Routine Physical Activities Research Articles

Entheseal surface (Sharpey's fiber insertion) alterations identify past trauma; bone base robusticity, level of routine activity.

Sharpey's fiber alterations, referred to as entheseal reaction or enthesopathy, have long been considered an indicator of daily activities. Such semantic transformation seems to conflate processes which alter the characteristics of tendonous and ligamentous attachments to bone with the rugosity and extent of their base/footprint. Rather than reflecting normal activities, it is suggested that surface reactions are actually the response to the application of sudden or unconditioned repetitive stresses-analogous to stress fractures. Thus, they are distinct from enlargement of the base/footprint, the bone remodeling process responsible for the robusticity of the area to which the enthesis attaches, which is actually a measure of actual muscle activity. Surface reactions in attachment areas represent injury, be it mechanical stress fracture-equivalents or inflammation-derived. Bone base/footprint is the reaction of the enthesis to stresses of routine physical activities. The character of underlying bone supporting Sharpey's fibers may be augmented by applied stress, but there is neither a physiologic mechanism nor is there evidence for significant addition of Sharpey's fibers beyond ontogeny. Behavior is responsible for the physiologic response of robusticity; spiculation, pathology.

Differential Diagnosis Clinical Presentation and Minimal Risk Factors – ST Segment Elevation Myocardial Infarction vs Myopericarditis: A Case Report

The condition of STEMI (ST Segment Elevation Myocardial Infarction) can resemble infectious diseases of the heart such as Myopericarditis with the presence of dominant gastrointestinal symptoms, minimal demographic characteristics and cardiovascular risk factors as well as limited supporting examinations, making it a challenge in determining the diagnosis of cardiovascular disease. Case Report: 31 year old male with complaints of pain in the pit of the stomach that was difficult to describe and discomfort that extended to the chest that was not specific, a history of fever for 2 days, nausea and vomiting and a history of the habit of only consuming alcohol without smoking and the patient doing routine physical activities. ECG examination showed sinus rhythm with ST segment elevation in the precordial (anterior and lateral), inferior and LAD (Left Axis Deviation) leads as well as PR segment depression, Troponin I increased and Echocardiography showed a hypokinetic pattern in the posterior and septal segments of the heart. Fibrinolytics improved the patient's symptoms but not serial EKGs, giving rise to suspicion of STEMI which resembles Myopericarditis. Conclusion: Differential diagnosis with the possibility of myopericarditis was based on clinical findings and minimal risk factors, history of the course of the disease, ECG examination, Cardiac Biomarkers, TTE and Coronary Angiography. The patient underwent a Coronary Angiography examination with normal results, thereby ruling out a diagnosis of STEMI. The diagnostic overlap between STEMI and Myopericarditis was difficult to evaluate.

Cardiopulmonary Exercise Testing in Heart Failure.

Cardiopulmonary exercise testing (CPET) provides important information for the assessment and management of patients with heart failure. This testing measures the respiratory and cardiac responses to exercise and allows measurement of the oxygen uptake (V˙O2) max and the relationship between minute ventilation (V˙E) and carbon dioxide excretion (V˙CO2). These two parameters help classify patients into categories that help predict prognosis, and patients with a V˙O2 < 14 mL/kg/min and V˙E/V˙CO2 slope >35 have a poor prognosis. This testing has been used in drug trials to determine complex physiologic responses to medications, such as angiotensin-converting enzyme inhibitors. For example, a study with enalapril demonstrated that the peak V˙O2 was 14.6 ± 1.6 mL/kg/min on placebo and 15.8 ± 2.0 mL/kg/min on enalapril after 15 days of treatment. The V˙E/V˙CO2 slopes were 43 ± 8 on placebo and 39 ± 7 on enalapril. Chronic heart failure and reduced physical activity measured by cardiopulmonary exercise testing are associated with increases in BNP, and several studies have demonstrated that cardiac rehabilitation is associated with reductions in BNP and increases in V˙O2. Therefore, BNP measurements can help determine the benefits of cardiac rehabilitation and provide indirect estimates of changes in V˙O2. In addition, measurement of microRNAs can determine the status of skeletal muscle used during physical activity and the changes associated with rehabilitation. However, CPET requires complicated technology, and simpler methods to measure physical activity could help clinicians to manage their patients. Recent advances in technology have led to the development of portable cardiopulmonary exercise testing equipment, which can be used in various routine physical activities, such as walking upstairs, sweeping the floor, and making the bed, to provide patients and clinicians a better understanding of the patient's current symptoms. Finally, current smart watches can provide important information about the cardiorespiratory system, identify unexpected clinical problems, and help monitor the response to treatment. The organized use of these devices could contribute to the management of certain aspects of these patients' care, such as monitoring the treatment of atrial fibrillation. This review article provides a comprehensive overview of the current use of CPET in heart failure patients and discusses exercise principles, methods, clinical applications, and prognostic implications.

A51: A Study on Improvement of Sensory Integration Disorder in Children Aged 6-7 Years with Fancy Skipping Rope

Purpose: At present, the number of children with sensory unison disorder continues to rise in our country, which is a kind of disease that mainly happens in the children of the nervous system, so that the young children's physical quality drops, the uncoordinated movement, attention, and poor performance, affecting the normal healthy development. In the face of the disorder, the intervention can be improved by games in PE class and sensory integration training. Methods: In this paper, literature, mathematical statistics, questionnaire, and other research methods were used to test and study the vestibular function, proprioception, tactile defense and learning ability of freshmen. Two classes of experimental group (N=128) and two classes of control group (N=128) were randomly selected. The experimental group carried out the teaching of the first and second level of fancy rope skipping for the public in physical education class, while the control group carried out the routine physical education activities and carried out the exercise experiment intervention for four months, and the data before and after the experiment were compared. Results: 1) After the first and second action intervention of the general public, the experimental group of students improved in the four ability indicators of sensory integration, and the experimental group of students' sensory integration disorder significantly improved (P &lt; 0.01), and compared with ordinary physical education activities, fancy rope skipping has more significant improvement on the transformation of students with sensory integration disorder into normal students. 2) After 16 weeks of fancy rope skipping intervention, the vestibular function and tactile defense of students in the experimental group were significantly improved, which were to improve their balance ability, concentration, and interest in physical fitness. 3) Both the fancy rope skipping, and the routine physical education activities can significantly improve the proprioceptive ability of the tested students, and their muscle control ability is more significantly improved; The coordination of physical quality and balance ability have improved significantly. Conclusion: It is of great significance for the healthy growth of freshmen to classify the symptoms of sensory dysregulation by means of systematic and targeted integrated training of skipping rope, and gradually increase the intensity and frequency of training.

Eating Behaviour and Stress due to the Psychological Impact of COVID-19 among Bariatric Surgery Patients Resulting in Weight Regain: A Narrative Review

The Coronavirus Disease-2019 (COVID-19) pandemic has significantly changed the lifestyle of people around the globe. Epidemics are well known for initiating mental stress and patients having undergone bariatric surgery for obesity are at high risk for the common presence of psychological co-morbidities The recent lockdowns imposed by various governments to curb the COVID-19 epidemic have affected the eating habits of many people. In patients with bariatric surgeries, eating disorders can have a profound impact on their health, leading to weight regain. Individuals who have undergone bariatric surgery may represent a particularly susceptible population. The adverse effects might be manifested in the form of eating disorders, psychological problems, and negative impacts on weight loss outcomes. There have been challenges in weight loss due to lockdowns, resulting in negative psychological impacts. Furthermore, changes in socialisation, routine physical activities, emotional stress, and experiences of trauma that have been evident at global levels might have a negative impact on the eating habits of bariatric surgery patients. The current paper highlights the psychological impact of COVID-19 among bariatric surgery patients resulting in weight regain caused by eating disorders and stress and addresses the psychological morbidity in this understudied population. In addition, the impact on the psychology of patients, as their surgeries have been delayed owing to lockdown procedures, has been discussed.

Smart Design of Hip Replacement Prostheses Using Additive Manufacturing and Machine Learning Techniques

The field of additive manufacturing, particularly 3D printing, has ushered in a significant transformation in the realm of joint arthritis treatment through prosthetic surgery. This innovative technology allows for the creation of bespoke prosthetic devices that are tailored to meet the specific needs of individual patients. These devices are constructed using high-performance materials, including titanium and cobalt-chrome alloys. Nevertheless, the routine physical activities of patients, such as walking, sitting, and running, can induce wear and tear on the materials comprising these prosthetic devices, subsequently diminishing their functionality and durability. In response to this challenge, this research has endeavored to leverage novel techniques. The primary focus of this study lies in the development of an algorithm designed to optimize hip replacement procedures via the mechanical design of the prosthesis. This optimization process exploits the capabilities of machine learning algorithms, multi-body dynamics, and finite element method (FEM) simulations. The paramount innovation in this methodology is the capacity to design a prosthetic system that intricately adapts to the distinctive characteristics of each patient (weight, height, gait cycle). The primary objective of this research is to enhance the performance and longevity of prosthetic devices by improving their fatigue strength. The evaluation of load distribution on the prosthetic device, facilitated by FEM simulations, anticipates a substantial augmentation in the useful life of the prosthetic system. This research holds promise as a notable advancement in prosthetic technology, offering a more efficacious treatment option for patients suffering from joint arthritis. The aim of this research is to make meaningful contributions to the enhancement of patient quality of life and the long-term performance of prosthetic devices.

Survey of Lecturers' Understanding of Sports Massage Clinic Services at Bina Darma University

Sport is a series of regular and routine physical activities carried out by individuals to achieve certain goals. Sport is a physical activity that is planned to develop various physical components. Those who perform high-intensity sports activities become tired. Fatigue can generally refer to the body losing energy until it cannot move. Work systems and human resources both depend on occupational safety and health (OSH). This study aims to determine the understanding of employee lecturers on massage services at Bina Darma University's sports massage clinic. This research is descriptive research. The research population is patients who utilize massage services at Bina Darma University's sports massage clinic. The sampling technique used is incidental sampling with a sample size of 20 people. The data collection technique used a questionnaire. Data analysis using descriptive analysis and percentage. The results of research at the Bina Darma University Sport The results of the research at Bina Darma University Sport Massage Clinic in 20 people on each question item became in the very satisfying category of 85.75%, in the satisfying category of 76.75%, in the unsatisfactory category of 2.5% and there were no patients who gave an assessment of the sports massage clinic in the very unsatisfactory category.

Fused Left Supernumerary Kidney with Single Blood Supply and Ureter

Abstract Supernumerary kidneys, also known as accessory kidneys, refer to the presence of more than two kidneys. It is a rare congenital abnormality of the urinary system with only a few cases reported so far in literature. The extra kidney commonly has its own collecting system, blood supply, and well-defined encapsulated tissue. It may or may not be fused to the other kidneys by fibrous tissue or a parenchymal bridge. Imaging for vague abdominal symptoms may result in an incidental finding of the rare anatomical variant which may indicate an adjustment of routine physical activities to avoid renal trauma, as well as relevant considerations for surgical planning. We present a 62-year-old woman who presented with vague abdominal pains. Findings on physical examination were unremarkable. Her abdominal ultrasound scan showed two kidneys of about the same size fused together. Computed tomography urography showed two fused renal tissues of nearly same size on the left. The accessory kidney is more medial, slightly cranial. The native kidney is more lateral and more caudal. The native and accessory kidneys had only one blood supply, venous drainage, and a single ureter. As at the time of reporting, the patient has not received any intervention because there was no remarkable symptom noted. This case is rare and unique, in that it is a fused supernumerary kidney seen at the age of 62 and has a single blood supply and ureter. Imaging for vague symptoms can result in an incidental finding of a rare anatomical variant. It is also very essential for planning surgical intervention if need be.

Effect of a Physical Exercise Program on the Inflammatory Response, Cardiac Functions, Functional Capacity, and Quality of Life in Patients with Sickle Cell Disease.

The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1-Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2-Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. Comparisons between groups were made using Student's t-test, Mann-Whitney test, chi-square test, or Fisher's exact test. Spearman's correlation coefficient was calculated. The significance level was set at p < 0.05. There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient -0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient -0.480; p = 0.013) in SCD patients in both groups. The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.

The bioelectrical properties of bone tissue.

Understanding the bioelectrical properties of bone tissue is key to developing new treatment strategies for bone diseases and injuries, as well as improving the design and fabrication of scaffold implants for bone tissue engineering. The bioelectrical properties of bone tissue can be attributed to the interaction of its various cell lineages (osteocyte, osteoblast and osteoclast) with the surrounding extracellular matrix, in the presence of various biomechanical stimuli arising from routine physical activities; and is best described as a combination and overlap of dielectric, piezoelectric, pyroelectric and ferroelectric properties, together with streaming potential and electro-osmosis. There is close interdependence and interaction of the various electroactive and electrosensitive components of bone tissue, including cell membrane potential, voltage-gated ion channels, intracellular signaling pathways, and cell surface receptors, together with various matrix components such as collagen, hydroxyapatite, proteoglycans and glycosaminoglycans. It is the remarkably complex web of interactive cross-talk between the organic and non-organic components of bone that define its electrophysiological properties, which in turn exerts a profound influence on its metabolism, homeostasis and regeneration in health and disease. This has spurred increasing interest in application of electroactive scaffolds in bone tissue engineering, to recapitulate the natural electrophysiological microenvironment of healthy bone tissue to facilitate bone defect repair.

The Effect Of Cognitive Behavioral Therapy (CBT) Application On Lifestyle In Hypertension Patients At Royal Prima Marelan Hospital 2022

Hypertension is still a health problem in the elderly group. As a result of rapid development and a prosperous standard of living and health services can increase life expectancy, so that the number of elderly people increases every year. This increase in age is often followed by an increase in degenerative diseases and other health problems in this group. Psychological interventions are believed to be able to change a person's behavior towards a better direction in disease control and prevention. This study measures the impact of cognitive behavioral therapy (CBT) interventions on self-care management of hypertensive patients.This type of research is a quasi-experimental design with a pretest-posttest and control group design. The research subjects were divided into two groups, namely the intervention group (35 people) and the intervention group (35 people). control group (35 people). The research was conducted at the Royal Prima Marelan Hospital in 2022. Data were analyzed using the t-dependent test (α = 0.05).The results showed that in the intervention group there were differences in self-care management of hypertensive patients before and after being given CBT which included diet (p &lt;0.001; 95% CI -6.663-(-4.796)), physical activity (p&lt;0.001; 95 %CI -5.344-(-4.370)), and attitude (p=&lt;0.001; 95%CI -13.086-(-10.115)). In the control group, there was no difference in self-care management of hypertensive patients, including diet n (p= 0.083; 95% CI -0.183-0.012), physical activity (p= 0.058; 95% CI- 0.291-0.005), and attitude T2DM patients (p = 0.094; 95% CI -0.225-0.003). This means that CBT is effective in improving self-care management of Hypertension patients.It is suggested to the Management of Royal Prima Marelan Hospital to implement routine physical activities such as hypertension gymnastics in order to prevent hypertension among young people.

Comparison of Physical Activity Among Private and Public Undergraduates Medical Students

Medical students and other health care professionals have substantial knowledge of the benefits of regular physical activity. Furthermore, as they have an ethical obligation to prescribe suitable exercises, they can influence their patients’ attitude toward physical activity and can become role models for their patients. Study design is cross-sectional. The questionnaire of research was distributed among 200 private medical students and 200 public medical students from different medical. Non Probability Convenience Sampling Technique was adopted to select the study population. International Physical Activity Questionnaire (IPAQ) (10) was developed which consists of different questions about their routine physical activities. Data was recorded anonymously, and we respected the confidentiality of the respondents. In our basic study there were a total of 400 medical. The study subjects included 26 % males and 74 % females in private sector and 19 % males and 81 % females in public sector. 29.5 % population belonged to 1st professional year and 70.5 % senior years in private sector whereas in public sector 69.5 % population belonged to 1st professional years and 30.5 % in senior years. The mean age of students is 21.9. And results obtained were not significant statistically and there was a lack in physical activity of both sectors almost on a par. The corresponding comparison of knowledge, attitude and practices of medical students between private and public sectors suggests that adequate knowledge about physical activity is not sufficient. There were a large number of medical students of both sectors who, despite being aware of benefits of physical activity, did not meet the recommended level of physical activity the reason as to why the results obtained were not significant statistically. Keywords: medical,physical,undergraduates,activity

Musculoskeletal pain and its effect on daily activity and behaviour in Icelandic children and youths with juvenile idiopathic arthritis: a cross-sectional case-control study

BackgroundJuvenile idiopathic arthritis is characterised by recurring episodes of acute inflammation, with joint swelling in one or more joints, often accompanied by pain. These episodes can now be controlled better than in the past because of a new category of medications. However, despite more stable disease activity, pain may continue to cause problems in the children with juvenile idiopathic arthritis and can reduce their performance of routine physical activities and participation in social or school activities.AimTo evaluate the prevalence of pain, pain intensity, pain behaviour, and pain interference in Icelandic children with juvenile idiopathic arthritis compared with healthy peers.MethodsA cross-sectional, case-control study including 8-18 years old children; 28 with juvenile idiopathic arthritis and 36 in a control group. The children answered questions on pain experienced during the last 7 days, painful areas of the body and pain frequency. They completed short form versions of the Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires on pain intensity, pain behaviour, and pain interference.ResultsSignificantly more children with juvenile idiopathic arthritis had pain compared with the control group (p = 0.02). Children with JIA also had a greater number of painful body areas (p = 0.03), more pain intensity (p = 0.009), and showed more pain behaviour (p = 0.006), and pain interference (p = 0.002). Children with juvenile idiopathic arthritis who had pain, experienced more pain interference (p = 0.023) than their peers who had pain. However, the groups did not differ in terms of pain intensity (p = 0.102) and pain behaviour (p = 0.058).ConclusionThe research results indicate that pain experience was different between children with juvenile idiopathic arthritis and the control group. The results suggest that further research of the role of pain management on functional outcomes in children with juvenile idiopathic arthritis is needed.

Prevalence of Neck pain and its effects on Quality of life of Software Engineers in Lahore

Background: Neck pain is a sensation of discomfort in the dorsal and lateral side of cervical spine due to postural or mechanical faults. It affects health - status, work productivity and multiple interventions are used to treat neck pain. Aim: To check the prevalence of neck pain, its effects on quality of life of software engineers of Lahore city. Methodology: This was an observational study Cross-sectional survey. Three hundred and thirty eight participants with minimum one year of job experience in software house were included in the study. Neck pain disability and quality of life were observed by using NDI and SF-12 respectively. Data was entered and analyzed by SSS 22.0.s Results: Results showed the prevalence as mild, moderate, severe and complete neck pain disability in software engineers was 150(44.38%), 68(20.12%), 19(5.62%) and 3(0.89%) respectively and 98(28.99%) participants were without neck pain. There are more male participants 86(25.44%) without neck pain than female participants 12(3.55%) without neck pain. Neck pain showed no significant association with age of software engineers because p &gt; 0.05 in chi-square test. There were fewer participants with excellent and poor physical health 8.28% and 10.36% respectively. Conclusion: Neck pain is common in software engineers of Lahore city. Neck pain is more prevalent in female software engineers as compared to male. Severe neck pain declined their Physical health and complete neck pain caused disability. They are facing the physical health issues with resulting limitations in their routine office work, physical activities and social activities. Neck pain is associated with gender and physical health of software engineers. Keywords: Neck pain, quality of life, software engineers, Lahore city

Effect of cervical exercises with corrective instructions on neck pain and disability in smartphone addicted users

IntroductionSmartphone use has progressively increased worldwide in the recent few years, with has raised the incidence of musculoskeletal problems related to smartphone overuse. Neck pain is common in subjects practising various occupational and recreational activities. This study investigated the effects of deep cervical flexor muscles exercises with corrective instructions for smartphone use on neck pain and disability in smartphone addicted users.MethodsOverall, 40 subjects suffering from mechanical neck pain were randomly assigned to group A, who performed deep cervical flexor exercises and were given instructions regarding the correct smartphone use, and to group B, who maintained their routine physical activities during the study period, without any further advice. Neck pain intensity was measured with the visual analogue scale, while neck disability was evaluated with the Neck Disability Index.ResultsThe dependent t-test showed a significant post-treatment reduction (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) in neck pain and disability in group A, while no significant differences (&lt;i&gt;p&lt;/i&gt; &gt; 0.05) were found in group B. The independent t-test declared no significant pre-treatment differences (&lt;i&gt;p&lt;/i&gt; &gt; 0.05) between groups in the measured variables; after treatment, it revealed a significant reduction (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) in neck pain and disability in group A compared with group B.ConclusionsRegular practice of deep cervical flexor muscles training in addition to following corrective instructions for smartphone use constitutes an effective therapeutic tool in decreasing neck pain and disability in smartphone addicted users.

UPAYA PENINGKATAN PENGETAHUAN TENTANG AKTIVITAS FISIK DAN ASUPAN GIZI SEIMBANG LANSIA DI MASA PANDEMI COVID-19

Background ; The view of some people who consider the elderly as human beings who are incapable, weak, and sickly, causes all activities to be very limited. This condition is exacerbated by the absence of time, place, and opportunity for the elderly to carry out activities. The COVID-19 pandemic (coronavirus) causes many changes in daily life, this can also have an impact on the elderly considering that the body condition of the elderly is susceptible to being exposed to viruses and diseases if the immune system is not optimal. Method of Implementation ; Conduct health counseling to elderly posyandu cadres about balanced nutritional intake for the elderly during the covid-19 pandemic, and provide exercise videos to elderly posyandu cadres in the Kentigan Kulon area, Jebres sub-district, Surakarta with the hope that the video can be useful and can be used as sports and physical exercise for the elderly. Conclusion ; There is an increase in knowledge of elderly posyandu cadres after being given health counseling about balanced nutrition intake during the covid 19 pandemic. Routine physical exercise activities can increase body immunity during the pandemic Keywords: Elderly, physical activity, balanced nutrition

Prevalence of Tension-Type Headache among Medical Students in Tabuk University, Saudi Arabia

Background: Headaches disorders have a significant burden on the world. Tension Type Headache is the most common type among primary headaches. Since medical students are exposed to a lot of stress, and it is associated with a tension-type headache, the importance of this study comes. This study aims to measure the prevalence of tension-type headache among medical students at Tabuk University 2020.&#x0D; Methodology: A cross-sectional study in Tabuk, Saudi Arabia was conducted. The study included medical students at the University of Tabuk in the academic years from 2nd to 6th grades during the calendar year of 2020. An adapted semi-structured self-administered questionnaire was retrieved from other validated questionnaires. The internal validity and reliability of the questionnaire were tested using Cronbach's alpha test and was highly reliable (25 items, α = .715). Both medical and research experts assessed the face and content validity. The data were coded, tabulated, and analyzed using the Statistical Package for the Social Sciences (SPSS, version 27).&#x0D; Results: The total number of the students was 380 (response rate, 78.6%). 55.22% were females, and 44.78% were males their mean age was 21.18 ± SD 1.78 years. Out of the 297 students, only 122 met the diagnostic criteria. The 1-year prevalence Tension Type Headache (TTH) included the three types: frequent TTH 67.2%, 18.0% infrequent TTH, and only 14.8% suffered from chronic TTH. The most common aggravating factors included studying stressors (82%), 68% of the participants reported daily activity interference, and 48.4% reported that headache aggravate with routine physical activities (e.g., walking or climbing stairs). The headache quality varied between throbbing/pulsating (54.9%), pressing/tightening (68.9%) and sharp/stabbing (10.7%). The median headache intensity was 5.25 at pain level score (IQR =2). Only 28% of the students sought counseling where the main analgesic used was Acetaminophen (74%). Many non-pharmacological therapies were practiced by the students to relieve headache, including sleep (60.7%), rest (63.1%) and caffeine (41.8%).23% of the medical students reported that they sought medical counseling to maintain their performance level. There was a statistically significant difference between the average age of medical students suffering from frequent and infrequent TTH, t(102) = 2.31, p = .023.&#x0D; Conclusion: Tension-type headache is a prevalent type of headache among Saudi medical students. Prevalence and aggravating factors in our study were comparable to previously reported literature. Future studies with large sample size may be required among all university students to define burden of the case in Saudi Arabia.

Digital Tracking of Physical Activity, Heart Rate, and Inhalation Behavior in Patients With Pulmonary Arterial Hypertension Treated With Inhaled Iloprost: Observational Study (VENTASTEP).

BackgroundPulmonary arterial hypertension restricts the ability of patients to perform routine physical activities. As part of pulmonary arterial hypertension treatment, inhaled iloprost can be administered via a nebulizer that tracks inhalation behavior. Pulmonary arterial hypertension treatment is guided by intermittent clinical measurements, such as 6-minute walk distance, assessed during regular physician visits. Continuous digital monitoring of physical activity may facilitate more complete assessment of the impact of pulmonary arterial hypertension on daily life. Physical activity tracking with a wearable has not yet been assessed with simultaneous tracking of pulmonary arterial hypertension medication intake.ObjectiveWe aimed to digitally track the physical parameters of patients with pulmonary arterial hypertension who were starting treatment with iloprost using a Breelib nebulizer. The primary objective was to investigate correlations between changes in digital physical activity measures and changes in traditional clinical measures and health-related quality of life over 3 months. Secondary objectives were to evaluate inhalation behavior, adverse events, and changes in heart rate and sleep quality.MethodsWe conducted a prospective, multicenter observational study of adults with pulmonary arterial hypertension in World Health Organization functional class III who were adding inhaled iloprost to existing pulmonary arterial hypertension therapy. Daily distance walked, step count, number of standing-up events, heart rate, and 6-minute walk distance were digitally captured using smartwatch (Apple Watch Series 2) and smartphone (iPhone 6S) apps during a 3-month observation period (which began when iloprost treatment began). Before and at the end of the observation period (within 2 weeks), we also evaluated 6-minute walk distance, Borg dyspnea, functional class, B-type natriuretic peptide (or N-terminal pro–B-type natriuretic peptide) levels, health-related quality of life (EQ-5D questionnaire), and sleep quality (Pittsburgh Sleep Quality Index).ResultsOf 31 patients, 18 were included in the full analysis (observation period: median 91.5 days, IQR 88.0 to 92.0). Changes from baseline in traditional and digital 6-minute walk distance were moderately correlated (r=0.57). Physical activity (daily distance walked: median 0.4 km, IQR –0.2 to 1.9; daily step count: median 591, IQR −509 to 2413) and clinical measures (traditional 6-minute walk distance: median 26 m, IQR 0 to 40) changed concordantly from baseline to the end of the observation period. Health-related quality of life showed little change. Total sleep score and resting heart rate slightly decreased. Distance walked and step count showed short-term increases after each iloprost inhalation. No new safety signals were identified (safety analysis set: n=30).ConclusionsOur results suggest that despite challenges, parallel monitoring of physical activity, heart rate, and iloprost inhalation is feasible in patients with pulmonary arterial hypertension and may complement traditional measures in guiding treatment; however, the sample size of this study limits generalizability.Trial RegistrationClinicalTrials.gov NCT03293407; https://clinicaltrials.gov/ct2/show/NCT03293407International Registered Report Identifier (IRRID)RR2-10.2196/12144

Migraine pathophysiology, clinical correlates

Migraine is well known by the headache itself, however there are many other signals and symptoms that can occur during an attack. Some symptoms, called premonitory symptoms, such as yawning and feeling tired, occur in 72–84% of patients. About 20% of migraineurs present aura. The most common aura is visual disturbances, following by sensitive symptoms. The headache of migraine is characterized by pulsatile unilateral pain, of moderate to severe intensity, that worsen by routine physical activities, associated with photo/phonofobia, nausea and vomiting. About 68–80% of migraine patients present the last phase called postdrome or resolution, in which the most common symptoms are tiredness and cognitive difficulties. This lecture will discuss the pathophysiological aspects of the main signals and symptoms of a migraine attack.

Dietary practices of adult Egyptians before and during the COVID-19 lockdown.

AimThe aim of this study was to describe dietary practices of adult Egyptians, estimate changes in their body mass index (BMI), and identify possible determinants of such changes before and during the COVID-19 lockdown.Subject and methodsA cross-sectional web-based survey was conducted during the nationwide COVID-19 partial lockdown. Data were obtained from 430 Egyptian adults regarding their personal and socio-demographic characteristics, routine daily physical activities, dietary patterns, practices related to food purchase and food handling, and weight and BMI before and during the lockdown using an online web-based questionnaire.ResultsThe number of daily meals and daily snacks significantly increased during the lockdown. Moreover, the consumption of all types of snacks increased, except for chocolate and sweets, whose consumption decreased. Eating of fast food decreased, whereas the number of individuals practicing indoor physical activities increased during the lockdown. During the lockdown, no significant changes in the mean BMI were observed. The mean weekly consumption of starch, meat, milk, fat, and free foods decreased, whereas the mean weekly consumption of fruits and vegetables increased. Food handling practices improved during the lockdown. Based on the results of the linear regression analysis, age, the number of daily meals, practicing of physical activities during lockdown, and mean weekly consumption of meat were the independent predictors of BMI during the lockdown.ConclusionDuring the lockdown, no significant changes in the BMI of adult Egyptians were observed, whereas dietary practices and food handling practices changed.