Non-pharmacological Treatment Methods Research Articles

The effect on perioperative anxiety and emergence delirium of the child or parent's preference for parental accompaniment during anesthesia induction in children undergoing adenotonsillectomy surgery.

Pediatric emergence delirium (ED) occurs in the early postoperative period and is defined as a complex psychiatric disorder. Non-pharmacological methods of treatment, such as perioperative parental presence, have been the focus of many studies, but the impact on preventing ED of which parent accompanies the child during anesthesia induction has not been identified as yet. Therefore, the aim of this study was to determine whether the selection made by children undergoing adenotonsillectomy of which parent will accompany them during anesthesia induction has the effect of reducing postoperative delirium scores and incidence compared to selections made by the parents. The study included 80 children of both genders, aged 5-12 years, who underwent day-case surgery in the otorhinolaryngology clinic. The patients were separated randomly into two groups of 40. In Group 1, the children were asked to choose which of their parents would accompany them during general anesthesia induction, and in Group 2, the parents were asked to decide who would be the accompanying parent. Evaluation of postoperative delirium was made using the Pediatric Anesthesia Emergence Delirium (PAED) scale. The anxiety level of the children was evaluated with the modified Yale Preoperative Anxiety Scale (mYPAS) both in the preoperative waiting area and during the anesthesia induction. The State-Trait Anxiety Inventory (STAI) was used to evaluate the anxiety level of the parents. The mean PAED scores were similar in both groups (mean difference [95% CI]: -0.1 [-2.8 to 0.7]). The incidence of emergence delirium was also similar in both groups (risk ratio 0.9 [0.4 to 1.8]). The mean mYPAS scores during the induction of anesthesia of Group 1 was lower than that of Group 2 (mean difference [95% CI]: -8.4 [-15.2 to -1.6]). The mean mYPAS scores evaluated in the preoperative waiting area were found to be similar in the two groups (mean difference [95% CI]: -1.9 [-7.5 to 3.5]). The mean STAI anxiety scores of the parents were similar in both groups, with higher scores obtained by mothers compared to fathers, at all measurement times. The incidence or severity of ED did not decrease significantly even though lower anxiety scores were obtained during anesthesia induction in children who were allowed to make the decision of accompanying parent. Based on these findings, it can be concluded that postoperative delirium is a more complicated process that can be affected by many other variables rather than just the parent-child general interaction.

Appliance therapy for temporo-mandibular disorder- A case report

Disorder of the or facial complex that affects a vast majority of the people now-a days, almost about 1/3rd of the population is “Temper mandibular Disorders” also commonly referred to as TMDs. These are essential disorders of masticatory structures whose onset is associated with the motion and movement of the mandible in relation to the temper mandibular complex and has wide similarities with musculoskeletal disorders of other parts of the human body. Clinical presentation a young college going student presented with pain in the right temper mandibular joint region following trauma.(?) Treatment anterior positioning appliance was used for the treatment. Conclusion after proper case selection and treatment planning following relevant physical examination and other diagnostic procedures Anterior Positioning Appliance can be used as a non-pharmacological method of pain management and treatment of the described condition.

EFEKTIFITAS TEKNIK PERNAPASAN BUTEYKO UNTUK MENINGKATKAN PENGONTROLAN ASMA BRONKIAL DI PUSKESMAS KOTA PADANG

ABSTRACT
 Bronchial asthma is one of the chronic respiratory diseases caused by the narrowing of the airways due to hypersensitivity reactions in the bronchi, resulting in symptoms such as wheezing, coughing, and shortness of breath. When asthma patients experience breathlessness, there is an increase in respiratory frequency and a decrease in oxygen saturation. If not promptly treated, it can lead to oxygen deficiency (hypoxia), which can ultimately result in death. The management of bronchial asthma is typically done with pharmacological therapy aimed at achieving a normal lifestyle, avoiding attacks, and restoring optimal lung function. However, it has not shown significant improvement in preventing bronchial asthma. Non-pharmacological treatment methods, such as Buteyko breathing technique, are expected to complement pharmacological treatment in reducing the frequency of asthma attacks (exacerbations). The Buteyko breathing technique has shown an increase in peak expiratory flow rate (PEFR) values and a decrease in bronchial asthma score values. The objective of this study is to analyze the effectiveness of the Buteyko breathing technique in controlling bronchial asthma in the Padang Health Center area. Before the intervention, the average bronchial asthma control was 15.44, with a standard deviation of 2.279, and a minimum control of 11 and a maximum of 19. After the intervention, the average control increased to 21.69, with a standard deviation of 2.387, and a minimum control of 16 and a maximum of 25. Similarly, bronchial asthma control in the control group showed an increase from 16.19 to 15.38 after the intervention. Statistical tests using independent t-tests showed a significant influence of the Buteyko breathing technique on bronchial asthma control, with a p-value of 0.000 (p?0.05). This indicates that the Buteyko breathing technique has a significant impact on improving bronchial asthma control. Therefore, this research provides evidence that the Buteyko breathing technique can be a valuable addition to the treatment of bronchial asthma, helping patients achieve better control of their condition and reducing the risk of asthma attacks.
 Keywords: Buteyko breathing technique; Breathing patterns.

Novel Techniques of Radiotherapy in the Management of Oncologic Pain

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Oncologic pain (OP), in general, increases with disease progression. Moderate or severe intensity OP occurs in around 30% of cancer patients receiving treatment and in 60% to 90% of patients with advanced cancer. Radiotherapy (RT) is an effective non-pharmacological method of treatment of OP. Two new techniques of RT are available for pain control: ablative RT for oligometastatic disease and lattice RT, for voluminous tumors. We will review their efficacy and results, concluding that OP is a complex biologic phenomenon and its successful treatment requires careful assessment of its nature, understanding the different types and patterns. Specific pain management with new radiation techniques can be effective and provide good pain control, allowing the reduction of analgesics use, improving the quality of life.

A Comprehensive Review of Gastroesophageal Reflux Disease (GERD) Treatment and its Clinical Perspectives

Gastroesophageal reflux disease (GERD) occurs by regurgitation of food in the stomach. Aggressive factors increase GERD whereas defensive factors decrease GERD progression. GERD if mild can be put under control by lifestyle modification and giving non-pharmacological treatment methods to patients however if the disease progresses non-pharmacological methods are ineffective. Drugs reduce GERD progression and also maintain the pH of the stomach to a normal level and prevent abnormal acid exposure to the oesophagus. Antacids and alginate protect oesophagus by reducing acidity and increasing viscosity. Proton pump inhibitors and histamine 2 receptor antagonists reduce acid secretion by inhibiting its secretion. Prokinetic agents increase the motility of the stomach and reduce obesity. Metabotropic glutamate receptors, gamma-aminobutyric acid receptor agonists, and cannabinoid receptors are receptor-specific drugs that act on receptors underlying the gastrointestinal tract and alter the function of receptors which increases reflux disease. Combination of antacid and alginate, domperidone and omeprazole, omeprazole and baclofen, aluminum hydroxide, magnesium, and simethicone are frequently given in GERD to expedite the healing rate and reduce acid secretion. Combinations of suitable medications reduce the adverse effects of a single medication and also make it therapeutically more effective than using monotherapy drugs. The pharmacological method is safe and effective and treats GERD completely.

Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

BackgroundIn the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process. AimTo evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h. DesignCross-sectional study. MethodsThe study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the “Patient Information Form” and the “Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)”. ResultsThe medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain. ConclusionsMost of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.

Determination of the Frequency of Migraine Attacks in Pregnant Women and the Ways They Cope with Headaches: A Cross-Sectional Study.

One out of every five women of reproductive age suffers from migraine. Although headaches subside in most women during pregnancy, attacks continue and even worsen in some women. Pregnant women try to relieve pain with medication or non-pharmacological treatment methods. This descriptive and cross-sectional study was conducted to determine the incidence of migraine attacks in pregnant women diagnosed with migraine and the ways they cope with headaches. The study included 191 pregnant women who were diagnosed with migraine in the pre-pregnancy period. McNemar analysis was performed to test the relationship between descriptive statistical methods and categorical variables when the data were analyzed. The mean gestational age of the participants was 28.31 ± 8.64 weeks, and their mean age at the onset of migraine was 20.74 ± 5.63 years. The comparison of the duration, frequency, and severity of headaches suffered before and during pregnancy demonstrated that there were statistical differences between them (p < 0.05). The frequency of using methods such as taking painkillers, resting in a dark room, and having cold application and massage to relieve headaches before pregnancy decreased statistically significantly during pregnancy (p < 0.05). As a result, the frequency and severity of migraines decrease during pregnancy. The tendency to resort to pharmacological or non-pharmacological methods used to relieve headaches decreases during pregnancy. Although migraine has many adverse effects on pregnancy, pregnant women do not demand satisfactory information from health professionals about migraine headaches during pregnancy.

SPA THERAPY: A GERIATRIC PERSPECTIVE

Spa therapy refers to the preventative, therapeutic, and rehabilitative use of thermo mineral waters, mud/peloid compresses, and natural gases. Applications are administered in sessions, and treatment regimens are determined in detail. Various modalities, such as exercise interventions, massage, phytotherapy, relaxation techniques, psychotherapy, nutrition, and electrotherapy, can be incorporated into the treatment process. Spa therapy has been effectively used to manage various diseases in many European countries, Japan, and Israel. Due to its natural structure, the difficulties in using drugs that frequently have side effects, and the limitations of many contemporary therapeutic alternatives, it is still a choice for treating a number of chronic conditions, especially rheumatic disorders. Furthermore, the global population is getting older. Considering the comorbidities, organ dysfunctions, and multiple drug use of elderly individuals, non-pharmacological treatment methods such as spa therapy have become more prominent. Spa therapy has been shown to be effective in treating osteoarthritis, balance problems, and chronic pain in older adults. Additionally, it might be chosen for managing psychiatric conditions and mood changes. Alterations in telomere lengths, reduced pain levels, increased cortisol concentrations, and an overall anti-inflammatory influence may mediate spa therapy’s anti-aging effect. Although opinions and assumptions support its anti-aging properties, more research is needed to prove its biological effects.

Arterial hypertension and chronic kidney disease: consensus statement on patient management

Arterial hypertension is both the cause and the result of the progression of chronic kidney disease, which affects about 10-15% of the population worldwide and the prevalence of which is steadily increasing. As the glomerular filtration rate decreases, the blood pressure level rises respectively. Arterial hypertension (AH) and chronic kidney disease (CKD) are independent and well-known risk factors for the development of cardiovascular diseases, and their combination significantly increases the incidence and mortality from cardiovascular disease. Blood pressure control is the most important factor in slowing the progression of CKD and reducing cardiovascular risk. Currently, there is a place for discussions in the scientific community regarding the target blood pressure levels in patients suffering from CKD. Non-pharmacological methods of treatment can reduce the level of blood pressure in some cases, but do not help to achieve the target values in most of the cases. Patients with hypertension and CKD need combined drug therapy. Certain modern drugs have additional cardio- and nephroprotective properties and should be considered as the first line of therapy. A personalized approach based on evidence-based principles makes it possible to achieve blood pressure control, reducing cardiovascular risk and slowing the progression of CKD. This consensus summarizes the current literature data, as well as highlights the main approaches to the management of patients with hypertension and CKD.

A review on the research progress on non-pharmacological therapy of Helicobacter pylori.

Helicobacter pylori is a pathogenic microorganism that mainly resides in the human stomach and is the major cause of chronic gastritis, peptic ulcer and gastric cancer. Up to now, the treatment of Helicobacter pylori has been predominantly based on a combination of antibiotics and proton pump inhibitors. However, the increasing antibiotic resistance greatly limits the efficacy of anti-Helicobacter pylori treatment. Turning to non-antibiotic or non-pharmacological treatment is expected to solve this problem and may become a new strategy for treating Helicobacter pylori. In this review, we outline Helicobacter pylori's colonization and virulence mechanisms. Moreover, a series of non-pharmacological treatment methods for Helicobacter pylori and their mechanisms are carefully summarized, including probiotics, oxygen-rich environment or hyperbaric oxygen therapy, antibacterial photodynamic therapy, nanomaterials, antimicrobial peptide therapy, phage therapy and modified lysins. Finally, we provide a comprehensive overview of the challenges and perspectives in developing new medical technologies for treating Helicobacter pylori without drugs.

Choice of sinus rhythm control strategy in patients with atrial fibrillation: why, when and how? A review

After 20 years of dubious notions of parity between sinus rhythm control and ventricular rate control strategies in patients with atrial fibrillation, there is evidence of the prognostic superiority of the former. The review article presents the results of randomized trials that support early rhythm control in patients with atrial fibrillation, possible pharmacological and non-pharmacological methods of such treatment in real clinical practice.

Applications for oral research in microgravity - lessons learned from burning mouth syndrome and ageing studies.

The negative consequences of microgravity for the human body are central aspects of space travel that raise health problems. Altered functions of the same systems and treatment options are common points of spaceflight physiology, age-related diseases, and oral medicine. This work emphasizes the convergence of knowledge between pathophysiological changes brought on by aging, physiological reactions to microgravity exposure, and non-pharmacological and non-invasive treatment methods that can be used in spaceflight. Sarcopenia, peripheral nerves alterations, neuromotor plaque in the masticatory muscles, lingual, labial, and buccal weakness, nociplastic pain in oral mucosal diseases, and microgravity, as well as soft tissue changes and pathologies related to chewing and swallowing, corticomotor neuroplasticity of tongue, and swallowing biomechanics, are of particular interest to us. Neurologic disease and other pathologies such as recovery from post-stroke dysphagia, nociplastic pain in glossodynia, sleep bruxism, and obstructive sleep apnea have been studied and, in some cases, successfully treated with non-invasive direct and transcranial magnetic stimulation (TMS) methods in recent decades. An interdisciplinary team from medical specialties, engineering, and biophysics propose an exploratory study based on the parallelism of ageing and space physiology, along with experiment scenarios considering TMS and non-invasive direct methods.

Efektifitas Terapi Akupuntur Terhadap Penderita Hipertensi

Background of Study : Hypertension in elderly caused by many factors that were closely related with aging process. One of the non-pharmacological treatment methods is acupuncture therapy. The needle prick method in acupuncture will stimulate the release and activation of active substances such as Nitric Oxide (NO). Needle prick at the acupuncture will stimulate impulses parasympathetic nervous and pressed sympathetic nervous. The parasympathetic dominant will issue of acetylcholine, Where ties acetylcholine in endothelial cells to induce the formation of local nitrite oxide, Which are then diffuses passing through the smooth muscle blood vessels, and then affect blood flow and local, circulation so there. smooth muscle relaxation of the blood vessels. Research purposes determine the effect of acupuncture on hypertensive patients.Methods : This research was conducted in Klinik pakualaman II Omah Gandok Tajem Sleman. This research is a pre-experimental research design with One-Group Pretest-Posttest Design. The population in this study were patients with hypertension and the sample was taken by purposive sampling method. The data were processed and analyzed using paired t-test with a significance value of p0.05.Results : The results obtained that the value of p = 0.000 in the systole measurement and p = 0.007 in the diastolic measurement (p 0.05) means that there is a significant difference in the respondent's blood pressure before acupuncture is performed with blood pressure after acupuncture is performed.Conclusion : there is a difference in the decrease in blood pressure before and after being given acupuncture therapy

Potential problems and solutions of opioid-based treatment in neonatal opioid withdrawal syndrome (NOWS): a scoping review protocol

IntroductionRates of neonatal opioid withdrawal syndrome (NOWS) have paralleled the rise of opioid use during pregnancy. While short-term phenotypic symptoms of NOWS are well defined, molecular implications and long-term effects...

The effect of auricular acupressure on short-term postoperative pain intensity after cesarean section: A three-arm randomized controlled trial

: Pain control after a cesarean section remains a challenge for healthcare professionals and both pharmacological and non-pharmacological treatment methods can be used to reduce this pain. The present study evaluated the effect of auricular acupressure (applied using the finger) combined with routine care on the short-term pain severity compared to sham acupressure or routine care alone. : A randomized controlled clinical trial with three parallel groups was conducted between April and May 2021. Participants were pregnant women aged 18-35 years, of gestational age 37-40 weeks who underwent cesarean section according to the anesthesia protocol provided in Imam Ali Hospital, Amol, Mazandaran, Iran. Using the balanced blocks randomization method, participants were randomly allocated into three study groups. Participants (N=180) were randomly assigned to either routine care with auricular acupressure (n=60), routine care with sham control (n=61), or routine care only (n=59). The intervention (auricular acupressure) was performed by a trained nurse three times (three, five, and seven hours after surgery) on ear acupoints including Shen Men, Point Zero, Pelvic, abdomen, Endocrine, and Uterus points, in both ears. The primary outcome was pain severity assessed using the Visual Analog Scale (VAS) at eight time points (i.e., before the intervention, and then 15, 30, and 60 minutes after the intervention, and 3, 6, 12, and 24 hours after the intervention). Patients and outcome assessors were blind. : The pain intensity in the three groups was not significantly different until 6 hours after the intervention. The level of pain in the intervention group receiving auricular acupressure was significantly lower than the sham group at 6 hours (MD: -1.06 [95% CI: -1.83; -0.30]), 12 hours (MD: -1.24 [95% CI: -1.96; -0.52]), and 24 hours (MD: -1.21 [95% CI: -1.96; -0.47]) after the intervention. Also, the pain intensity in the intervention group was significantly lower than the control group at 6 hours (MD: -0.80 [95% CI: -1.53; -0.08]), 12 hours (MD: -0.98 [95% CI: -1.67; -0.30]) and 24 hours (MD: -1.00 [95% CI: -1.70; -0.29]) after the intervention. Moreover, no adverse outcomes were observed related to auricular acupressure. : Auricular acupressure might be an effective adjuvant complementary treatment for post-operative cesarean pain in controlling pain and reducing the need for analgesics with no adverse effect. : Registered prospectively in the Iranian Registry of Clinical Trials (Decree code: IRCT20130822014436N1). : Mazandaran University of Medical Sciences.

THE ASSESSMENT OF ACUPRESSURE EFFECTIVENESS AND SAFETY IN THE COMPREHENSIVE TREATMENT AND REHABILITATION OF PATIENTS WITH PEPTIC ULCERS

Aim: The paper evaluates effectiveness and safety of acupressure (AP) in the comprehensive treatment and rehabilitation of patients with uncomplicated peptic ulcer disease (PUD). Materials and Methods: The study retrospectively assessed the effectiveness of treating 24 PUD patients, who received AP session following the author’s protocol based on Houston F.M. recommendations. The statistical analysis of the results employed the algorithm for qualitative data analysis applying the MedCalc 2023 software package. We analyzed the frequency of clinical syndrome manifestations before and after treatment, calculating the interval estimate of this measure (95% confidence interval (CI)). The study formulated null and alternative statistical hypotheses applying the McNemar test to check the null hypothesis for paired samples. When evaluating the risk of AP side effects, we determined 95% CI for proportion, considering binomial distribution of the feature (“presence-absence of complications”). Results: After completing the treatment course and observing the absence of endoscopic signs of peptic gastropathy, we detected statistically significant changes in the frequency of all clinical syndrome manifestations (p-value &lt; 0.0001, based on the McNemar test). AP rapidly and effectively alleviated the main clinical manifestations in patients with PUD. The tolerability of acupressure was good, without side effects. The study determined with 95% probability, that the risk of adverse effects did not exceed 15%. Conclusions: AP is easy to use, non-invasive adjunctive therapy and alternative medical practice during the rehabilitation stage for PUD patients. It proves to be effective, safe, and inexpensive non-pharmacological method of treatment and rehabilitation, aligning with the alternative statistical hypothesis.

The impact of music therapy in the rehabilitation of individuals with COPD: systematic review

Introduction: In the pulmonary rehabilitation of COPD, it is recommended to use non-pharmacological treatment methods with the participation of the individual, as well as pharmacological treatment methods. Music therapy, a non-pharmacological treatment method, is also used in COPD symptom management.&#x0D; Aim: To clarify the impact of music therapy in the rehabilitation of individuals with COPD.&#x0D; Method: The research was created under PRISMA-P standards. In this research, Science Direct, Cochrane Library, PUBMED, CINAHL, and Web of Science databases were reviewed. The databases were viewed from the first article to the 25.10.2022 date in English words. Cochrane MeSH’s; ‘COPD and music’, ‘COPD and music therapy’, ‘COPD and acoustic stimulation’, ‘COPD and auditory stimulation’ were written. In total 3070 articles were reached. Duplicate articles are cleared with the Mendeley citation program. Inclusion criteria are defined according to PICOS. Studies included randomized controlled trials. The review was structured by considering the Cochrane Guideline.&#x0D; Result: From databases, with MeSH terms, a total of 3070 studies were reached. 16 randomized controlled trials were evaluated with reasons for study inclusion and exclusion criteria from 1995 to 2022 years. The studies included in the review were seen using five different music therapy interventions: singing, singing and harmonica playing, harmonica playing, listening, and auditory stimulation. &#x0D; Conclusion: According to the data obtained from studies, music therapies are effective in the rehabilitation of adult individuals with COPD. However, there is still a need for randomized controlled studies involving different music therapy interventions and a large number of individuals.

Effect of Mechanical Stimuli and Zoledronic Acid on the Femoral Bone Morphology in Rats with Obesity and Limited Mobility.

Our study aimed to compare the impact of zoledronic acid and whole-body vibration (WBV) as a non-pharmacological method of treatment for early obesity/immobility-related osteoporosis in male rat models. In total, 36 male Wistar rats were assigned to the following groups: obese control with immobility (Control, n = 12) and two experimental groups (n = 12 each), including obese and immobile rats subjected to whole-body vibration with an acceleration level of 3 m/s2 g (obesity and immobility + WBV) and obese and immobile rats that received an intramuscular injection of zoledronic acid at a dose of 0.025 mg/kg (obesity and immobility + ZOL). After the 8th and 16th week of treatment, n = 6 rats from each group were euthanized and isolated femora were subjected to a histological examination of bone, and analysis of the expression of osteoprotegerin (OPG) and the receptor activator of nuclear factor kappa-B ligand (RANKL) involved in bone turnover and the amount of thin collagen fibers (PSR stain). The obtained results showed that short-term vibrotherapy (up to 8 weeks) can lead to improvement in bone remodeling in rat models with obesity and limited mobility.

Substantiation of the possibility of using osteopathic correction in the complex treatment of patients with shoulder-shoulder pain syndrome

Introduction. Shoulder pain is one of the most common causes of disability in the population. Modern approaches to the treatment of shoulder pain syndrome give preference to the use of drug therapy. However, frequent side effects remain relevant the wider introduction of non-pharmacological methods of treatment. Osteopathy is one of such promising method. In this regard, the assessment of the effectiveness of osteopathic correction of patients with humeroscapular pain syndrome is in demand.The aim to substantiate the possibility of using osteopathic correction in the complex treatment of patients with shoulder pain syndrome.Materials and methods. The study involved 40 patients with shoulder pain syndrome. By the method of randomization using randomization envelopes, the 20 patients were included in the control group and the 20 patients in the main group. Participants of the control group received standard drug and physiotherapy treatment, participants of the main group additionally received a course of osteopathic correction. In both groups, before and after treatment, there were assessed the osteopathic status, the severity of pain syndrome by a 10-point visual analogue scale, the state (functioning) of the shoulder joints, and daily life activities by a 30-point Swanson scale. The duration of temporary disability in both groups was also recorded.Results. At the start of the study, a number of regional (most often — the neck region, structural component, and the chest region — visceral and structural component) and local (most often — the shoulder joint and temporomandibular joint) somatic dysfunctions were detected in patients with humeroscapular syndrome. After treatment in the main group, a statistically significant (p&lt;0,05) positive dynamics was recorded in relation to disorders of the neck region (structural component), thoracic region (visceral and structural component), and pelvic region (structural component). In the control group, significant positive dynamics was observed only in relation to disorders of the thoracic region (visceral component). The groups began to differ significantly (p&lt;0,05) by the disorders detection frequency of the neck and pelvis region (structural component). Also a statistically significant (p&lt;0,05) positive dynamics was recorded in relation to disorders of the shoulder joint and temporomandibular joint in the main group, and in the control group it was detected only in relation to the shoulder joint disorders. At the start of the study, patients in both groups were characterized by a fairly intense pain syndrome (mean score over seven in both groups). After treatment, significant (p&lt;0,05) positive dynamics was observed in both groups, but in the main group the result was significantly (p&lt;0,05) more pronounced: 1,6±0,89 points in the main group versus 2,7±0,86 points in the control group. The shoulder joints state and the daily life activity at the study start moment were characterized by relatively low rates — the average total value was no more than 15 points in both the control and main groups. After the treatment, significant (p&lt;0,05) positive dynamics was observed in both groups, but in the main group the result was more pronounced: 28,0±1,86 points in the main group versus 22,1±2,34 points in the control group (p&lt;0,05). The average duration of temporary disability in days was 8,1±1,07 days in the main group and 15,0±1,84 days in the control group, the difference between the groups is statistically significant (p&lt;0,05).Conclusion. Based on the obtained results, it can be assumed that osteopathic correction included in the complex treatment contributes to faster recovery of the patient, improvement of the shoulder joint functioning, pain relief and increased daily life activity, and this allows us to recommend it for use in patients with such pathology.

Comparing the Efficacy of Pharmacological vs Nonpharmacological Methods of Treatment for Anxiety in Parkinson's Disease: A Narrative Review

Anxiety disorders comprise the most prevalent mental health disorders in the general population and remain a serious concern for patients with Parkinson’s disease (PD). Current literature posits a myriad of methods, pharmacological and nonpharmacological, that may be utilized in the clinical management of this condition. However, recent systematic reviews and meta-analyses have not reached a definitive conclusion as to which method of treatment is most effective. This review aims to address this gap in the field by critically examining the efficacy of several notable treatment options. Specifically, this review highlights the need to discontinue the use of benzodiazepines in this PD-specific population and confirms findings from previous literature that tricyclic antidepressants (TCAs) are the most effective first-line defense for this condition. It additionally highlights the need for subsequent placebo-controlled randomized controlled trials (RCTs) to be conducted to further investigate the efficacy of numerous nonpharmacological treatment options.