Left Dt Research Articles

One spinal manipulation session reduces local pain sensitivity but does not affect postural stability in individuals with chronic low back pain: a randomised, placebo-controlled trial

BackgroundClinical practice guidelines recommend spinal manipulation for patients with low back pain. However, the effects of spinal manipulation have contradictory findings compared to placebo intervention. Therefore, this study investigated the immediate effects of lumbar spinal manipulation on pressure pain threshold (PPT) and postural stability in people with chronic low back pain (cLBP). Second, we investigated the immediate effect of lumbar spinal manipulation on pain intensity and the interference of the participant beliefs about which treatment was received in the PPT, postural stability, and pain intensity.MethodsA two-arm, randomised, placebo-controlled, double-blind trial was performed. Eighty participants with nonspecific cLPB and a minimum score of 3 on the Numeric Pain Rating Scale received one session of lumbar spinal manipulation (n = 40) or simulated lumbar spinal manipulation (n = 40). Primary outcomes were local and remote PPTs and postural stability. Secondary outcomes were pain intensity and participant’s perceived treatment allocation. Between-group mean differences and their 95% confidence intervals (CIs) estimated the treatment effect. One-way analysis of covariance (ANCOVA) was performed to assess whether beliefs about which treatment was received influenced the outcomes.ResultsParticipants had a mean (SD) age of 34.9 (10.5) years, and 50 (62.5%) were women. Right L5 [between-group mean difference = 0.55 (95%CI 0.19 to 0.90)], left L5 [between-group mean difference = 0.45 (95%CI 0.13 to 0.76)], right L1 [between-group mean difference = 0.41 (95%CI 0.05 to 0.78)], left L1 [between-group mean difference = 0.57 (95%CI 0.15 to 0.99)], left DT [between-group mean difference = 0.35 (95%CI 0.04 to 0.65)], and right LE [between-group mean difference = 0.34 (95%CI 0.08 to 0.60)] showed superior treatment effect in the spinal manipulation group than sham. Neither intervention altered postural stability. Self-reported pain intensity showed clinically significant decreases in both groups after the intervention. A higher proportion of participants in the spinal manipulation group achieved more than two points of pain relief (spinal manipulation = 90%; sham = 60%). The participants’ perceived treatment allocation did not affect the outcomes.ConclusionOne spinal manipulation session reduces lumbar pain sensitivity but does not affect postural stability compared to a sham session in individuals with cLPB. Self-reported pain intensity lowered in both groups and a higher proportion of participants in the spinal manipulation group reached clinically significant pain relief. The participant’s belief in receiving the manipulation did not appear to have influenced the outcomes since the adjusted model revealed similar findings.

Conventional Echocardiography changes in Children with Diabetes Mellitus Type I with Lipid Profiles the Variation

Introduction: Diabetes mellitus type I (DMTI) is a highlighted endocrine and digestion issue that involved heart organs with more effect when lipid profiles considered. The study aimed to assess the conventional echocardiographic changes in children with diabetes mellitus type I with their lipid profiles variation. Materials and Methods: This analytical and comparison study performed on 96 DMTI and 96 healthy children. The examination run with collaboration of endocrinology and cardiology between March 2018 and April 2019. The DMTI confirmed by the clinical manifestation and laboratory measures. Both groups underwent conventional echocardiography and HbA1c, diabetic duration and lipid profiles measured for the children with diabetes. Data analyzed via SPSS 18.0 and P < 0.05 was considered significant level. Results: About 52.6% and 47.9% were boys in participants and patients respectively. Mean age of participants was 10.82± 3.15 years and 10.87±3.46 and 10.77±2.82 years for patients and controls respectively. Left MPI was higher in patients (p=0.001). Patients with poor controlled had higher LVMI and left DT (p<0.05). Patients with abnormal CHO had higher EF, FS, left E/A, LAd/Aod, LAs/Aos, left ET and PWD when right DT, aortic diameter in diastole, aortic diameter in systole, left MPI and left DT had lower levels. LDL effects on aorta diameter in diastole, right deceleration time, aorta diameter in systole, left MPI and left DT, FS, Left E/A, LAd / Aod, LAs/Aos, and PWD. Patients with abnormal HDL, had higher left MPI and lower left ET. Conclusion: It was concluded that more conventional echocardiography involvement in DMTI children who have abnormal lipids profile as well as abnormal HbA1c and longer diabetes duration.

Evaluation of Gluten-free Diet on the Heart Functions in Children with Celiac Disease

Background Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and a chronic inflammatory condition caused by immune pathology in the small intestines in genetically susceptible individuals. This study aimed to determine the efficacy of gluten free diet on cardiac functions using conventional and Doppler tissue echocardiography (DTE) in children with CD compared to controls. Materials and Methods This case-control study was conducted on 107 children with CD and 45 healthy children. The study was performed in the Ali Ebne Abi Talib hospital, affiliated to Zahedan University of Medical Sciences, Zahedan (ZaUMS), Iran. After considering exclusion criteria, participants underwent echocardiography. Data were analyzed through SPSS software version 20.0. Results: Results showed that tTG-IgA was different in participants. Left MPI was different in control-positive (p<0.001), control-newly diagnosed (p=0.024), and positive-negative (p<0.001). Right MPI was different in control-positive (p<0.001), control-newly diagnosed (p=0.024), positive-negative (p<0.001), and negative-newly diagnosed (p<0.001). Left MPI’ was different in control-positive (p<0.001), control-newly diagnosed (p<0.001), positive-negative (p=0.014), and negative-newly diagnosed (p=0.010). Right MPI’ was different in control-positive (p<0.001), control-newly diagnosed (p<0.001), positive–negative (p=0.010), and negative-newly diagnosed (p=0.034). Left DT was different in positive-negative. Right ET was different in control-positive, control-newly diagnosed, positive-negative and negative-newly diagnosed. Right AT was different in positive-negative and positive-newly diagnosed. Conclusion It was concluded in patients with positive response to gluten free diet that some heart functions were similar to the controls and in patients with negative response, some were similar to newly diagnosed patients. Diastolic and systolic dysfunctions are important findings in CD children and TDE is a better method to identify cardiac involvements in subclinical patients with CD.