Hot Pack Research Articles

Local passive heating administered during recovery impairs subsequent isokinetic knee extension exercise performance

BACKGROUND: Passive heating has attracted attention as a potentially promising recovery modality in sports. However, investigations of passive heating have yielded only inconsistent results for exercise performance. OBJECTIVE: To investigate the acute effects of local passive heating administered between repeated bouts of isokinetic exercise. METHODS: The experiment was a randomized crossover study. There was a total of three visits including a familiarization visit. During the remaining two visits, eleven healthy men performed three bouts of nine sets of isokinetic knee extensions using their dominant single-leg (30 repetitions/set, 180∘/sec). A 15 min recovery, during which a local passive heating pad at control (CON) or heating (HT) was applied to the rectus femoris, was afforded after the 3rd and 6th sets (Recovery 1 and 2). Isokinetic exercise performance, as assessed by peak torque, total work, and average power was analyzed using two-way repeated-measures ANOVA. RESULTS: Following Recovery 1 and 2, isokinetic exercise performance, as assessed by peak torque, total work, and average power was reduced in Set 4 (p< 0.001, p< 0.001, p= 0.080) and Set 7 (p< 0.001, p< 0.001, p= 0.009) in the HT group relative to the CON group. Electromyography analysis revealed that signal amplitude was lower in the HT group in Set 4 (p< 0.001) subsequent to Recovery 1, and that firing frequency was higher in Set 7 (p= 0.002) in the HT group after Recovery 2. Furthermore, EMG time-frequency maps from one representative participant showed that following Recovery 1 and 2 peak energy decreased during the first five repetitions in Set 4 and 7. CONCLUSIONS: Local passive heating administered during recovery decreased subsequent performance of isokinetic knee extensors, muscle activation ability and increased firing frequency maintaining force output. Therefore, local passive heating is not an appropriate acute recovery strategy for isokinetic exercises.

A low-cost device for cryoanesthesia of neonatal rodents

Studying the development of neural circuits in rodent models requires surgical access to the neonatal brain. Since commercially available stereotaxic and anesthetic equipment is designed for use in adults, reliable targeting of brain structures in such young animals can be challenging. Hypothermic cooling (cryoanesthesia) has been used as a preferred anesthesia approach in neonates. This commonly involves submerging neonates in ice, an approach that is poorly controllable. We have developed an affordable, simple to construct device – CryoPup – that allows for fast and robust cryoanesthesia of rodent pups. CryoPup consists of a microcontroller controlling a Peltier element and a heat exchanger. It is capable of both cooling and heating, thereby also functioning as a heating pad during recovery. Importantly, it has been designed for size compatibility with common stereotaxic frames. We validate CryoPup in neonatal mice, demonstrating that it allows for rapid, reliable and safe cryoanesthesia and subsequent recovery. This open-source device will facilitate future studies into the development of neural circuits in the postnatal brain.

DİZ OSTEOARTRİTİ OLAN HASTALARDA BALNEOTERAPİNİN ERKEN DÖNEM ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

OBJECTIVE: Balneotherapy is a non-pharmacological method recommended and used in knee osteoarthritis. The aim of this study is to evaluate the early-term effectiveness of the physical therapy program applied together with balneotherapy in patients with knee osteoarthritis. MATERIAL AND METHODS: Sixty patients diagnosed with primary knee osteoarthritis were included in the study. Randomization was carried out as a balneotherapy group (n=30) and a control group (n =30) by simple randomization method. In Both groups, all of the patients were treated with a fifteen sessions physical therapy program consisting of a hot pack, transcutaneous electrical stimulation, and ultrasound (1 MHz, 1,5 Watt/cm2). Patients in the balneotherapy group were also treated for fifteen sessions balneotherapy program lasting 20 min/day in addition to the physical therapy program. Patients were assessed by Visual Analogue Scale (VAS), WOMAC, and isokinetic muscle testing at the beginning and end of the therapies. RESULTS: A statistically significant improvement was observed in the mean scores of VAS, all WOMAC scores, and isokinetic test measurements after treatment in both groups (p<0.001). Comparison of the groups by percent changes showed that; VAS (p=0.047), WOMAC pain (p=0.002), WOMAC stiffness (p=0.004), WOMAC function (p=0.001), WOMAC total (p=0.001) differed significantly in favor of balneotherapy group, no significant difference was found in isokinetic muscle strength measurements (p>0.05). CONCLUSIONS: Balneotherapy combined with a physical therapy program in patients with knee osteoarthritis is effective in reducing pain and increasing physical function in the early period.

EFFECT OF SPINAL THRUST MANIPULATION VERSUS MAITLAND MOBILIZATION AT T10-L1 IN PRIMARY DYSMENORRHEA - A RANDOMIZED CONTROLLED TRIAL

Background: Primary Dysmenorrhea refers to painful menstruation without any pelvic pathology. Women with this condition reported that menstruation have a negative impact on their quality of life. To compare the effect of Objective: Spinal thrust Manipulation versus Maitland Mobilization in subjects with primary Dysmenorrhea in terms of pain and Quality of life by using VAS and MOOS Questionnaire. Setting and design: A Randomized controlled study was conducted in tertiary health centre, Belagavi Methods: Forty-two females between 19-25 years of age with Primary Dysmenorrhea were recruited and were randomly allocated in three groups. All groups received hot moist pack and deep transverse massage as a conventional therapy, in addition Group B received spinal thrust manipulation and Group C received Maitland mobilization on their 21st, 23rd and 1st day of menstrual cycle. Patients were assessed at baseline and post intervention using VAS and MOOS Questionnaire. The Intra group analysis showed a Results: considerable amount of change in percentage of VAS in group B and MOOS in group C (p<0.05). Inter group analysis of group A and B showed statistical differences in VAS. Group C showed statistical difference in MOOS score as compare to group A. Post HOC analysis showed no signicant differences in the variables. Conclusion: Spinal thrust manipulation and Maitland mobilization were equally effective in reducing pain and improving quality of life in subjects with primary dysmenorrhea

Development of a Korean Medicine Online Program on Mental Health.

The coronavirus disease 2019 has deteriorated mental health, particularly in mothers with elementary school children. Although the country has developed several health promotion programs to preserve mental health, no program has incorporated Korean medicine. Thus, this study focuses on developing vital Korean medicine mental health care programs. The program follows the Korean medicine health promotion program principles. Guidelines, reports, research, and previous programs were analyzed to form interventions and lecture content. Pellets, hot packs, meditation, lavender oil, and green tea were selected as final intervention strategies. Mental health-related guidelines were analyzed to produce stress management lecture materials. In addition, an operational methods and evaluation tool manual was created. We designed a health promotion program capitalizing on Korean medicine to improve mental health. This program will be assessed and accordingly improved through practical applications.

Sacroiliac joint manipulation helps to improve pain pressure threshold in chronic piriformis syndrome: a 6-week randomized controlled trial US

Background: Piriformis syndrome (PS) has negative impact on the daily activities of the patients and lead to disability. There is an anatomical association of piriformis muscle with sacroiliac joint (SIJ). So manual therapy including manipulation of SI joint may be the option for relieving the symptoms of PS Objective: To investigate the effectiveness of Sacroiliac joint manipulation in improving pain pressure threshold in patients with chronic piriformis syndrome. Materials and Methods: A randomized clinical trial (NCT04603703) was conducted at Max Rehab and Physical Therapy Centre G8-Markaz, Islamabad, Pakistan. A total of n=30 patients were randomly divided into Experimental group (n=15) and control group (n=15). Both groups received conventional physical therapy including therapeutic ultrasound, moist hot pack, piriformis muscle stretching, myofascial release of paraspinal muscles, gluteal strengthening, sciatic neurodynamics. The experimental group additionally received sacroiliac joint manipulation. The outcome measures were pain, straight leg raise (SLR), pain pressure threshold and piriformis muscle length. The total time frame of the treatment was 3 days per week for 6 weeks and pre and post intervention assessment was done. Result: The mean age of participants was 40.46 ±10.513 years. Pain, SLR, pain pressure threshold and piriformis length was significantly improved (p<0.001) in both the experimental and control group after 6th week intervention. Between group comparison there was no significant difference between the groups after 6-week intervention regarding the pain, SLR and piriformis muscle length, except pain pressure threshold which was significantly improved in experimental group as compared to control group (67.7±18.42 vs 52.51±15.26, p=0.020) . Conclusion: Addition of the sacroiliac joint thrust manipulation technique and conventional physical therapy alone were equally effective in decreasing pain intensity and normalizing length of Piriformis and Straight leg raise. But SIJ manipulation showed promising results on pain pressure threshold. Keywords: Articular, physical therapy modalities, piriformis muscle syndrome, pain threshold, range of motion, sacroiliac joint.

Skeletal muscle oxidative adaptations following localized heat therapy

Repeated heat treatment has been shown to induce oxidative adaptations in cell cultures and rodents, but similar work within human models is scarce. This study investigated the effects of 6 weeks of localized heat therapy on near-infrared spectroscopy-(NIRS) derived indices of muscle oxidative and microvascular function. Twelve physically active participants (8 males and 4 females, age: 34.9 ± 5.9 years, stature: 175 ± 7 cm, body mass: 76.7 ± 13.3 kg) undertook a 6-week intervention, where adhesive heat pads were applied for 8 h/day, 5 days/week, on one calf of each participant, while the contralateral leg acted as control. Prior to and following the intervention, the microvascular function was assessed using NIRS-based methods, where 5 min of popliteal artery occlusion was applied, and the reperfusion (i.e., re-saturation rate, re-saturation amplitude, and hyperemic response) was monitored for 2 min upon release. Participants also performed a 1-min isometric contraction of the plantar flexors (30% maximal voluntary contraction), following which a further 2 min interval was undertaken for the assessment of recovery kinetics. A 20-min time interval was allowed before the assessment protocol was repeated on the contralateral leg. Repeated localized heating of the gastrocnemius did not influence any of the NIRS-derive indices of microvascular or oxidative function (p > 0.05) following 6 weeks of treatment. Our findings indicate that localized heating via the use of adhesive heat pads may not be a potent stimulus for muscle adaptations in physically active humans.

Improving Electric Vehicle Range and Thermal Comfort through an Innovative Seat Heating System

In the last decade, car manufactures invested a lot of effort to align their products to the latest energy directives which encourage the production and usage of electrified vehicles to reduce the greenhouse gases production. This resulted in several important developments, which enhanced the advantages of electric vehicles in terms of local emissions (zero tailpipe emissions), efficiency, convenience in urban areas and others and ultimately led to their ever-increasing adoption. However, there are still some challenges that need to be addressed. One example is the negative influence of low (winter) and high (summer) atmospheric temperatures on electric vehicle range due to the cabin temperature heating and cooling. This requires more efficient ways of using energy to avoid sacrificing the passenger thermal comfort for an increased vehicle range. The present study proposes a new strategy for heating the seats in electrically powered vehicles using an uneven distribution of the heating elements. The uneven positioning of the heating elements is based on the thermal sensitivity of the human skin measured data and scientific literature. For this, a thermal sensitivity test device was developed to map the human skin thermal sensitivity. To test the new solution, a vehicle seat was equipped with heating pads (arranged according to the position of the relevant human skin thermal sensitivity points). For the next step, comparative measurements (power consumption, temperature distribution—with an IR camera—and human subjectivity test) were carried out between a classical vehicle seat heating system and the newly proposed heating solution. The outcome of the study revealed that the proposed heating system will supply at least the same thermal comfort sensation as the standard vehicle seat but using only half of the energy consumption, which translates in an increase of the electrically powered vehicle range between 1.2% and 1.5%, depending on the climate and driving conditions (over the WLTC). For example, a vehicle with a 16 kWh battery driving over the WLTC in Frankfurt climate conditions can gain in 1 year between 139.6 and 164.5 km.

Supporting decision making in design creativity through requirements identification and evaluation

ABSTRACT Product innovation, based on the identification and implementation of new solutions, is essential to keep a company competitive. However, the risk of failure of a new solution must be properly weighted during the decision-making in the design activity. This study proposes a method to evaluate a new design solution through the comparison with an old one to be substituted, and based on their requirements. In order to better evaluate the new solution, new requirements about its specific peculiarities are extracted from patents of similar solutions and considered in the evaluation. Requirements extraction is carried out automatically, through natural language processing, while the evaluation considers technical, marketing, and economic criteria. In particular, financial proceeds and patents investments were considered. The proposed method was applied in a real industrial case study were the substitution of carbon fiber heating mat over the copper heating mat was assessed. This study contributes to support creativity in innovation design by providing unknown requirements on which to work on the new product. In addition, it can stimulate the designer on this aim, by presenting the requirements along with new ideas, already implementing them in other fields/contexts that can act as sources of inspiration or creativity triggers.

Time-Course Changes in Dorsiflexion Range of Motion, Stretch Tolerance, and Shear Elastic Modulus for 20 Minutes of Hot Pack Application.

The application of thermal agents via hot packs is a commonly utilized method. However, the time-course changes in the range of motion (ROM), stretch sensation, shear elastic modulus, and muscle temperature during hot pack application are not well understood. This study aimed to investigate the time-course changes in these variables during a 20-minute hot pack application. Eighteen healthy young men (21.1 ± 0.2 years) participated in this study. We measured the dorsiflexion (DF) ROM, passive torque at DF ROM (an indicator of stretch tolerance), and shear elastic modulus (an indicator of muscle stiffness) of the medial gastrocnemius before and every 5 minutes during a 20-minute hot pack application. The results showed that hot pack application for ≥5 minutes significantly (p < 0.01) increased DF ROM (5 minutes: d = 0.48, 10 minutes: d = 0.59, 15 minutes: d = 0.73, 20 minutes: d = 0.88), passive torque at DF ROM (5 minutes: d = 0.71, 10 minutes: d = 0.71, 15 minutes: d = 0.82, 20 minutes: d = 0.91), and muscle temperature (5 minutes: d = 1.03, 10 minutes: d = 1.71, 15 minutes: d = 1.74, 20 minutes: d = 1.66). Additionally, the results showed that hot pack application for ≥5 minutes significantly (p < 0.05) decreased shear elastic modulus (5 minutes: d = 0.29, 10 minutes: d = 0.31, 15 minutes: d = 0.30, 20 minutes: d = 0.31). These results suggest that hot pack application for a minimum 5 minutes can increase ROM and subsequently decrease muscle stiffness.

Suppressive effects of a transient receptor potential melastatin 8 (TRPM8) agonist on hyperthermia-induced febrile seizures in infant mice.

Background: Febrile seizures (FSs) are the most frequent type of seizures in infancy and childhood. Epileptiform discharges (EDs) on electroencephalogram at the time of first FS recurrence can increase the risk of epilepsy development. Therefore, inhibition of EDs is important. Recently, WS-3, a transient receptor potential melastatin 8 (TRPM8) agonist, reportedly suppressed penicillin G-induced cortical-focal EDs. However, the effects of TRPM8 agonists on FSs remain unknown. In this study, we aimed to clarify the effects of the TRPM8 agonist, and the absence of TRPM8 channels, on hyperthermia-induced FS by analyzing the fast ripple band. Methods: Hyperthermia (43°C for 30min) induced by a heating pad caused FSs in postnatal day 7 wild-type (WT) and TRPM8 knockout (TRPM8KO) mice. FSs were defined as EDs occurring during behavioral seizures involving hindlimb clonus and loss of the righting reflex. Mice were injected with 1% dimethyl sulfoxide or 1mM WS-3 20min before the onset of hyperthermia, and electroencephalograms; movies; and rectal, brain and heating pad temperatures were recorded. Results: In wild-type mice, WS-3 reduced the fast ripple amplitude in the first FS without changing rectal and brain temperature thresholds. In contrast, the anti-FS effect induced by the TRPM8 agonist was not observed in TRPM8KO mice and, compared with wild-type mice, TRPM8 deficiency lowered the rectal and brain temperature thresholds for FSs, exacerbated the fast ripple amplitude, and prolonged the duration of the initial FS induced by hyperthermia. Conclusion: Our findings suggest that TRPM8 agonists can be used to treat hyperthermia-induced FSs.

Effect of hot saline pack versus topical tranexamic acid in post adenoidectomy bleeding

BackgroundAdenoidectomy is a popular surgical technique in the field of otolaryngology that is successful, safe, and effective. Diffuse microvascular post-adenoidectomy bleeding, on the other hand, is still a common concern.AimThe objective of this study is to do a comparison between the efficacy of a hot saline pack versus topical tranexamic acid when administered topically in children who have had only adenoidectomy in terms of intra-operative blood loss and post-operative bleeding.MethodsThis prospective case-control study contained a total of 180 patients, divided into three classes. Class A: This included 60 patients with application of a hot saline pack in control of intra-operative adenoidectomy bleeding. Class B: This included 60 patients with application of a topical tranexamic acid pack in control of intra-operative adenoidectomy bleeding. Class C: This included 60 patients with the use of a pack to hold intra-operative adenoidectomy bleedingResultsThe mean intraoperative blood loss in class B was lower than classes A and C, the mean pre- and post-operative HB level was lower in class C than in classes A and B, the difference was statistically considerable between the three classes, comparison between classes showed statistically considerable differences between classes A and C and also between classes B and C, while there was a statistically non-considerable difference between classes A and B.ConclusionThe current study found that a topical tranexamic acid pack was more effective for post-adenoidectomy haemostasis than a hot saline pack, with a shorter time to haemostasis and fewer recurettage and electrocauterization procedures.Trial registrationName of registration trial: Research ethics committee faculty of medicine Benha university. Registration number: Ms1-1-2020. Date of registration: 22-1-2021.

Improving Hands-Free Speech Rehabilitation in Laryngectomized Patients with a Moldable Adhesive.

This study aims to assess the product performance of a new moldable peristomal adhesive with corresponding heating pad designed to facilitate and improve automatic speaking valve (ASV) fixation for hands-free speech in laryngectomized patients. Twenty laryngectomized patients, all regular adhesive users with prior ASV experience, were included. Study-specific questionnaires were used for data collection at baseline and after two weeks of moldable adhesive use. The primary outcome parameters were adhesive lifetime during hands-free speech, use and duration of hands-free speech, and patient preference. Additional outcome parameters were satisfaction, comfort, fit, and usability. The moldable adhesive enabled ASV fixation adequate for hands-free speech in the majority of participants. Overall, the moldable adhesive significantly increased adhesive lifetime and duration of hands-free speech compared to participants' baseline adhesives (p< 0.05), regardless of stoma depth, skin irritation, or regular use of hands-free speech at baseline. The participants who preferred the moldable adhesive (55% of participants) experienced a significant increase in the adhesive lifetime (median of 24 h, range 8-144 h) and improved comfort, fit, and ease of speech. The moldable adhesive's lifetime and functional aspects, including the ease of use and custom fit, are encouraging outcomes and enable more laryngectomized patients to use hands-free speech more regularly. 4 Laryngoscope, 133:2965-2970, 2023.

Comparing Primal Reflex Release Technique and Stretching Exercises on Pain and Function in Coccydynia

Objectives: This study aims to find and compare the effects of primal reflex release technique and stretching exercises on pain intensity, functional performance, and pain-free sitting duration in patients with coccydynia. Methods: This is a randomized clinical trial. A total of 46 individuals were chosen for the sample based on the inclusion criteria, and they were divided into groups A and B. Pre-treatment values of patients for pain assessment were taken by the Numerical Pain Rating Scale (NPRS), Dallas Pain Questionnaire (DPQ), and pain-free sitting duration (PFSD). Group A received treatment with a hot pack and primal reflex release technique. Group B received treatment with a hot pack and stretching exercises. Each patient received a total of 12 sessions over the course of 4 weeks, 3 sessions per week. After 4 weeks of therapy, both groups were evaluated again. The obtained data were analyzed using SPSS 21. Results: Findings revealed that within-group differences were statistically significant (P&lt;0.05) for all variables. In the primal reflex release technique group, the average NPRS value reduced from 5.565±1.4086 to 1.7391±1.09617, the average DPQ value from 129.967±33.102 to 38.000±26.691 and the average PFSD duration increased from 43.043±20.323 to 368.478±160.464. In the stretching group, NPRS reduced from 6.087±1.345 to 3.695±1.490, DPQ from 116.032±35.054 to 60.608±22.186 and PFSD increased from 28.260±11.928 to 94.130±102.154. The between-group analysis also indicated statistically significant differences in NPRS, DPQ, and pain-free sitting duration with P values ≤0.001, 0.003, and ≤0.001, respectively Discussion: The study concluded that both the primal reflex release technique and stretching exercises were effective in reducing pain and improving functional status with a marked increase in pain-free sitting duration. However, the primal reflex release technique was found to be more useful than stretching exercises in terms of mentioned outcome measures on basis of their mean differences.

Preliminary Study: Short-term Beneficial Effects of Thai Tok Sen Massage on Pain, Pressure Pain Threshold, and Upper Trapezius Muscle Thickness Among People with Shoulder Pain.

Shoulder muscle pain and spasm is the most common problem in people after prolonged working, similar to that resulting from office syndrome. Various medicinal treatments with analgesic drugs, hot packs, therapeutic ultrasound, or deep friction techniques can be clinically applied. Alternatively, traditional Thai massage (TM) with deep compression gentle technique also can help to release that problem. In addition, an traditional Thai treatment with Tok Sen (TS) massage has been generally performed in the Northern part of Thailand without any scientific evidence support. Thus, the aim of this preliminary study was to reveal the scientific value of Tok Sen massage on shoulder muscle pain and upper trapezius muscle thickness among people with shoulder pain. Twenty participants (6 males and 14 females) who suffered from shoulder pain were randomized into TS (n =10, aged 34.2 ± 7.34 yrs) or TM (n=10, aged 32.8 ± 7.24 yrs). Each group received two times 5-10 minutes of treatment, one week apart. At the baseline and after completing two times of each intervention, pain score, pain pressure threshold (PPT), and specific trapezius muscle thickness were evaluated. Before both TM and TS interventions, pain score, PPT, and muscle thickness were not statistically different between groups. After two times of intervention, pain scores significantly reduced in TM (3.1 ± 0.56; p = .02, 2.3 ± 0.48; p < .001), as same as in TS (2.3 ± 0.67; p = .01, 1.3 ± 0.45; p < .001) when compared to baseline. This was the same as the results of PPT in TM (4.02 ± 0.34; p = .012, 4.55 ± 0.42; p = .001) and TS (5.67 ± 0.56; p = .001, 6.8 ± 0.72; p < .001). However, the trapezius muscle thickness reduced significantly after two interventions by TS (10.42 ± 1.04; p = 0.002 & 9.73 ± 0.94 mm, p < .001), but did not change in TM (p > .05). Moreover, when compared between intereventions at the first and second periods, TS showed a significant difference in pain score (p = .01 & p <.001), muscle thickness (p = .008 & p = .001) as well as PPT (p < .001 & p < .001) when compared to TM. Tok Sen massage improves upper trapezius thickness from muscle spasms and reduces pain perception and increases the pressure threshold pain among participants who suffer from shoulder pain similar to that of office syndrome.

Clinical observation of Chinese herbal medicine hot pack therapy combined with meibomian gland massage in the treatment of dry eye of Liver-kidney Yin deficiency and related nursing measures

Clinical observation of Chinese herbal medicine hot pack therapy combined with meibomian gland massage in the treatment of dry eye of Liver-kidney Yin deficiency and related nursing measures

Fabrication of magnetic bifunctional composite via anchoring CoY on waste heating pad as a cycling material for peroxymonosulfate activation to degrade p-arsanilic acid and simultaneously eliminate secondary As(V)

Herein, waste heating pad, which mainly contains iron and vermiculite components after calcination in air, was used to support cobalt-yttrium bimetallic oxide for the first time. The magnetic material (IV@CoY) was applied for the activation of peroxymonosulfate (PMS) to simultaneously realize the removal of p-arsanilic acid (p-ASA) and the secondary inorganic arsenic (As(V)). 50 µM p-ASA was completely degraded in the system of IV@CoY (0.2 g/L) and PMS (0.5 mM) within 7 min, and about 99 % of the produced As(V) was adsorbed within 150 min. Electrochemical experiments illustrated that IV@CoY possessed the superior conductivity as compared to CoY, which greatly boosted PMS activation. The pseudo-first-order rate constant (kIV@CoY) was high up to 0.873 min−1, which was 7.6 times larger than kCoY (0.115 min−1). Catalytic mechanism analyses revealed that the produced SO4•−, •OH and 1O2 participated in the oxidation of p-ASA and As(III). The adsorption of the produced As(V) was achieved by ion exchange with −OH/CO32− on the surface of IV@CoY. The degradation pathways of p-ASA were further proposed on the basis of the detection of its intermediate products. Initial pH exerted a significant effect on the degradation-adsorption reaction and weak acidic or neutral condition was beneficial to the removal of p-ASA and As(V). To evaluate the practical application potential of IV@CoY, the disposal of p-ASA and secondary As(V) were also carried out in real water samples. Furthermore, IV@CoY was consecutively used for 5 times, and almost 100% degradation of p-ASA and over 97% adsorption of inorganic arsenic were still achieved even in the fifth round, which prove its high stability and reusability. Our results fully demonstrate that the magnetic IV@CoY is a promising catalyst to activate PMS for eliminating organoarsenic from water.

Effect of Hot Pack Administration on Shivering in Post Sectio Caesarea Patients with Spinal Anesthesia

The use of anesthetic techniques is an option for patients with sectio caesarea because the patient is conscious and the recovery period is faster. The impact that often arises after spinal anesthesia is shivering. This study aims to determine the effect of hot packs on shivering in post-cesarean section patients with spinal anesthesia. The research design is a Quasi Experiment with a pre-test post-test control group design. The independent variable of this study is giving hot packs and the dependent variable is shivering. This research was conducted in the High Care Unit Room (HCU) of Aminah Islamic Hospital Blitar from 6 to 31 January 2020. The samples obtained were 32 respondents, 16 respondents in the treatment group and 16 respondents in the control group using accidental sampling. The results showed that the majority of respondents in the treatment and control groups experienced a shivering scale of 2 before administering the hot pack. After administration of the shivering scale hot packs in the treatment group experienced a significant decrease to 0 while the control group experienced a not very significant decrease in shivering scale, namely to 1. Statistical test This study uses Mann Whitney with a p-value of 0.000. This means that giving hot packs has an effect on shivering in post sectio caesarea patients with spinal anesthesia. After administration of hot packs, the shivering scale in the treatment group experienced a significant decrease to 0, while in the control group, the shivering scale decreased which was not too significant, namely to 1. The statistical test of this study used Mann Whitney with a p-value of 0.000. This means that giving hot packs has an effect on shivering in post sectio caesarea patients with spinal anesthesia. After administration of hot packs, the shivering scale in the treatment group experienced a significant decrease to 0, while in the control group, the shivering scale decreased which was not too significant, namely to 1. The statistical test of this study used Mann Whitney with a p-value of 0.000. This means that giving hot packs has an effect on shivering in post sectio caesarea patients with spinal anesthesia.

Effects of Hot Packs on pain in patients with Osteoarthritis (OA) in Saidu Group of Teaching Hospital Swat: A Randomized Control Trial

Objective: The main objective of this study was to evaluate the effect of heat packs on pain in patients with osteoarthritis. Study design: A Randomized Control Trial Place and duration: Saidu Group of Teaching Hospital Swat for the period of six months. Methodology: Methods: This research employed a randomised controlled trial (RCT) design. A total of 60 patients met the inclusion criteria and were randomly assigned (30 in each) to either the experimental or control group. The severity of the pain was measured using a Visual Analog Scale. The patients in the control group received 20 minutes of heat therapy consisting of hot packs heated to 40 degrees Celsius administered to the affected joint. All patients were checked at day 0, day 3, day 8, and day 15 after treatment. Results: On days 8 and 15, patients in the experimental group reported significantly less pain than those in the control group (p = 0.002 and p 0.001, respectively). Patients younger than 50 years old in the study group experienced less pain on day 8th and 15th than those in the control group. Conclusion: As this study's findings indicate, using a hot pack can significantly reduce pain experienced by those suffering from osteoarthritis (OA). Further, it showed that the effectiveness of a hot pack on pain differed between patients based on factors including age and gender Keywords: Osteoarthritis, Hot pack, Randomized Control Trial, significant, convenient, cost effective.

Clinical Decision Making of Electrophysiological Agents by Physical Therapists

Background: Therapeutic modalities play a major role in rehabilitation and assist other therapeutic treatments, such as physical exercise and manual therapy. Aim: To assess the factors that affect the clinical decision making of electrophysiological agents by physical therapists. Study design: Descriptive cross-sectional survey. Methodology: Sample was taken through non- probability sampling technique. Sample size was calculated through Census method. Data was collected through online survey and questionnaires that were randomly distributed to all clinical physical therapists. Data was evaluated by using SPSS vr 24. Quantitative variables are represented in the form of frequencies %age. Results: 31(54%) of PTs reported Research evidence as a strong factor, 30(52%) reported availability of equipment and 40(70%) of PTs reported past clinical experience as a strong factor that influence the decision of usage of electrophysiological agents. The most frequently available agents were ultrasound (96%), hot pack (98%), cold pack (96%) and TENS (98%). Practical Implication: This study has determined the influence of various factors that affect the clinical decision-making abilities of clinical physical therapists working in Pakistan. Conclusion: It was concluded that making a decision while using EPAs was a complex phenomenon. All the factors must be considered when using EPA as treatment modality. Furthermore, there must be a regular check-up regarding the availability and up-dated version of EPAs by health policy makers in all clinical settings. Keywords: Electrophysiological Agents, Therapeutic Modalities and Rehabilitation.