multiple sclerosis, white matter, age

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Authors: Yung-Chih Kuo, Che-Yu Lin, Jay-Shake Li, Yung-I Lou

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Curcumin (CRM) and nerve growth factor (NGF) were entrapped in liposomes (LIP) with cardiolipin (CL) to downregulate the phosphorylation of mitogen-activated protein kinases for Alzheimer’s disease (AD) management. AD belongs to neurodegenerative disorder with a gradual loss of memory, yielding irreversible dementia. CL-conjugated LIP loaded with CRM (CRM-CL/LIP) and that with NGF (NGF-CL/LIP) were applied to AD models of SK-N-MC cells and Wistar rats with an insult of β-amyloid peptide (Aβ). Lipids comprising 1,2-dipalmitoyl-sn-glycero-3- phosphocholine (Avanti Polar Lipids, Alabaster, AL), 1',3'-bis[1,2- dimyristoyl-sn-glycero-3-phospho]-sn-glycerol (CL; Avanti Polar Lipids), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-N- [methoxy(polyethylene glycol)-2000] (Avanti Polar Lipids), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[carboxy(polyethylene glycol)-2000] (Avanti Polar Lipids) and CRM (Sigma–Aldrich, St. Louis, MO) were dissolved in chloroform (J. T. Baker, Phillipsburg, NJ) and condensed using a rotary evaporator (Panchum, Kaohsiung, Taiwan). Human β-NGF (Alomone Lab, Jerusalem, Israel) was added in the aqueous phase. Wheat germ agglutinin (WGA; Medicago AB, Uppsala, Sweden) was grafted on LIP loaded with CRM for (WGA-CRM-LIP) and CL-conjugated LIP loaded with CRM (WGA-CRM-CL/LIP) using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (Sigma–Aldrich) and N-hydroxysuccinimide (Alfa Aesar, Ward Hill, MA). The protein samples of SK-N-MC cells (American Type Tissue Collection, Rockville, MD) were used for sodium dodecyl sulfate (Sigma–Aldrich) polyacrylamide gel (Sigma–Aldrich) electrophoresis. In animal study, the LIP formulations were administered by intravenous injection via a tail vein of male Wistar rats (250–280 g, 8 weeks, BioLasco, Taipei, Taiwan), which were housed in the Animal Laboratory of National Chung Cheng University in accordance with the institutional guidelines and the guidelines of Animal Protection Committee under the Council of Agriculture of the Republic of China. We found that CRM-CL/LIP could inhibit the expressions of phosphorylated p38 (p-p38), p-Jun N-terminal kinase (p-JNK), and p-tau protein at serine 202 (p-Ser202) to retard the neuronal apoptosis. Free CRM and released CRM from CRM-LIP and CRM-CL/LIP were not in a straightforward manner to effectively inhibit the expression of p-p38 and p-JNK in the cytoplasm. In addition, NGF-CL/LIP enhanced the quantities of p-neurotrophic tyrosine kinase receptor type 1 (p-TrkA) and p-extracellular-signal-regulated kinase 5 (p-ERK5), preventing the Aβ-induced degeneration of neurons. The membrane fusion of NGF-LIP activated the ERK5 pathway and the targeting capacity of NGF-CL/LIP enhanced the possibility of released NGF to affect the TrkA level. Moreover, WGA-CRM-LIP improved the permeation of CRM across the blood–brain barrier (BBB) and significantly reduced the Aβ plaque deposition and malondialdehyde level and increased the percentage of normal neurons and cholinergic function in the hippocampus of AD rats. This was mainly because the encapsulated CRM was protected by LIP against a rapid degradation in the blood. Furthermore, WGA on LIP could target N-acetylglucosamine on endothelia and increased the quantity of CRM transported across the BBB. In addition, WGA-CRM-CL/LIP could be effective in suppressing the synthesis of acetylcholinesterase and reduced the decomposition of acetylcholine for better neurotransmission. Based on the in vitro and in vivo evidences, WGA-CRM-CL/LIP can rescue neurons from apoptosis in the brain and can be a promising drug delivery system for clinical AD therapy.

Keywords: Alzheimer’s disease, β-amyloid, liposome, mitogen-activated protein kinase

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

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Authors: Ezzati Givi M., Ezzatigivi N., Eimani H.

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Trigeminal Neuralgia (TN) consists of painful attacks often triggered with general activities, which cause impairment and disability. The first line of treatment consists of pharmacotherapy. However, the occurrence of many side-effects limits its application. Acute pain relief is crucial for titrating oral drugs and making time for neurosurgical intervention. This study aimed to examine the long-term anesthetic effect of QX-314 and capsaicin in trigeminal neuralgia using an animal model. TN was stimulated by surgical constriction of the infraorbital nerve in rats. After seven days, anesthesia infiltration was done, and the duration of mechanical allodynia was compared. Thirty-five male Wistar rats were randomly divided into seven groups as follows: control (normal saline); lidocaine (2%); QX314 (30 mM); lidocaine (2%)+QX314 (15 mM); lidocaine (2%)+QX314 (22 mM); lidocaine (2%)+QX314 (30 mM); and lidocaine (2%)+QX314 (30 mM) +capsaicin (1μg). QX314 in combination with lidocaine significantly increased the duration of anesthesia, which was dose-dependent. The combination of lidocaine+QX314+capsaicin could significantly increase the duration of anesthesia in trigeminal neuralgia. In the present study, we demonstrated that the combination of QX-314 with lidocaine and capsaicin produced a long-lasting, reversible local anesthesia and was superior to lidocaine alone in the fields of the duration of trigeminal neuropathic pain blockage.

Keywords: trigeminal neuralgia, capsaicin, lidocaine, long-lasting

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Authors: Anasuya Ghosh, Subhramoy Chaudhury

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During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.

Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery

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Authors: Y. N. Reddy

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The class of differential-difference equations which have characteristics of both classes, i.e., delay/advance and singularly perturbed behaviour is known as singularly perturbed differential-difference equations. The expression ‘positive shift’ and ‘negative shift’ are also used for ‘advance’ and ‘delay’ respectively. In general, an ordinary differential equation in which the highest order derivative is multiplied by a small positive parameter and containing at least one delay/advance is known as singularly perturbed differential-difference equation. Singularly perturbed differential-difference equations arise in the modelling of various practical phenomena in bioscience, engineering, control theory, specifically in variational problems, in describing the human pupil-light reflex, in a variety of models for physiological processes or diseases and first exit time problems in the modelling of the determination of expected time for the generation of action potential in nerve cells by random synaptic inputs in dendrites. In this paper, we envisage the use of Liouville Green Transformation to find the solution of singularly perturbed differential difference equations. First, using Taylor series, the given singularly perturbed differential difference equation is approximated by an asymptotically equivalent singularly perturbation problem. Then the Liouville Green Transformation is applied to get the solution. Several model examples are solved, and the results are compared with other methods. It is observed that the present method gives better approximate solutions.

Keywords: difference equations, differential equations, singular perturbations, boundary layer

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Authors: Michael Stevens

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David Hunter, a musicologist, has suggested that both Beethoven and Handel had chronic lead poisoning from the wine that they drank. These two eminent musical composers had some striking similarities. Beethoven had alcohol dependency and preferred wine, to which lead had been added to improve the taste. Handel was obese due to an eating disorder that included drinking tainted wine after large meals. They both had paresthesia of their extremities that they interpreted as rheumatism. This is a common sensory symptom from chronic lead poisoning. Their differences are marked in that Beethoven was profoundly deaf by the end of his life, whereas Handel had remarkably good hearing. Handel had paresis of three fingers of his right hand, whereas Beethoven lacked any motor symptoms. Beethoven reported recurrent abdominal pain suggestive of lead colic, whereas it can only be inferred that this symptom was present in Handel. Lead poisoning is likely in Handel because his paralysis was consistent with radial nerve involvement in the dominant hand. In addition, it was cured by hot baths, which have been shown to reduce total body lead content by exchanging with iron and calcium ions in water. Although lead produces predominantly motor symptoms in classic or subacute lead poisoning, and sensory symptoms in chronic lead poisoning, lead poisoning causes a variety of symptoms that depending on duration and level of exposure, are extremely variable from person to person. It therefore seems likely that Handel had lead poisoning, but extremely likely that Beethoven did because of the confirmatory finding of high levels of lead deep in his skull bone, which is a good measure of total body burden.

Keywords: beethoven, handel, lead, poisoning

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Authors: Waseem Al Talalwah, Shorok Al Dorazi, Roger Soames

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The inferior gluteal artery is a prominent branch of the anterior trunk of internal iliac artery. It escapes from the pelvic cavity through the greater sciatic foramen below the lower edge of piriformis. In gluteal region, it provides several muscular branches to gluteal maximus and articular branch to hip joint. Further, it provides sciatic branch to sciatic nerve. Current study investigates the origin of the inferior gluteal artery of 41 cadavers in Centre for Anatomy and Human Identification, University of Dundee, UK. It arose from the anterior trunk in 37.5% independently and 45.7% dependently as with the internal pudendal artery. Therefore, it arose from the anterior trunk in 83.2%. However, it found to be as a branch of the posterior trunk of internal iliac artery in 7.7% which is either a direct branch in 6.2% as or indirect branch in 1.5%. Beside the inferior gluteal artery arose with internal pudendal artery as from GPT of anterior division in 45.7%, it arose from the GPT arising from the internal iliac artery bifurcation site in 1.5%. Further, the inferior gluteal artery arose from the trunk with internal pudendal and obturator arteries in 1.5% referred as obturatogluteopudendal trunk. Occasionally, it arose from the sciatic artery in 1.5%. In few cases, the inferior gluteal artery found to be congenital absence in 4.6% which is compensated by the persistent sciatic artery. Therefore, radiologists have to aware of the origin variability of the inferior gluteal artery to alert surgeons. Knowing the origin of the inferior gluteal artery may help the surgeons to avoid iatrogenic sciatic neuropathy in pelvic procedures such as removing prostate or of uterine fibroid. Further, it may also prevent avascular necrosis of femur neck as well as gluteal claudication.

Keywords: inferior gluteal artery, internal iliac artery, sciatic neuropathy, gluteal claudication

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Authors: Amany Mohamed, Alaa Balbaa, Magdoline Mishel

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Background: Pain in the neck or scapular region is one of the most frequent symptoms in cervical radiculopathy, which is commonly caused by degenerative process in the spine. Purpose: To determine the effect of scapular stabilization exercises in the treatment of chronic neck pain regarding pain and disability and limitation in the range of motion. Patients and Methods: Thirty male and female patients with chronic neck pain were involved. Aged between 30-50 years old. They were randomly assigned into two groups. In group (A), patients received physical therapy program in the form of infrared, transcutaneous electrical nerve stimulation (TENS), Stretching and cervical stabilization exercises. In group (B), patients received scapular stabilization exercises in addition to the same physical therapy program. Treatment was given 3 times a week for 4 weeks. Range of motion of the cervical spine, range of motion of the scapula, neck pain and disability were assessed before and after treatment. Results: There was significant improvement in both groups (A and B) in cervical range of motion, pain and disability. Group (B) showed more significant improvement than group (A) in cervical range of motion and pain and disability. There was no significant improvement in both groups in scapular range of motion. Conclusion: Scapular stabilization exercises should be used as an integral part in the rehabilitation program

Keywords: Neck pain, neck stabilization exercise, scapular stabilization exercise, chronic neck pain

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Authors: Aman Upaganlawar, Chandrasekhar Upasani

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The present study was designed to screen the neuroprotective and antioxidant activity of corosolic acid in painful diabetic neuropathy (DN). Diabetes was induced in rats by single dose of STZ (60mg/kg, i.p). Diabetic rats were tested every week for the development of pain, at 5th week rats showed sensation of pain. At 6th week the rats developed significant neuropathic pain. They were divided into different groups and treated with Corosolic acid (2 and 4 mg/kg, p.o) for further two weeks. Pain was assessed in the diabetic rats by mechano-tactil allodynia, mechanical hyperalgesia and cold allodynia. At the end of treatment period rats were scarified and biochemical changes such as plasma glucose level, endogenous antioxidants (Lipid peroxidation, reduced glutathione, superoxide dismutase and catalase) in sciatic nerve were evaluated. Further Na+/K+ ATPase and nitric oxide content was also evaluated. Treatment with corosolic acid for two weeks restored the altered body weight and elevated blood sugar level. Further corosolic acid showed dose dependent reduction in pain in neuropathic animals. The level of endogenous antioxidants enzymes, Na+/K+ ATPase and nitric oxide were significantly prevented. In conclusion, the result of the present study suggests the antidiabetic, antioxidant and neuroprotectieve property of corosolic acid in diabetic rats with neuropathic pain.

Keywords: neuropathic pain, diabetes, corosolic acid, antioxidant

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Authors: Simon B. N. Thompson

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Cortisol is important to our immune system, regulates our stress response, and is a factor in maintaining brain temperature. Saliva cortisol is a practical and useful non-invasive measurement that signifies the presence of the important hormone. Electrical activity in the jaw muscles typically rises when the muscles are moved during yawning and the electrical level is found to be correlated with the cortisol level. In two studies using identical paradigms, a total of 108 healthy subjects were exposed to yawning-provoking stimuli so that their cortisol levels and electrical nerve impulses from their jaw muscles was recorded. Electrical activity is highly correlated with cortisol levels in healthy people. The Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details were collected and exclusion criteria applied for voluntary recruitment: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners as compared with the non-yawners between rest and post-stimuli. Significant evidence supports the Thompson Cortisol Hypothesis that suggests rises in cortisol levels are associated with yawning. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, diagnosis, neurological disease, thompson cortisol hypothesis, yawning

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Authors: Sushish Baral, Pratibha Joshi, Yaman Maharjan

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Glaucoma is a chronic eye condition that causes vision loss that is irreversible. Early detection and treatment are critical to prevent vision loss because it can be asymptomatic. For the identification of glaucoma, multiple deep learning algorithms are used. Transformer-based architectures, which use the self-attention mechanism to encode long-range dependencies and acquire extremely expressive representations, have recently become popular. Convolutional architectures, on the other hand, lack knowledge of long-range dependencies in the image due to their intrinsic inductive biases. The aforementioned statements inspire this thesis to look at transformer-based solutions and investigate the viability of adopting transformer-based network designs for glaucoma detection. Using retinal fundus images of the optic nerve head to develop a viable algorithm to assess the severity of glaucoma necessitates a large number of well-curated images. Initially, data is generated by augmenting ocular pictures. After that, the ocular images are pre-processed to make them ready for further processing. The system is trained using pre-processed images, and it classifies the input images as normal or glaucoma based on the features retrieved during training. The Vision Transformer (ViT) architecture is well suited to this situation, as it allows the self-attention mechanism to utilise structural modeling. Extensive experiments are run on the common dataset, and the results are thoroughly validated and visualized.

Keywords: glaucoma, vision transformer, convolutional architectures, retinal fundus images, self-attention, deep learning

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Authors: Osaretin Rosemary Uyi, A. O. Ogungbemi

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Female involvement in policy making and partnership in a man-driven-world is fast gaining international recognition. The Nigeria commercial real estate is one of the sectors of the economy that has a significant number of the male in the business. This study was conducted to assess the participation of females in estate management in Lagos state, Nigeria. Lagos is the commercial nerve center of Nigeria having the highest number of real estate practitioners and investors. The population due to the daily influx of people has made real estate business to continue to grow in this part of Nigeria. A structured questionnaire duly pre-tested and validated was used to elicit information from the respondents. The data collected were presented using tables and charts and were analyzed using descriptive statistical tools such as frequency counts, percentages, were used to test the hypothesis. The results also indicated that most females that participated in commercial real estate business are educated (80%), fell within 31-40 years of age (75%) and of high income status (88%) earn above ₦800,000 per year, while 10% are real estate investors and 82% of the female in the sector are employee. The study concluded that the number of female participating in various aspect of commercial real estate business in the study area was moderate while the numbers of female investors are low when compared to male. This might be due to the problems associated with rent collection, land disputes and other issues that are associated with property management in Nigeria. It is therefore recommended that females in real estate should be empowered and encouraged to match with their male counterpart.

Keywords: commercial real estate, empowerment, female, participation, property management

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Authors: Hyunsik Park

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As the rate of cerebrovascular disease increases in old populations, the prevalence rate of vascular dementia would be expected. Therefore, authors designed this study to find out the possibility of somatosensory evoked potentials(SSEP) as a parameter for early diagnosis and prognosis prediction of vascular dementia in cortical vascular dementia patients. 21 patients who met the criteria for vascular dementia according to DSM-IV,ICD-10and NINDS-AIREN with the history of recent cognitive impairment, fluctuation progression, and neurologic deficit. We subdivided these patients into two groups; a mild dementia and a severe dementia groups by MMSE and CDR score; and analysed comparison between normal control group and patient control group who have been cerebrovascular attack(CVA) history without dementia by using N20 latency and amplitude of median nerve. In this study, mild dementia group showed significant differences on latency and amplitude with normal control group(p-value<0.05) except patient control group(p-value>0.05). Severe dementia group showed significant differences both normal control group and patient control group.(p-value<0.05, <001). Since no significant difference has founded between mild dementia group and patient control group, SSEP has limitation to use for early diagnosis test. However, the comparison between severe dementia group and others showed significant results which indicate SSEP can predict the prognosis of vascular dementia in cortical vascular dementia patients.

Keywords: SSEP, cortical vascular dementia, N20 latency, N20 amplitude

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Authors: S. Aswath, Chinmaya Krishna Tilak, Amal Suresh, Ganesh Udupa

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There are technologies to control a humanoid robot in many ways. But the use of Electromyogram (EMG) electrodes has its own importance in setting up the control system. The EMG based control system helps to control robotic devices with more fidelity and precision. In this paper, development of an electromyogram based interface for human gesture recognition for the control of a humanoid robot is presented. To recognize control signs in the gestures, a single channel EMG sensor is positioned on the muscles of the human body. Instead of using a remote control unit, the humanoid robot is controlled by various gestures performed by the human. The EMG electrodes attached to the muscles generates an analog signal due to the effect of nerve impulses generated on moving muscles of the human being. The analog signals taken up from the muscles are supplied to a differential muscle sensor that processes the given signal to generate a signal suitable for the microcontroller to get the control over a humanoid robot. The signal from the differential muscle sensor is converted to a digital form using the ADC of the microcontroller and outputs its decision to the CM-530 humanoid robot controller through a Zigbee wireless interface. The output decision of the CM-530 processor is sent to a motor driver in order to control the servo motors in required direction for human like actions. This method for gaining control of a humanoid robot could be used for performing actions with more accuracy and ease. In addition, a study has been conducted to investigate the controllability and ease of use of the interface and the employed gestures.

Keywords: electromyogram, gesture, muscle sensor, humanoid robot, microcontroller, Zigbee

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Authors: Asif Arsalan

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The mortality rate of type 2 diabetes increasing day by day at an alarming rate. Changing lifestyle and environment have contributory effect in increase rate of type 2 diabetes mellitus. This study introduces a new method in physiotherapy field of treating a disease like diabetes, and gives the new way to control the diabetes without medicines.50 patients were selected on the basis of inclusion and exclusion criteria and were assigned to receive either TENS (group A) on the bilateral ST36 acupoints at a frequency of 25 Hz with intensity of 9 mA or placebo (group B) treatment for 5 minutes for 7 days. The blood glucose level was measured at both pre and post stimulation. Stimulation was given after 3 hours of food on every day regularly on stipulated time.There was significant improvement (P<0.05) in random blood sugar level of type 2 diabetes mellitus. It has been found TENS on bilateral ST36 acupoints have an effect to control plasma glucose level for type 2 diabetic mellitus patients and can be used without having any side effect. This study gives new idea to treat the type 2 diabetes conservatively with the TENS. As there are some study that TENS had been used to treat nausea, spasticity etc. condition by stimulating the acupoint but it is the very first time that TENS has been used to treat diabetes like disease. This study help the physiotherapy community to spread the physiotherapy treatment in other branches of the medical field and this gives a new identity for the physiotherapy. This also gives the benefit to patients to take a safe and cost effective treatment for the diabetes, and make the new use of TENS to treat other condition rather than pain.

Keywords: acupoint, plasma glucose level, type 2 diabetic mellitus, TENS

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Authors: Ali Golestani, Vahid Naseri, Hossein Taheri

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Recently, some of studies examined the effect of exercise on neurotrophic factors influencing the growth, protection, plasticity and function in central and peripheral nerve cells. The aim of this study was to investigate the effects of continuous and interval aerobic exercises with moderate intensity on serum levels of glial cell line-derived neurotrophic factor (GDNF) and aerobic capacity in obese children. 21 obese students with an average age of 13.6 ± 0.5 height 171 ± 5 and BMI 32 ± 1.2 were divided randomly to control, continuous aerobic and interval aerobic groups. Training protocol included continuous or interval aerobic exercises with moderate intensity 50-65%MHR, three times per week for 10 weeks. 48 hours before and after executing of protocol, blood samples were taken from the participants and their GDNF serum levels were measured by ELISA. Aerobic power was estimated using Shuttle-run test. T-test results indicated a small increase in their GDNF serum levels, which was not statistically significant (p =0.11). In addition, the results of ANOVA did not show any significant difference between continuous and interval aerobic training on the serum levels of their GDNF but their aerobic capacity significantly increased (p =0.012). Although continuous and interval aerobic exercise improves aerobic power in obese children, they had no significant effect on their serum levels of GDNF.

Keywords: aerobic power, continuous aerobic training, glial cell line-derived neurotrophic factor (GDNF), interval aerobic training, obese children

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Nashed Atef Nashed Farag

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Introduction: Reporting adverse events following vaccination remains a challenge. WHO has mandated pharmacovigilance centers around the world to submit Adverse Events Following Immunization (AEFI) reports from different countries to a large electronic database of adverse drug event data called Vigibase. Despite sufficient information about AEFIs on Vigibase, they are not available to the general public. However, the WHO has an alternative website called VigiAccess, an open-access website that serves as an archive for reported adverse reactions and AEFIs. The aim of the study was to establish a reporting model for a number of commonly used vaccines in the VigiAccess system. Methods: On February 5, 2018, VigiAccess comprehensively searched for ESSI reports on the measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine, and tuberculosis vaccine (BCG). These are reports from all pharmacovigilance centers around the world since they joined the WHO Drug Monitoring Program. Results: After an extensive search, VigiAccess found 9,062 AEFIs from the measles vaccine, 185,829 AEFIs from the OPV vaccine, 24,577 AEFIs from the yellow fever vaccine, 317,208 AEFIs from the pneumococcal vaccine, 73,513 AEFIs from the rotavirus vaccine, and 145,447 AEFIs from meningococcal cal vaccine, 22,781 EI FI vaccines against tetanus and 35,556 BCG vaccines against AEFI. Conclusion: The study found that among the eight vaccines examined, pneumococcal vaccines were associated with the highest number of AEFIs, while measles vaccines were associated with the fewest AEFIs.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK vaccines, adverse reactions, VigiAccess, adverse event reporting

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Authors: Naim Izet Kajtazi

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Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

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Authors: Christolyn Raj, Lewis Levitz

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Introduction: Two cases of late presentation ( > five years ) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentations(s): Case 1 is an 83-year-old female who has been stable on Ibrutinib (Imbruvica ®) for chronic lymphocytic leukemia (CLL). She presented with bilateral blurred vision from severe cystoid macula edema seven years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with Ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema six years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last five years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of the chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.

Keywords: macula edema, oral kinase inhibitors, retinal toxicity, pseudo-phakia

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Authors: Gi-Hoon Yang, JongHan Ha, MyungGu Yeo, JaeYoon Lee, SeungHyun Ahn, Hyeongjin Lee, HoJun Jeon, YongBok Kim, Minseong Kim, GeunHyung Kim

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Tissue engineering scaffolds must be biocompatible and biodegradable, provide adequate mechanical strength and cell attachment site for proliferation and differentiation. Furthermore, the scaffold morphology (such as pore size, porosity and pore interconnectivity) plays an important role. The electrospinning process has been widely used to fabricate micro/nano-sized fibres. Electrospinning allows for the fabrication of non-woven meshes containing micro- to nano-sized fibers providing high surface-to-volume area for cell attachment. Due to its advantageous characteristics, electrospinning is a useful method for skin, cartilage, bone, and nerve regeneration. In this study, we fabricated PCL scaffolds (SP) consisting of spiral-like struts using 3D melt-plotting system and micro/nanofibers using direct electrospinning writing. By altering the conditions of the conventional melt-plotting method, spiral-like struts were generated. Then, micro/nanofibers were deposited selectively. The control scaffold composed of perpendicular PCL struts was fabricated using the conventional melt-plotting method to compare the cellular activities. The effect on the attached cells (osteoblast-like cells (MG63)) was evaluated depending on the bending instability of the struts. The SP scaffolds showed enhanced biological properties such as initial cell attachment, proliferation and osteogenic differentiation. These results suggest that the SP scaffolds has potential as a bioengineered substitute for soft and hard tissue regeneration.

Keywords: cell attachment, electrospinning, mechanical strength, melt-plotting

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Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

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Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

Procedia PDF Downloads 359

Authors: Shi-Uk Lee, Chae Young Lim

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Objective: The aim of this study was to evaluate the changes of lumbar deep muscle thickness and cross-sectional area using ultrasonography with magnetic stimulation. Methods: To evaluate the changes of lumbar deep muscle by using magnetic stimulation, 12 healthy volunteers (39.6±10.0 yrs) without low back pain during 3 months participated in this study. All the participants were checked with X-ray and electrophysiologic study to confirm that they had no problems with their back. Magnetic stimulation was done on the L5 and S1 root with figure-eight coil as previous study. To confirm the proper motor root stimulation, the surface electrode was put on the tibialis anterior (L5) and abductor hallucis muscles (S1) and the hot spots of magnetic stimulation were found with 50% of maximal magnetic stimulation and determined the stimulation threshold lowering the magnetic intensity by 5%. Ultrasonography was used to assess the changes of L5 and S1 lumbar multifidus (superficial and deep) cross-sectional area and thickness with maximal magnetic stimulation. Cross-sectional area (CSA) and thickness was evaluated with image acquisition program, ImageJ software (National Institute of Healthy, USA). Wilcoxon signed-rank was used to compare outcomes between before and after stimulations. Results: The mean minimal threshold was 29.6±3.8% of maximal stimulation intensity. With minimal magnetic stimulation, thickness of L5 and S1 deep multifidus (DM) were increased from 1.25±0.20, 1.42±0.23 cm to 1.40±0.27, 1.56±0.34 cm, respectively (P=0.005, P=0.003). CSA of L5 and S1 DM were also increased from 2.26±0.18, 1.40±0.26 cm2 to 2.37±0.18, 1.56±0.34 cm2, respectively (P=0.002, P=0.002). However, thickness of L5 and S1 superficial multifidus (SM) were not changed from 1.92±0.21, 2.04±0.20 cm to 1.91±0.33, 1.96±0.33 cm (P=0.211, P=0.199) and CSA of L5 and S1 were also not changed from 4.29±0.53, 5.48±0.32 cm2 to 4.42±0.42, 5.64±0.38 cm2. With maximal magnetic stimulation, thickness of L5, S1 of DM and SM were increased (L5 DM, 1.29±0.26, 1.46±0.27 cm, P=0.028; L5 SM, 2.01±0.42, 2.24±0.39 cm, P=0.005; S1 DM, 1.29±0.19, 1.67±0.29 P=0.002; S1 SM, 1.90±0.36, 2.30±0.36, P=0.002). CSA of L5, S1 of DM and SM were also increased (all P values were 0.002). Conclusions: Deep lumbar muscles could be stimulated with lumbar motor root magnetic stimulation. With minimal stimulation, thickness and CSA of lumbosacral deep multifidus were increased in this study. Further studies are needed to confirm whether the similar results in chronic low back pain patients are represented. Lumbar magnetic stimulation might have strengthening effect of deep lumbar muscles with no discomfort.

Keywords: magnetic stimulation, lumbar multifidus, strengthening, ultrasonography

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Authors: Bailey Houghtaling, Sarah Misyak

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Food access; the availability, affordability, convenience, and desirability of food and beverage products within communities, is influential on consumers’ purchasing and consumption decisions. These variables may contribute to lower dietary quality scores and a higher obesity prevalence documented among rural and disadvantaged populations in the United States (U.S.). Current research assessing linkages between food access and obesity outcomes has primarily focused on distance to a traditional grocery/supermarket store as a measure of optimality. However, low-income consumers especially, including U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) participants, seem to utilize non-traditional food store formats with greater frequency for household dietary needs. Non-traditional formats have been associated with less nutritious food and beverage options and consumer purchases that are high in saturated fats, added sugars, and sodium. Authors’ formative research indicated differences by U.S. region and rurality in the distribution of traditional and non-traditional SNAP-authorized food store formats. Therefore, using Virginia as a case study, the purpose of this research was to determine if a relationship between store format, rurality, and obesity exists. This research applied SNAP-authorized food store data (food access points for SNAP as well as non-SNAP consumers) and obesity prevalence data by Virginia county using publicly available databases: (1) SNAP Retailer Locator, and; (2) U.S. County Health Rankings. The alpha level was set a priori at 0.05. All Virginia SNAP-authorized stores (n=6,461) were coded by format – grocery, drug, mass merchandiser, club, convenience, dollar, supercenter, specialty, farmers market, independent grocer, and non-food store. Simple linear regression was applied primarily to assess the relationship between store format and obesity. Thereafter, multiple variables were added to the regression to account for potential moderating relationships (e.g., county income, rurality). Convenience, dollar, non-food or restaurant, mass merchandiser, farmers market, and independent grocer formats were significantly, positively related to obesity prevalence. Upon controlling for urban-rural status and income, results indicated the following formats to be significantly related to county obesity prevalence with a small, positive effect: convenience (p=0.010), accounting for 0.3% of the variance in obesity prevalence; dollar (p=0.005; 0.5% of the variance), and; non-food (p=0.030; 1.3% of the variance) formats. These results align with current literature on consumer behavior at non-traditional formats. For example, consumers’ food and beverage purchases at convenience and dollar stores are documented to be high in saturated fats, added sugars, and sodium. Further, non-food stores (i.e., quick-serve restaurants) often contribute to a large portion of U.S. consumers’ dietary intake and thus poor dietary quality scores. Current food access research investigates grocery/supermarket access and obesity outcomes. These results suggest more research is needed that focuses on non-traditional food store formats. Nutrition interventions within convenience, dollar, and non-food stores, for example, that aim to enhance not only healthy food access but the affordability, convenience, and desirability of nutritious food and beverage options may impact obesity rates in Virginia. More research is warranted utilizing the presented investigative framework in other U.S. and global regions to explore the role and the potential of non-traditional food store formats to prevent and reduce obesity.

Keywords: food access, food store format, non-traditional food stores, obesity prevalence

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Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Three nociceptive thresholds of thermal, electrical, and mechanical thresholds commonly use to evaluate the local anesthesia in many species, for instance, cow, horse, cat, dog, rabbit, and so on. Due to the lack of investigations to evaluate and/or validate such those nociceptive thresholds, our plan was the comparison of two-foot local anesthesia methods of Intravenous Regional Anesthesia (IVRA) and our modified four-point Nerve Block Anesthesia (NBA). Materials and Methods: Eight healthy nonpregnant nondairy Holstein Frisian cows in a cross-over study design were selected for this study. All cows divided into two different groups to receive two local anesthesia techniques of IVRA and our modified four-point NBA. Three thermal, electrical, and mechanical force and pinpricks were applied to evaluate the quality of local anesthesia methods before and after local anesthesia application. Results: The statistical evaluation demonstrated that our four-point NBA has a qualification to select as a standard foot local anesthesia. However, the recorded results of our study revealed no significant difference between two groups of local anesthesia techniques of IVRA and modified four-point NBA related to quality and duration of anesthesia stimulated by electrical, mechanical and thermal nociceptive stimuli. Conclusion and discussion: All three nociceptive threshold stimuli of electrical, mechanical and heat nociceptive thresholds can be applied to measure and evaluate the efficacy of foot local anesthesia of dairy cows. However, our study revealed no superiority of those three nociceptive methods to evaluate the duration and quality of bovine foot local anesthesia methods. Veterinarians to investigate the duration and quality of their selected anesthesia method can use any of those heat, mechanical, and electrical methods.

Keywords: mechanical, thermal, electrical threshold, IVRA, NBA, hind limb, dairy cow

Procedia PDF Downloads 219

Authors: Bailey Houghtaling, Elena Serrano, Vivica Kraak, Samantha Harden, George Davis, Sarah Misyak

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United States (U.S.) Department of Agriculture Supplemental Nutrition Assistance Program (SNAP) participants are low-income Americans receiving federal dollars for supplemental food and beverage purchases. Participants use a variety of (traditional/non-traditional) SNAP-authorized stores for household dietary purchases - also representing food access points for all Americans. Importantly consumers' food and beverage purchases from non-traditional store formats tend to be higher in saturated fats, added sugars, and sodium when compared to purchases from traditional (e.g., grocery/supermarket) formats. Overconsumption of energy-dense and low-nutrient food and beverage products contribute to high obesity rates and adverse health outcomes that differ in severity among urban/rural U.S. locations and high/low-income populations. Little is known about the SNAP-authorized food store format landscape nationally, regionally, or by urban-rural status, as traditional formats are currently used as the gold standard in food access research. This research utilized publicly available U.S. databases to fill this large literature gap and to provide insight into modes of food access for vulnerable U.S. populations: (1) SNAP Retailer Locator which provides a list of all authorized food stores in the U.S., and; (2) Rural-Urban Continuum Codes (RUCC) that categorize U.S. counties as urban (RUCC 1-3) or rural (RUCC 4-9). Frequencies were determined for the highest occurring food store formats nationally and within two regionally diverse U.S. states – Virginia in the east and California in the west. Store format codes were assigned (e.g., grocery, drug, convenience, mass merchandiser, supercenter, dollar, club, or other). RUCC was applied to investigate state-level differences in urbanity-rurality regarding prevalent food store formats and Chi Square test of independence was used to determine if food store format distributions significantly (p < 0.05) differed by region or rurality. The resulting research sample that represented highly prevalent SNAP-authorized food stores nationally included 41.25% of all SNAP stores in the U.S. (N=257,839), comprised primarily of convenience formats (31.94%) followed by dollar (25.58%), drug (19.24%), traditional (10.87%), supercenter (6.85%), mass merchandiser (1.62%), non-food store or restaurant (1.81%), and club formats (1.09%). Results also indicated that the distribution of prevalent SNAP-authorized formats significantly differed by state. California had a lower proportion of traditional (9.96%) and a higher proportion of drug (28.92%) formats than Virginia- 11.55% and 19.97%, respectively (p < 0.001). Virginia also had a higher proportion of dollar formats (26.11%) when compared to California (10.64%) (p < 0.001). Significant differences were also observed for rurality variables (p < 0.001). Prominently, rural Virginia had a significantly higher proportion of dollar formats (41.71%) when compared to urban Virginia (21.78%) and rural California (21.21%). Non-traditional SNAP-authorized formats are highly prevalent and significantly differ in distribution by U.S. region and rurality. The largest proportional difference was observed for dollar formats where the least nutritious consumer purchases are documented in the literature. Researchers/practitioners should investigate non-traditional food stores at the local level using these research findings and similar applied methodologies to determine how access to various store formats impact obesity prevalence. For example, dollar stores may be prime targets for interventions to enhance nutritious consumer purchases in rural Virginia while targeting drug formats in California may be more appropriate.

Keywords: food access, food store format, nutrition interventions, SNAP consumers

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Authors: I. Wardana Ketut, I. Suparwa Nyoman

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This study investigated the form and characteristic of speech sound produced by three Balinese subjects who have recovered from aphasia as well as intervened their language impairment on side of linguistic and neuronal aspects of views. The failure of judging the speech sound was caused by impairment of motor cortex that indicated there were lesions in left hemispheric language zone. Sound articulation phenomena were in the forms of phonemes deletion, replacement or assimilation in individual words and meaning building for anomic aphasia. Therefore, the Balinese sound patterns were stimulated by showing pictures to the subjects and recorded to recognize what individual consonants or vowels they unclearly produced and to find out how the sound disorder occurred. The physiology of sound production by subject’s speech organs could not only show the accuracy of articulation but also any level of severity the lesion they suffered from. The subjects’ speech sounds were investigated, classified and analyzed to know how poor the lingual units were and observed to clarify weaknesses of sound characters occurred either for place or manner of articulation. Many fricative and stopped consonants were replaced by glottal or palatal sounds because the cranial nerve, such as facial, trigeminal, and hypoglossal underwent impairment after the stroke. The phonological intervention was applied through a technique called phonemic articulation drill and the examination was conducted to know any change has been obtained. The finding informed that some weak articulation turned into clearer sound and simple meaning of language has been conveyed. The hierarchy of functional parts of brain played important role of language formulation and processing. From this finding, it can be clearly emphasized that this study supports the role of right hemisphere in recovery from aphasia is associated with functional brain reorganization.

Keywords: aphasia, intervention, phonology, stroke

Procedia PDF Downloads 176