Combination Of Hyperbaric Oxygen Therapy Research Articles

Anti-cancer effects of hyperbaric oxygen therapy in mice: a meta-analysis

Abstract Objectives Hypoxia is a ubiquitous condition in solid tumors and is associated with increased glycolysis, therapy resistance and disease progression. Hyperbaric oxygen therapy (HBOT) systemically elevates O2 tension in tissues and thus counteracts hypoxia. Here, we conducted a meta-analysis to quantify the effects of HBOT on survival in mice with cancer. Methods Studies retrieved from PubMed and Google Scholar were included if they allowed extracting restricted mean survival times in an HBOT-treated and control group. Meta-analyses were conducted using standardized mean differences (SMDs) and the log-transformed response ratio (lnRR) between the RMST of the treatment and control group with multilevel random effects models in order to account for non-independence of effect sizes. Publication bias was tested using a multilevel version of Egger’s regression. Results All studies applied HBOT with pressures between 2 and 3 atmospheres absolute (ATA). When administered without additional treatments, HBOT was associated with longer mouse survival times (pooled SMD=1.359 ± 0.624, p=0.0446; lnRR=0.065 ± 0.029, p=0.0399). Higher pressure was significantly associated with higher efficacy of hyperbaric oxygen monotherapy. When combined with chemotherapy, radiotherapy, targeted therapy or a ketogenic diet, HBOT was associated with significantly prolonged survival times compared to mice receiving these treatments without HBOT (SMD=2.696 ± 0.545, p<0.0001; lnRR=0.228 ± 0.042, p<0.0001). The combination of HBOT with chemotherapy was associated with lower efficacy than the combination with other treatment modalities. Conclusions We found weak evidence that HBOT prolongs survival times in cancer-bearing mice and strong evidence for synergistic effects with other therapies. The translational potential of these findings and extrapolation to lower-pressure HBOT remain to be determined.

Effects of Hyperbaric Oxygen Therapy Combined with Music Therapy on Brain Function and Mental Health of Patients with Aneurismal Subarachnoid Hemorrhage: A Retrospective Study.

Hyperbaric oxygen therapy (HBOT), which is widely used in clinical practice, is aimed at improving nerve function impairment after brain injury. Meanwhile, the effects of music therapy on brain function are unclear. This retrospective study was conducted to explore the application effect of HBOT combined with music therapy on patients suffering from aneurysmal subarachnoid hemorrhage (aSAH). For this retrospective study, 130 patients with aSAH after HBOT were selected from our hospital from June 2021 to June 2022. The patients were divided into the observation (n = 70) and control (n = 60) groups based on whether they received music therapy. Comparisons were made on general demographic data, blood flow rate in median cerebral artery (MCA), cerebral vasospasm (CVS), National Institutes of Health Stroke Scale (NIHSS), activities of daily living (ADL) score, Self-Rating Depressive Scale (SDS), and Self-Rating Anxiety Scale (SAS) of patients. Baseline data between the two groups showed no statistically significant difference (P > 0.05). After management, patients in the observation group presented significantly lower SAS and SDS scores (P < 0.05), lower blood flow rate in MCA, CVS and NIHSS scores (P < 0.05), and higher ADL scores than the control group (P < 0.05). The combination of HBOT and music therapy can considerably improve cerebral neurological deficits, slow down cerebral arterial blood flow, promote the recovery of postoperative cerebral function in aSAH patients, and improve anxiety and depression and the patients' ADL.

Potency of Hyperbaric Oxygen Therapy on Oral Candidiasis Diabetes Mellitus.

This study aimed to determine the potency of hyperbaric oxygen therapy (HBOT) to the blood glucose level, amount of lymphocytes, and the expression of antibody anti-Candida in oral candidiasis diabetes mellitus. Thirty Wistar rats were divided into five groups: K1 normal-control group, while K2, P1, P2, and P3 were diabetes induced by streptozotocin 50 mg/kg body weight. Oral candidiasis was induced by inoculation 0.1 mL Candida albicans ATCC 10321 on dorsum of the tongue. P1 was given nystatin oral suspension, P2 was treated by HBOT 2.4 ATA, 3 × 30 minutes each with a 5-minute interval, and P3 was treated by the combination of nystatin and HBOT. All the treatments were performed for 5 consecutive days. Fasting blood glucose level was examined on glucometer strips, lymphocyte was examined from complete blood count, and the expression of antibody anti-Candida was examined on immunohistochemistry staining STATISTICAL ANALYSIS: Data analyzed by a one-way analysis of variance and least significant difference test with the result of p-value less than 0.05 was considered to be statistically significant. HBOT reduced blood glucose level (p > 0.05) increased the amount of lymphocyte (p < 0.05). All treatments reduced the expression of antibody anti-Candida (p < 0.05) with the best result on combination of HBOT with nystatin. HBOT decreased the blood glucose level, increased the amount of lymphocytes, and reduced the expression of antibody anti-Candida in oral candidiasis diabetes mellitus.

The therapeutic effect of hyperbaric oxygen therapy in patients with severe to profound idiopathic sudden sensorineural hearing loss

The optimal treatment for sudden sensorineural hearing loss (SSNHL) is unclear. Hyperbaric oxygen therapy (HBOT) has been suggested as a viable option for treatment of SSNHL as it improves vascular dysfunction. In this study, we evaluated the therapeutic effects of HBOT by retrospectively reviewing the records of 2206 patients with SSNHL. 54 who had received HBOT were selected for the HBOT groups, while 59 age-matched controls who had not were selected for the control groups. The HBOT and control groups were divided into subgroups according to intratympanic steroid (ITS) use. Groups A–D had received oral steroids + HBOT, oral steroids only, oral steroids + ITS + HBOT, and oral steroids + ITS, respectively. Of the 113 SSNHL patients, 21 had diabetes mellitus (DM) (2, 0, 9, and 10 patients in Groups A–D, respectively). There was no notable difference in hearing improvement between patients receiving HBOT and those in the control group. However, among diabetic patients, those who underwent HBOT demonstrated a significant improvement in hearing when compared to the control group. The combination of HBOT and steroids could potentially be beneficial for treating severe to profound SSNHL patients with DM.

Management of penile post-circumcision ischemia by pentoxifylline infusion and hyperbaric oxygen therapy

BackgroundPost-circumcision penile ischemia is a devastating complication. We will present our experience in managing children with various forms of penile ischemia.Materials and methodsThis cohort prospective observational and interventional study was performed on all male children with post-circumcision penile ischemia between April 2017 and October 2021. A designed and approved protocol includes a combination of early pentoxifylline infusion, hyperbaric oxygen inhalation, early catheterization, and appropriate surgical debridement were applied for patients with deep ischemia 11/23, mainly the necrotic skin and subcutaneous tissues. Data of patient age, anesthesia method, monopolar diathermy usage, early presentation and positive wound culture were collected and analyzed statistically.ResultsDuring the study period 3,382 children were circumcised for non-medical reasons; 23 children were diagnosed with penile ischemia (0.7%), among other complications (9%). Most of the penile ischemia is associated with the use of monopolar diathermy (74%). The use of compressive wound dressing to control post-circumcision bleeding and infections is also responsible for ischemia in 52.2% and 43.5% of the cases. Inexperienced physicians were commonly responsible for ischemia (73.9%). Patients managed at first 24 h had better outcomes than those who were presented later (p = 0.001).ConclusionIn children with post-circumcision penile ischemia, a combination of hyperbaric oxygen therapy and pentoxifylline is especially effective for patients with skin and facial necrosis, this management reduces penile tissue loss.

Results of acute cerebral infarction treatment with hyperbaric oxygen therapy, 2020-2022.

Cerebral stroke is the third leading cause of death after cardiovascular disease, cancer and the leading cause of disability for patients. Hyperbaric oxygen is a non-drug treatment that has the potential to improve brain function for patients with ischaemic stroke. The objective of this study was to evaluate the results of treatment of acute cerebral infarction with hyperbaric oxygen therapy (HBOT). This was a case-control study. One hundred ninety-five patients diagnosed with cerebral infarction, with signs of onset within 24 hours, were treated at the Centre for Underwater Medicine and Hyperbaric Oxygen of Vietnam National Institute of Maritime Medicine during the period from January 2020 to December 2022. Study group included 100 patients with acute cerebral infarction treated with a combination of HBOT and medication and reference group included 95 patients treated by medication only (antiplatelets drugs, statins, control of associated risks factors) RESULTS: After 7 days of treatment with hyperbaric oxygen (HBO), symptoms such as headache, dizziness, nausea, sensory disturbances, and Glasgow score of the study group improved better than that of the reference group (p < 0.01). Movement recovery in the study group was better than the reference group: the percentage of patients with mild and moderate paralysis in the study group increased higher than that of the reference group (86.0% and 68.4%), the degree of complete paralysis of the study group decreased more than that of the reference group (14.0% and 31.6%). The degree of independence in daily activities in the study group was better than the reference group. In the study group, the percentage of patients with complete independence in daily life increased from 27.0% to 84.0%. In the reference group, the rate of patients who were independent in their daily activities increased from 37.9% to 51.6%. The average number of treatment days of the study group was 10.32 ± 2.41 days and it the reference group 14.51 ± 3.24 days. Hyperbaric oxygen therapy is a non-drug treatment with many good effects in the treatment of cerebral infarction, especially acute cerebral infarction. HBOT reduces and improves functional symptoms, improves mobility, and reduces treatment time for patients.

CT-008: The Positive Effect of SKD Plus IOT and HBO2T in the Treatment of Cancer [Introducing Sorush Cancer Treatment Protocol (SCTP)

Background The aim of this research is to figure out the effectiveness of the Sorush Cancer Treatment Protocol (SCTP) which is based on the Evolutionary Metabolic Hypothesis of Cancer (EMHC) and introducing the Specific Ketogenic Diet (SKD) plus Intravenous Ozone Therapy (IOT) in Phase (1) on 54 cancer patients, and combination of Hyperbaric Oxygen Therapy with vitamin/mineral and herbal supplementation beside the SKD and IOT in Phase (2) of this research on the remaining 31 cancer patients. Materials and Methods Based on the research from 1928–2016 and the experimentation of cancer treatments and protocols on cancer patients, we have reached a treatment and decided to test it on 54 voluntary cancer patients in the first stage of their disease. In this treatment we used a 5-day water fasting state, the Specific Ketogenic Diet (SKD) designed by ourselves and Intravenous Ozone Therapy (IOT) in the duration of 90 days (Phase 1) and another 90 days (Phase 2) with the entrance of Hyperbaric Oxygen Therapy (HBO2T) and several supplements which have been effective in previous studies on cancer patients. We have used the measurement of saliva pH, the MRI device and statistical methods to test the shrinkage of the tumors. Results After Phase (1) of this research on 54 patients the average percentage decrease in the tumors was 58% and after Phase (2) on 31 remaining cancer patients the average percentage decrease in the tumors was 98.8%. The average saliva pH in the fasting state of the cancer patients improved from acidic to alkaline as well. Conclusion In conclusion, we have reached an effective cancer treatment based on SCTP by the usage of SKD, IOT, HBO2T and several supplements. There was an obvious improvement of cancer tumor decrease, lifestyle, saliva pH and we did not observe any side effects or cachexia in any of the patients.

Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

&lt;p class="abstract"&gt;Perioperative vision loss (POVL) is a catastrophic complication of spine surgery and several risk factors are identified. As spine fusion surgery is rising in number, POVL incidence is increasing. Preventive strategies can decrease the risk of this complication. Prognosis depends on the level of occlusion and how quickly oxygen supply can be restored to retina. We present a 65-year-old female patient with multiple cardiovascular risk factors that who underwent lumbar fusion. Upon waking up from anesthesia, the patient reported total loss of vision in her left eye. An occlusion of the central retinal artery due to a probable embolic cause was diagnosed and the patient promptly started treatment with anti-aggregation therapy and hyperbaric oxygen therapy (HBOT) with good results. The combination of HBOT with anti-aggregation therapy may have had a synergistic effect contributing to the good outcome presented in this case and may be a good option for the treatment of this patients. &lt;/p&gt;

A Combination of Hyperbaric Oxygen Therapy and Steroid for Treatment of Severe COVID-19

A Combination of Hyperbaric Oxygen Therapy and Steroid for Treatment of Severe COVID-19

Abstract A61: The positive effect of SKD plus IOT and HBO2T in the treatment of cancer

Abstract Background: The aim of this research is to figure out the effectiveness of the Sorush Cancer Treatment Protocol (SCTP), which is based on the Evolutionary Metabolic Hypothesis of Cancer (EMHC) and introducing the Specific Ketogenic Diet (SKD) plus Intravenous Ozone Therapy (IOT) in phase (1) on 54 cancer patients, and combination of hyperbaric oxygen therapy with vitamin/mineral and herbal supplementation beside the SKD and IOT in phase (2) of this research on the remaining 31 cancer patients. Introduction: Cancer based on the introduction of EMHC by Dr. Somayeh Zaminpira and Dr. Sorush Niknamian in 2017 is an evolutionary metabolic disease and through the incline of the reactive oxygen species (ROS) and the Butterfly Effect in normal eukaryotic cells, the mitochondria become damaged or shut down. Cancer cells are primitive eukaryotic cells that have existed since around 1.5 billion years ago before the entrance of mitochondrion as endosymbiont. Materials and Methods: Based on the researches from 1928-2016 and the experimentation of cancer treatments and protocols on cancer patients, we have reached a treatment and decided to test it on 54 voluntary cancer patients in the first stage of their disease. In this treatment we used a 5-day water fasting state, the Specific Ketogenic Diet (SKD) designed by ourselves and Intravenous Ozone Therapy (IOT) in the duration of 90 days (phase 1) and another 90 days (phase 2) with the entrance of hyperbaric oxygen therapy (HBO2T) and several supplements that have been effective in previous studies on cancer patients. We have used the measurement of saliva PH, the MRI device and statistical methods to test the shrinkage of the tumors. Results: After phase (1) of this research on 54 patients, the average percentage decrease in the tumors was 58%, and after phase (2) on 31 remaining cancer patients the average percentage decrease in the tumors was 98.8%. The average saliva PH in the fasting state of the cancer patients improved from acidic to alkaline as well. Conclusion: We have reached an effective cancer treatment based on SCTP by the usage of SKD, IOT, HBO2T and several supplements. There was an obvious improvement of cancer tumor decrease, lifestyle, and saliva PH, and we did not observe any side effects or cachexia in any of the patients. Citation Format: Sorush Niknamian. The positive effect of SKD plus IOT and HBO2T in the treatment of cancer [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2018 Nov 27-30; Miami Beach, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(4 Suppl):Abstract nr A61.

Hyperbaric oxygen therapy for perioperative posterior ischemic optic neuropathy: a case report

To report the successful treatment of postoperative posterior ischemic optic neuropathy (PION) with hyperbaric oxygen therapy and to review the current literature on the pathogenesis and treatment of PION. During an angiographic procedure at a community hospital, an elderly woman had a transient drop in blood pressure after receiving an intravenous dose of hydralazine. During recovery, the patient experienced bilateral vision loss. She was transferred to our specialty referral center for treatment with hyperbaric oxygen. We followed Table 5 in the U.S. Navy Diving Manual, the protocol for decompression sickness. Our patient's vision improved markedly immediately after the first session and continued to improve throughout the course of treatment to its completion. Follow-up ophthalmology visits found the patient's vision to be close to baseline. PION is a rare condition. It has been difficult to determine a successful therapeutic approach because of the lack of large case-controlled studies. Hyperbaric oxygen has been used to treat other ischemic ophthalmic conditions, but there are only few reports of its use in patients with PION. Systemic steroids and antiplatelet therapy have also been used, with mixed success. In our patient, the combination of hyperbaric oxygen therapy and steroids was successful in restoring vision after postoperative PION.

Utility of Hyperbaric Oxygen Therapy for Acute Acoustic Trauma: 20 years' Experience at the Japan Maritime Self-Defense Force Undersea Medical Center.

Introduction Acute acoustic trauma, which is a kind of sensorineural hearing loss, is caused by acoustic overstimulation. Hyperbaric oxygen therapy (HBOT) is reported to be effective against acute acoustic trauma. Objective We aimed to evaluate the efficacy of HBOT against acoustic hearing loss based on our 20 years of experience with such cases. Methods Patients who were treated with HBOT for acute acoustic trauma between April 1997 and August 2017 were evaluated in this study. Thirty-five patients with a mean age of 25.7 ± 9.2 (range: 16–48) years were included. Thirty-nine out of 70 ears (35 patients) were damaged. We investigated the initial level of hearing loss; the extent to which hearing recovered; subjective symptoms, such as tinnitus and aural fullness; and the treatment administered. Results The planned HBOT was completed in 37 of 39 ears. Twenty-six of the 37 ears (70.2%) displayed improved hearing, and 31 of the 37 ears (83.9%) exhibited symptom improvement. Twenty-three (76.7%) and 26 (86.7%) of the 30 ears treated with steroids demonstrated improvements in hearing and subjective symptoms, respectively. Conclusion A combination of HBOT and steroids should be considered as a treatment for acute acoustic trauma in cases involving symptoms such as tinnitus and aural fullness.

PENGARUH KOMBINASI TERAPI OKSIGEN HIPERBARIK DAN PROPOLIS TERHADAP DIAMETER PEMBULUH DARAH DI DAERAH TARIKAN LIGAMEN PERIODONTAL SELAMA PERGERAKAN GIGI UNTUK MENCEGAH RELAPS

&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: The mechanical force of orthodontic device causes occurrence of a tension and a pressure area in the periodontal ligament. In the tension area, an inflammatory response characterized by vasodilation of blood vessels will occur. The function of blood vessel is to flow blood and other nutrients to accelerate the periodontal ligament remodeling process, so that relapse can be prevented. &lt;strong&gt;Objective:&lt;/strong&gt; To determine the effect of combination of propolis 3%, 5% for 14 days and HBOT 2,4 ATA 3x30 minutes with 5 minutes interval for 7 days in the tension area of the periodontal ligament as an effort to prevent relapse. &lt;strong&gt;Materials and Methods&lt;/strong&gt;: A randomized post-test only control group design was used in this study. 42 male guinea pigs (cavia cobaya) are divided into 7 groups K- (without treatment), K + (using separator), P1 (using separator and propolis extract 3%), P2 (using separator and propolis extract 5%), P3 (using separator and hyperbaric oxygen therapy), P4 (using separator and combination of hyperbaric oxygen therapy and 3% propolis extract), and P5 (using separator and combination of hyperbaric oxygen therapy and 5% propolis extract) . &lt;strong&gt;Results&lt;/strong&gt;: Data shows that mean of diameter of blood vessels increased from the smallest K- (41,8417±0,84511), K+(61,77±1,254482), P1(72,5983±0,68869), P2(73,2333±1,24481), P3(74,2583± 0,62030), P4(91,47±0,76585), to the largest in P5(91,5483±0,96178). One-way Anova and LSD test showed significant differences in blood vessels diameter (p &amp;lt;0.05). &lt;strong&gt;Conclusion&lt;/strong&gt;: The combination of propolis 3% and 5% and HBOT have significant effect in increasing blood vessels diameter in the tension area of the periodontal ligament&lt;/em&gt;

Inovasi Terapi Oksigen Hiperbarik Dan Stichopus hermanii Terhadap Jumlah Makrofag Pada Ligamen Periodontal Antara Daerah Tekanan Dan Tarikan Selama Pergerakan Gigi Ortodonti

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The prevalence of malocclusion in Indonesia reaches 80%, causing orthodontic treatment needs to increase. Orthodontic treatment takes a long time around 15-24 months so additional therapy is needed to accellerate the orthodontic treatment process. Hyperbaric oxygen therapy (HBOT) and Stichopus hermanii (golden sea cucumber) which contain bioactive ingredients can work synergistically to reduce inflammatory cytokines. &lt;strong&gt;Purpose: &lt;/strong&gt;To determine the effect of HBOT and Stichopus hermanii on the number of macrophages in periodontal ligament of pressure and tension area in the process of orthodontic tooth movement. &lt;strong&gt;Material and Methods: &lt;/strong&gt;This research used Randomized Post Test Only Control Group Design. A sample of 30 marmot was randomly divided into 5 groups: negative groups (K-), positive groups (K+), Stichopus hermanii treatment group (P1), HBOT group (P2), and combination (P3). On K+ and treatment groups, maxillary incisors of marmot is installed helical spring in order to move the teeth to distal. Analysis of the number of macrophages histologically using Hematoxylin Eosin (HE) staining. And then tested using the Kruskal-Wallis test, and the Mann Whitney Wilcoxon test. &lt;strong&gt;Result: &lt;/strong&gt;The research data showed a decrease of mean average number of macrophages in the pressure area, K (-): 1.90 ± 0.41; K (+): 4.40 ± 1.14; P1: 4,30 ± 0,90; P2: 3.60 ± 0.54; P3: 2.90 ± 0.41 and the mean number of machrophages in tension area also descreased, K (-): 2.00 ± 0.35; K (+): 4.00 ± 1.00; P1: 4,30 ± 0,27; P2: 4,10 ± 0,65; P3: 3.60 ± 0.65. &lt;strong&gt;Conclusion: &lt;/strong&gt;The combination of HBOT and Stichopus hermanii decreases the number of macrophages in the pressure and tension area in orthodontic tooth movement.&lt;/em&gt;&lt;/p&gt;

Ossigenoterapia iperbarica e terapia a pressione negativa nel trattamento delle lesioni difficili/Hyperbaric oxygen therapy and negative pressure wound therapy in the treatment of non-healing wounds

Lo scopo di questo articolo è valutare i risultati ottenibili trattando lesioni difficili attraverso la combinazione di ossigenoterapia iperbarica (OTI) e terapia a pressione negativa (TPN). Individuare le modalità con cui queste possano agire in sinergia coadiuvandosi, al fine di ottimizzare la rigenerazione dei tessuti e favorire la guarigione come qualità e tempi più brevi. Sono stati presi in analisi i dati di tre pazienti trattati presso il Centro Iperbarico di Ravenna che presentavano ferite agli arti inferiori aperte da più di sei settimane. È stato eseguito l’assessment iniziale della ferita e applicato un approccio multi terapeutico OTI e TPN per un periodo compreso tra 3-6 settimane. I pazienti presi in analisi sono giunti a guarigione completa entro 10 settimane di trattamento rispetto alla media di presa in carico per 28 settimane degli altri pazienti trattati presso la stessa struttura (dato reale) e alla media di 12 settimane previste nelle linee guida (benchmark). Le due terapie associate hanno prodotto un esito positivo che avrebbe richiesto tempi e costi maggiori se fossero state utilizzate singolarmente.&#x0D; The purpose of this work is the evaluation of the results obtaineble by treating hard to heal wounds with the combination of Hyperbaric Oxygen Therapy (HBOT) and Negative Wound Pressure Therapy (NWPT). Identify how HBOT and NWPT can act in synergy, in order to optimize tissue regeneration and promote a good quality healing and in shorter time. The study analyzes data of three patients affected, for more than six week, by lower limb wounds and treated at the Hyperbaric Center of Ravenna. The initial wound assessment was performed and a multi-therapeutic approach, HBOT and NWPT, was applied over a period of 3-6 weeks. The patients underwent to a complete healing after a maximum of 10 weeks of treatment compared to the 28-weeks average of other patients treated at the same facility (real data) and the 12-weeks average expected in the guidelines (benchmark).The combination of the two therapies, has led to a positive result saving time and money; the individual use of them would have required more time and costs.

HYPERBARIC OXYGEN THERAPY (HBOT)

The role of steroids in the treatment of Bell’s palsy is well known provided patientspresent within 72hrs of symptoms onset. If patients present late or with severe Bell’s palsythe effect of steroids or other treatment modalities is not yet clear. Aim of this study was toevaluate the effect of HBOT along with oral steroids in treatment of such patients. Setting:Diving department at Armed Forces Hospital King Abdul Aziz Naval Base Jubail, Kingdom ofSaudi Arabia (KSA). Period: January 2010 to Dec. 2015. Methods: Bell’s palsy patients ofage 13 years and above were treated with steroids &amp; HBOT. Prednisolone 60mg was givenorally for one week to all patients &amp; those patients who could tolerate HBOT were selected fortreatment with Hyperbaric Oxygen in a closed chamber at 2.5 ATA, 90 minutes a day and fivedays a week. HBOT was continued till complete recovery or up to 20 sessions before declaringpartial recovery or failure. Assessment was done by physician using House-Brackmanngrading system for Facial nerve dysfunction. Patients were followed up to 3 months beforedeclaring partial recovery or treatment failure. Results: Treatment was started on 125 patientsbut 15 patients could not tolerate HBOT due to ear pain (10 patients) or high blood pressure(5 patients) in the HBOT chamber whereas 10 patients did not show up for follow up so only100 patients completed the treatment. Out of 100, 22(22%) patients had mild (grade I to II), 40patients (40%) had moderate (grade III to IV) and 38 patients (38%) had severe (grade V to VI)Bell’s palsy. Majority of patients (85%) presented after 72hrs of symptoms onset. At 3 monthsof follow up 90% (n=90) patients had full recovery whereas 10% (n=10) patients had partialrecovery. Severity of disease (OR 0.125, CI 0.025---0.6255, p =0.00595) and time between onsetof symptoms and start of treatment &gt;2weeks (OR 0.0966 CI 0.0187---0.4987, p=0.00280) werestatistically significant. Conclusion: Combination of Hyperbaric Oxygen therapy and steroids is

English

The role of steroids in the treatment of Bell’s palsy is well known provided patientspresent within 72hrs of symptoms onset. If patients present late or with severe Bell’s palsythe effect of steroids or other treatment modalities is not yet clear. Aim of this study was toevaluate the effect of HBOT along with oral steroids in treatment of such patients. Setting:Diving department at Armed Forces Hospital King Abdul Aziz Naval Base Jubail, Kingdom ofSaudi Arabia (KSA). Period: January 2010 to Dec. 2015. Methods: Bell’s palsy patients ofage 13 years and above were treated with steroids &amp; HBOT. Prednisolone 60mg was givenorally for one week to all patients &amp; those patients who could tolerate HBOT were selected fortreatment with Hyperbaric Oxygen in a closed chamber at 2.5 ATA, 90 minutes a day and fivedays a week. HBOT was continued till complete recovery or up to 20 sessions before declaringpartial recovery or failure. Assessment was done by physician using House-Brackmanngrading system for Facial nerve dysfunction. Patients were followed up to 3 months beforedeclaring partial recovery or treatment failure. Results: Treatment was started on 125 patientsbut 15 patients could not tolerate HBOT due to ear pain (10 patients) or high blood pressure(5 patients) in the HBOT chamber whereas 10 patients did not show up for follow up so only100 patients completed the treatment. Out of 100, 22(22%) patients had mild (grade I to II), 40patients (40%) had moderate (grade III to IV) and 38 patients (38%) had severe (grade V to VI)Bell’s palsy. Majority of patients (85%) presented after 72hrs of symptoms onset. At 3 monthsof follow up 90% (n=90) patients had full recovery whereas 10% (n=10) patients had partialrecovery. Severity of disease (OR 0.125, CI 0.025---0.6255, p =0.00595) and time between onsetof symptoms and start of treatment &gt;2weeks (OR 0.0966 CI 0.0187---0.4987, p=0.00280) werestatistically significant. Conclusion: Combination of Hyperbaric Oxygen therapy and steroids is

The lack of effectiveness of hyperbaric oxygenation as a treatment for Leishmania major in a mouse model.

We aimed to study the effectiveness of hyperbaric oxygen therapy (HOT) (100% oxygen at 2 ATA for 70 minutes each session for 20 consecutive days) on BALB/c male mice infected with Leishmania major. Fifty-one mice were assigned to six groups. Group 1 was treated with HOT from 1 day after the inoculation. In Groups 2-5, treatment began when the cutaneous lesions appeared. Group 2 received HOT only, Group 3 received topical therapy with Leshcutan only, Groups 4 and 5 received a combination of HOT and Leshcutan for 5 and 10 days respectively, and Group 6 did not receive any treatment (control group). When comparing the control group with Group 1, treatment with HOT in Group 1 did not significantly affect the time of the appearance of the lesions. In contrast, mice treated with Leshcutan demonstrated a significant difference in lesion size and spleen dimensions as compared to the rest of the mice (p<0.001). The results show that HOT treatment has no positive effect on the course of Leishmaniasis in a BALB/c mice model infected with Leishmania major. Further studies are needed with a mouse model closer to humans and with different HOT protocols.

Cyclophosphamide-induced intractable hemorrhagic cystitis treated with hyperbaric oxygenation and intravesical sodium hyaluronate

Cyclophosphamide is a well-known cause of hemorrhagic cystitis. However, the best treatment for hemorrhagic cystitis is still unknown. Herein, we present a patient with cyclophosphamide-induced hemorrhagic cystitis. The patient had a history of myasthenia gravis and had received cyclophosphamide therapy for 14 years. He was admitted due to gross hematuria, which was initially treated by cystoscopic fulguration, followed by continuous bladder irrigation. Due to refractory hemorrhaging, fulguration was repeated and percutaneous suprapubic cystostomy was performed. The bladder hemorrhage eventually subsided after hyperbaric oxygen therapy and intravesical sodium hyaluronate instillation. The combination of hyperbaric oxygen therapy and intravesical sodium hyaluronate instillation may be useful in severe hemorrhagic cystitis caused by cyclophosphamide.

Pyoderma gangrenosum: A case report of bilateral dorsal hand lesions and literature review of management

Pyoderma gangrenosum is a great masquerader in wound diagnosis and management. Frequently misdiagnosed as a necrotizing infection, the elusive nature of its etiology and pathogenesis has thwarted the establishment of a standardized management algorithm, leaving immunosuppressant therapies as the mainstay of treatment. The present report describes a 61-year-old woman presenting with temporally discrete bilateral dorsal hand lesions successfully managed with distinctive multimodality therapies. The initial lesion was managed under the auspices of a necrotizing process using a combination of hyperbaric oxygen therapy and skin grafting with a negative-pressure dressing, both individually demonstrated to be effective for prompt wound stabilization and coverage. A subsequent contralateral hand lesion was similarly managed as a necrotizing infection before a diagnosis of pyoderma gangrenosum was considered. Stabilization and eventual resolution was achieved using intravenous and topical steroids followed by hyperbaric oxygen therapy, again highlighting the benefits of multimodality therapy in the setting of pyoderma gangrenosum.