End Of 4th Week Research Articles

Efficacy of Autologous Platelet Rich Plasma For Treatment of Diabetic Foot Ulcer

Background: Diabetic foot ulcer (DFU) is a common complication of long standing uncontrolled diabetes mellitus. There are different types of treatment commonly practiced among the clinicians to treat DFU. Among them, autologous platelet rich plasma (PRP) application is getting popularity day by day throughout the western world. Methodology: It was a prospective, randomized, controlled study that was carried out among 40 DFU patients in the Department of Surgery, Dhaka Medical College Hospital. Among them, 20 patients were treated by autologous PRP and another 20 patients were treated by conventional method. They were followed up for 12 weeks period. Data collected from the participants were analyzed to compare the healing rate among two groups. Result: In PRP treated ulcers, healing rate was significantly faster and better in comparison to conventionally treated ulcers. After 10th weeks follow up, in PRP group 14 ulcers were completely healed whereas in control group,4 ulcers were completely healed. On the contrary, 3 ulcers in control group showed further deterioration. At the end of 12th weeks follow up, 19 ulcers in PRP group were completely healed whereas 13 ulcers in control group were completely healed. In PRP group no patient showed any complication during treatment, whereas in control group 7 patients experienced local complications. Conclusion: Treatment of diabetic foot ulcer with autologous platelet rich plasma results in faster and better ulcer healing in comparison to conventional treatment. PRP accelerates the healing rate and keep the ulcer area safe from external pathogens. Hence, autologous PRP is a better selection for DFU treatment. J Dhaka Med Coll. 2023; 32(1) : 38-42

A Combination of Chemotherapy and Autogenous Vaccine for Control of Bovine Papillomatosis in Cattle

The present study was conducted during the period from July, 2023 to January, 2024. Two clinical cases of cattle were reported with cutaneous papillomas, one near right umbilical region and another over the right hind teat of cattle. Both the animals were treated with a protocol designed such that it can regulate the secondary bacterial infection, speedy recovery of integument system and enhance the immune response for complete regression of the warts. The innate immune responses of infected animals were augmented with inactivated pathogen associated molecular patterns (PAMPs) as autogenous vaccine candidate. The warts were surgically excised, triturated in sterile PBS, inactivated with 0.5% formaline and prepared the autogenous vaccine. The sterility test of vaccine revealed that the vaccine was free from bacterial and fungal contaminants. The chemotherapy includes the use of drugs Thuja ointment, Inj.Enrofloxacin, Inj.Avil and Inj.Anthiomaline. The dose of the vaccine was 1 ml 20 kg-1 b.wt. subcutaneously and given at weekly intervals for a period of 4 weeks. It was observed that the treatment protocol was successfully effective and regression of warts was noticed from 2nd week onwards. By end of 4th week a complete recovery of the wart infected area was noticed with a black scar left behind. The formalin inactivated autogenous vaccine was effective, and applied for control of bovine papillomavirus infection in cattle with combination of chemotherapeutic drugs resulted in early regression of warts.

Effect of Mat Pilates intervention on sleep quality in adolescent girls: A single blinded randomised controlled trial

BackgroundPilates, a low-to-moderate intensity workout provides an alternative to traditional methods that stimulate both the mind and the body. Adolescent girls often experience sub optimal sleep quality, especially on school days, posing significant health risks. This study aims to investigate the effects of Pilates on the sleep quality of adolescent females. MethodsA single-blinded Randomized Controlled Trial was conducted at a Physiotherapy OPD. Eligible adolescent girls (aged 10–19) with PSQI scores exceeding 5 were enrolled. Sixty participants were allocated each to Group A (Control) or Group B (Mat Pilates) via convenience sampling. Parental consent and participant assent were obtained. Group A maintained daily activities with ergonomic exercises, while Group B underwent Mat Pilates training three times weekly for eight weeks. Data were collected at baseline, at the end of 4th and 8th week. ResultBetween-group analysis at the 4th and 8th weeks showed significant differences. Post hoc analysis with Bonferroni adjustment revealed notable improvements from baseline to both time points (p < 0.05). The experimental group achieved a 45.14 % greater reduction in Global PSQI score compared to the control group, indicating significant improvements in sleep quality. The experimental group also showed a substantial 53.39 % improvement in sleep duration and a significant 65 % reduction in sleep latency, outperforming the control group. ConclusionThis study reveals promising improvements in sleep quality, highlighting the potential benefits of Pilates for this demographic. This can be a valuable approach to enhancing sleep quality among adolescent girls, potentially contributing to their overall health and life quality.

Comparative Evaluation of Effects of Oral Diltiazem and Topical Diltiazem (2%) Ointment in the Treatment of Chronic Anal Fissure: A Prospective Randomized Study.

Fissure-in-Ano is a common condition of the anorectal region. Most of the time, it is managed non-surgically. There are various drugs used for the treatment of anal fissures. Calcium channel blockers are one of them that reduce the tone of sphincter muscles. The present study compares the efficacy of oral diltiazem and topical 2% diltiazem ointment in patients with chronic anal fissures. Patients were randomized into two groups. Group A (n=25) received treatment in the form of oral diltiazem, while group B (n=25) received treatment in the form of 2% (weight/volume) diltiazem ointment for local application in addition to other conservative methods like sitz bath and stool softeners. Outcomes in the form of success of treatment and complications were assessed. Statistical analysis was done using MedCalc software version 14.0. P value of<0.05 was considered significant. The mean age of patients was 32.00±10.67 years in group A and 30.64±9.53 years in group B. Pain relief was significantly better in group B than in group A at the end of the first week (P=0.00018), but at the end of 6th week, no significant difference was observed. Fissure healing was more significant in group B than in group A after 6 weeks (P=0.0152). Local diltiazem ointment is a better option than oral diltiazem for anal fissures with respect to better outcomes and lesser complications.

Levels of Corticosterone and Glucose in Blood of Rats under Conditions of Chronic Unpredictable Stress of Different Duration

INTRODUCTION: Mammals are almost constantly exposed to a variety of stressors. The changes in the concentration of corticosterone and the level of glucose in blood of animals under such conditions seems relevant for understanding the influence of repeated stress effects on endocrine and metabolic processes. AIM: To study the concentrations of corticosterone and glucose in blood of rats in different time periods of prolonged low-intensity unpredictable stress. MATERIALS AND METHODS: Experiments were carried out on 42 male Wistar rats. Individuals of the experimental groups were subjected to 7-day cycles of alternating stressors using a modified model of chronic unpredictable mild stress with presentation of different stressors. The concentration of corticosterone and glucose in blood was determined at 1, 2, 3 and 4 weeks of observation. RESULTS: A pronounced decrease in corticosterone levels was found in rats at 1 week of stress exposure, followed by a slow recovery by the end of 4th week. Blood glucose level increased at 2 weeks of exposure. CONCLUSION: The data obtained illustrate the specificity of changes in the levels of glucose and corticosterone in the blood of mammals in different time periods of chronic stress. These changes characterize the dysregulation of the integrative physiological systems in relatively early periods of chronic stress with the subsequent development of adaptation in the later stages of repeated stress exposures.

Assessment of efficacy and safety of clindamycin with nicotinamide in mild to moderate acne vulgaris: a prospective study

Background: Acne vulgaris is a very common skin disease that is usually treated with topical products, systemic medications, or a combination of both. Acne vulgaris affects approximately 9% of the population worldwide causing permanent physical scarring, negatively affects the quality of life and self-image, and has been associated with increased rates of anxiety, depression, and suicidal ideation. Methods: This was a prospective study conducted at BMCRI including thirty-five subjects who were diagnosed with mild to moderate acne vulgaris. Patients were treated with topical clindamycin 1% with nicotinamide 4%. Efficacy was assessed by mean change in acne severity index (ASI) and total lesion count (TLC) from baseline and at the end of 4, 8 and 12 weeks. Safety was assessed by adverse events reported. Results: There was statistically significant improvement noted at the end of each visit. Baseline ASI was 88.05±4.02 and end of 12 weeks was 14.17±2.7. Baseline TLC was 30.17±1.33 and at the end of 12 weeks was 4.25±0.99. Both the ASI and TLC results were statistically significant at the end of fourth, eighth and twelfth-week p value &lt;0.0001. Conclusions: Combination topical formulations are the most broadly used treatment regimen for Acne vulgaris to target one or more steps in the pathogenesis of acne. From the results of the present study the participants on combination of clindamycin with nicotinamide had a significant improvement in acne lesions at end of 12th week of topical application and were satisfied with the therapy with no major adverse effects.

A Study on Refractive Outcome Following Manual Small Incision Cataract Surgery with Rigid PCIOL

Introduction: Cataract is a significant and increasing global problem with vast economic and social implications[1]. It is the principal cause of blindness in India accounting for 62.6% (92). The prevalence of blinding cataract will only increase as people live longer, so cataract will continue to be, by far, the most important treatable cause of blindness. It is estimated that the present number of 20 million of cataract blind will double by year 2030.[2] . Materials and Methods: Study design: Cross sectional observational study Source of data: All the patients admitted with small incision cataract surgery (SICS) with PCIOL implant, in the department of Ophthalmology Rajarajeshwari Medical College and Hospital, Bangalore Study period: 18 months (Jan 2021- June 2022) Sample size: 200 patients. Results and Observations: In our study, at 1st post operative week, most patients had visual acuity score of better than 6/9 and least had less than 6/60 score. A follow up of patients at 2nd week, 6th week and end of 6th week showed that visual acuity improved at 2nd and 6th post-operative weeks.. Most patients were in the refraction range of &lt; -0.50. Conclusion: From our study we conclude that the uncorrected visual acuity of cataract patients improved in the early and late post-operative weeks, after undergoing Manual Small Incision Cataract Surgery with Rigid PCIOL (MSICS) to a great extent. MSICS can be accepted as an alternative to phacoemulsification in developing countries like India. Keywords: Cataract, Small incision, Astigmatic, Visual outcome

Synthesis, Characterizations and Optimization of Magnesium Oxide Scaffold for Bone Healing Applications

In this work, the structural properties of Magnesium oxide nanoparticles (MgONPs) are synthesized by a simple chemical technique. X-ray diffraction pattern (XRD) pattern showed the crystalline nature of MgO NPs. The average diameter of MgO NPs calculated by SEM and XRD was around 19 nm. Energy dispersive X-ray spectroscopy (EDS) spectrum and XRD pattern suggested that prepared MgO NPs were highly pure. The viability of cells in a medium containing MgO-AV composite scaffold was nearly equal to that of MgO, AV, and control, with no statistically significant difference (p&gt;0.05). The Runx2-mediated modulation of gene expressions of the bone biomarkers ALP and OCN was investigated to determine the mechanism of scaffold-induced improvement in bone repair. ALP was immunodetected in the injured site of the right femur twenty-one days after the bone defects were created. The implantation of scaffolds into the bone defect region of the left femur, on the other hand, resulted in a noticeable increase in ALP levels. Similarly, OCN was immunodetected in the right femur's bone defect site. The implantation of scaffolds into the bone defect location of the left femur, on the other hand, resulted in a significant increase in OCN levels. The low-level diode laser therapy (LLLT) promotes the partially bony incorporation of the xeno bony implantation with the recipient femoral bone, and can successfully fill the space, and support the weight after removing the internal fixation methods, with no body rejection. The histopathological finding at the end of the 6th week post-operation in treatment groups the trabecular bone is mature and wide with little cavity. The control group showed immature and thin trabecular bone, with large cavities, and an area of connective tissues not organized. At the end of 12th weeks, post-operation the treatment groups revealed mature trabecular bone surrounding the bony device and lamellar bone formation with partial bony incorporation, the lacuna and haversian canals of the bony device filled with osteocyte and blood vessels, while in control groups the trabecula bone not mature, and many lucana and havesan canal still empty in the bony device

Treatment Related Acute Toxicities Between Treatment with 3D-CRT and IMRT in Localised Prostate Cancer.

To compare the acute toxicities of two radiation treatment techniques, intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (3D-CRT) in localised prostate adenocarcinoma. Descriptive study. Place and Duration of the Study:Department of Oncology, Dr. Ziauddin Hospital, Karachi, Pakistan, from July 2016 to June 2022. Patients with localised prostate adenocarcinoma who underwent treatment using two different advanced radiotherapy techniques i.e., IMRT and 3D-CRT were recruited during the study period. They were followed up for six months for acute gastrointestinal (GI) and genitourinary (GU) adverse events (acute toxicities) related to both treatment modalities according to Modified radiation therapy oncology group (RTOG) criteria. The acute toxicities were assessed at the 2nd, 4th, and 6th week during treatment and at the 3rd and 6th month after treatment. There were 78 patients, with 39 patients in each group. The mean age was 68 ± 10 years in the 3D-CRT and 68 ± 07 years in the IMRT group. Patients in the IMRT group exhibited markedly lower treatment-related acute GI and GU effects at the end of 4th and 6th weeks for anorectal pain (p = 0.04) and (p = 0.01) and burning micturition (p = 0.003) and (p = 0.01), respectively. Furthermore, at 3 months anorectal pain (p = 0.02), loose stools (p = 0.005), and burning micturition (p = 0.01) were present and at 6 months anorectal pain was (p = 0.01) still present. Radiation therapy modalities 3D-CRT and IMRT both showed acceptable toxicity profile in the management of localised prostate cancer, while IMRT group exhibited significantly lower treatment-related acute GI and GU effects. 3D-CRT (3-Dimensional Conformal Radiation Therapy), IMRT (Intensity-Modulated Radiation Therapy), Radiation toxicity.

Anti-ageing effects of CollabZen™ in healthy human volunteers: a randomized, double blind, placebo-controlled study

Background: There are several concerns related to combating signs of ageing. Considering the long-term safety concerns of cosmetic formulations, a safe and effective approach using nutritional supplements and naturals should be of great help. CollabZenTM is one such a blend of three plant materials known as Phyllanthus emblica, Camellia sinensis, and Coffea arabica, earlier tested for collagen building in human cells in-vitro. The current study aims to explore its potential as a nutraceutical product for skin ageing. Methods: The study enrolled 64 volunteers both genders (mean age=45.75) with crow's feet wrinkles. One group (n=32) received a placebo capsule (Product A) and other group received CollabZenTM capsules (Product B). Dermatological parameters were assessed at 0th day, 4th and 8th week, and self-assessment questionnaires for efficacy and tolerance were collected on 4th and 8th week. The trial is registered at https://ctri.nic.in/, CTRI/2022/10/046168. Results: The results showed that product B (CollabZenTM) was significantly effective than the placebo in improving deep skin hydration on the face (p=0.009), increasing facial skin elasticity (p=0.001), and enhancing firmness (p=0.001) after 8 weeks. Participants in Group B reported higher levels of satisfaction regarding their perceived skin health compared to group A based on self-assessment at the 8th weeks (p&lt;0.01). Moreover, only one volunteer in each group experienced mild intolerance at the end of 8th week, demonstrating the safety of these nutraceutical ingredients and excipients. Conclusions: CollabZenTM, with its known antioxidant and collagen-boosting properties and current findings can be considered a valuable nutraceutical product for the anti-ageing sector of the cosmetic industry.

Evaluation of effectiveness of Letrozole in treatment of infertility in women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disease, characterized by hyperandrogenism, oligomenorrhea, and polycystic ovaries. PCOS is one of the most causes that affect the women of childbearing age, and often leads to infertility. Various managements were proposed for infertile women with PCOS. However, the optimal management option has not been addressed satisfied. Although multiple treatments including weight reduction, clomiphene citrate, metformin, gonadotropins, and ovary cauterization have been reported to treat such condition, the efficacy still has insufficient evidence to support. Objectives: Purpose of this study was to evaluate the effectiveness of Letrozole in treatment of infertility in women with polycystic ovary syndrome. Materials &amp; method: This study was carried out to assess the effectiveness of letrozole and on pregnancy outcomes including the ovulation induction, pregnancy rate, and endometrial thickness in infertile women with polycystic ovarian syndrome (PCOS). Total 106 infertile PCOS patients were recruited and allocated in two groups, Group-L (received letrozole at 2.5 mg twice daily on the 3rd–5th days of menstrual cycle for 5 consecutive days), Group-G 75 U/d−1 gonadotropin through intramuscular injection for 5 days starting from the third day of menstrual cycle). All patient in both arm completed treatment and follow-up. Patients in both groups were treated up to 5 treatment cycles. During follow up, transvaginalultrasonogram (TVS) was performed to see the details of the follicles and the endometrium. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Comparison was done by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram &amp; charts etc. Result: Mean age of the patient was 26.3 ± 5.7 years in group-L and 25.9 ± 6.1 years in group-G. There were no statistical significant differences between the 2 groups regarding age, body weight, height, body mass index (BMI). Present study results showed that patients who received letrozole exert better outcomes in primary endpoint, including ovulation rate (86.7% in group-L &amp; 62.2% in group-G, P =0.004), endometrial thickness (9.3 ± 1.1 mm in group-L &amp; 8.5 ± 1.1 mm in group-G, P = 0.003) and pregnancy rate (64.1% in group-L &amp; 30.1% in group-G, P =0.005). Abortion rate (till the end of 12th week) and multiple pregnancy rate were higher in group-G, but result were non-significant in between groups. Live birth rate in the letrozole group was higher 29(54.7%) than group-G 14(26.4%), the difference was statistically significant (P &lt; .05). Conclusion: Patients who took Letrozole had significantly higher endometrial thickness than other group. Due to the higher pregnancy rate and lower incidence of abortion or multiple pregnancy, letrozole can be an effective for the treatment of anovulatory subfertility of the PCOS patients. Central Medical College Journal Vol 7 No 1 January 2023 Page: 13-19

Effects of Intra-Articular Platelet Rich Plasma on Clinical Outcomes in Knee Osteoarthritis

Background and Aim: With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treatcartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA). The aimof our research was to study the effectiveness of intra-articular PRP injections in early-stage OA patients and toevaluate the clinical outcome and QOL at 6 months.Material and Methods: Present study was conducted on 80 patients at tertiary care institute of Gujarat for thePeriod of 1 year. Intraarticular administration of PRP was done by injecting 5 mL of platelet concentrate in thesupra-patellar pouch through supero-lateral approach with a 22-gauge needle. The patients were followed upfor reduction in pain, reduction in stiffness and improvement in physical function in accordance with WOMACscoring system on day 0 and at the end of 6th week, 3rd and 6th months and QOL in accordance with WHOQOLquestionnaire before PRP therapy and at the end of 6th month.Results: In our study of 80 patients 26 had very poor, 23 had poor and 1 had neither poor nor good QOL beforePRP injection evaluated by WHOQOL. At 6 months post PRP therapy 5 had very good, 59 had good, 15 hadneither good nor poor and 1 had poor QOL which showed highly significant improvement in QOL.Conclusion: Intra-articular injection of autologous PRP is a safe, cheap, easy to prepare and use, and has atherapeutic role in early knee OA. Hence, PRP therapy can be used in management of early stage knee OA toprovide relief from symptoms and to improve QOL with negligible complication, low cost and ultimately withgood results.

Evaluation of autologous platelet rich fibrin in chronic non-healing leg ulcers

Context: Chronic non healing leg ulcers cause psychological, social, and financial burden to the patient. Platelet rich fibrin (PRF), a biological membrane with plethora of growth factors acts as a cheaper and simpler option for the management of non-healing leg ulcers. Aims: To evaluate the effectiveness of PRF in the treatment of chronic nonhealing leg ulcers of varying etiologies. Material and Methods: It was a prospective study conducted in 30 patients in a tertiary care center. PRF dressing was done weekly for the chronic non healings ulcers of various etiologies for 6 weeks. Response to therapy was assessed by calculation of wound area and volume and digital photographs before each treatment session. Statistical analysis was done using Chi-square test, paired t-test and ANOVA test to get P values. Results: In our study, the mean age of subjects was 55.9 ± 14.08. 21 (70%) subjects were male and 9 (30%) were female. Majority of the ulcers were trophic ulcers due to hansen’s disease (n = 11, 36.7%), followed by diabetic ulcers (n = 9, 30%), venous ulcers (n = 6, 20%) and traumatic ulcers (n = 4, 13.3%). Percentage decrease of mean ulcer area and volume were 92.3% and 97.6%, respectively. There was significant decrease in the mean area and volume (P &lt; 0.0001) of the ulcer from 2nd week onwards till the end of 6th week. Conclusions: PRF can be used as an adjuvant along with standard treatment in the management of chronic non healing ulcers to reduce the duration of healing.

Feasibility of an Integrated Digital and Pharmacological Approach Targeting Blood Lipids in Atherosclerotic Cardiovascular Disease Management

Objectives: Strong evidence supports the importance of lipid-lowering and exercise therapies in the long-term therapy of atherosclerotic cardiovascular disease (ASCVD). Establishing efficient comprehensive intervention programs that combine pharmacological and exercise prescription is crucial to investigate with the aid of digital technologies. Methods: A convenience sample of 25 ASCVD patients (57.8 ± 9.5 years, 76% males) was gathered. All participants were prescribed with 12-week home exercise program supervised by an app and bimonthly 75mg alirocumab subcutaneous injections. Follow up visits were scheduled at the end of 4th and 12th week. Results: Nineteen participants completed the program with a retention rate of 76%. Sixteen (84.2%) participants received all six doses of alirocumab. The total management time of the 12-week program added up to 65.47 minutes per patient. Satisfaction score was 4.2 ± 0.6 and the User Version of the Mobile Application Rating Scale (uMARS) overall objective quality score on the app was 3.4 ± 0.7. At the 4-week and 12-week follow-ups, LDL-C levels reduced compared to baseline (−1.5 ± 0.8 mmol/L, P &lt; 0.001, −1.6 ± 0.8 mmol/L, P &lt; 0.001, respectively), along with TC (−1.8 ± 1.2 mmol/L, P &lt; 0.001, −1.6 ± 1.3 mmol/L, P &lt; 0.001, respectively), but not TG, HDL-C, GAD-7 and PHQ-9. Conclusion: The integrated pharmaceutical and digital ERx intervention program was feasible and well accepted in ASCVD patients.

Improvement in muscular strength, body flexibility and balance by yoɡasana and with reduced detraining effects by yoɡa breathing maneuvers: A non-randomized controlled study

BackgroundYoɡa was reported to have the potential to improve physical fitness. Its applications are being used by common persons for wellness, but literature on the training and detraining effects of components of yoga is scarce. ObjectivesTo explore the potential of different proportions of yoga postures (Yogasana) and yoga breathing maneuvers (YBM), consisting of Pranayama and kriya, on muscular strength, flexibility, and balance in training and detraining management. Methodsː 32 physically active male students, aged 20.5 ± 1.3 yrs, were divided into control (CG) and yoga group (YG). YG practiced yogasana, YBM, and dhyana for 45 min in each session for 6 days per week for 12 weeks. From 1st week to 6th week, they practiced yogasana in greater proportion. 7th week onwards YBM was inducted by increasing its duration and varieties. CG did not practice yoga. Back-leg strength (BLS), Hand Grip Strength (HGS), flexibility, and balance were recorded before, the 6th week and 12th weekend of training. Resultsː.In YG, the pre-training value of BLS was 110.8 ± 12.6 kg. It increased (2.3 %) to 113.3 ± 11.4 kg (p < 0.001) on the 6th weekend. On the 12th weekend, it further increased in lesser magnitude (0.4 %) to 113.7 ± 11 kg (p < 0.05) and the pattern of improvement was the same in other parameters, but in flexibility and balance its magnitude was greater (p < 0.001). CG did not show such changes. Conclusionsː Yogasana helps in the improvement of muscular strength, flexibility, and balance and YBM counteracts detraining effects in the absence of yogasana. Judiciously selected components of yoga/YBM may have applications in sports, occpational health and recuperative patients.

Effect of aripiprazole on promoting cognitive function and enhancing clinical efficacy in patients with first-episode depression on escitalopram: A randomized controlled trial

ObjectivesTo explore the effect of escitalopram combined with aripiprazole on cognitive function in patients with major depressive disorder (MDD), and to evaluate the clinical efficacy of the combination therapy. MethodA total of 70 patients with first-episode MDD were randomly divided into the study group or the control group, receiving escitalopram combined with aripiprazole (5 mg/day) or escitalopram monotherapy respectively for 8 weeks. The severity of illness was assessed by using the Hamilton Rating Scale for Depression (HAMD) at baseline, at the end of 4th and 8th week, and cognitive function was assessed by using the THINC integrated tool (THINC-it), the Wisconsin Card Sorting Test (WCST), and the Continuous Performance Test (CPT). Rating Scale for Extrapyramidal Side Effects (RSESE) was applied to assess adverse reactions. ResultsThe average HAMD-17 and HAMA scores decreased over time in both the control and the study groups, but the reductions were not statistically different between two groups with the passage of time. In WCST, total number of response (TR) of the study group decreased relative to the baseline at the end of the eighth week, but the control group did not significantly change during whole eight weeks. Perseverative errors (PE) in the control group eventually decreased at the end of Week 8 compared to that at Week 4, but in the study group, it was a continuous trend of decrease. In CPT, the decrease of leakage responses (LR) in the study group was higher than that of the control group in 2-digit number, and LR of the control group was higher than that of the study group at the end of Week 8 in 4-digit number. The downtrend of LR in 4-digit number kept for the whole period in study group, while in the control group, the LR did not decrease significantly until the end of Week 8 compared to that at baseline. ConclusionEscitalopram combined with a low-dose of aripiprazole, and escitalopram monotherapy could both enhance cognitive function of MDD patients, while the improvements of combination therapy might happen relatively earlier. The combined use of escitalopram and aripiprazole might be more beneficial to the domains of executive function (EF) and continuous attention compared to escitalopram monotherapy. There was no significant differences between two treatment options in alleviating depressive and anxiety symptoms.

Effects of rutin on laying performance, egg quality, serum biochemistry, antioxidant capacity and immunity in laying hens fed a diet containing stored soybean meal

This study aimed to investigate the effects of rutin on laying performance, egg quality, serum biochemical parameters, serum immunoglobulin, and antioxidant status in laying hens fed a diet containing stored soybean meal (SBM). The dietary treatments used were arranged in a 2 × 2 factorial arrangement with 2 types of SBM (FSM: SBM was stored in the cold storage warehouses at −20 °C for 45 days and was considered as fresh SBM; RTSM: SBM was stored in room temperature warehouse (15 °C to 25 °C), average temperature was 20 °C for 45 days) and 2 levels of rutin (0 and 500 mg/kg). In total, 384 Hy-Line Brown laying hens (220 days of age) were randomly divided into 4 groups with eight replicates. Pre-feeding period was 1 week, and the experiment lasted for 8 weeks. The results showed that the RTSM diet had no effect on laying performance (p > 0.05). Compared with the diet without rutin, diet with 500 mg/kg rutin exhibited a tendency to increase egg mass compared with the diet without rutin (p = 0.096), and there was a trend of interaction effect on average egg weight (p = 0.061). The RTSM diet decreased the egg Haugh unit significantly compared with the FSM diet at the end of 8th week (p < 0.05). Compared with the diet without rutin, dietary rutin supplementation could affect egg quality as evidenced by increased eggshell thickness, albumen height, egg yolk colour at the end of 4th week and increased eggshell strength and eggshell thickness at the end of 8th week (p < 0.05). Furthermore, dietary rutin supplementation increased urea nitrogen, decreased the immunoglobulin M (IgM) content in serum compared with the diet without rutin (p < 0.05). Compared with the diet without rutin, dietary supplementation with rutin improved the total antioxidant capacity in the serum and liver (p < 0.05). The interactions of SBM × Rutin were observed on egg yolk ratio at the end of 8th week, and the urea nitrogen and IgM content in serum. These findings suggested that diet with RTSM had adverse effects on egg quality in laying hens. The RTSM diet negatively impacted egg quality of laying hens over time when compared to the FSM diet. Dietary rutin supplementation could improve the egg quality, and antioxidant capacity of laying hens.

Eye Movement Desensitization and Reprocessing Therapy in Adolescents With Panic Disorder: A Twelve-Week Follow-Up Study.

The aim of this study is to investigate the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) treatment in adolescents with panic disorder (PD). This follow-up study consists of 30 adolescents with PD without agoraphobia, aged 14-17 (15.53 ± .97). They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, also the Panic and Agoraphobia Scale (PAS) and Beck Anxiety Inventory (BAI) were administered at baseline, at the end of the 4th and 12th weeks of treatment. EMDR therapy which is an eight-phase treatment approach composed of standardized protocols and procedures was applied for 12weeks, one session per week. The baseline mean of the total PAS score decreased from 40.06 to 13.13 at fourth week and 1.2 at the end of 12th week of treatment. In addition, BAI score decreased significantly from 33.67 to 13.83 at 4weeks and 5.31 at the end of 12th week of treatment. Overall, our results underscore the effectiveness of EMDR in adolescents with PD. Moreover, the current study suggests that EMDR may represent an effective intervention technique for PD in adolescents to protect against relapses and to overcome a fear of future attacks.

Comparison between rood inhibitory approach and bobath reflex inhibiting patterns to improve gross motor function and reduce spasticity in hemiplegic children of encephalitis

Objectives: To compare the effects of Rood Inhibitory approach and Bobath Reflex Inhibiting pattern to improve Gross motor Function and reduce spasticity in Hemiplegic Children of Encephalitis. Methods: A randomized clinical trial was conducted comprising of 22 patients recruited from different clinics of Faisalabad. Participants from both genders, in age range from 08-12 years were recruited and randomly allocated into two groups. Treatment group A received Rood inhibitory approach and treatment group B received Bobath Reflex inhibiting pattern. Measurement of Modified Ashworth scale were recorded at pre-treatment and weekly for 4 weeks, while (GMFM-88 and GMFM- 66) was assessed at baseline and at end of 4th week. SPSS version 22 was used to analyze the data. Result: Mean age in Group A was 10.00+1.673 years and in Group B was 9.82+1.537 years. Total 11 were male and 11 were female. There was significant improvement in mean MAS score at 2nd week, 3rd week and 4th week post treatment readings (p value &lt; 0.05). There was significant improvement in mean (GMFM-88 and GMFM- 66) at 4th week post treatment readings (p value &lt; 0.05).

Influence of Processed Cassava Peel-leaf Blend as Replacement for Maize on Growth Performance and Serum Parameters of Growing Pigs

Background: The use of alternative feedstuff like cassava peel and leaf in pig production is of great concern due to reduced nutrient availability caused by high fibre and antinutritional constituent. The current study investigated the effect of dietary inclusion of differently processed cassava peel-leaf blend (CPLB) on growth and blood parameters of growing pigs. Methods: CPLB (Cassava peel: Cassava leaf; 5:1) was included in pigs diet in a feeding trial for 16 wks. The CPLB replaced maize at 100%. 24 pigs of mean weight range (20-22 kg) were assigned on a weight equalization basis to four dietary treatments having six replicates with one pig per replicate. A standard corn soya-based diet (control), Unfermented CPLB (UCPLB), water fermented CPLB (WCPLB) and microbial fermented CPLB (MCPLB) using Aspergillus tamarii as inoculum was formulated. Growth response was measured and serum analysis was carried out at the end of the 8th and 16th week. Result: There was no significant (p greater than 0.05) effect on growth performance at the end of the 8th and 16th weeks. Dietary inclusion of MCPLB resulted in higher (p less than 0.05) cholesterol (144.30 mmol/L) in pigs than those fed control diet (97.20 mm/L) at the end of 8th week. Pigs fed diet containing UCPLB had reduced (p less than 0.05) serum creatinine (0.58 mg/dl) at the end of 16th week. In conclusion, CPLB based diet irrespective of processing method did not significantly affect growth performance and without negative effect on blood serum parameters.