Corresponding Values In Group Research Articles

Therapeutic efficacy of the combination of two surgical procedures with tamsulosin in treatment of benign prostatic hyperplasia complicated with bladder stones

Purpose: To compare the efficacies of two surgical methods combined with tamsulosin in treating benign prostatic hyperplasia (BPH) complicated with bladder stones.
 Methods: A total of 86 patients with BPH complicated with bladder stones and admitted to The People’s Hospital of Dingzhou, Hebei, from October 2021 to October 2022 were selected as subjects. The patients were equally divided into groups A and B (n = 43). Patients in group A were treated with transurethral vaporization and electro-resection of the prostate (TURP) + percutaneous nephroscopic lithotripsy (PCNL), while patients in group B were treated with TURP + holmium laser lithotripsy (HLL). Baseline clinical information, curative effect, surgery-related indicators, clinical symptoms, and recurrence were compared between the two groups of patients.
 Results: At 4 weeks post-surgery, Qmax was significantly higher in group B than in group A, while IPSS score, RUV, and prostate volume were significantly lower in group B than in group A (p ˂ 0.05). The levels of physiological state, psychological state, social functionality and level of subjective judgment were higher in group B than in group A (p ˂ 0.05). The incidence of complications in group A was 11.63 %, with a recurrence rate of 6.98 %, while the corresponding values for group B were 13.95 and 4.65 %, respectively (p > 0.05).
 Conclusion: The effect of TURP + HLL surgery on patients with BPH complicated with bladder stones is significantly better than that of TURP + PCNL surgery. The former also reduces clinical symptoms while improving the quality of life of patients.

Multidisciplinary rehabilitation intervention on mobility and hemodynamics of joint contracture animal model

BackgroundJoint contracture causes a decrease in range of motion (ROM), which severely affects activities of daily living of patients. We have investigated the effectiveness of a multidisciplinary rehabilitation on joint contracture by rat model.MethodsWe used 60 Wistar rats in this study. The rats were divided into five groups as follows: group 1 was the normal control group; except the group 1, we created left hind limb knee joint contracture using Nagai method for other four groups. The joint contracture modeling group 2 was the model control group for monitoring the spontaneous recovery, and other three groups were given different rehabilitation treatments; for example, group 3 was treadmill running group; group 4 was medication group; group 5 was treadmill running plus medication group. The left hind limbs knee joint ROM and the femoral blood flow indicators (FBFI) including PS, ED, RI, and PI were measured right before and after the 4 weeks of rehabilitation.ResultAfter 4 weeks of rehabilitation treatments, the measured values of ROM and FBFI are compared with the corresponding values of group 2. Firstly, we did not see clear difference in the values of ROM and FBFI for group 2 before and after 4 weeks spontaneous recovery. The improvement of left lower limb ROM for group 4 and group 5 as compared to the group 2 was statistically significant (p < 0.05), whereas a less recovery for group 3 was observed. However as compared to the group 1, we did not observe full recovery in ROM of group 4 and group 5 after 4 weeks of rehabilitation. The PS and ED level for rehabilitation treatment groups was significantly higher than those modeling ones (Tables 2, 3, Figs. 4, 5), while the RI and PI values show the contrary trends (Tables 4, 5, Figs. 6, 7).ConclusionOur results indicate that multidisciplinary rehabilitation treatments had a curative effect on both contracture of joints and the abnormal femoral circulations.

Long-term clinical effects of intravitreal injections of conbercept for the treatment of choroidal neovascularization in patients with pathological myopia.

To observe the long-term clinical efficacy of intravitreal injections of conbercept, a novel vascular growth factor inhibitor, for the treatment of pathological myopia choroidal neovascularization (PM-CNV). A total of 67 eyes (from 67 patients; mean age, 54.90±12.7y) with PM-CNV were retrospectively researched. Based on the different schemes used for the administration of the drug, the patients were divided into two groups: group A (n=35; average age, 53.31±13.6y; average diopter, 9.25±1.72 D), which received only one injection of pro re nata (PRN; 1+PRN regimen), and group B (n=32; average age, 56.49±11.8y; average diopter, 9.63±2.24 D), which received one injection per month for 3mo (3+PRN regimen). Best-corrected visual acuity (BCVA) analysis, intraocular pressure (IOP) examination, slit-lamp microscopy, fundus examination and optical coherence tomography were performed at each follow-up. The recurrence and treatment times of CNV were recorded. The patients were followed up for at least 12mo. The BCVA was increased in 29 eyes (82.9%) in group A and 30 eyes (93.75%) in group B; no increase or decrease was observed in 6 (17.1%) and 2 (6.25%) eyes in groups A and B, respectively. The BCVA (logMAR) values before treatment (0.67±0.48 and 0.71±0.56) were significantly higher than those 12mo after treatment (0.31±0.26 and 0.33±0.17) in groups A and B, respectively (P<0.05). The mean central macular thickness (CMT) values had significantly decreased from 346.49±65.99 and 360.10±82.31 µm at baseline to 257.29±40.47 and 251.97±48.26 µm in groups A and B, respectively, after 12mo of treatment. A total of 21 eyes in group A needed reinjection (60%; average number of injections, 2.51±0.98); the corresponding values in group B were 6 eyes (18.75%; average number of injections, 3.74±1.22). There were no adverse ocular and systemic complications during the treatment and follow-up. Intravitreal injection of conbercept with 1+PRN or 3+PRN improve the visual acuity, reduce macular edema and reduce the level of CMT in patients with PM-CNV. The 3+PRN regimen demonstrates a lower recurrence rate of CNV than the 1+PRN regimen, but requires more treatment. However, both treatment regimens demonstrate long-term safety and efficacy for the treatment of PM-CNV.

Evaluation of Healing and Microbial Responses to Surgical Wounds in Alloxan-induced Diabetic Rabbits

The wounds of diabetic patients are associated with delayed healing and microbial invasion. This study evaluated the healing and microbial responses to surgical wounds in diabetic rabbits. Sixteen (16) New Zealand White rabbits were used in this study. They were divided into 4 groups of 4 rabbits each, namely; A, B, C and D. A is the control (non-diabetic and non-wounded), B (diabetic and non-wounded), C (wounded and non-diabetic) and D (wounded and diabetic). Three (3) cm2 skin wounds were created in a standard aseptic condition while diabetes was induced by intravenous administration of 200 mg/kg of alloxan monohydrate. Blood samples were collected from ear vein of each rabbit on days 0, 3, 7, 14, 21 and 28 post-surgery for analysis of blood glucose level. Wound samples were collected on days 3, 7, 14 and 21 to evaluate microbial contaminants. The wounds were examined for exudation and recorded as none (0), scant (1), moderate (2) and large (3) and diameter of wound epithelialization and contraction were determined. The blood glucose concentration of groups B and D from days 3 to 28 ranged between 288.00 ± 40.22 mg/dl to 358.65 ± 25.89 mg/dl), and were significantly higher (P &lt; 0.05) than the corresponding values of groups A and C which ranged from 120.60 mg/dl ± 14.29 to 129.60 ± 8.18 mg/dl. The rate of wound contraction in the C group on day 7 (11.02 ± 2.17%) was significantly higher (P &lt; 0.05) than the D group (2.23 ± 4.60%). Staphylococcus and Pseudomonas subspecies were identified in the wounds of rabbits in groups C and D. It was concluded that alloxan-induced diabetes caused delayed wound healing. At the same time Staphyloccocus and Pseudomonas species were the predominant microorganism detected in the acute wounds of diabetic and non-diabetic rabbits.

LBSAT247 Factors Guiding Successful Treatment Discontinuation In Levothyroxine Replacement Therapy Overuse: Short And Long-term Observation Data Of 802 Subjects.

Abstract Background Levothyroxine (LT4-Rx) is one of the most commonly prescribed drugs worldwide and the vast majority of patients receive long-term treatment. However, in a recent study of LT4-Rx withdrawal in 291 subjects, it was found that 60% of those remained biochemically euthyroid two months after LT4-Rx discontinuation1. Aim of the study A prospective clinical cohort follow-up study was carried out to address this issue. We registered all patients presented in our clinical practice who were not on LT4-Rx for a solid diagnosis of hypothyroidism and abruptly discontinued treatment. All subjects underwent weight, height, TSH, TPO, Tg-Abs and free T4 measurement and thyroid ultrasound on enrolment, 2-4 months later, and at the end of follow up. A TSH value of ≥4.5IU/mL was considered as underlying hypothyroidism. Results We enrolled 802 consecutive subjects (83% females) aged 48±16 (range 18-84 years) with 8.8±7.3 years on LT4-Rx. The treatment indications and corresponding percentage for LT4-Rx were classified as a nodule(s) (35%), indefinite (25%), post-partum (7%) and Hashimoto's (33%); 48% of subjects were part of Group A and long-term follow-up up to 5 years was achieved in the remaining. Among the entire cohort, n=182 subjects became hypothyroid, while the remaining n=620 remained euthyroid off LT4-Rx (23 vs. 77%, p&amp;lt;0. 001). On subgroup analysis, 40% of subjects comprising Group A became hypothyroid, whereas the corresponding value for Group B was 7%. In Group A, the reason for LT4-Rx, LT4 dose, LT4 dose/BMI, TSH levels and the presence of increased thyroid autoantibodies titers (ATA) were significantly different in those who became hypothyroid, whereas only the reason for LT4-Rx differed in Group B. Subjects with a diagnosis of nodules, negative ATA, lower TSH values and lower LT4 dose during treatment had significantly lower probability to become hypothyroid. Furthermore, in Group A, 14.8% became hypothyroid with baseline TSH&amp;gt;3IU/mL vs. 5.2% with baseline TSH&amp;lt;3IU/mL (p&amp;lt;0. 001); the corresponding values for Group B were 22.2% vs. 8.8%, (p&amp;lt;0. 001), respectively. Conclusions These findings suggest considerable overuse of thyroxine therapy. In cases of uncertainty, the existence of nodules, a low-normal TSH value, a relatively small T4 dose, and the absence of ATA are strong predictors of euthyroidism, and accordingly a treatment discontinuation trial is recommended. Furthermore, if hypothyroidism does not ensue 2-4 months post-treatment discontinuation, the likelihood to develop hypothyroidism in the long term is minimal.1. Livadas S, et al. Thyroid 2018. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Effect of modified Wenyang Buxin decoction and routine therapy on cardiac function and serum levels of H-FABP, cTnI and Ang-2 in chronic heart failure patients

Purpose: To investigate the effect of modified Wenyang Buxin decoction and routine therapy on cardiac function and serum levels of heart-type fatty acid binding protein (H-FABP), cardiac troponin-1 (cTnI) and angiopoietin-2 (Ang-2) in chronic heart failure (CHF) patients.Methods: A total of 120 CHF patients admitted to Zhejiang Province Rongjun Hospital (from January2019 - January 2020) were selected for this study. They were randomly but equally distributed into groups A and B. All patients were given routine therapy such as diuretic treatment and detumescence, while those in group A received 150 mL of modified Wenyang Buxin decoction daily, in addition to routine therapy. At 2 months after therapy, cardiac function indices, serum H-FABP, cTnI and Ang-2 levels, hemorheology indices, traditional Chinese medicine (TCM) syndrome scores, and Chinese questionnaire of quality of life in cardiovascular patients (CQQC) scores of the two groups were evaluated.Results: After therapy, cardiac function indices, serum H-FABP, cTnI and Ang-2 levels, hemorheology indices as well as TCM syndrome score and CQQC score were significantly improved in group A, when compared with corresponding values in group B (p &lt; 0.05).Conclusion: Modified Wenyang Buxin decoction and routine therapy improves serum biomarker levels, cardiac function and quality of life, and relieves clinical symptoms of CHF in patients. Therefore, this treatment approach may be useful in the management of CHF patients.

Assessment of sudomotor function in hypertensive with/without type-2 diabetes patients using SUDOSCAN: An electrophysiological study

ObjectiveElectrochemical skin conductance (ESC) test is a simple and non-invasive screening test can detect dysfunction of the peripheral sudomotor, and indirectly estimates the function of cardiac autonomic nerves. This study aimed to assess the ESC values in hypertensive patients with/without type-2 diabetes by using SUDOSCAN technology. Moreover, this study evaluated the role of cardiometabolic risk factors on the results of ESC test. MethodsThis cross-sectional study was carried on three groups of participants, includinghealthy subjects (Group I, n = 49), hypertensive without type-2 diabetes (Group II, n = 75) patients, and hypertensive with type-2 diabetes (Group III, n = 76) patients. Body mass index (BMI), blood pressure (systolic, diastolic and pulse pressure index), fasting serum glucose, and lipid profile were determined. ESC test as a measurement sudomotor function was determined by applying a small direct current at low voltage to hands and feet sensor plates through SUDOSCAN device. ResultsESC values of the peripheral sudomotor nerves in the Group II and III patients were significantly lower than the corresponding values of Group I. SUDOSCAN results of Group II and III. Significant discriminators of cardiac autonomic neuropathy (≥30 score) that determined by the area under the curve (AUC) with 95% confidence interval (95% C.I.) were, duration of the disease, BMI, and mean blood pressure in Group II, while the duration of the disease and the BMI were significant discriminators in Group III. ConclusionsSUDOSCAN is a simple, useful device, which can detect the impairment of peripheral autonomic small nerve fibers and the risk of cardiac autonomic neuropathy in hypertension. Moreover, the duration of the disease and the associated cardiometabolic risk factors are important predictors of significant SUDOSCAN findings. SignificanceESC test is useful in detecting subclinical neuropathy in hypertensive patients as well as in type 2 diabetes.

Elastic Power of Mechanical Ventilation in Morbid Obesity and Severe Hypoxemia.

To minimize ventilator-induced lung injury, the primary clinical focus is currently expanding from measuring static indices of the individual tidal cycle (eg, plateau pressure and tidal volume) to more inclusive indicators of energy load, such as total power and its elastic components. Morbid obesity may influence these components. We characterized the relative values of elastic subcomponents of total power (ie, driving power and dynamic power) in subjects with severe hypoxemia, morbid obesity, or their combination. We analyzed data from subjects receiving mechanical ventilation divided into 4 groups. [Formula: see text]/[Formula: see text] < 150 mm Hg (severe hypoxemia) indicated probable reduction of lung compliance while body mass index > 40 kg/m2 (morbid obesity) suggested a possible contribution to reduced respiratory system compliance from the chest wall. Group 1 included subjects with no expected abnormality of lung compliance or chest wall compliance; Group 2 included subjects with expected reduction of lung compliance on the basis of severe hypoxemia but with no morbid obesity; Group 3 included subjects with morbid obesity without severe hypoxemia; and Group 4 included subjects with morbid obesity and severe hypoxemia. All ventilator-induced lung injury predictors were compared among groups using mixed-effects linear models. Groups 1-4 included 61, 52, 49, and 51 subjects, respectively. Mean body mass index averaged 28.7 kg/m2 for nonobese subjects and 52.1 kg/m2 for morbidly obese subjects. Mean driving pressure, dynamic power, and driving power of Groups 2 and 3 exceeded the corresponding values of Group 1 but fell into similar ranges when compared with each other. These values were highest in Group 4 subjects. In Group 2, mean dynamic power and driving power values were comparable to those in Group 3. In mechanically ventilated subjects, stress and energy-based ventilator-induced lung injury indicators are influenced by the relative contributions of chest wall and lung to overall respiratory mechanics. Numerical guidelines for ventilator-induced lung injury risk must strongly consider adjustment for these elastic characteristics in morbid obesity.

The risk of developing chronic heart failure in patients with hypertension depending on the actual arterial stiffness

Objective. To determine the risk of developing chronic heart failure (CHF) in patients with hypertension (HTN) depending on the actual arterial stiffness.Material and Methods. The study included 175 patients with HTN without a verified diagnosis of heart failure. The average age was 48.5 ± 6.8 years. Patients underwent general clinical examination, volume sphygmoplethysmography assessments of cardio-ankle vascular index (CAVI), echocardiography study (left ventricular (LV) ejection fraction, LV diastolic function, LV myocardial mass index, indexed LV volume by echocardiography), and tests for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). Patients were divided into two groups depending on CAVI. Group 1 included 141 (80.6%) patients with CAVI &lt; 9; group 2 included 34 (19.4%) patients with CAVI &gt; 9.Results. In patients of group 1, the level of NT-proBNP was 0.008 [0.006; 5.770], which was significantly lower than the corresponding value in group 2, where the level of NT-proBNP was 13.08 [0.01; 350.65] ng/mL (p = 0.041). Indicators of odds ratio (OR) and relative risk (RR) were also significant. The chance of developing CHF with CAVI &gt; 9 increased by almost 7 times (OR = 6.9; 95% CI = 2.8–16.8), and OR of CHF onset was 4.1 (95% CI = 2.2–7.6). Sensitivity and specificity rates were 55.9% and 84.4%, respectively. Correlation analysis revealed a medium degree of dependence and direct relationships between NT-proBNP level and CAVI values (r = 0.35; p &lt;0.05).Conclusion. Serum level of NT-proBNP depended on the actual arterial stiffness. Patients with CAVI &gt; 9 indicative of an increase in true arterial stiffness had a greater risk of developing heart failure assessed based on the level of NT-proBNP in the blood. Further studies are required to assess the effects of arterial stiffness, registered within the intermediate values of CAVI index, on the risk of heart failure onset.

Endothelial function in pregnant women with chronic hypertension and abdominal obesity

Objective. To evaluate endothelial function in pregnant women with chronic hypertension and abdominal obesity. Material and Methods. We studied 30 pregnant women with chronic hypertension and abdominal obesity (group I), 28 pregnant women with chronic hypertension and normal body mass index (group IIa), 27 pregnant women with abdominal obesity without chronic hypertension (group IIb), and 33 pregnant women without chronic hypertension and abdominal obesity (control group). We performed reactive hyperemia tests, assessed the serum levels of endothelin-1 and homocysteine, and analyzed the outcomes of pregnancy and delivery. Results. The values of endothelium-dependent vasodilation (EDVD) in pregnant women of groups I, IIa, and IIb were comparable and were 6.7 (3.2–9.1)%, 7.0 (3.9–11.4)%, and 7.2 (4.4–10.8)%, respectively. Significant differences were found in EDVD values between the groups mentioned above and the control group, where the EDVD value was 12.5 (10.5–13.9)%, p &lt; 0.05. The endothelin-1 concentration in group I was 14.0 (10.3–17.5) pg/mL, which significantly exceeded the corresponding values in group IIa ( p &lt; 0.05) and the control group ( p &lt; 0.05). The endothelin-1 level in patients with abdominal obesity was twice higher than the corresponding value in the control group ( p &lt; 0.05). Significant differences were observed between patients with chronic hypertension (groups I and IIa) and control group ( p &lt; 0.05). The level of homocysteine in control group [6.1 (3.9; 8.0) µmol/L] significantly differed from the corresponding values in group I [9.3 (7.8; 10.5) µmol/L, p &lt; 0.05], group IIa [7.8 (6.8; 9.8) µmol/L, p &lt; 0.05], and group IIb [7.8 (6.8; 9.8) µmol/L, p &lt; 0.05]. Conclusions. This study showed the presence of endothelial dysfunction in pregnant women with chronic arterial hypertension and abdominal obesity. This observation was confirmed by the lower values of EDVD, higher frequency of attenuated and paradoxical responses to the reactive hyperemia test, and the elevated serum levels of homocysteine and endothelin-1 in this category of patients. The endothelial dysfunction contributed to the development of pregnancy complications and adverse outcomes of pregnancy compared with the control group and women who had isolated manifestations of chronic hypertension and abdominal obesity.

RESULTS OF COMBINED MODALITY TREATMENT WITH PREOPERATIVE CHEMOTHERAPY IN ESOPHAGEAL CANCER PATIENTS

The purpose of the study: to analyze the efficacy of combined modality treatment including preoperative chemotherapy with gemcitabine/cisplatin in patients with stage II-III esophageal cancer (EC). Materials and methods: The study included 70 patients with stage II-III EC, who were treated at the Cancer Research Institute (Tomsk, Russia) from 2012 to 2019. The patients were divided into 2 groups. Group I comprised 35 patients, who received 2 cycles of preoperative chemotherapy with gem-citabine (1250 mg/m2 on days 1 and 8) and cisplatin (80 mg/ m2 on day 1) followed by radical surgery. Group II included 35 patients who underwent surgery alone. All patients underwent subtotal resection of the esophagus with simultaneous esophageal reconstruction using gastric tube (68.6%) or colon tissue (31.4%). Results: The overall tumor response to preoperative chemotherapy according to RECIST 1.1 criteria was 57.1%, including complete response (5.7%) and partial response (51.4%). No severe complications were observed. R0 resection was achieved in all patients (100%). No difference in the rate of postoperative complications between Group I and Group II was found (34.3% and 40%, respectively). There was no statistically significant difference in the mortality rate between treatment groups (8.6% versus 57%) (p&gt;0.05). Pathological complete tumor response was 5.7%. In Group I patients, the 2-year disease-free and overall survival rates were 71.8% and 81.3%, respectively. The corresponding values in Group II patients were 39.4% and 51.5%, respectively (p=0.01). Conclusion: Preoperative chemotherapy for patients with stage II-III EC demonstrated high response rates, having no adverse effect on the perioperative period and mortality. The 2-year survival rates were significantly higher in patients, who received combined modality treatment with preoperative chemotherapy than in patients, who underwent surgery alone.

Dyslipidemic profile in healthy women in relation to body fat distribution

Abdominal obesity is associated with particularly adverse lipidemic profile. The aim of this study was to determine the characteristics of the dyslipidemic profile in healthy women with extreme abdominal obesity determined anthropometrically. Lipid profile and atherogenic indexes were determined in 80 healthy women, grouped in 4 groups according to their body mass index (BMI) and grouped in 3 groups according to their body fat distribution (BFD) by means of anthropometric indexes waist/hip ratio (WHR) and waist/thigh ratio circumference (WTR): group M with normal BFD (WHR&lt;0.85 and WTR&lt;1.45), group N with moderate (WHR 0.85-1 and WTR 1.45-1.7) and group O with extremely expressed abdominal BFD. HDL-cholesterol (HDL-C) levels (0.84±0.26mmol/L) were significantly lowest in group O (p&lt;0.002), and significantly lower compared to group N (1.14±0.43mmol/L) (p&lt;0.006). Triglyceride (TG) levels were significantly higher in group O compared to group M (p&lt;0.001) and also higher in group N compared to group M (p&lt;0.044). Atherogenic indexes C/HDL-C, LDL/HDL-C and TG/HDL-C values in group O were significantly higher compared to the corresponding values in group M (p&lt;0.004; p&lt; 0.006; p&lt;0.001), and their values were also higher in group O compared to group N, but with lower significance of the difference (p&lt;0.05) indicating lower increase of the atherogenic indexes in moderate and significant increase in women with extreme abdominal obesity. Dyslipidemic profile and high atherogenic indexes in women with abdominal obesity with significantly highest WHR, WTR and BMI values indicated the need to intervene earlier and more effectively in the prevention and treatment of cardiovascular and metabolic risks. Keywords: abdominal obesity, anthropometric indexes, lipid profile, atherogenic indexes

Effect of Uncomplicated Cataract Surgery on Central Macular Thickness in Diabetic and Non-diabetic Subjects.

PurposeTo assess the quantitative changes of macula in diabetic and non-diabetic eyes after uncomplicated cataract surgery.MethodsIn this prospective interventional study being performed in a tertiary healthcare hospital, a total of 660 eyes were divided into two groups. Group 1 included 330 eyes from healthy subjects and group 2 included 330 eyes from well-controlled diabetic subjects with no diabetic retinopathy planned for phacoemulsification with foldable IOL implantation by the same surgeon under similar settings. Optical Coherence Tomography (Heidelberg Spectralis SD-OCT) was used to assess preoperative and postoperative central macular thickness (CMT) at weeks 1 and 6.ResultsThe mean CMT in group 1 preoperatively, at postoperative week 1, and at post-operative week 6 was 257.03 20.904, 262.82 17.010, and 265.15 20.078 µm, respectively. The corresponding values in group 2 were 255.36 17.852, 259.15 16.644, and 266.09 18.844 µm, respectively. There was no significant difference in the mean CMT values between the two groups on any of the three occasions when the CMT was measured (P = 0.374 and P = 0.313 at weeks 1 and 6, respectively).Conclusion There was no statistically significant difference in CMT between normal subjects and diabetic subjects without diabetic retinopathy preoperatively and in early postoperative period after uncomplicated phacoemulsification surgery.

Effect of Acupressure versus Aerobic Exercise on Depression in Postmenopausal Women

AbstractBackground: The effect of acupressure and aerobic exer-cise on depression was a hot topic in physical therapy in the past decades. The results of the research available to date showed that acupressure and exercise training might be a promising, additional, safe and economical method to help in improving depression.Aim of Study: This study was conducted to compare the effect of acupressure versus aerobic exercise on depression in postmenopausal women.Material and Methods: A sample of 40 postmenopausal women diagnosed with depression by gynecologist and con-firmed by Zung self-rating depression scale, their ages ranged from 45 to 55 years with body mass index not exceeded 30kg/m2 participated in this study from the outpatient clinic of Kasr Al-Ainy University Hospital, Cairo University. They were distributed into two groups; each consisted of 20 post-menopausal women, Group (A) received acupressure by wearing wrist band for four weeks for 24 hours and Group (B) performing aerobic exercises on treadmill 3 sessions per week for four weeks for a duration 40mins (10mins warming up, 20mins running and 10mins cooling down).Results: Showed that there was a statistically significant decrease in the value of Zung self-rating depression scale measured at post-treatment compared with the pre-treatment in both study Groups (A) and (B) (p=0.001).On the other hand at post-treatment, there was a statistical significant decrease in value of Zung self-rating depression scale in Group B (38.80±3.02) when compared with its cor-responding value in Group A (46.90±3.82) with Z-value= –4.903 and p-value=0.001.Conclusion: Both acupressure and aerobic exercise have significant effect on depression in postmenopausal women but, patients may get additional benefit in improving the depression level through aerobic training program more than the acupressure.

Choroidal Thickness and Hemoglobin A1c Levels in Patients with Type 2 Diabetes Mellitus.

PurposeThe aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT).MethodsIn this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared.ResultsMean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30 m) were significantly less than non-diabetic healthy subjects (277.56, 262.92, and 266.32 m). Additionally, mean central, nasal, and temporal choroidal thickness values in group 4 (277.56, 262.92, and 266.32 m) were significantly greater than the corresponding values in group 2 (248.34, 237.55, and 236.45 m) and group 3 (239.81, 234.62, and 233.94 m), but was not significantly different from corresponding values in group 1 (259.46, 246.12, and 251.00 m).Conclusion HbA1c values have a significant correlation with choroidal thickness in diabetic patients, and better glycemic control with HbA1c 7% may prevent choroidal thinning.

Superantigens of Staphylococcus Aureus Colonization in Atopic Dermatitis and Treatment Efficacy of Oral Cefuroxim in Vietnamese Patients.

BACKGROUND:Atopic dermatitis (AD) is a common, chronic, relapsing, genetically determined inflammatory skin disorder. Staphylococcus aureus (S. aureus) plays an important role in the pathogenesis of AD. Atopic skin is susceptible to infection with S. aureus.AIM:This study was aimed to compare the skin S. aureus colonisation status and its secretion of superantigens in adult AD and healthy subjects and to evaluate the efficacy of two treatment regimens (oral cefuroxime plus topical betamethasone dipropionate 0.05% versus topical betamethasone dipropionate 0.05%) in AD patients.METHODS:A group of 128 AD and 40 healthy subjects were recruited in this study and treatment efficacy was assessed by the SCORAD score.RESULTS:S. aureus was found in skin lesions in 83.8% of AD patients while only 37.5% of healthy subjects possessed this kind of bacteria in the external nares (p < 0.001). Superantigen production was more common in S. aureus strains isolated from AD than the control group (58.6% versus 6.6%, p = 0.0006) and staphylococcal enterotoxin B was predominant (88.89%). 68 AD patients who had positive cultures with S. aureus were included in a clinical therapeutic trial. The isolated bacteria were all sensitive to cefuroxime. Patients were randomised to receive either oral cefuroxime 500 mg b.i.d. Plus topical betamethasone dipropionate 0.05% twice daily for 2 weeks (so-called group 1, 36 patients) or only topical betamethasone dipropionate 0.05% twice daily for 2 weeks (so-called group 2, 32 patients). The mean SCORAD scores of group 1 at baseline and after 1 and 2 weeks of treatment were 44.61, 26.69 and 16.61, respectively. The corresponding values for group 2 were 43.03, 32.53 and 23.41, respectively.CONCLUSION:The reduction in SCORAD scores was significantly higher in group 1 than group 2 in comparison to the baseline value of each study group (p = 0.003 after 1 week and p < 0.001 at the end of treatment).

Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients.

Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes. In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients. There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84 ) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02 ) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73). This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.

Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma.

To evaluate the outcomes of Ahmed glaucoma valve implantation in refractory primary congenital glaucoma as well as primary procedure in aphakic glaucoma. In this retrospective study, medical records of patients who underwent Ahmed glaucoma valve implantation for refractory glaucoma and aphakic glaucoma were reviewed. Primary outcome measures were the surgical success defined as intraocular pressure ≤21 mm Hg and decreased ≥20% and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity, and intraocular pressure. A total of 62 eyes of refractory primary congenital glaucoma patients (group 1) and 33 eyes of aphakic glaucoma patients (group 2) were included in our study. Mean follow-up was 51 ± 33 months in group 1 and 49 ± 41 months in group 2 (p = 0.82). The cumulative probability of success was 90% in both groups at the first year; however, the success rate was 52.5% in group 1 and 71.5% in group 2 at 5 years' follow-up visit. In group 1, the mean intraocular pressure ± standard deviation was 33.1 ± 8.6 mm Hg at the baseline and decreased to 17.1 ± 5.3 mm Hg at 1 year and 18.5 ± 6.4 at 3 years postoperatively (all p's < 0.001). Corresponding values for group 2 were 28.9 ± 6.1, 15.2 ± 4.6, and 16.0 ± 5.9 mm Hg, respectively (all p's < 0.001). The baseline number of glaucoma medications was 3 ± 0.7 that decreased to 2 ± 0.8 at final follow-up (p = 0.02). Ahmed glaucoma valve implantation has a moderate success rate in the management of refractory primary congenital glaucoma with an increased chance of tube-related complications. The surgical success rate is higher in case of primary Ahmed glaucoma valve implant for aphakic glaucoma with acceptable safety profile.

Salivary Flow Rate as a Noninvasive Method for an Early Prediction of Pre Diabetes in Patients at Tanta University Hospitals

Purpose: Early diagnosis of pre-diabetes mellitus is essential for oral health and prevention of diabetes complications. It has been suggested that xerostomia may be an early indication of diabetes screening. Materials and Methods: The present study was carried out on 90 subjects, 34 (37.8%) males and 56 (62.2%) females. The mean age was 36.37+7.9 years, ranged from (20-60) years old with no history of diabetes and suffering from xerostomia. To diagnose xerostomia, a questionnaire was applied to the patients to be answered by yes or no illustrating presence of xerostomia. The selected patients divided into three groups according to their complain of xerostomia, Group I: Control, Group II: Xerostomia and Group III: Hypo-salivation patients. Unstimulated whole saliva flow rates (UWSFRs) and HbA1c values were determined. Statistical analysis of the collected data was carried out. Results: UWSFRs is markedly decreased in groups II& III in comparison to its corresponding value in group I. is statistically significant difference between the studied groups (F value was 98.242, P value<0.0001*). Conclusion: a dental office could be a good location for (pre)diabetes screening in patients with xerostomia.

Serum levels of serotonin as a biomarker of newly diagnosed fibromyalgia in women: Its relation to the platelet indices.

Background:This study aimed to assess the serum serotonin levels in the newly diagnosed fibromyalgia (FM) and to relate these levels to the presenting signs and symptoms.Materials and Methods:This case–control study included 35 healthy women (Group I) served as controls and 130 women with newly diagnosed FM (Group II). The diagnosis of FM was confirmed by the diagnostic criteria of the American College of Rheumatology-10. The assessment of pain using a revised fibromyalgia impact questionnaire and tender points scoring, blood platelet indices, and serum serotonin levels were determined.Results:Group II patients had significantly (P < 0.001) higher values of mean platelet volume (MPV) (10.60 ± 1.57fL) and platelet width distribution (16.25 ± 1.45%) than the corresponding values in Group I (8.73 ± 0.81fL and 15.0 ± 1.15%). Significant low-serum serotonin levels observed in Group II patients compared with Group I healthy individuals (187.3 ± 50.3 ng/ml vs. 219.5 ± 78.3 ng/ml, P = 0.026). Multiple linear regression analysis showed the nonsignificant correlations between serum serotonin levels and platelet indices in Group II patients.Conclusion:Newly diagnosed FM women have significantly low-serum serotonin levels, which does not correlate with a significant increment of the platelet activity expressed as increase MPV and platelet width distribution percentage. Therefore, this study highlighted that the correction of serum serotonin level by medicines could help the patients.