Spasm Research Articles

Effectiveness of the Cunningham technique for shoulder dislocation reduction and its role in providing analgesia and muscle relaxation as an adjunctive method

BackgroundShoulder dislocation, particularly anterior dislocation, is a common orthopedic injury often presenting in emergency care settings, characterized by significant pain and muscle spasms. Prompt reduction is essential to alleviate symptoms and restore function. The Cunningham technique employs gentle pulling and massage motions targeted at the muscles and has emerged as a promising method for reducing anterior shoulder dislocations. However, its reported success rates vary widely across studies, and questions remain regarding its efficacy, particularly in cases of failure. This study aims to evaluate the effectiveness of the Cunningham technique for reducing anterior shoulder dislocations and its potential role in providing analgesia and muscle relaxation as an adjunctive method. MethodsA retrospective study was conducted on patients presenting with acute anterior shoulder dislocation at a single center. Reduction using the Cunningham technique was performed initially, followed by the external rotation technique if unsuccessful. Procedural sedation and analgesia were administered if the reduction was still not achieved, and shoulder dislocation reduction was performed again through the external rotation method. The patients’ VAS scores were recorded and evaluated the Cunningham technique's effectiveness in reduction and whether it increases the effectiveness of other techniques applied for reduction by lowering the VAS score, even in cases where it is not effective. ResultsA total of 61 patients were included in the study. The reduction was performed using the Cunningham technique in 34.4% (21/61) patients, the external rotation technique in 47.5% (29/61) patients, and the external rotation technique with PSA in 18% (11/61) patients. Significant differences were observed in the duration of hospital stay among the three techniques, with ER with PSA resulting in the longest stay. VAS scores showed significant improvements from initial presentation to post-reduction in all three groups. A significant decrease in pre-reduction VAS scores was observed during the transition from the Cunningham technique to other techniques. ConclusionThe Cunningham technique showed effectiveness in reducing anterior shoulder dislocations, providing analgesia, and muscle relaxation. It demonstrated favorable outcomes as an initial reduction technique, with the external rotation technique used as a subsequent option. Further studies comparing the success rates and complications of the Cunningham technique with other reduction methods are warranted to establish its role in clinical practice.

Combination Effects of Microwave Diathermy and Mulligan Bent Leg: Raise Technique on Myogenic Low Back Pain

Myogenic Low Back Pain, commonly known as lower back pain, is caused by the muscles receiving repeated static loads which cause pain, lower back muscle spasms and limited lumbosacral mobility resulting in decreased functional activity. This research is a pre-experiment with a one group pretest-posttest design, aimed at finding out the effect of a combination of Microwave Diathermy and Mulligan Bent Leg Raise Technique on increasing the functional ability of Myogenic Low Back Pain. This research was carried out at the Physiotherapy Polyclinic at RSUD dr. La Palaloi Maros with a sample of 14 people. Results: Based on the Wilcoxon test analysis, p = 0.001 (p < 0.05), which means that microwave diathermy and Mulligan bent leg raise technique interventions can significantly increase functional activity in myogenic low back pain patients. Providing microwave diathermy and mulligan bent leg raise technique can have a significant effect on increasing functional ability in sufferers of myogenic low back pain.

A-230 - Management of muscle spasms induced by sonidegib in a 93-year-old patient with a multimodal gait disorder

A-230 - Management of muscle spasms induced by sonidegib in a 93-year-old patient with a multimodal gait disorder

Unmasking Late Neurological Recovery through Reduced Intrathecal Baclofen

Abstract This case report explores the intricacies of utilising intrathecal baclofen (ITB) therapy for spasticity management and its impact on neurological recovery. Baclofen, a GABAB agonist with antispasmodic properties, has gained prominence in treating spasticity and muscle spasms related to neurological conditions. This report sheds light on a patient who was under ITB treatment and experienced unexpected late-stage improvements in motor function after the dose was inadvertently reduced. The study underscores the need for careful dosing adjustments to unveil potential neurological recovery masked by ITB therapy. The case highlights the importance of multi-physician communication and frequent dosage evaluation in long-term intrathecal therapy. Moreover, it calls attention to the possibility of motor recovery years following a traumatic brain injury, emphasising the role of neuroplasticity in such cases.

Analysis of research hotspots and development trend of acupuncture for facial muscle spasm

Analysis of research hotspots and development trend of acupuncture for facial muscle spasm

Successful management of severe tetanus in a 10-year-old unvaccinated girl: A case report

Tetanus is a potentially fatal disease caused by Clostridium tetani, which produces muscle spasms, autonomic dysfunction, and respiratory failure by the action of a powerful neurotoxin. Tetanus can be prevented by vaccination, proper wound care, and tetanus prophylaxis, but it remains a significant public health concern in regions with inadequate vaccination coverage. We report a case of severe tetanus in an unvaccinated 10-year-old girl following a tetanus prone injury on her right big toe and was treated with antibiotics, tetanus immunoglobulin, tetanus toxoid, sedatives, neuromuscular blockers, and tracheostomy with mechanical ventilation. She recovered after 28 days of supportive multi-disciplinary intensive care and was discharged with no neurological sequelae.

Stiff-person syndrome

Stiff-person syndrome is a rare autoimmune disorder manifested by stiffness in the trunk and proximal limb muscles and painful muscle spasms in them. The disease is associated with the production of glutamate decarboxylase autoantibodies, an enzyme converting glutamate into gamma-aminobutyric acid. An increase of anti-GAD antibody serum levels above 10.000 IU/mL is specific for stiff-person syndrome. Our own clinical observation of a patient diagnosed with stiff-person syndrome is presented.

Effect of Invasive Pelvic Floor Management in Vaginismus among Reproductive Aged Females-A Case Study

Vaginismus is defined as condition which leads to involuntary vaginal muscle spasm leading to painful sexual Intercourse. It is also classified as sexual pain disorder. It is one of the most common conditions prevalent among females who experience pain during vaginal intercourse leading to sexual pain disorder. The main objective of the study was to rule out the effectiveness of intra-vaginal management on patient with Vaginismus. Vaginismus is a sexual pain disorder in which female have difficulties in vaginal penetration during sexual Intercourse due to number of reasons such as fear, involuntary muscle contraction, sexual abuse and pelvic pain etc. As per studies, it had been showed that vaginismus is also one of the main reasons behind Infertility among many females. Most of the females in North India are not aware regarding the pelvic floor examination or to consult the pelvic floor practitioner for their problems related to Infertility. In many cases, as per studies we had founded that most of the females are being focused to go for number of testing procedures but they are not being guided to undergo pelvic floor examination.

A Case Report of Feline Hyperesthesia

The hyperesthesia syndrome is an idiopathic disease that affects feline animals that present different clinical signs. Cats may experience rippling of the skin in the lower back, spontaneously or induced by a low touch, unsuccessful attempts at compulsive body licking and tail chase. Many of these signs are accompanied by excessive and unusual vocalization, episodes of uncontrolled jumping and running and hallucinations. In the most serious cases, mutilation of the tail is described. Its diagnosis is based on the exclusion of dermatological, behavioral, orthopedic, and neurological disorders. This case report describes feline specie, with 6-year-old, male, who was initially served with a dry, unproductive cough. During clinical examination, the presence of rippling movements of the skin in the dorsolumbar region was verified, involuntary muscle spasms, decreased flexion in the lower back and compulsive attempt to lick. Blood count, serum biochemistry, urinalysis and chest x-ray were requested, and serology for Toxoplasma gondii, feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Based on clinical behavioral manifestations and the absence of relevant laboratory or imaging changes, the cat was diagnosed as having feline hyperesthesia syndrome.

Design and Development of Cyclobenzaprine HCl Sustained Release Pellets by Wurster Coating Method

Background Cyclobenzaprine is structurally related to the tricyclic antidepressants. Cyclobenzaprine may be slightly different than the other musculoskeletal agents because it is believed to decrease skeletal muscle spasm through atropine-like effects directly on the cerebral motor neurons. Cyclobenzaprine may also have analgesic properties that may add to its therapeutic effects. This research encompasses all oral dosage forms and strengths.Objective Even though Cyclobenzaprine HCl tablets are available in market we can formulate pellets because pellets demonstrate good flow properties in the intestine and require less cost for the production of formulation. The main aim of the present study was to produce the extended-release Cyclobenzaprine HCl capsules of 16 hours release to reduce the dosing frequency as a skeletal muscle relaxant when compared with the innovator drug Amrix. Cyclobenzaprine HCL is a muscle relaxant that works on the central nervous system by altering the signals from the brain causing muscle to tighten.Methodology Cyclobenzaprine hydrochloride sustained release SR pellets were prepared by Wurster coating method using different excipients and polymers to release the drug slowly for an extended period of time. The method of preparation of Cyclobenzaprine hydrochloride SR pellets involves two steps drug coating and polymer coating. In the drug coating process the drug was coated in a suspension form on the dummy pellets dried and sieved. Drug coated pellets were coated with SR polymer to form SR pellets. These SR pellets were dried sieved and sent for quality control.Results After 12th hour the percentage drug release from the formulations were 89.6 87.4 85.8 85.6 83.9 75.1 for the formulation containing EC N14 2.5 5 7.5 and EC N50 10 12.5 and 15 respectively. The dissolution profile was shown and the mean dissolution time of pellets was noted to be 6.19 hrs. Formulation F5 was identified to be the most superior formulation.Conclusion Accordingly it can be concluded that the F5 12.5 ww EC N50 is a robust one and the performance is less likely to be affected by the various factors studied. The formulations were subjected to stability studies according to the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use ICH guidelines for three months which demonstrated all the tested formulations to be stable.

A REVIEW ON SHAMI (PROSOPIS CINERARIA L.) AN ETHNOMEDICINAL PLANT IN A DESERT AREA OF RAJASTHAN, INDIA

Prosopis cineraria is a member of the Leguminosae family, often referred to as Khejri, Khijdo, Shami, and Jandi. The tree is known as Kalptaru because all of its components are beneficial. It is also known as the "wonder tree," making it the "lord of the desert." Locally known as "Sangari," the pods are fresh green vegetables that Rajasthani people enjoy together with its dry fruits. In times of scarcity, make pickles with Karir (Capparis decidua) and use them with bajara chapati as a meal. It is also a good source of vitamins for people who live in desert areas. The herb has also been employed as a folk treatment for various illnesses in indigenous folk medicine systems, including leprosy, dysentery, bronchitis, asthma, leukoderma, piles, muscle spasms, and wandering thoughts. Plant components such as leaves, pods, flowers, stems, and seeds have unique metabolites. Significant phytochemical substances found in plants have previously been identified as including fatty acids, carbohydrates, protein, saponins, tannins, alkaloids, and glucoside. Analgesic activity, antitumor activity, anticonvulsant activity, antihyperlipidemic activity, antipyretic activity, and antimicrobial activity are some of the pharmacological properties of plants.

ASSESSMENT OF KNOWLEDGE AND SELF-MEDICATION PRACTICE OF DYSMENORRHEA AMONG PHARMACY UNDERGRADUATE STUDENTS: A CROSS-SECTIONAL STUDY

Dysmenorrhea is pain during menstruation that is experienced during adolescence caused by uterine muscle spasms. Data on knowledge of dysmenorrhea and self-medication practice among undergraduate student at Universitas Pembangunan Nasional Veteran Jakarta (UPN Veteran Jakarta) are scarce. This study aimed to assess and determine the relationship between the level of knowledge and primary dysmenorrhea self-medication practice. A cross-sectional study was carried out among female undergraduate Pharmacy Student of UPN Veteran Jakarta. A total of 107 unmarried and nulliparous female students were included in this study using the stratified random sampling technique. Based on the results of the study, 47 students (43.9%) had adequate knowledge, 46 students (43.0%) had moderate knowledge, and 14 students (13.1%) had inadequate knowledge. Forty female students (37.4%) had good practice, 40 female students (37.4%) had moderate practice, and 27 female students (25.2%) had poor practice regarding dysmenorrhea, and in this study, the value of confidentiality (p< 0.05). It is considered significant, with the intention that there is a relationship between the level of knowledge and primary dysmenorrhea self-medication.

THE EFFECT OF GIVING ACID TURMERIC ON REDUCING MENSTRUAL PAIN (DYSMENORRHEA) IN ADOLESCENT WOMEN

Dysmenorrhea is menstrual pain felt by women during menstruation. The pain felt is usually accompanied by dizziness, nausea, and vomiting before menstruation. Pain during menstruation is caused by uterine muscle spasms. The aim is to determine the effect of tamarind turmeric on changes in the pain scale in young women in Tambe Village, Bolo District, Bima Regency. The research design used in this research is the One Group Pre-Test-Post Test Design. The research subjects were teenagers in the working area of Bima Health Center. Who met the inclusion criteria? The sample was determined using purposive sampling. Data was obtained from the questionnaire sheet univariately and bivariately. Bivariate analysis in the form of frequency distribution is presented in table form using the Wilcoxon test. The effect of giving tamarind turmeric on reducing dysmenorrhoea pain in young women in Tambe Village, Bolo District, Bima Regency in 2023, obtained a value of ρ = 0.000.Keywords: Adolescents, Dysmenorrhea, Tamarind Turmeric

Localisation of the centre of the highest region of muscle spindle abundance of anterior forearm muscles.

The centre of the highest region of muscle spindle abundance (CHRMSA) in the intramuscular nerve-dense region has been suggested as the optimal target location for injecting botulinum toxin A to block muscle spasms. The anterior forearm muscles have a high incidence of spasticity. However, the CHRMSA in the intramuscular nerve-dense region of the forearm anterior muscle group has not been defined. This study aimed to accurately define the body surface position and the depth of CHRMSA in an intramuscular nerve-dense region of the anterior forearm muscles. Twenty-four adult cadavers (57.7 ± 11.5 years) were included in this study. The curved line close to the skin connecting the medial and lateral epicondyles of the humerus was designated as the horizontal reference line (H line), and the line connecting the medial epicondyle of the humerus and the ulnar styloid was defined as the longitudinal reference line (L line). Modified Sihler's staining, haematoxylin-eosin staining and computed tomography scanning were employed to determine the projection points (P and P') of the CHRMSAs on the anterior and posterior surfaces of the forearm. The positions (PH and PL) of point P projected onto the H and L lines, and the depth of each CHRMSA, were determined using the Syngo system. The PH of the CHRMSA of the ulnar head of pronator teres, humeral head of pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, ulnar part of flexor digitorum superficialis, radial part of flexor digitorum superficialis, flexor pollicis longus, ulnar part of flexor digitorum profundus, radial portion of flexor digitorum profundus and pronator quadratus muscles were located at 42.48%, 45.52%, 41.20%, 19.70%, 7.77%, 25.65%, 47.42%, 53.47%, 12.28%, 38.41% and 51.68% of the H line, respectively; the PL were located at 18.38%, 12.54%, 28.83%, 13.43%, 17.65%, 32.76%, 57.32%, 64.12%, 20.05%, 45.94% and 88.71% of the L line, respectively; the puncture depths were located at 21.92%, 27.25%, 23.76%, 18.04%, 15.49%, 31.36%, 26.59%, 41.28%, 38.72%, 45.14% and 53.58% of the PP' line, respectively. The percentage values are the means of individual values. We recommend that the body surface puncture position and depth of the CHRMSA are the preferred locations for the intramuscular injection of botulinum toxin A to block anterior forearm muscle spasms.

Occupational Health Hazards among Petrol Station Workers in Ibadan, Oyo State, Nigeria

When a consumer comes to the gas station to buy fuel, the attendants are their initial point of contact. Petrol station employees deal with a variety of risks and health issues on the job. This study was carried out to ascertain the health risks, occupational safety practices, and health issues among gas station workers in Ibadan, Oyo State. Africa.
 This intervention study was conducted with all willing attendants that operate at Ibadan's filling stations. A semi-structured interviewer-administered English-language questionnaire was used to gather data. STATA 12.1 software was used for data analysis after structured interviewer-administered questionnaires were used to gather data. Both descriptive and inferential statistics were used in the analysis. A 5% threshold for significance was used.
 The study involved 620 respondents in total for both genders, the mean age of the responders was 29.4 ± 4.6 years. The inhalation of petrol fumes, customer confrontation, and noise exposure were among the hazards that were reported. Dust-related chronic cough; heat stress that frequently leads to heat exhaustion and heat stroke; hearing loss; hypertension from excessive equipment noise; back and general body ache from bending over repeatedly at work; robbery; fire; harsh weather; and exhaust fume incidence. Health problems reported included headache, blurry vision, vomiting, drowsiness, vertigo, heartburn, slurred speech, weakness, staggering, facial flushing, itching, loss of consciousness, heart failure, convulsion, irritability, memory loss, nausea, tremor, involuntary eye movement, cough, muscle spasms, hallucination, altered vision, insomnia, poor appetite and stomach upset factor associated with health problem. The results, which have a p-value of 0.29, demonstrate that there is no meaningful correlation between occupational safety practices and health issues. Occupation-related health hazards, work environment, and health problems are significantly correlated, with p-values of less than 0.01. Additionally, there is no significant correlation (p-value of 0.12), between understanding of safety procedures and health issues.
 In conclusion, the study found that attendants at fiilling stations were subjected to a variety of risks and health issues. Poor hand washing techniques, first aid box availability, PPE awareness and use, and medical assessment procedures were all present. The Independent Petroleum Marketers Association and other relevant parties should endeavor to guarantee that filling station owners assume accountability for the well-being and security of their employees.

SENAM HAMIL DALAM MENURUNKAN KELUHAN KRAM KAKI PADA IBU HAMIL TRIMESTER III

Cramps in pregnant women can occur due to a lack of blood circulation to the lower part of the body, which is usually obstructed due to increased body weight and pressure in the uterus. One solution to avoid leg cramps is to do pregnancy exercises. Pregnancy exercises can optimize physical balance, attitude and movement during pregnancy, reduce physical complaints such as back pain and muscle spasms. The purpose of this research is to provide midwifery care to pregnant women by doing pregnant exercises in reducing leg cramps in third trimester pregnant women. This research was conducted using case study methodology, field observation, and descriptive qualitative methods. This study used one respondent. The results obtained were reduced leg cramps after routine pregnancy exercises. The conclusion that can be obtained is that pregnant gymnastics can reduce the intensity of leg cramps in third trimester pregnant women.

Degenerative disorders of temporomandibular joint- Current practices and treatment modalities

Degenerative Joint Disorders (DJD) of the Temporomandibular Joint (TMJ) represent a challenging and multifaceted group of conditions that severely impact the joint's function and quality of life. This comprehensive review delves into the etiology, pathogenesis, clinical manifestations, and contemporary management strategies of TMJ-OA. While systemic illnesses, aging processes, hormonal factors, and behavioral factors have been implicated in its development, recent evidence highlights the pivotal role of mechanical overloading in initiating a series of degenerative changes within the TMJ.Painful joints, a hallmark of TMJ-OA, result from the soft tissues around the affected joint and reflexive muscle spasm, following Hilton's law, which innervates the joint's muscles and overlying skin. This self-preservation reflex protects against further joint damage. Moreover, painful symptoms may arise from subchondral bone destruction.Recognizing the importance of understanding the biomechanical environment within the TMJ, this review underscores its relevance in identifying the mechanisms behind TMJ pain and disability. Furthermore, it discusses the potential application of tissue engineering in TMJ reconstruction, emphasizing the need to learn from past TMJ implant experiences.In the context of treatment, the review highlights the significance of managing TMJ-OA, focusing on restoring function and reducing pain. Treatment modalities span from non-invasive therapies to surgical options, with the latter reserved for cases unresponsive to conservative approaches and severely affecting an individual's quality of life.This review serves as a vital resource for both clinicians and researchers, offering insights into the multifaceted nature of TMJ-OA and the evolving landscape of its diagnosis and management, incorporating biomechanical considerations and potential advances in tissue engineering. Understanding the complexities of TMJ-OA is instrumental in enhancing the care and well-being of individuals affected by this condition.

A woman with Clostridium tetani infection and metastatic breast cancer: A case report

Tetanus could be a genuine and possibly dangerous neurological infection caused by the tetanus poison delivered by the bacterium Clostridium tetani. Infection occurs through contaminated wounds, burns, surgical wounds, and insect bites. Related symptoms include muscle spasms, autonomic instability, and respiratory failure. Complications occur in the form of fractures, sprains, muscle tears, and death. Early diagnosis and prompt treatment are crucial to prevent complications and improve outcomes. Risk factors for tetanus infection include the lack of routine vaccinations, wound contamination with C. tetani-contaminated soil, and improper hygiene practices during childbirth. We presented a case report of a 32-year-old woman with a history of breast cancer, who developed a rapidly growing and foul-smelling mass. Despite early diagnosis and treatment measures, the patient did not respond to treatment and died due to the severity of mixed infections. The case highlights the importance of early diagnosis, prompt treatment, and routine vaccinations to prevent complications and improve outcomes in tetanus infection.

Beyond neuromuscular activity: botulinum toxin type A exerts direct central action on spinal control of movement

Overt muscle activity and impaired spinal locomotor control hampering coordinated movement is a hallmark of spasticity and movement disorders like dystonia. While botulinum toxin A (BoNT-A) standard therapy alleviates mentioned symptoms presumably due to its peripheral neuromuscular actions alone, the aim of present study was to examine for the first time the toxin's trans-synaptic activity within central circuits that govern the skilled movement. The rat hindlimb motor pools were targeted by BoNT-A intrasciatic bilateral injection (2 U per nerve), while its trans-synaptic action on premotor inputs was blocked by intrathecal BoNT-A–neutralising antitoxin (5 i.u.). Effects of BoNT-A on coordinated and high intensity motor tasks (rotarod, beamwalk swimming), and localised muscle weakness (digit abduction, gait ability) were followed until their substantial recovery by day 56 post BoNT-A. Later, (day 62–77) the BoNT-A effects were examined in unilateral calf muscle spasm evoked by tetanus toxin (TeNT, 1.5 ng). In comparison to peripheral effect alone, combined peripheral and central trans-synaptic BoNT-A action induced a more prominent and longer impairment of different motor tasks, as well as the localised muscle weakness. After near-complete recovery of motor functions, the BoNT-A maintained the ability to reduce the experimental calf spasm evoked by tetanus toxin (TeNT 1.5 ng, day 62) without altering the monosynaptic reflex excitability. These results indicate that, in addition to muscle terminals, BoNT-A-mediated control of hyperactive muscle activity in movement disorders and spasticity may involve the spinal premotor inputs and central circuits participating in the skilled locomotor performance.

Bioequivalence Study of Two Tablet Formulations of Clonazepam 2mg: A Randomized, Open-Label, Crossover Study in Healthy Mexican Volunteers Under Fasting Conditions.

The prevalence of neurological disorders is high among the Mexican population. Clonazepam is primarily indicated to treat panic disorders, certain kinds of epilepsy such as status epilepticus, childhood motor seizures (petit mal absence, Lennox-Gastaut syndrome, and infantile spasms), anxiety, and muscle spasm. This study was performed to compare bioequivalence between two oral tablet formulations of clonazepam 2mg in healthy Mexican volunteers under fasting conditions. This phaseI, randomized, open-label, two-treatment, crossover study included 30healthy volunteers. Subjects were randomly assigned to either test or reference formulation of clonazepam 2mg. Each study period was separated by 21-day washout period. Blood samples were collected at pre-dose and up to 72h after drug administration. Clonazepam concentrations were determined using a validated ultra-flow liquid chromatography-tandem mass spectrometric method. Pharmacokinetic parameters were determined using a non-compartmental method. Two formulations were considered bioequivalent if geometric mean ratios (test/reference) were between 80% and 125%. Safety was evaluated by recording adverse events. Pharmacokinetic parameters were comparable between test and reference formulations. The mean maximum plasma concentration (Cmax) was ≈ 13ng/mL, area under the plasma concentration-time curve from time0 to last measurable concentration (AUC0-t) was ≈ 360ngh/mL, time to reach maximum plasma concentration (Tmax) was ≈ 3h, and elimination half-life (t1/2) was ≈ 43h. Geometric mean ratios (90% confidence interval) of Cmax (99.2-115.3%), AUC0-t (100.6-110.6%), and AUC0-∞ (98.5-111.6%) were within the bioequivalence range. Seven non-serious adverse events (mostly asymptomatic hypotension) were recorded. The test and reference formulations of clonazepam 2mg were bioequivalent and well tolerated in healthy Mexican volunteers under fasting conditions. 213301410B0051 (Approved on April 13, 2021).