Pack Application Research Articles

Reducing Opioid Consumption and Length of Stay After Bariatric Surgery: A Nonpharmacologic ERAS Intervention Bundle

PurposeTo reduce opioid consumption and decrease length of stay (LOS) in bariatric surgical patients by implementing an evidence-based, nonpharmacologic enhanced recovery after surgery (ERAS) intervention bundle. DesignEvidence-based practice project. MethodsWe developed and implemented a nonpharmacologic ERAS bundle from existing American Society of PeriAnesthesia Nurses Standards and bariatric and subspecialty surgical ERAS protocols to standardize the postoperative nursing care of bariatric patients. The bundle consisted of early ambulation, immediate initiation and prolonged use of oxygenation, prevention of nausea and vomiting, frequent use of incentive spirometry, and application of ice packs to surgical sites. The two project outcomes were opioid consumption and patient LOS. We used descriptive statistics to summarize opioid consumption and LOS among surgical bariatric patients at baseline and post intervention and independent samples t tests to determine the statistical significance of pre- or post-LOS changes. FindingsAfter implementing the ERAS bundle in 31 bariatric surgical patients, we found that the percentage of patients given an opioid substantially decreased by 13.8%, with both fentanyl and hydromorphone (Dilaudid) consumption meaningfully decreasing by 11.0% and 25.6%, respectively. The average LOS significantly decreased (P = .015) by 23 minutes per patient following the intervention, from 1 hour and 58 minutes to 1 hour and 35 minutes, representing a 19.5% reduction in total patient time in the PACU. ConclusionsUse of a nonpharmacologic ERAS bundle and standardizing postoperative care decreased overall PACU bariatric surgical patient opioid consumption and significantly reduced PACU LOS. Optimizing pain management for bariatric patients in the PACU could lead to improved pain control and reduced reliance on opioids during their entire hospital stay, enhancing health care outcomes and improving patient safety. Perioperative leaders and educators can use our example to develop initiatives that decrease opioid use and LOS to improve care for the high-acuity bariatric patient population.

Innovative Poly(lactic Acid) Blends: Exploring the Impact of the Diverse Chemical Architectures from Itaconic Acid

Environment-friendly polymer blends of poly(lactic acid) (PLA) and itaconic acid (IA), poly(itaconic acid) (PIA), poly(itaconic acid)-co-poly(methyl itaconate) (Cop-IA), and net-poly(itaconic acid)-ν-triethylene glycol dimethacrylate (Net-IA) were performed via melt blending. The compositions studied were 0.1, 1, 3, and 10 wt% of the diverse chemical architectures. The research aims to study and understand the effect of IA and its different architectures on the mechanical, rheological, and thermal properties of PLA. The PLA/IA, PLA/PIA, PLA/Cop-IA, and PLA/Net-IA blends were characterized by dynamic mechanical thermal analysis, rotational rheometer (RR), thermogravimetric analysis, differential scanning calorimetry, X-ray diffraction, and scanning electron microscopy. The complex viscosity, storage module, and loss module for the RR properties were observed in the following order: PLA/Cop-IA, PLA/Net-IA, and PLA/PIA > PLA > PLA/IA. Thermal stability improved with increasing concentrations of Cop-IA and Net-IA. In the same way, the mechanical properties were enhanced. In addition, the micrographs illustrated the formation of fibrillar structures for all blends. The crystallinity degree displayed higher values for the blends that contain Net-IA > Cop-IA than IA > PIA. Therefore, IA and its architectures can influence these studied properties, which have potential applications in disposable food packing.

Evaluation of sodium hyaluronate-based composite hydrogels for prevention of nasal adhesions.

During the healing process after intra-nasal surgery, the growth and repair of damaged tissues can result in the development of postoperative adhesions. Various techniques have been devised to minimize the occurrence of postoperative adhesions which include insertion of stents in the middle meatus, application of removable nasal packing, and utilizing biodegradable materials with antiadhesive properties. This study assesses the efficacy of two sodium hyaluronate (SH)-based freeze-dried hydrogel composites in preventing postoperative nasal adhesions, comparing them with commonly used biodegradable materials in nasal surgery. The freeze-dried hydrogels, sodium hyaluronate and collagen 1(SH-COL1) and sodium hyaluronate, carboxymethyl cellulose, and collagen 1 (SH-CMC-COL1), were evaluated for their ability to reduce bleeding time, promote wound healing, and minimize fibrous tissue formation. Results showed that SH-CMC-COL1 significantly reduced bleeding time compared to both biodegradable polyurethane foam and SH-COL1. Both SH-COL1 and SH-CMC-COL1 exhibited enhanced wound healing effects, as indicated by significantly greater wound size reduction after two weeks compared to the control. Histological analyses revealed significant differences in re-epithelialization and blood vessel count among all tested materials, suggesting variable initial wound tissue response. Although all treatment groups had more epithelial growth, with X-SCC having higher blood vessel count at 7 d post treatment, all treatment groups did not differ in all histomorphometric parameters by day 14. However, the long-term application of SH-COL1 demonstrated a notable advantage in reducing nasal adhesion formation compared to all other tested materials. This indicates the potential of SH-based hydrogels, particularly SH-COL1, in mitigating postoperative complications associated with nasal surgery. These findings underscore the versatility and efficacy of SH-based freeze-dried hydrogel composites for the management of short-term and long-term nasal bleeding with an anti-adhesion effect. Further research is warranted to optimize their clinical use, particularly in understanding the inflammatory factors influencing tissue adhesions and assessing material performance under conditions mimicking clinical settings. Such insights will be crucial for refining therapeutic approaches and optimizing biomaterial design, ultimately improving patient outcomes in nasal surgery.

Time Course Effects of Kinesio Taping in Knee Osteoarthritis Patients

Background: Knee osteoarthritis is a common musculoskeletal disorder in the elderly, characterized by cartilage loss leading to pain, stiffness, and restricted movement. Kinesiotaping has been suggested as a therapeutic approach to reduce pain and improve functional outcomes in knee osteoarthritis patients. Objective: This study aimed to compare the effects of quadriceps and patellar kinesiotaping applied for different durations (24, 48, and 72 hours) on pain, balance, and functional performance in patients with knee osteoarthritis. Methods: A randomized clinical trial was conducted from March to September 2020 at the Railway General Hospital, Rawalpindi, and Abasyn Rehabilitation Center, Islamabad. Forty-eight patients with knee osteoarthritis (grades 2-3) were randomly assigned to three groups: Group A (kinesiotaping for 24 hours), Group B (kinesiotaping for 48 hours), and Group C (kinesiotaping for 72 hours). All participants also received conventional therapy, including hot pack application, quadriceps strengthening exercises (15 repetitions × 3 sets), and stretching exercises (5 repetitions with a 10-second hold × 3 sets). Pain, balance, and functional performance were assessed at baseline, post-intervention, and one week later using the Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Functional Reach Test (FRT), and Time Up and Go Test (TUG). Data were analyzed using SPSS version 25, with intragroup comparisons conducted using the Wilcoxon signed-rank test and intergroup comparisons using the Kruskal-Wallis test. A p-value of less than 0.05 was considered statistically significant. Results: Significant reductions in pain were observed across all groups (p < 0.05), with the most notable improvement in Group C (72 hours), where NPRS scores decreased from a median of 2 (IQR 1.75) at baseline to 1 (IQR 1) at follow-up (p < 0.05). However, no significant improvements were noted in balance or functional performance across the groups, as indicated by FRT, WOMAC, and TUG scores (p > 0.05). Conclusion: Kinesiotaping significantly reduces pain in knee osteoarthritis patients, particularly when applied for 72 hours, but does not appear to significantly impact balance or functional performance. These findings suggest that kinesiotaping is effective for short-term pain management, though additional interventions may be necessary to improve functional outcomes.

Evaluation of the use of box size priors for 6D plane segment tracking from point clouds with applications in cargo packing

This paper addresses the problem of 6D pose tracking of plane segments from point clouds acquired from a mobile camera. This is motivated by manual packing operations, where an opportunity exists to enhance performance, aiding operators with instructions based on augmented reality. The approach uses as input point clouds, by its advantages for extracting geometric information relevant to estimating the 6D pose of rigid objects. The proposed algorithm begins with a RANSAC fitting stage on the raw point cloud. It then implements strategies to compute the 2D size and 6D pose of plane segments from geometric analysis of the fitted point cloud. Redundant detections are combined using a new quality factor that predicts point cloud mapping density and allows the selection of the most accurate detection. The algorithm is designed for dynamic scenes, employing a novel particle concept in the point cloud space to track detections’ validity over time. A variant of the algorithm uses box size priors (available in most packing operations) to filter out irrelevant detections. The impact of this prior knowledge is evaluated through an experimental design that compares the performance of a plane segment tracking system, considering variations in the tracking algorithm and camera speed (onboard the packing operator). The tracking algorithm varies at two levels: algorithm (Awpk\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$A_{wpk}$$\\end{document}), which integrates prior knowledge of box sizes, and algorithm (Awoutpk\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$A_{woutpk}$$\\end{document}), which assumes ignorance of box properties. Camera speed is evaluated at low and high speeds. Results indicate increments in the precision and F1-score associated with using the Awpk\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$A_{wpk}$$\\end{document} algorithm and consistent performance across both velocities. These results confirm the enhancement of the performance of a tracking system in a real-life and complex scenario by including previous knowledge of the elements in the scene. The proposed algorithm is limited to tracking plane segments of boxes fully supported on surfaces parallel to the ground plane and not stacked. Future works are proposed to include strategies to resolve this limitation.

The effects of conventional treatment in addition to Pilates on biopsychosocial status in chronic neck pain: A randomized clinical trial.

Although guidelines and systematic reviews recommend the use of exercise in the treatment of chronic pain and neck pain, there are no clear recommendations for conservative treatments frequently used in clinics. The effect of supporting clinical Pilates exercises with passive physiotherapy methods on biopsychosocial status is still unknown. The objective was to investigate the effects of conventional treatment (CT) in addition to clinical Pilates on pain levels, physical condition, functional status, and psychosocial status in individuals with chronic neck pain. Fifty women were randomly divided into 2groups, the clinical Pilates group (Pilates, n= 25), and the group receiving CT in addition to clinical Pilates (Pilates-CT, n= 25). Both groups received treatment 3days a week for 6weeks. The CT program involved the implementation of hot pack (HP) application, Transcutaneous Electrical Nerve Stimulation (TENS), and therapeutic ultrasound (US) to the cervical area. CT in addition to Pilates was more effective in reducing the Visual Analog Scale (at rest and during activity), Neck Disability Index, Fear-Avoidance Beliefs Questionnaire, NeckPix Scale, Hospital Anxiety and Depression Scale-depression, and Cognitive Exercise Therapy Approach-Biopsychosocial questionnaire scores (p< 0.05) and in increasing the degree of change in the extension range of motion (ROM) and cervical flexor endurance values and scores in the energy parameter of Short Form-36 (p< 0.05). CT provided in addition to Pilates was more effective in reducing pain levels, disability, fear of movement, depression levels, and negative biopsychosocial status and improving extension ROM and cervical flexor endurance, neck awareness, and the energy/vitality parameter of quality of life in individuals with chronic neck pain.

Synthesis and tailoring the morphological, structural and optical characteristics of SiO2–CO2O3 nanomaterials doped PVA–PEG for optoelectronic and food packing applications

Synthesis and tailoring the morphological, structural and optical characteristics of SiO2–CO2O3 nanomaterials doped PVA–PEG for optoelectronic and food packing applications

17-Cell battery monitoring analog front end with high sampling accuracy for battery pack applications

Battery management system (BMS) is a critical aspect to ensure the safe, reliable operation of lithium ion batteries for battery pack applications. Although some battery pack monitoring schemes have increased the number of measurable channels in a chip for higher voltage battery packs, the issue of accuracy caused by the common mode voltage difference in each unit of series battery pack remains unsolved. A high voltage multiplexer of 17-cell battery monitoring analog front end (AFE) is adopted to acquire each cell voltage for accurate monitoring. Besides, a current compensation scheme is proposed to tackle the current leakage in each channel to further improve the acquisition accuracy. The proposed scheme is implemented in 0.18 μm high-voltage BCD process, and occupies a die size of 2.92 × 3.23 mm2. The experimental results reveal that the sensing error of 17 battery cells is within ±2 mV under the input cell voltage from 1 to 5V.

PPG opens $30-million battery pack application center in China

PPG opens $30-million battery pack application center in China

A Study to Assess the Effectiveness of Cold Pack Application on Episodic Pain Among Patients with Migraine in Selected Community Areas.

A migraine is typically described as a sick headache, since the patient apart from the headache feels very sick. Migraine is a genetic neurological disease, characterized by episodes often called Migraine attacks. To assess the effectiveness of cold pack application on episodic pain among patients with migraine. To associate the posttest level of episodic pain among patients with migraine with selected demographic variables. A quasi experimental group pretest and posttest research design with a purposive sampling technique. The sample size of the study consists of 60 patients with migraine headaches. Demographic variables education (χ2 = 16.113, p=0.013) and residence (χ2=7.329, p=0.026) had shown statistically significant association with post test level of episodic pain among patients with migraine at post test level of episodic pain among patients with migraine. This study concluded Cold Pack Application may reduce the level of episodic pain among patients with migraine.

Multi‐walled carbon nanotubes doped with Phytocompounds of Centella asiatica for food packing applications and their anti‐microbial properties

Multi‐walled carbon nanotubes doped with Phytocompounds of <i>Centella asiatica</i> for food packing applications and their anti‐microbial properties

A comparative study to assess the effectiveness of ice pack application vs manual pressure on pain at pentavalent vaccination site among infants attending immunization clinic in selected hospital, Bangalore

A comparative study to assess the effectiveness of ice pack application vs manual pressure on pain at pentavalent vaccination site among infants attending immunization clinic in selected hospital, Bangalore

The influence of intraoral cryotherapy on postoperative pain and substance P in symptomatic apical periodontitis: randomized clinical study

Cryotherapy is widely utilized in medicine, particularly for pain management. This randomized clinical trial aimed to assess the effect of intraoral cold pack application (cryotherapy) on postoperative pain (POP) and the level of Substance P (SP) in patients with symptomatic apical periodontitis (SAP). Enrolled patients were randomly assigned to either cryotherapy or control group. After adequate anesthesia, access cavity, and biomechanical preparation of the root canal system were completed, the first apical fluid (AF) sample (S1) was obtained. A custom-made intraoral ice-gel pack was applied for 30 min in the cryotherapy group, while no intervention was performed in the control group. The second AF sample (S2) was collected 30 min later in both groups. Patients were asked to complete the Visual Analogue Scale (VAS) questionnaire to assess their POP. Quantification of SP in AF samples was performed using the enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed statistically, revealing a significant reduction in POP and SP levels in the cryotherapy group compared to the control group (P ≤ 0.05). Furthermore, a moderate positive correlation was observed between SP levels and POP (P ≤ 0.05). In conclusion, intraoral cryotherapy represents a simple and cost-effective option for controlling POP and reducing inflammation levels in patients with SAP.

Development of a Biodegradable Cassava Starch Biofilm based on a Combination of Plasticizers with Bio‐SiO2 Extracted from Sugarcane Leaves

AbstractThis study prepares biodegradable biofilms for packaging applications from biomass to help reduce plastic waste while also adding value to biomass. Furthermore, the effects of plasticization with 30 wt% plasticizer (relative to the mass of cassava starch) by glycerol (G), sorbitol (S), and a mixture of glycerol and sorbitol (GS) plasticizers are investigated, and the effects of bio‐SiO2 particles extracted from sugarcane leave via the sol–gel method are evaluated in terms of the mechanical and biodegradability properties of the cassava starch‐based biofilms. Biofilms used for packing applications must be insoluble and exhibit good elongation properties. In this context, the results indicate that the GS mixture produces a biofilm that exhibits these desirable properties. Thus, cassava starch‐based biofilms are prepared using GS and varying concentrations of the bio‐SiO2 particles (i.e., 0, 0.5, 1, and 1.5 wt%). The films containing bio‐SiO2 exhibit significantly lower water solubilities and moisture contents than the corresponding bio‐SiO2‐free films. Additionally, the inclusion of bio‐SiO2 particles increases the water resistance properties of the biofilms. Overall, the results suggest that cassava starch films prepared using a mixture of plasticizers and reinforced with bio‐SiO2 particles can be considered a safe material for application in biodegradable food packaging.

Flower Extract–Polyvinyl Alcohol‐Based Biocomposites for Sustainable Food Packaging Applications

The proliferation of single‐use plastics has led to widespread pollution and ecological harm, prompting a concerted effort to develop sustainable alternatives. Among them, biocomposite plastic films have emerged as a promising solution for food packing applications. Herein, the preparation of polyvinyl alcohol (PVA) biocomposite films incorporating Clitoria ternatea (CT) flower extracts is reported. The obtained films are subjected to various analytical techniques. Fourier transform infrared spectroscopy analysis reveals the intense peak of hydrogen bonding at 3321 cm−1 in the composite film. CT‐PVA films possess less opacity and UV light‐blocking capabilities. The PVA‐CT films are examined for water absorption, UV barrier, soil degradability, and water‐soluble properties, greater propensity to dissolve in water during the water absorption test is noticed. Enzymatic oxidation followed by hydrolysis of functional groups enhances the soil degradation rate in biocomposite films. Further, the colorimetric study of CT‐PVA solution at different pH shows colored CT–PVA films. From the results and observations, the CT‐PVA biocomposite film (8 mL) proves to be a promising candidate for utilization in the food industry as a packaging material.

Addressing practical challenges of LiB cells in their pack applications

In a battery pack, several lithium-ion batteries (LiBs) are connected in series and parallel so that sufficient voltage, current and power can be provided for applications. To ensure safe operation, when one of the LiB cells in a pack has its SoH below 80%, the entire pack will have to be discarded. Thus, ensuring all the LiB cells degrade similarly in a pack is crucial to maximize the potential of all the cells in a pack. There are several methods to perform screening on the LiB cells for such purpose, but there exist many practical challenges for estimating and predicting the degradation rate of the cells before they are chosen to be put in a pack which will be described in this work. This work provides solutions to some of these challenges and shows through experiments that one can screen the weak cells from production batch with just the first discharge cycle, and one can also predict the statistical distribution of the degradation rates of LiB cells in a production batch. On-line in-situ determination of the SoH of each cell connected in a pack is also made possible with a solution presented in this work, and this method is verified over many different types of LiB from various manufacturers.

Comparative Study of Topical Application of Injection Tranexamic Acid and Anterior Nasal Packing in the Management of Epistaxis.

Epistaxis, defined as bleeding from the nose, is one of the common ENT cases coming to emergency department. Epistaxis is experienced by at least 60% of the population once in their life time and about 6% of them will require medical attention. The different treatment modalities include: local pressure, application of topical vasoconstrictor substances, or nasal packing depending on personal physician preference. Tranexamic acid (TXA), a synthetic analogue of the amino acid lysine, belongs to a class of drugs known as antifibrinolytics. It acts by reversibly binding four to five lysine receptor sites on plasminogen and can be used in emergency department for reducing the bleeding time in epistaxis. To evaluate the efficacy of topical application of injection TXA compared to cases managed with anterior nasal packing for the treatment of patients with epistaxis. 100 patients presenting with epistaxis in emergency department, above the age of 18years were randomly divided into two groups with 50 patients each. Group 1 were managed with anterior nasal packing with gel foam and Group 2 with topical application of injection TXA. Causes,duration to control epistaxis, and occurrence of rebleeding were recorded. Our study showed homogenous distribution of age and sex among the patients. Bleeding stopped within 10min in 38 patients in group 2 compared to 17 patients in group 1. For 31 patients in group 1, bleeding stopped between 10 and 15min compared to 12 in group 2. In group 1, 8 patients had rebleeding compared to 2 patients in group 2. Our study showed that topical application of TXA reduces the bleeding time and number of rebleeds compared to anterior nasal packing with gelfoam. Since it is easily available in an emergency setup and cheaper compared to gelfoam, it can be used as an elective method in managing epistaxis in emergency department.

Opportunity for a Community Health Fair Model of Bleeding Control Training.

Traumatic hemorrhage is a prevalent cause of death nationally, with >50% of civilian deaths estimated to be preventable with more timely intervention. This study investigated the efficacy of training large and diverse audiences in bleeding control methods including tourniquets in community health fair settings. A booth was utilized for bleeding control training at community health fairs via direct demonstrations of pressure, wound packing, and commercial and improvised tourniquet application followed by hands-on practice. Participants self-rated their perceived abilities while instructors rated the participant competency. 117 community members participated during two fairs, though not every person completed every portion of the training. Average age was 33 (range 6-82) and the majority were female (65.0%). There was no difference in self-perceived skill compared to trainer grading of participant's ability to identify life-threatening bleeding (112 (97.4%) vs 106 (97.2%); P = 1), apply pressure (113 (98.3%) vs 106 (97.2%); P = .68), and pack a wound (102 (88.7%) vs 92 (84.4%); P = .43). No difference in difficulty was noted in placing commercial vs improvised tourniquets (16 (43%) vs 14 (45%); P = .87). However, participants were overconfident in their ability to place tourniquets compared to trainer grading, respectively (112 (98.2%) vs 100 (91.7%; P = .03)). Community fair classes provide opportunities to train large and diverse audiences in bleeding control techniques. However, participants overestimated their ability to appropriately apply tourniquets. Further investigation is needed into best educational approaches to optimize the impact of bleeding control kits that have been distributed in multiple states.

Safe and sustainable food packaging: Argemone albiflora mediated green synthesized silver-carrageenan nanocomposite films

Silver-Carrageenan (Ag/Carr) nanocomposite film for food packing application by the green method using Argemone albiflora leaf extract has been developed in this study. Different plant parts of Argemone albiflora (blue stem prickly poppy) are used all over the world for the treatment of microbial infections, jaundice, skin diseases etc. GC–MS analysis was used to examine the phytochemical found in the Argemone albiflora leaf extract which reduces the metal ions to nanoscale. The biopolymer employed in the synthesis of nanocomposite film was carrageenan, a natural carbohydrate (polysaccharide) extracted from edible red seaweeds. We developed a food packing that is biodegradable, eco-friendly, economical and free from harmful chemicals. These films possess better UV barrier and mechanical and antimicrobial properties with 1 mM AgNO3 solution. The presence of silver nanoparticles in the carrageenan matrix was evident from FESEM. The mechanical properties were analysed by a Universal testing machine (UTM) and different properties like water vapour permeability (WVP), moisture content (MC) and total soluble matter (TSM) important for food packing applications were also analysed. The antimicrobial properties of the synthesized film samples were studied against E. coli and S. aureus pathogenic bacteria. These films were employed for the storage of cottage cheese (dairy product) and strawberries (fruit). This packing increased the shelf life of the packed food effectively. Ag/Carr films are biodegradable within four weeks.

GOOD OUTCOMES OF OCULAR MYASTHENIA GRAVIS IN A YOUNG ADULT MALE: A CASE REPORT

Abstract&#x0D; Introduction : Myasthenia gravis (MG) is characterized by fluctuating weakening and fatigability of skeletal muscles. Ocular MG (OMG) occurs when the symptoms of MG are limited to the ocular muscles.&#x0D; Case Illustration : A 21-year-old male presents with a two-month history of drooping both eyelids. The drooping eyelids improved in the morning or after a nap, and got worse in the evening. Ocular examination revealed limitation towards all gazes with bilateral ptosis. Visual acuity, anterior segment, visual fields, slit lamp, and fundus examinations were unremarkable. The ice pack and rest test resulted in a significant improvement after two minutes of ice pack application and 30-minute rest, raising suspicion for the diagnosis of MG. Acetylcholine receptor antibody (AChR) test was positive for AChR binding antibody. Treatment for OMG is initiated with an oral acetylcholinesterase inhibitor, pyridostigmine, and corticosteroid. The ptosis and ophthalmoplegia improved after one week follow- up and recovered completely after eight weeks of follow-up.&#x0D; Discussion : The hallmarks of MG are fluctuating fatigable muscle weakness that worsen with activity and improve on rest. Neurological exam and clinical neurological history are essential to establish the diagnosis. Bedsite tests, electrophysiologic test, and the antibody test all support the clinical diagnosis of MG.&#x0D; Conclusion : OMG progresses to its generalized form 90% of the time during the first two years of the onset of ocular symptoms. Early detection and prompt treatment are the key which may help to prevent or minimize the occurrence of myasthenia crisis.