Improvement In General Health Research Articles

The Positive Clinical Consequence of Early Intervention of Combined Therapy (Omega 3 Fatty Acids and B12 Vitamin) in Children Under 5 with Variable Forms of Cerebral Palsy

Background: Cerebral palsy is a common pediatric problem encountered in about 1:3 per 1000 born children and causing variable mental, motor and behavioral dilemmas. Newly introduced trials of neurogenesis with different agents are now extensively evaluated. Objective: Our study was conducted to evaluate the neurotrophic response to B12 vitamin and omega-3 fatty acids in children diagnosed early with variable forms of cerebral palsy. The response was monitored both clinically and with C.T Scan as being a highly predictive tool for assessing cerebral palsy. Design: The study was carried out on 40 cerebral palsy patients; 26 (65%) out of them were girls, and 14 of them were boys, aged from 0 to 5 years old; from outpatient clinic at Zakho/Duhok General Hospital in Kurdistan Region-Iraq. Patients were treated and followed up for 6 months to one year. They were represented and adjusted by full history taking and clinical examination. Brain C.T scans was done for every patient to assess the degree of brain atrophy before starting this combined therapy, and every month for six months to one year. There was an improvement in general health of children after interventional therapy. Results: The study revealed that early intervention of both omega 3 and B12 vitamin in children under 5 with cerebral palsy (cp) shows great response based on clinical examination and CT scan findings. Almost, after combined therapy, 80% of children with delayed speech delay have very good response and improvement, 77% of children with delayed milestone and hypertonia, and 87% with delayed walking have positive clinical outcomes. Both sexes have equal response to combined therapy. Such findings were obtained as a result of early treatment and diagnosis of children with (CP). In addition, among the treated children with CP, improvement in CT scan results was obtained. 84% of treated children have great improvement in their neuroimaging results from moderate/severe forms of brain atrophy to mild form of brain atrophy after being treated and followed up for 6 months to 1 year. Conclusion: The damaged brain sites based on CT scan results, showed progressive improvement in response to B12 and omega-3 fatty acids upon daily supplement throughout 6 months to one year. However, combining these 2 drugs showed preservative synergistic consequences. B12 vitamin and omega- 3 fatty acids are valuable therapy for children with various forms of cerebral palsy particularly when being linked. The greatest improvement in speech and motor development was significantly observed in about 32 patients (80%) of treated children with B12 vitamin and omega- 3 fatty acids. Others have less response to combine therapy as being presented and diagnosed beyond 1 year of age (16%).

Possitive Effects of Movement Performed in Water

Abstract Given the effects that swimming has on the body, the improvement of general health and recreation, it can be considered a mass sport. It can be practiced from the first months of life to old age, because the effort can be modified at least according to age and health. It is one of the most complete sports because of the changes it brings to the body as well as the hygiene conditions in which it is practiced. It is beneficial to all functions, organs, exerts an increased demand for all muscle groups as well as general body attitude. Swimming is recognized as a very enjoyable, relaxing and prophylactic activity that almost everyone can enjoy.

Iranian Health Reform Advantages in Health Care System: A Qualitative Study

Background: Iranian Health Reform Plan in health care systems launched in 2014. The aim of this program was to expand equity in the field of health, improve quality, increase accessibility to health services, and increase people’s satisfaction. Objectives: This study designed to explore Iranian health reform advantages in health care systems on the perspective of health managers, health care providers, and clients. Methods: In this content analysis study, participants included 22 health managers, 118 health care providers, and 15 clients affiliated with the health deputy of the Qom University of Medical Sciences. Sampling was conducted in the purposeful method. Individual semi- structured interviews were used for data gathering and data was analyzed by the conventional approach. Similar codes were merged and categorized and the extracted subcategories were named based on their essence. MAXQDA software was used to manage qualitative data. Results: 328 codes, 19 subcategories and 7 main categories were extracted. On the perspective of participants, Iranian health reform advantages in health care system, categorized in 7 main categories included; improvement of general health, improvement of equity in the health system, improvement of health literacy, providing comprehensive health services, providing personalized health services, increased general satisfaction, and providing electronic health records. Conclusions: Health managers, health care providers, and clients expressed their satisfaction from Health Reform Plans and pointed to different aspects of it. On these findings, Iranian Health Reform Plans can facilitate promoting health care services and in sequence, public health.

Minimal clinically important difference for the 22‐item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis

To determine the minimal clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in individuals undergoing medical management for their chronic rhinosinusitis (CRS). Prospective observational study. Academic, tertiary care centre. A total of 247 adults undergoing medical management for CRS. At enrolment, participants completed a SNOT-22. At a subsequent follow-up visit, 2-12months after enrolment, participants also completed a SNOT-22. At follow-up, participants also rated the change in their sinus symptoms and general health as "Much worse," "A little worse," "About the same," "A little better" or "Much better" compared with enrolment; these two questions were used as sinus symptom and general health anchor questions, respectively. The SNOT-22 MCID was calculated using distribution-based, anchor-based and receiver operating characteristic (ROC) curve-based methods. Using the distribution-based method, the SNOT-22 MCID was 11.6. Using the sinus symptom anchor question, the SNOT-22 MCID was 10.5; applying the ROC method to the sinus symptom anchor yielded an MCID of 12.5. In comparison, using the general health anchor question, the SNOT-22 MCID was 8.3; applying the ROC method to the sinus symptom anchor yielded an MCID of 17.5. In all cases, the calculated MCID had a sensitivity of approximately 50-60% and specificity of approximately 80-90%. Based on our results, we propose a SNOT-22 MCID of 12 in medically managed patients with CRS. The MCID, while specific, was not sensitive for identifying patients with CRS experiencing a noticeable improvement in sinus symptoms or general health.

Dietary supplement use among patients with chronic kidney disease

Dietary supplements (DS) are available over the counter, but patients with impaired renal function are specifically at risk for toxicity when consuming certain DS. The aim of this study was to evaluate the prevalence and characteristics of DS use in patients with chronic kidney disease (CKD). A cross-sectional, controlled DS use survey (22 questions) was conducted among 180 CKD patients (stage 1-5, dialysis, kidney transplant), with 60 patients without CKD serving as controls. DS use did not differ significantly between subjects with and without CKD, unless the CKD patients were on dialysis. In the CKD group, 20% admitted to use DS regularly and 22% did not take the mat all. In the controls, DS consumption was 17% and 13%, respectively (NS). The DS use was higher among women ascompared to men (89% vs. 70%; p < 0.005), and people living in cities versus those living in the country side (81% vs. 63%; p < 0.05). DS most commonly used were: vitamins, minerals, and herbs. Major indications for DS use included: musculoskeletal issues, general health improvement and prevention of urinary tract infections. Subgroup analyses revealed that dialysis patients were characterized by a significantly higher DS use in comparison to CKD stage 1-5 subjects and renal transplant recipients. The decision to introduce DS was made by the physician in 54% of cases; by a pharmacist in 9% of cases, and by the patients themselves in 37%. Only 21% of patients with CKD, and 27% of subjects without CKD, declared knowledge of any possible side-effects associated with DS (NS). The use of DS among patients with CKD is similar to patients without CKD, with the exception of those on dialysis. Vitamins and minerals were the most commonly reported DS consumed. The knowledge on potential side-effectof DS was limited to approximately one-fourth of those surveyed.

Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial.

BackgroundPractice of meditation or exercise may enhance health to protect against acute infectious illness.ObjectiveTo assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness.DesignRandomized controlled prevention trial with three parallel groups.SettingMadison, Wisconsin, USA.ParticipantsCommunity-recruited adults who did not regularly exercise or meditate.Methods1) 8-week behavioral training in mindfulness-based stress reduction (MBSR); 2) matched 8-week training in moderate intensity sustained exercise (EX); or 3) observational waitlist control. Training classes occurred in September and October, with weekly ARI surveillance through May. Incidence, duration, and area-under-curve ARI global severity were measured using daily reports on the WURSS-24 during ARI illness. Viruses were identified multiplex PCR. Absenteeism, health care utilization, and psychosocial health self-report assessments were also employed.ResultsOf 413 participants randomized, 390 completed the trial. In the MBSR group, 74 experienced 112 ARI episodes with 1045 days of ARI illness. Among exercisers, 84 had 120 episodes totaling 1010 illness days. Eighty-two of the controls had 134 episodes with 1210 days of ARI illness. Mean global severity was 315 for MBSR (95% confidence interval 244, 386), 256 (193, 318) for EX, and 336 (268, 403) for controls. A prespecified multivariate zero-inflated regression model suggested reduced incidence for MBSR (p = 0.036) and lower global severity for EX (p = 0.042), compared to control, not quite attaining the p<0.025 prespecified cut-off for null hypothesis rejection. There were 73 ARI-related missed-work days and 22 ARI-related health care visits in the MBSR group, 82 days and 21 visits for exercisers, and 105 days and 24 visits among controls. Viruses were identified in 63 ARI episodes in the MBSR group, compared to 64 for EX and 72 for control. Statistically significant (p<0.05) improvements in general mental health, self-efficacy, mindful attention, sleep quality, perceived stress, and depressive symptoms were observed in the MBSR and/or EX groups, compared to control.ConclusionsTraining in mindfulness meditation or exercise may help protect against ARI illness.LimitationsThis trial was likely underpowered.Trial registrationClinicaltrials.gov NCT01654289

Factors affecting the results of analgesic therapy. Results of the Russian multicentre study of NOTE (NSAID: Open-label Trial of Efficacy).

To identify factors affecting the effectiveness of NSAIDs in patients with OA and LBP. An observational study was conducted to evaluate the effectiveness of a 2-week course of NSAIDs in OA and LBP in real clinical practice. The study group consisted of 3604 patients with OA and LBP (60.6% women and 39.4% men, mean age 55.0±13.4 years). According to the study design, aceclofenac (Airtal) and other NSAIDs used in the ratio 1:1. The main criterion of effectiveness was the frequency of complete pain relief after 2 weeks of therapy. In addition, the decrease of pain and general health were determined on a 10-point numerical rating scale (NRS). We compared the frequency of complete pain relief in patients who had and did not have the studied factors. The value of the studied factors was determined using OR (95% CI). Most patients received aceclofenac (54.9%), as well as diclofenac (2.0%), ketoprofen (1.9%), lornoxicam (2.2%), meloxicam (13.7%), naproxen (2.1%), nimesulide (5.8%), celecoxib (5.9%), ethicoxib (7.1%) and other NSAIDs (4.4%); 56.2% of patients received muscle relaxants, mainly tolperisone (74.7%), vitamin B (10.4%), and proton pump inhibitors (42.8%). Complete pain relief was achieved in 54.8% of patients. The pain decrease and general health improvement were (for NRS) 63.9±13.4% and 61.7±14.8%, respectively. The efficacy of aceclofenac was slightly higher than in the whole group: complete pain relief was in 59.9% of patients. Adverse events in aceclofenac use were observed in 2.3% of patients, other NSAIDs-from 2.4 to 14.1%. The frequency of complete pain relief was higher in men: OR 1,239 (95% CI 1.08-1.418; p=0.002), who had the first episode of pain - OR 3.341 (95% CI 2.873-3.875; p=0.000), a good&quot; response &quot; to NSAIDs in history - OR 1.656 (95% CI 1.385-1.980; p=0.000) and received NSAIDs in combination with muscle relaxants - OR 1.218 (95% CI 1.067-1.390; p=0.004). The effect of therapy is lower in patients 65 years and older-OR 0,378 (95% CI 0.324-0.442; p=0,000), with body mass index &gt;30 kg/m² - OR 0.619 (95% CI 0.529-0.723; p=0.000), with severe pain (≥7 points NRS) - OR 0.662 (95% CI 0.580-0.756; p=0.002), with pain at rest, - OR 0.515 (95% CI 0.450-0,589; p=0.000), pain at night - OR 0.581 (95% CI 0.501-0.672; p=0.000) and the presence of stiffness - OR 0.501 (95% CI 0.438-0,573; p=0.000). Treatment results are significantly worse in the cases of combination of LBP and joint pain, as well as pain in the trochanter major and pes anserinus area (p&lt;0.001). NSAIDs are the first-line medications for the pain treatment in LBP and OA. Aceclofenac is effective and safe in this conditions. When carrying out analgesic therapy should take into account factors that affect the effectiveness of treatment: old age, overweight, insufficient effect of NSAIDs in history, severe pain, signs of &quot;inflammatory&quot; pain, multiple sources of pain.

Applying psychoeducational program on general health and communication skills in caregivers of patients with schizophrenia: A randomized controlled trial

Background and objectivesThrough the use of an experimental design with a baseline and post intervention, the aim of this study was to investigate the effectiveness of a psychological intervention in increasing public health and communication skills for caregivers. MethodsThis randomized controlled trial was designed in Razi Hospital in Tehran, Iran. A sample size of 90 participants was evenly divided into intervention and control groups. The intervention group was given routine treatments and also participated in planned educational sessions. The planned educational program was implemented in 10 group sessions over a period of 5 weeks. Each session lasted 45–60min. The outcome measures were: (1) improvement in the caregiver's general health as measured by the changes in their General Health Questionnaire (GHQ) scores taken at baseline and post intervention and (2) changes in the caregiver's communication skills, measured by the communication skills questionnaire taken at baseline and after 3 months. ResultsAn independent samples t-test revealed that there was a significant difference between the two groups in the mean scores of communication skill at baseline (P<0.001). To adjust for the effects of pre-intervention scores on the post-intervention results, a covariance analysis was used. Consequently, differences between the mean scores of post-intervention GHQ total, GHQ subcategories, and communication skills in the intervention group and the control group were statistically significant (P<0.001). ConclusionResults of our study confirm that providing education on effective communication skills can be an effective, cost-efficient, and convenient strategy to reduce the psychological complications for caregivers and improve the care of patients living with schizophrenia.

ENDOVASCULAR TREATMENT OF THE RESIDUAL THROMBOEMBOLIC PULMONARY HYPERTENSION AFTER PULMONARY THROMBENDARTERECTOMY WITH THE DENERVATION SYSTEM SYMPLICITY

Aim. To assess the safety and efficacy of radiofrequency denervation of pulmonary artery (PA) with the Simplicity system in patients with residual pulmonary hypertension (PH) after the thromberarterectomy surgery.Material and methods. To the study, 12 patients included, with the signs of residual PH (by echocardiography data, mean PH pressure ≥25 mmHg), who had undergone surgery (thrombendarcterectomy) for chronic thromboembolic PH. Mean time interval between the diagnosis of PH and pulmonary denervation was 8,5 years. After catheterization of the right chambers of the heart and tensiometry in small circle circulation, the spot circular radiofrequency denervation performed of the right and left PH at the area of ostia, with ablation catheter Simplicity. The success was defined by decrease of mean PA pressure &gt;10 mmHg, absence of complications, exercise tolerance increase after the procedure immediately and in 12 months.Results. At long term period after the intervention there was significant decrease of mean PA pressure from 58±6 to 33±4 mmHg (p&lt;0,01), of pulmonary vascular pressure from 8,6±2,1 to 3,2±1,4 mmHg (p&lt;0,01) and increase of exercise tolerance from 321±19 m to 487±29 m (p&lt;0,01). During the follow up period, 1 patient died in 8 months after inclusion due to severe gastrointestinal bleeding. The rest did not present with adverse events or non­planned hospitalizations. Nine patients noted significant improvement of general health, decrease of dyspnea and fatigue, 3 patients had discontinued sildenafil. There were no complications at PA radiofrequency ablation procedure (death, arrhythmias, PA perforation, acute PA thrombosis in the place of access, bleeding).Conclusion. Utilization of the Simplicity system in PA denervation is safe and effective. Further randomized studies in need to confirm clinical benefits from the procedures in PH patients.

When is quitting an escape? How different job demands affect physical and mental health outcomes of retirement.

The demographic aging of societies and the need to adapt to this trend makes it important to gain insight into the way retirement affects different forms of health, and factors that influence this relationship. Pre-retirement job characteristics have only rarely been included in this type of research. The regressor variable method is applied to two waves (4 and 5) of data from the Survey of Health Ageing and Retirement in Europe, a multi-national prospective cohort study. The final sample consists of 9092 people aged 50-70 at wave 4, of whom 1257 retired voluntarily. Health is assessed through the presence of physical health problems, general self-rated health and the EURO-D scale for depressive symptoms. The findings indicate that retirement from jobs with high physical demands leads to a relative improvement in general self-rated health compared with those who remain at work. Retirement from a psychologically demanding job is associated with less depressive symptoms. No effects are found for health measured as the presence of physical health problems. Different types of measures for health yield different results for outcomes of retirement; pre-retirement job demands play an important role in how retirement affects health; physical demands seem primarily related to physical health benefits, psychological demands seem primarily related to mental health benefits.

Working Health Services Scotland: a 4-year evaluation.

BackgroundWorking Health Service Scotland (WHSS) supports the self-employed and employees of small and medium-sized enterprises (SMEs) in Scotland with a health condition affecting their ability to work, who are either absent or at risk of becoming absent due to it.AimsTo evaluate the impact on health and work outcomes of WHSS clients over a 4-year period.MethodsData were collected at enrolment, entry, discharge and follow-up at 3 and 6 months after discharge. Clients completed up to three validated health questionnaires at entry and discharge—EuroQol five dimensions (EQ-5D) and visual analogue scale (VAS); Hospital Anxiety and Depression Scale (HADS); and Canadian Occupational Performance Measure (COPM).ResultsA total of 13463 referrals occurred in the 4-year period; 11748 (87%) were eligible and completed entry assessment and 60% of the latter completed discharge paperwork. The majority of referrals were due to musculoskeletal conditions (84%) while 12% were referred with mental health conditions. Almost a fifth (18%) of cases were absent at entry and back at work at discharge. Work days lost while in WHSS was associated with age, length of absence prior to entering WHSS, primary health condition and time in programme. All health measures showed significant improvements from entry to discharge. Improvement in general health was sustained at 3- and 6-month follow-up.ConclusionsThe WHSS evaluation findings indicate that participation was associated with positive changes to health and return-to-work. The extent of the positive change in health measures and work ability can be highly important economically for employees and employers.

Effectiveness of Brief DBT-informed Group Therapy on Psychological Resilience: A Preliminary Naturalistic Study

ABSTRACTThis naturalistic study was designed to examine the effectiveness of a 4-week skill-based group therapy that focuses on building resilience. The group, informed by Dialectical Behavior Therapy (DBT; Linehan, 1993, 2015), targets general clients at college counseling centers and emphasizes mindfulness as a coping strategy to stress, cognitive rigidity, emotion dysregulation, and interpersonal difficulties. Results indicated that group members showed clinically significant improvement in psychological resilience and general mental health at the conclusion of group therapy. Implications are discussed.

Decoding increasing prevalence of noncommunicable diseases

Background: In recent times, noncommunicable diseases (NCDs) have attained epidemic status in India and several other countries. Globally, each year, NCDs cause premature deaths of nearly 40 million people younger than 60 years accounting for 70% of all deaths; 80% of these premature deaths are reportedly in the low- and middle-income countries. Many studies have reported increasing prevalence of NCDs such as type 2 diabetes, coronary and pulmonary diseases, and cancer. Incidentally, all these studies besides discussing environmental pollution have grossly ignored dietary profiling of affected populace despite the fact that several studies have established a direct correlation between food quality and good health.Objective: Besides pollutants, an attempt is made to analyze mathematically effects of dietary changes over the last four decades on constantly increasing prevalence of NCDs at cellular level. A relationship seems to exist between increasing prevalence of NCD and large-scale consumption of synthetic salt.Conclusions: Elimination of essential trace elements and micro- and macro-minerals in regular diet through synthetic salt fortified with iodine alone appears to cause more harm than benefits associated with iodization of salt than pollutants. Regular intake of essential trace elements is necessary for normal functioning of many fundamental functions of the body such as Na-K pump, electron–proton transport, biochemistry, and thermodynamics. An attempt has been made to study effects of salt constituents used in food at the most fundamental cellular level by means of disturbances in body electrolyte through heat and ion transport mechanism that is fundamental to various underlying processes in human body. Interestingly, almost all the families who switched over to unprocessed rock salt from synthetic iodized salt reported improvement in general health and reported reduction in medical visits.

The significance of EEG in the evaluation of arterial hypertension treatment

To assess the efficacy of the treatment of patients with arterial hypertension (AH) using electroencephalography (EEG). Arterial pressure (AP) was recorded in 250 patients with AH, along with simultaneous recording of EEG with electrocardiography (ECG), computed CT of the brain, which did not reveal any pathological changes. Patients were examined during AH elevation and after its normalization and improvement of general health state. Normalization of EEG parameters depended only on the AH level was observed in systolic AH <140 mm hg and diastolic AD <90 mm hg in the improvement of general health state during 1-2 month. AH normalization led to disappearance of monophasic spikes, synchronized to ECG R wave, an increase in α-rhythm index, absence of bilateral synchronized spikes. The method of simultaneous recording of AH, ECG and EEG can be used for assessment of AH treatment efficacy and medical-social expertise of patients. The method of biofeedback is effective only when used together with pharmacological treatment of AH according to current treatment standards.

Effects of periodontal treatment on serum inflammatory markers and CD4T-lymphocyte cell count in patients with human immunodeficiency virus infection

Introduction. Several studies have reported reduction in the serum concentration of systemic inflammatory markers upon completion of periodontal therapy. However, no studies have been conducted on the effects of periodontal therapy on systemic inflammation in human immunodeficiency virus-positive patients. The aim of this study was to investigate the effects of periodontal therapy on the serum levels of systemic inflammatory biomarkers and CD4T-lymphocyte cell count in human immunodeficiency virus-positive patients. Material and Methods. The study included 34 human immunodeficiency viruspositive patients with chronic periodontitis receiving antiretroviral therapy. Periodontal parameters (plaque index, gingival index, papilla bleeding index, probing depth and clinical attachment level) and serum samples, assessed for the levels of interleukin- 1 ?, tumor necrosis factor-?, and C-reactive protein, were evaluated at baseline, 1- and 3-months upon completion of the non-surgical periodontal therapy. The CD4T-lymphocyte count was measured at baseline and three months after treatment completion. Results. Significant reduction in the values of plaque index, gingival index, papilla bleeding index, and probing depth was noted (p &lt; 0.001), whereas the reduction in the median clinical attachment level value did not reach a statistically significant level (F = 1.321; p = 0.261). Local inflammation reduction was accompanied by a significant decrease in serum C-reactive protein (F = 5.765; p = 0.014) and a CD4Tlymphocyte count increase (t = 2.321; p = 0.027). Serum interleukin-1? and tumor necrosis factor-? did not change significantly as a result of periodontal treatment. Conclusion. Periodontal therapy contributes to the reduction of C-reactive protein and improvement of general health in human immunodeficiency virus-positive patients receiving highly active antiretroviral therapy.

Culture Of Health, Medicare, And More.

Culture Of Health, Medicare, And More.

Typhoid Fever Drug Resistance Outcomes and Current Vaccine Recommendations

The incidence of typhoid fever has not decreased since 1990, making it an important yet neglected contributor to health care costs. There has been an emergence of multi drug resistant typhoid fever, wherein there is no response to the first line of antimicrobials like ampicillin, chloramphenicol and cotrimoxazole. The fluoroquinolones and cephalosporins have been used in the treatment of cases, but there has been a recent epidemic of resistance to these drugs in some parts of the world. The H58 clade which is responsible for the development of resistance, has been found globally, indicating a geographical spread. Plasmid mediated transfer of resistance along with genetic mutations contribute to the extensive spread of antimicrobial resistance. To reduce the incidence of typhoid fever, the widespread use of protein conjugate typhoid vaccine is recommended in addition to improvements in awareness, general health and sanitation.

The Positive Clinical Consequence of Early Intervention of Combined Therapy (Omega 3 Fatty Acids and B12 Vitamin) in Children Under 5 with Variable Forms of Cerebral Palsy

Background: Cerebral palsy is a common pediatric problem encountered in about 1:3 per 1000 born children and causing variable mental, motor and behavioral s dilemmas. Newly introduced trials of neurogenesis with different agents are now extensively evaluated. Objective: Our study was conducted to evaluate the neurotrophic response to B12 vitamin and omega-3 fatty acids in children diagnosed early with variable forms of cerebralpalsy. The response was monitored both clinically and with C.T Scan as being a highly predictive tool for assessing cerebral palsy. Design: The study was carried out on 40 cerebral palsy patients; 26 (65%) out of them were girls, and 14 of them were boys, aged from 0 to 5 years old; from outpatient clinic at Zakho/Duhok General Hospital in Kurdistan Region-Iraq. Patients were treated and followed up for 6 month to one year. They were represented and adjusted by full history taking and clinical examination. Brain C.T scans was done for every patient to assess the degree of brain atrophy before starting this combined therapy, and every month for six months to one year. There was an improvement in general health of children after interventional therapy. Results: The study revealed that early intervention of both omega 3 and B12 vitamin in children under 5 with cerebral palsy (cp) shows great response based on clinical examination and CT scan findings. Almost, after combined therapy, 80% of children with delayed speech delay have very good response and improvement, 77% of children with delayed milestone and hypertonia, and 87% with delayed walking have positive clinical outcomes. Bothe sexes have equal response to combined therapy. Such findings were obtained as a result of early treatment and diagnosis of children with (CP). In addition, among the treated children with CP, improvement in CT scan results was obtained. 84% of treated children have great improvement in their neuroimaging results from moderate/severe forms of brain atrophy to mild form of brain atrophy after being treated and followed up for 6 month- 1 year. Conclusions: The damaged brain sites based on CT scan results, showed progressive improvement in response to B12 and omega-3 fatty acids upon daily supplement throughout 6 months to one year. However, combining these 2 drugs showed preservative synergistic consequences. B12 vitamin and omega- 3 fatty acids are valuable therapy for children with various forms of cerebral palsy particularly when being linked. The greatest improvement in speech and motor development was significantly observed in about 32 patients (80%) of treated children with B12 vitamin and omega- 3 fatty acids. Others have less response to combine therapy as being presented and diagnosed beyond 1 year of age (16%).

Circuit training enhances function in patients undergoing total knee arthroplasty: a retrospective cohort study

BackgroundThe number of patients receiving total knee arthroplasty (TKA) has been rising every year due to the aging population and the obesity epidemic. Post-operative rehabilitation is important for the outcome of TKA.MethodsA series of 34 patients who underwent primary unilateral TKA was retrospectively collected and divided into either exercise group (n = 16) and control group (n = 18). The exercise group underwent a 24-week course of circuit training beginning 3 months after total knee arthroplasty (TKA). The effect of circuit training on TKA patients in terms of motion analysis, muscle strength testing, Knee injury and Osteoarthritis Outcomes Score (KOOS) questionnaire and patient-reported outcome measurement Short-Form Health Survey (SF-36) at the pre-operation, pre-exercise, mid-exercise, and post-exercise.ResultsMotion analysis revealed the stride length, step velocity, and excursion of active knee range of motion significantly improved in the exercise group when compared to those in the control group. KOOS questionnaire showed a greater improvement in pain, ADL, and total scores in the exercise group. The SF-36 questionnaire revealed a significant improvement in general health, bodily pain, social function, and physical components score in the exercise group.ConclusionsThe post-operative circuit training intervention can facilitate recovery of knee function and decrease the degree of pain in the TKA and might be considered a useful adjunct rehabilitative modality. The ultimate influence of circuit training on TKA needs further a prospective randomized clinical trial study and long-term investigation.Trial registrationNCT02928562

Explaining time changes in oral health-related quality of life in England: a decomposition analysis

BackgroundOral diseases are highly prevalent and impact on oral health-related quality of life (OHRQoL). However, time changes in OHRQoL have been scarcely investigated in the current context of general improvement...