Non-pharmaceutical Therapy Research Articles

Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.

Exercise is an effective nonpharmaceutical therapy for knee osteoarthritis (KOA). To identify the most effective type of exercise therapy for KOA with regard to pain, stiffness, joint function, and quality of life. Systematic review; Level of evidence, 3. The PubMed, Web of Science, Embase, and Cochrane Library databases were searched, from inception to April 4, 2022. Included were randomized controlled trials that assessed the efficacy on KOA among 5 different exercise therapy groups (aquatic exercise [AE], stationary cycling [CY], resistance training [RT], traditional exercise [TC], and yoga [YG]) and compared with the control group. Outcomes among the groups were assessed with the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 6-minute walk test (6-MWT), visual analog scale (VAS) for pain, and Knee injury and Osteoarthritis Outcome Score (KOOS); weighted mean differences (WMDs) and 95% confidence intervals were calculated. Network meta-analyses comparing outcomes between all groups and with controls were performed, and group rankings were calculated using the surface under the cumulative ranking curve (SUCRA). A total of 39 studies (N = 2646 participants) were included. Most of the studies failed to blind participants and researchers, resulting in a high risk of performance bias. Significantly worse WOMAC-Pain scores were seen in controls compared with all exercise interventions except AE (WMD [95% CI]: CY, -4.45 [-5.69 to -3.20]; RT, -4.28 [-5.48 to -3.07]; TC, -4.20 [-5.37 to -3.04]; and YG, -0.57 [-1.04 to -1.04]), and worse scores were seen in controls compared with YG regarding WOMAC-Stiffness (WMD, -1.40 [95% CI, -2.45 to -0.34]) and WOMAC-Function (WMD, -0.49 [95% CI, -0.95 to -0.02]). According to the SUCRA, CY was the most effective for improving WOMAC-Pain (80.8%) and 6-MWT (76.1%); YG was most effective for improving WOMAC-Stiffness (90.6%), WOMAC-Function (77.4%), KOOS-Activities of Daily Living (72.0%), and KOOS-Quality of Life (79.1%); AE was the most effective regarding VAS pain (77.2%) and KOOS-Pain (64.0%); and RT was the most effective regarding KOOS-Symptoms (84.5%). All 5 types of exercise were able to ameliorate KOA. AE (for pain relief) and YG (for joint stiffness, limited knee function, and quality of life) were the most effective approaches, followed by RT, CY, and TC.

Initial therapeutic approaches for orofacial myofascial pain: three pilot studies

ABSTRACT Objective Myofascial pain diminishes the stomatognathic function and hinders clinical diagnosis. Therefore, initial pain reduction is crucial before definitive treatment. Here, the clinical validity of non-pharmaceutical therapies, including the Aqualizer® splint, physiotherapy, and dry-needle acupuncture was comparatively assessed. Methods Myofascial pain patients (n = 28; 20–65 years old) were examined through a visual analog scale, and intra- and extra-oral muscle palpation. Mandibular maximum opening and neck mobility were also evaluated. Changes in parameters through time were analyzed via the Kruskal-Wallis test, while the Friedman test and dot-plots were used for comparative therapies assessment. General patient improvement was represented via an isometric Principal Component. Results The Aqualizer® and physiotherapy resulted in improvement of all parameters except for mouth opening. Acupuncture improved extra-oral muscle pain and neck mobility. Conclusion The Aqualizer®, physiotherapy, and oral acupuncture are effective initial pain therapies. Among all, physiotherapy provided the greatest benefits, followed by the Aqualizer®.

A Randomized Placebo-Controlled Study of a Transcranial Photobiomodulation Helmet in Parkinson's Disease: Post-Hoc Analysis of Motor Outcomes.

Emerging evidence is increasingly supporting the use of transcranial photobiomodulation (tPBM) to improve symptoms of neurodegenerative diseases, including Parkinson's disease (PD). The objective of this study was to analyse the safety and efficacy of tPBM for PD motor symptoms. The study was a triple blind, randomized placebo-controlled trial with 40 idiopathic PD patients receiving either active tPBM (635 nm plus 810 nm LEDs) or sham tPBM for 24 min per day (56.88J), six days per week, for 12 weeks. The primary outcome measures were treatment safety and a 37-item MDS-UPDRS-III (motor domain) assessed at baseline and 12 weeks. Individual MDS-UPDRS-III items were clustered into sub-score domains (facial, upper-limb, lower-limb, gait, and tremor). The treatment produced no safety concerns or adverse events, apart from occasional temporary and minor dizziness. There was no significant difference in total MDS-UPDRS-III scores between groups, presumably due to the placebo effect. Additional analyses demonstrated that facial and lower-limb sub-scores significantly improved with active treatment, while gait and lower-limb sub-scores significantly improved with sham treatment. Approximately 70% of participants responded to active treatment (≥5 decrease in MDS-UPDRS-III score) and improved in all sub-scores, while sham responders improved in lower-limb sub-scores only. tPBM appears to be a safe treatment and improved several PD motor symptoms in patients that responded to treatment. tPBM is proving to be increasingly attractive as a possible non-pharmaceutical adjunct therapy.

Brain-computer interface applications to decrease phantom limb pain

Phantom limb pain is mainly experienced in people who have suffered limb amputation, its study and analysis are relevant to know the causes and help patients to reduce pain. On the other hand, brain-computer interfaces encode brain signals and decode them for communication with a device. Through the motor imagination of the movement of the amputated limb and with the help of a brain-computer interface, an amputee patient can reduce or eliminate pain. The objective of this paper is to give an introduction to brain-computer interfaces as a tool for the reduction of phantom limb pain. Therefore, the applications of interfaces in relation to pain are highlighted, some related studies are discussed, and their benefits and disadvantages are analyzed. Finally, it is established that phantom limb pain research benefits from incorporating brain-computer interfaces as part of non-pharmaceutical therapy because it is a tool that provides feedback on the reconfiguration of the cerebral cortex in relation to pain.

Non-pharmaceutical Treatment for Alzheimer’s Disease

Alzheimer's disease (AD) has grown to be a serious issue for human health. It has overtaken cancer as the world's fifth leading cause of death. People have invested a lot of time, effort, and money in the process of Alzheimer's disease treatment, but there hasn't been much progress in pharmaceutical treatment for AD over the years. People can start with non-pharmaceutical therapies in addition to drugs. This paper discusses several effective non-pharmaceutical therapies for Alzheimer's disease. Sixteen articles were analyzed and used to analyze different treatments for Alzheimer's disease. The research examines nine non-pharmaceutical treatments, which included the removal of Aβ burden, stimulation of the hippocampus or entorhinal cortex, cognitive therapy, exercise, mental stimulation, reminiscence therapy, diet therapy, caregivers, and life care. A large amount of data is analyzed, and the results, benefits, and disadvantages of these treatments are compared. This research proves that non-pharmaceutical therapies are feasible ways to treat Alzheimer's disease and play a very important role in the treatment process.

Acupuncture for hypertension with insomnia: Study protocol for a randomized, sham-controlled, subject-and-assessor-blinded trial.

Previous studies show that insomnia and hypertension are closely related. Currently, intervention for hypertension with insomnia has become a research hotspot. Acupuncture, as a representative non-pharmaceutical therapy of traditional Chinese medicine (TCM), has been widely used in improving insomnia and hypertension. However, there are few clinical studies on acupuncture for hypertension with insomnia. A single-center, subject-and-assessor-blind, randomized, sham-controlled trial has been designed for a study to be conducted in Jiangsu Province Hospital of Chinese Medicine. Sixty eligible patients will be randomly assigned to the treatment group and the control group in a 1:1 ratio. The treatment group will receive acupuncture treatment, while the control group will receive sham acupuncture treatment. Both groups will be treated three times per week for 4 weeks. Data will be collected at baseline and after 4 weeks of treatment and analyzed by using SPSS 25.0. The primary outcome measures are sleep parameters of portable polysomnography before and after treatment. Secondary outcomes are Pittsburgh Sleep Quality Index, Insomnia Severity Index, home blood pressure, and heart rate variability. This study aims to evaluate the efficacy of acupuncture using the portable polysomnography combined with sleep scales, and analyze heart rate variability to preliminarily explore the underlying mechanism of acupuncture on hypertension with insomnia. The trail, if proven to be effective, will provide strong scientific evidence to support acupuncture is effective to manage patients for hypertension with insomnia. ChiCTR2200059161.

NF-κB-mediated anti-inflammatory effects of an organic light-emitting diode (OLED) device in lipopolysaccharide (LPS)-induced in vitro and in vivo inflammation models.

Inflammation is the body's physiological response to harmful agents. However, if not regulated properly, inflammation can become pathological. Macrophages are key players in the inflammatory process, and modulate the immune response. Due to the side effects of anti-inflammatory drugs, non-pharmaceutical therapies for inflammatory diseases must be developed. Photobiomodulation is a non-invasive therapeutic approach to treating certain pathological conditions using light energy. Light-emitting diodes (LEDs) are commonly used as light sources for photobiomodulation treatment, but their clinical applications are limited. Organic LEDs (OLEDs) are thin, lightweight and flexible, enabling consistent and even delivery of light energy to target areas; this makes OLED promising components for therapeutic devices. In the present study, we examined the effects of OLED treatment on inflammation in vitro using a lipopolysaccharide (LPS)-induced macrophage RAW264.7 cell model, and in vivo using a pinna skin mouse model. We found that LPS-induced morphological changes and inflammatory cytokine expression were significantly reduced in RAW264.7 cells subjected to OLED treatment compared to the LPS-induced controls. This work provides evidence for the anti-inflammatory effects of OLEDs, demonstrating their potential to be incorporated into medical devices in the future.

Identifying opportunities for hepatic encephalopathy self-management: A mixed methods systematic review and synthesis.

Hepatic encephalopathy (HE) in cirrhosis is an extremely challenging complication for patients and care partners. To identify potentially modifiable factors to enhance HE self-management strategies, we conducted a synthesis of quantitative and qualitative research about real-world HE behaviours, knowledge, and experiences. Using the EPPI-Centre's mixed methods synthesis procedure, a systematic literature search in five databases was completed; methods of selected articles underwent critical appraisal followed by descriptive analysis and coded line-by-line of content. Through refutational translation, the findings from the quantitative and qualitative syntheses were juxtaposed to highlight congruencies, incongruencies, or gaps. These findings informed generation of cross-analytical themes that were transformed into action statements. The quantitative narrative review of synthesis (n = 17) generated four themes (patients had low awareness of HE and low treatment adherence rates, physicians had a non-uniform approach to non-pharmaceutical therapies). Meta-aggregation of qualitative data from six articles yielded three themes (patients and care partners had low levels of HE awareness, were unfamiliar with HE self-management, and were adherent to treatments). Comparison of findings revealed three congruencies, two gaps, and one incongruency. The combined synthesis yielded two self-management themes: universal patient-oriented cirrhosis HE education and ensuring each health care encounter systematically addresses HE to guarantee health care is continuously modified to meet their needs. By drawing on elements of Bloom's Taxonomy and distributed knowledge networks, deliberate patient-oriented HE messaging at all health care encounters is greatly needed to improve health outcomes and reduce care burdens related to HE.

Understanding Dystonia: A Summary of the Basics

Abstract Dystonia is a neurological movement disorder characterised by abnormal and involuntary twisting movements and postures. It comes in many forms and can affect various parts of the body. Dystonia is seen in children and adults as a standalone condition, or as one part of a complex disease. Dystonia can be caused by genetic mutations, specific medications, environmental and chemical factors, or, as in the majority of cases, the cause is unknown. There is currently no cure or disease modifying agent for dystonia, so treatments are aimed at managing symptoms and maintaining quality of life. The treatment options for dystonia include invasive surgeries, medications, botulinum toxin and non-pharmaceutical therapies. Dystonia is often a misunderstood and misdiagnosed disorder, which makes diagnosis difficult. The diagnosis of dystonia is usually made by a Neurologist who specialises in Movement Disorders. Research is ongoing to better understand the disorder and aims to find more effective and efficient treatments, and ultimately a cure for dystonia.

Non-pharmaceutical interventions and their relevance in the COVID-19 vaccine rollout in Saudi Arabia and Arab Gulf countries.

In the early stages of the pandemic, Saudi Arabia and other countries in the Arab Gulf region relied on non-pharmaceutical therapies to limit the effect of the pandemic, much like other nations across the world. In comparison to other nations in the area or globally, these interventions were successful at lowering the healthcare burden. This was accomplished via the deterioration of the economy, education, and a variety of other societal activities. By the end of 2020, the promise of effective vaccinations against SARS-CoV-2 have been realized, and vaccination programs have begun in developed countries, followed by the rest of the world. Despite this, there is still a long way to go in the fight against the disease. In order to explore disease transmission, vaccine rollout and prioritisation, as well as behavioural dynamics, we relied on an age-structured compartmental model. We examine how individual and social behaviour changes in response to the initiation of vaccination campaigns and the relaxation of non-pharmacological treatments. Overall, vaccination remains the most effective method of containing the disease and resuming normal life. Additionally, we evaluate several vaccination prioritisation schemes based on age group, behavioural responses, vaccine effectiveness, and vaccination rollout speed. We applied our model to four Arab Gulf nations (Saudi Arabia, Bahrain, the United Arab Emirates, and Oman), which were chosen for their low mortality rate compared to other countries in the region or worldwide, as well as their demographic and economic settings. We fitted the model using actual pandemic data in these countries. Our results suggest that vaccinations focused on the elderly and rapid vaccine distribution are critical for reducing disease resurgence. Our result also reinforces the cautious note that early relaxation of safety measures may compromise the vaccine's short-term advantages.

Big data analytics on the impact of OMICRON and its influence on unvaccinated community through advanced machine learning concepts

New SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus Type-2) variant termed to be “B.1.1.529” subtype mutation, which is a primary concern, might heavily influence further transmission, virulence and even affect the functioning of test methods and efficacy medications (vaccines). It is still not clear on the timeline for the Omicron (B.1.1.529) subtype to develop protective immunity or even when normal activities will rebound in our everyday lives. Computational analysis on the available big dataset of the Omicron variants’ and their effects on the unvaccinated population indicate that the concerned variant seemed to have a stronger propensity for the vulnerable group (unvaccinated community). In consequence of the terrible COVID-19 epidemic, scientific research on vaccine development and their future enhancement throughout the world have been stepped up significantly. We assessed approved vaccines’ effect on morbidity, hospital stays, and fatalities worldwide. Through available big datasets, an Ensemble learning strategy was used to estimate the likelihood of an unvaccinated person contracting a virus. Overall incidence rates dropped from 18.56 per cent to 2.8 per cent for the vaccinated community during the observation period. People ≥ 60 years had the most remarkable percentage drop (~ 15 per cent). In addition, about 70.4 per cent, immunization through vaccines lowered the number of hospitalizations (both ICU and non-ICUs) and fatalities. Through our research observations, the facts clear that immunization through vaccination has a significant influence on decreasing COVID-19 rapid transmission, even if it provides only a modest level of protection. However, to accomplish this effect, non-pharmaceutical therapies must be maintained indefinitely.

Electro-Acupuncture Regulates Metabolic Disorders of the Liver and Kidney in Premature Ovarian Failure Mice

As per the theory of traditional Chinese medicine (TCM), the liver and kidney dysfunction are important pathogenies for premature ovarian failure (POF). POF is a common gynecological disease that reduced the pregnancy rate. Electro-acupuncture (EA) is a useful non-pharmaceutical therapy that supposedly regulates the function of the liver and kidney in the treatment of POF with TCM. However, the underlying mechanism of EA in the treatment of POF has not been adequately studied through metabonomics with reference to the theory of TCM. Accordingly, we investigated the effect of EA on the liver and kidney metabolites in POF mice through metabolomics. POF mice were established via intraperitoneal injection of cisplatin. Both Sanyinjiao (SP6) and Guanyuan (CV4) were stimulated by EA for 3 weeks. The biological samples (including the serum and the ovary, liver, and kidney tissues) were evaluated by histopathology, molecular biology, and hydrogen-1 nuclear magnetic resonance (1HNMR)–based metabolomics to assess the efficacy of EA. 1HNMR data were analyzed by the orthogonal partial least squares discriminant analysis (OPLS-DA). The results revealed that EA was beneficial to ovarian function and the menstrual cycle of POF. Both the energy metabolism and neurotransmitter metabolism in the liver and kidney were regulated by EA. Notably, EA played an important role in regulating energy-related metabolism in the kidney, and the better effect of neurotransmitter-related metabolism in the liver was regulated by EA. These findings indicated that the ovarian functions could be improved and the metabolic disorder of the liver and kidney caused by POF could be regulated by EA. Our study results thus suggested that the EA therapy, based on the results for the liver and kidney, were related to POF in TCM, as preliminarily confirmed through metabolomics.

One-Year Course of Geriatric Rehabilitation Candidates with and Without Outpatient Geriatric Rehabilitation Care (AGRV)

The multicentre, prospective, controlled cohort study examines whether geriatric patients with or without participation in outpatient geriatric rehabilitation (AGRV) in Schleswig-Holstein differ with regard to the characteristics of independence, mobility, pain intensity, quality of life, need for support, changing their place of residence or utilization of hospital treatment or other forms of non-pharmaceutical therapy in the course of one year. Between May 2013 and April 2016 patients for whom geriatricians had recommended AGRV at five locations were interviewed four times within a year by telephone. The data were analyzed regarding the development within the groups as well as under the aspect of the different types of medical care (AGRV performed/not performed). At the beginning and in the second half of the study period, the two groups (122 persons without AGRV, 283 with at least 15 days of AGRV) did not differ significantly in any of the outcome parameters, and the null hypothesis (no difference between the groups in the Barthel Index after one year) was accepted. Patients with AGRV achieved faster progress in terms of their mobility and quality in life. AGRV enables many rehabilitation patients to improve their mobility more quickly. If the speed of achieving the therapeutic goal is of minor importance, outpatient physiotherapy and ergotherapy is sufficient for many patients. The Barthel Index is of limited use for follow-up of AGRV candidates.

Pharmaceutical and therapeutic interventions for anxiety in terminal illness

Background: Anxiety is a sensation where the human body reacts to a range of emotions in an adverse way, leading to symptoms of nervousness, anxiousness and excessive fear. Anxiety disorders arise in patients who are receiving end-of-life care for multiple reasons, including confronting mortality and having to accept a change in lifestyle. Therefore, a vital part of managing the symptoms of patients who are terminally ill is ensuring they receive the most appropriate intervention for these disorders, whether that be pharmaceutical or a non-pharmaceutical therapy. Methods: A rapid literature search was conducted between 20 February 2021 and 3 March 2021 through two main online databases (CINAHL Plus and PsycInfo). A total of 848 entries matched the search criteria and, after screening, seven papers were collated and used within this review. Results: All pharmacological interventions were shown to reduce anxiety-related symptoms in patients receiving end-of-life care. Most non-pharmaceutical therapeutic interventions showed some effects, including significant reductions in symptoms when evaluated against the Hospital Anxiety and Depression Scale or individual disclosure of improvements in quality of life. Conclusions: While none of the studies in this review directly compared pharmacological with non-pharmacological therapeutic interventions, both can improve end-of-life care for terminally ill patients. When treating patients diagnosed with a terminal illness who are receiving palliative care, their prognosis, time frame and personal wishes are key aspects to consider when deciding on the most appropriate management strategy for anxiety disorders.

Cerebral Metabolic Analysis of Patients With Colorectal Cancer and Chronic Enteritis: Inquiry Into Gut-Brain Crosstalk.

Gut-brain crosstalk has been demonstrated previously. However, brain metabolic patterns of colorectal cancer and chronic enteritis remain unclear. A better understanding of gut-brain crosstalk from a radiological perspective is necessary. We conducted a retrospective study in which we acquired 18F-fluorodeoxyglucose positron emission tomography in 45 colorectal cancer cases, 45 age- and sex-matched chronic enteritis patients, and 45 age- and sex-matched healthy controls. We calculated a scaled sub-profile pattern based on principal component analysis and metabolic connectivity to explore the brain metabolic model and analyzed correlations between various brain regions and cancer to identify potential neuroimaging markers for non-pharmaceutical therapies. We found a characteristic cerebral metabolic pattern in colorectal cancer patients, which mainly involved visceral sensation and both affective and cognitive psychological processes. The metabolic patterns of patients with colorectal cancer and chronic enteritis were similar but not identical. The metabolic connectivity of the postcentral gyrus and paracentral lobule was found to be significantly different between the controls and patients with colorectal cancer (p < 0.05, false discovery rate correction). The maximal standard uptake value of the cancer focus in colorectal cancer patients was negatively correlated with the dorsolateral superior frontal gyrus (p < 0.05). Patients with colorectal cancer may show abnormal glucose cerebral metabolism characterized by “point-line-surface.” This preliminary study revealed the cerebral metabolic characteristics and neurobiological mechanisms of colorectal cancer and chronic enteritis (ChiCTR2000041020; registered December 16, 2020).

Nonpharmaceutical therapy for autism spectrum disorder: A protocol for systematic review and network meta-analysis.

Background:Autism spectrum disorder (ASD) is a widespread developmental disorder of the nervous system with an unclear etiology and pathogenesis. Its global incidence is currently increasing, and no effective drugs are available to improve its core symptoms. Nonpharmaceutical therapy can effectively relieve the core symptoms of autism, has fewer side effects than drugs, and is easily accepted by patients. This systematic and network meta-analysis aimed to evaluate the impact of non-pharmaceutical therapy on autism to explore preferable therapeutic options for autism.Methods:Online databases, including the China National Knowledge Infrastructure [CNKI], SinoMed, Wanfang Database [WF], China Science and Technology Journal Database [VIP], MEDLINE, Web of Science, EMBASE, and the Cochrane Library will be searched for randomized controlled trials of nonpharmacological interventions for autism published before October 2021. Two researchers will be independently responsible for the literature screening, data extraction, and quality assessment. Standard paired and Bayesian network meta-analyses will be performed using RevMan 5.3 Software and GEMTC 0.14.3, to compare the efficacy and safety of different nonpharmacological regimens.Results:The results of this systematic and network meta-analysis will be submitted to a peer-reviewed journal for publication.Conclusion:This study provides a comprehensive and reliable evidence-based reference for the efficacy and safety of different non-pharmacological interventions for autism.PROSPERO registration number:CRD 42021275571

Meta Analysis of the Efficacy of Non-pharmaceutical Chinese Medicine Therapy in the Treatment of Obese Polycystic Ovary Syndrome

Objective: To systematically evaluate the effects of acupuncture, auricular point sticking, acupoint catgut embedding, cupping and other non-pharmaceutical Chinese medicine therapies on sex hormone as well as glucose and lipid metabolism in patients with obese polycystic ovary syndrome. Method: The databases such as China National Knowledge Infrastructure were searched by computer to collect the literature on the treatment of obese polycystic by non-pharmaceutical Chinese medicine therapy combined with western medicine or lifestyle change, and the literature quality of the included literature was evaluated, and finally the data were analyzed. A total of 15 randomized controlled trial (RCT) literature were included in this study, with a total of 1263 patients. Results: Non-pharmaceutical Chinese medicine therapy combined with metformin or lifestyle can reduce body mass index, insulin resistance index, fasting plasma insulin, fasting blood glucose, luteinizing hormone, ratio of luteinizing hormone to follicle stimulating hormone, testosterone, but it has no obvious advantage over follicle stimulating hormone (FSH). Conclusion: Compared with simple application of metformin or lifestyle change, traditional Chinese medicine non drug therapy combined with metformin or lifestyle change can better improve sex hormone and blood glucose metabolism in obese PCOS patients.

Contextualising evidence based medicine in determining the key root for translational effectiveness for chronic disease self-management and heart failure.

Congestive heart failure (CHF) management has proven devastating on morbidity, mortality, quality of life and also costly to health systems. Therapeutics for CHF have advanced and benefited greatly due to large multicentre randomised controlled trials and the evidence obtained from them. Management for chronic diseases and nonpharmaceutical therapies such as chronic disease self-management has lagged, and for CHF the evidence base has even been questioned. Perspective and non systematic mini review. Advancing translational research standards is important to achieve optimal cost effectiveness. Importantly is understanding evidence generation in medicine, identifying the primary roots for management and its translation.

INTENSE PULSED LIGHT (IPL) TREATMENT FOR DUPILUMAB INDUCED OCULAR SURFACE DISEASE (DIOSD)

PurposeTo report a case of dupilumab induced ocular surface disease (DIOSD) managed with intense pulsed light (IPL) as an effective adjunct therapy to topical steroids and topical immunomodulator lifitegrast.MethodsDiscussion of a patient’s case with accompanying anterior segment and meibography photos with diagnosed DIOSD for which adjunct therapy with IPL was an effective treatment after limited relief from and difficulty with adherence to traditional treatment with topical steroids and lifitegrast ophthalmic solutions. ConclusionThis case demonstrates the complexity of management required to treat patients with DIOSD and its chronic nature. IPL as a nonpharmaceutical adjunct therapy to topical steroids and immunomodulators in the treatment of DIOSD showed improved signs and symptoms of DIOSD.

Evaluating the Impact of a Multisensory Environment on Target Behaviors of Children With Autism Spectrum Disorder.

Worldwide, children are increasingly being diagnosed with autism spectrum disorder (ASD). The case of South Korea is not exceptional. One of the core symptoms of children with ASD is sensory reactivity issues, such as an unusual interest in the sensory aspects of the environment. One promising development in sensory enrichment for individuals with ASD is a multisensory environment (MSE). This study investigated the influence of MSE on the target behaviors of children with ASD with different sensory characteristics in the case of South Korea. A multiple treatment design {A-B-C-D (B + C) phases} was implemented to observe the six target behaviors of three children with ASD. The sensory environmental intervention focusing on visual and auditory stimuli was manipulated as a stimulating MSE or a relaxing MSE depending on the sensory profile of each participant. The analysis was undertaken using visual inspection with data patterns and graph slopes, which is a customary method of analyzing the single-subject design data. In addition, the means and standard deviations of the two target behaviors of each participant were analyzed together. The findings reveal that MSE interventions positively affected the target behaviors of children with ASD with diverse sensory characteristics. The stimulating MSE created by the integration of visual and auditory stimuli was the most effective intervention for the participants with hypo-visual and hypo-auditory sensitivities in this study. The MSE could be meaningful as a nonpharmaceutical therapy that could influence the daily behaviors of children with ASD.