Index Scale Research Articles

Clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy for symptomatic cervical spondylotic radiculopathy

BackgroundThis study aimed to evaluate the clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy (PECD) in treating patients with symptomatic cervical spondylotic radiculopathy (CSR).MethodsA total of 105 patients with single-segment symptomatic CSR treated between January 2020 and January 2022 were retrospectively analyzed and divided into PECD and ACDF groups based on the surgical approach. Patient demographics, operation time, estimated intraoperative blood loss, complications, postoperative hospital stay, total hospitalization cost, neck dysfunction index (NDI), arm and neck visual analog scale (VAS) scores were compared and analyzed. The learning curve of the PECD group was assessed using cumulative sum (CUSUM) analysis.ResultsThere was no statistically significant difference in baseline data between the two groups (P > 0.05). The PECD group had shorter operative time, smaller incision length, less estimated intraoperative bleeding, lower total hospitalization costs, and shorter postoperative hospital stays compared to the ACDF group (P < 0.05). Postoperative NDI, arm VAS, and neck VAS scores improved significantly in both groups compared to preoperative values (P < 0.05). However, no significant difference was found between the two groups during the same period (P > 0.05). There were also no significant differences between the PECD and ACDF groups in the number of intraoperative fluoroscopies, complications, or surgical success rates (P > 0.05). As more cases accumulated, a trend toward shorter operative times was observed in the PECD group. When grouped according to the learning curve, with the 23rd case as the cutoff point, there was no significant difference in clinical outcomes between the learning phase and proficient phase groups (P > 0.05).ConclusionsPECD is a safe and effective procedure for treating single-segment CSR, offering clinical outcomes comparable to ACDF. PECD has a notable learning curve, requiring beginners to perform 23 cases to reach proficiency. However, longer operative times do not negatively impact preclinical outcomes.Trial registrationRetrospectively registered.

The effects of maternal health literacy, family functioning and self-efficacy on antepartum depression in pregnant women in China: a moderated mediation model

BackgroundAntepartum depression (AD) is associated with a greater risk of adverse outcomes for both mothers and fetuses. Maternal health literacy (MHL), family functioning (FF), and self-efficacy (SE) are important factors affecting antepartum depression (AD) in pregnant women. Therefore, this study aimed to explore the associations between these factors and whether MHL and SE mediate the relationship between FF and AD.MethodsThis cross-sectional study included 1392 pregnant women from 6 hospitals in Chongqing, China. Data were collected via structured scales, including the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, the Maternal Health Literacy Scale and the General Self-Efficacy Scale (GSES). Structural equation modeling(SEM) was used to test the hypothesized relationships among the variables.ResultsIn our survey, 31.90% participants had depression symptoms. Correlation analysis revealed that all the variables were significantly correlated with AD (p < 0.01). The model indicated that FF had the strongest correlation with AD (β = -0.276, p < 0.01), followed by MHL (β = -0.248, p < 0.01) and self-efficacy (SE) (β = -0.222, p < 0.01). SE fully mediated the relationship between FF and AD and mediated the relationship between MHL and AD. There was no evidence of a mediating effect of MHL on the relationship between FF and AD.ConclusionsAD is correlated with MHL, SE and FF. MHL and FF can directly affect AD and mediate AD through SE. Future programs should consider MHL promotion, FF improvement and SE strengthening as breakthrough points when planning educational programs.

Comparative effects of gong's mobilization and mobilization with movement in patients with adhesive capsulitis: a randomized clinical trial.

Adhesive Capsulitis results in a progressive contraction of the Glenohumeral joint capsule limiting active and passive range of motion, leading to functional disabilities. Joint mobilization plays a key role in the physical therapy treatment of Adhesive Capsulitis. A relatively new technique, Gong's Mobilization, has been introduced for the treatment of Adhesive Capsulitis. It is focused on the correction of positional faults through controlled dynamic motion of the Glenohumeral joint. The mainstay of this clinical trial is a comprehensive comparative evaluation of MWM with Gong's Mobilization as it remains insufficiently explored. The objective of this clinical trial was to compare the effects of Gong's Mobilization and Mobilization with Movement on pain, range of motion and functional disability in patients with Adhesive Capsulitis. In this triple blinded randomized clinical trial, sixty patients of Adhesive Capsulitis were enrolled within group A (Gong's Mobilization) and group B (Mobilization with Movement). The treatment protocol covered 12 treatment sessions for 4 weeks. Numeric Pain Rating Scale (NPRS), Goniometer, and Urdu version of Shoulder Pain and Disability Index (U-SPADI) were used to assess the pain, range of motion and functional status respectively. These outcome measures were assessed at baseline, after 6 treatment sessions (2 weeks) and conclusively after 12 treatment sessions (4 weeks). For data analysis, within the group differences were measured by Repeated Measure ANOVA and across the group differences were measured by independent t test. A significant difference within the mean values of baseline, week 2 and week 4 NPRS, ROM, and SPADI score was observed in both study groups (p < 0.001). Results of independent t test used to calculate across the group differences indicated that Gong's Mobilization was more effective in reducing disability (SPADI)(p < 0.001) and improving ROM(p < 0.001), meanwhile both groups were equally effective in reducing NPRS scores(p = 0.78). Moreover, a medium to large effect size was also observed for all the outcomes, pain(d = 0.5), ROM (d = 0.5-2.7), SPADI(d = 0.5). It was concluded that Gong's Mobilization is more effective than Movement with Mobilization. Following four weeks of treatment, it pronounced statistically significant and clinically relevant results in improving pain, ROM and functional status of patients with Adhesive Capsulitis. Trial Registration Trial was registered in IRCT (Trial registration number: IRCT20190717044238N4 Trial Registration Date: 01-03-2023).

Reference values for the 1-minute sit-to-stand test to assess functional capacity and short-term mortality in people with idiopathic pulmonary fibrosis and fibrotic connective tissue related interstitial lung diseases: a prospective real-world cohort study

BackgroundEarly identification of functional decline in fibrotic interstitial lung disease (F-ILD) is crucial for timely treatment and improved survival. While the 6-minute walk test (6MWT) is the standard for functional evaluation, it has practical limitations. The 1-minute sit-to-stand test (1MSTS) offers a simpler alternative; however, its correlation with the 6MWT in F-ILD patients remains unclear. This study aims to establish reference values for the 1MSTS in assessing functional capacity, evaluate its correlation with the 6MWT, and explore its utility in predicting 18-month mortality in F-ILD patients.MethodsThis prospective study enrolled participants diagnosed with F-ILD based on multidisciplinary team discussions. Assessments included the 1MSTS, 6MWT, pulmonary function test (PFT), GAP score, mMRC scale, and Charlson Comorbidity Index (CCI). The association between 1MSTS repetitions and other variables was calculated using Spearman’s rho. Bland-Altman plots assessed the agreement between 1MSTS repetitions and the 6MWT. Predictors of 18-month mortality were evaluated using ROC curve and Kaplan-Meier curve.ResultsOf the 150 F-ILD patients, 37 (24.6%) had idiopathic pulmonary fibrosis (IPF), and 113 (75.4%) had connective tissue disease-related ILD (CTD-ILD). Using ≤ 23 repetitions as the cutoff for functional impairment in 1MSTS, 74 (47.3%) patients were classified as impaired. The 1MSTS significantly predicted 18-month mortality and demonstrated moderate correlations with GAP score (rs = -0.49), mMRC scale (rs = -0.47), and 6MWT distance (rs = 0.65). Bland-Altman analysis indicated agreement between 1MSTS repetitions and 6MWT distance. Using ≤ 23 repetitions as the cutoff value for the 1MSTS to predict 18-month mortality, the mortality rate was 76.4%, with an AUC of 0.81.ConclusionsThe findings suggest that ≤ 23 repetitions in the 1MSTS can serve as an indicator of functional impairment, demonstrate a good correlation with 6MWT distance, and effectively predict 18-month mortality in patients with F-ILD.Clinical trial numberNot applicable.

Balneotherapy for the treatment of post-COVID syndrome: a randomized controlled trial

BackgroundPost-Acute COVID Syndrome (PACS) is a complex disorder that currently lacks effective evidenced-based therapies to manage it. This randomized controlled trial aims to evaluate the effects of balneotherapy (BT) on PACS symptomatology.MethodsNinety-eight adults with PACS visited at Hospital del Mar Research Institute, Barcelona (Spain) were included to the study. Participants in the intervention group (n = 51) were allocated to 12 sessions of BT and aquatic exercises delivered in one month while the control group (n = 47) did not. The primary outcome was to evaluate the absolute change in questionnaire scores between baseline and two follow-up points: immediately after balneotherapy (or one-month post-baseline for the control group) and 2 months post-baseline. The following scales/questionnaires were employed: Post-COVID-19 functional status scale, mMRC dyspnea Scale, SF-36, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Memory failures in everyday life following severe head injury, and Visual Analogic Scale (VAS).ResultsForty-seven patients in the BT group and 43 in the control group completed the study. The majority of participants were middle-aged women (> 84%; mean age 48 years), and the most prevalent symptoms were fatigue, musculoskeletal pain, and neurocognitive impairment (> 88%). Noteworthy, the vast majority did not undergo a severe primary infection (ICU admissions < 3%). After BT, significant improvement was detected in the BT group vs. the control group in various SF-36 domains, PSQI total score (Beta-coefficient [95%CI] 2.641 [1.15;4.12]; p -value = 0.003), HAD’s anxiety subscale (Beta-coefficient [95%CI] 1.72 [0.40;3.03;p-value = 0.023), and VAS (Beta-coefficient [95%CI] 1.625 [0.32;2.96]; p-value = 0.026). Among these, SF-36’s energy/fatigue and pain subscales exhibited the most prominent changes with a Beta-coefficient [95%CI] of -17.45 [-24.23;-10.66] and − 21.634 [-30.48;-12.78], respectively (p-value < 0.0001). No severe adverse effects were reported during BT although seventeen patients reported mild and transient worsening of preexisting symptoms, particularly fatigue/post-exertional malaise mainly in the first sessions of BT.ConclusionBalneotherapy comprise an effective therapeutic modality that can alleviate several symptoms that characterize PACS, particularly musculoskeletal pain and fatigue. However, the sustainability of these effects over time remains uncertain, as evidenced by the loss of some between-group differences at the one-month follow-up.Trial registrationClinicalTrials.gov NCT05765591 (13/03/2023).

Real-World Efficacy and Safety of Dupilumab Use in Japanese Adult Patients with Atopic Dermatitis: A Single-Center, Retrospective, 104-Week, Observational Study

Background/Objectives: Dupilumab is an interlekin-4 receptor antibody that exerts its efficacy by inhibiting the signaling pathway of interleukin-4/interleukin-13, and it is currently used clinically as a highly potent therapeutic for atopic dermatitis. However, there have been few reports on the therapeutic effect of dupilumab using long-term real-world data. To accumulate further real-world data through long-term use of dupilumab, we performed a retrospective study on the courses of patients with atopic dermatitis who were treated with dupilumab for at least 104 weeks in our university hospital. Methods: We examined the treatment courses of 30 adult patients. Results: Subjective (e.g., itch visual analog scale and Dermatology Life Quality Index) and objective (e.g., Eczema Area and Severity Index) indices and some biomarkers showed improvements over time with dupilumab treatment, even in cases with poor early response to dupilumab treatment. As for the therapeutic effect on anatomical regions, although the therapeutic effect on the head and neck region was weak in the early stages, it improved over time, and at 104 weeks, it showed a therapeutic effect that was comparable to other regions. Conclusions: Therefore, our study demonstrated the advantages of prolonged administration of dupilumab in atopic dermatitis.

Evaluation of oclacitinib maleate and prednisolone combined therapy for the control of atopic dermatitis in dogs: A controlled clinical trial.

Canine atopic dermatitis (cAD) is a chronic inflammatory and pruritic dermatopathy requiring a multimodal therapeutic approach. To assess the effectiveness, safety and cost of oclacitinib and prednisolone treatment in dogs with AD. Twenty-three client-owned dogs with cAD. Dogs were randomly assigned to one of two groups: Group 1 received prednisolone (0.5 mg/kg every 24 h) for 7 days, then oclacitinib (0.5 mg/kg) and prednisolone (0.5 mg/kg), were administered alternately with a 1 day pause between each drug, for 7 additional weeks. Group 2 received oclacitinib (0.5 mg/kg every 12 h for 14 days, then every 24 h) for 8 weeks. Assessments included the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and pruritus Visual Analog Scale (PVAS) on Day (D)0, D7, D14, D30, D45 and D60. Both groups showed significant CADESI and PVAS reductions on D7 (p < 0.001). From D14 to D60, mean scores remained stable compared to D7, with no significant differences between groups. Adverse events included two dogs with polyuria and polydipsia, and three with polyphagia in Group 1, all of which resolved by D14. In Group 2, one dog experienced polyphagia, and two had self-limiting vomiting. Three dogs in Group 1 and one dog in Group 2 had mild increases in liver enzyme concentrations. The combined protocol was effective and safe for managing itch and inflammation over a 60 day period. It had a 73.3% lower cost compared to oclacitinib alone.

Abstract TP101: Predictors of Stroke Functional Prognosis in Cerebral Amyloid Angiopathy Hospitalized for Rehabilitation

Background and objective: Cerebral amyloid angiopathy (CAA) is one of the major causes of intracranial hemorrhage (ICH) and consequent functional impairments in the elderly. Currently, there is a lack of predictors of functional prognosis for CAA patients suffering after lobar ICH event. This study aimed to assess the clinical and neuroimaging factors that can predict functional outcomes in patients survived CAA-related ICH. Methods: Conducted as a retrospective cohort study from May 2014 to May 2022, this research included ICH survivors meeting the Boston criteria 2.0 of probable CAA. Rehabilitation metrics and neuroimaging features from MRI, including lobar cerebral microbleeds (CMBs), cortical superficial siderosis (cSS), perivascular spaces of the centrum-semiovale, and white matter hyperintensities (WMHs), were systematically assessed and subjected to analysis. CAA score was computed as a sum of these markers. Prognostic indicators, comprising the modified Rankin Scale (mRS) and Barthel Index at one month after ICH were evaluated. The data were analyzed with generalized linear models and logistic regression to examine the associations between the identified parameters and the prognostic indicators. The incidences of recurrent ICH or mortality within a six-month follow-up window were also assessed using survival analyses. Results: A total of 73 patients were included. In the multivariate analysis, predictive factors for higher mRS included impaired initial sitting balance (p&lt;0.001), compromised initial ability to sit up (p&lt;0.001), and higher CAA score (p=0.01) after adjusting covariants for age, sex, antithrombotic use, and pre-morbid mRS. During 6-month follow-up after ICH, a lower CAA score was associated with lower ICH recurrence (p &lt; 0.05), while better sitting balance was associated with lower mortality rate (p &lt; 0.05). Conclusion: In patients with CAA-related ICH, compromised sitting ability and higher CAA score predicted unfavorable functional outcomes.

Abstract TMP57: Cerebral Blood Reserve Predicts Early Neurological Deterioration in Minor Stroke with Large Vessel Occlusion or Severe Stenosis

Introduction: Literature demonstrates that nearly one-third of acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) or severe stenosis arrive at the emergency room with mild symptoms, attributed to favourable collateral status. However, approximately 20~40% of patients with mild symptoms due to LVO or severe stenosis are at risk of early neurological deterioration (END) as a consequence of subsequent collateral failure post arrival. This study aimed to identify the difference of collateral patterns between mild stroke patients with END and those without. Methods: AIS patients presenting within 24 hours from last known well, with a baseline NIHSS≤5 and anterior circulation LVO or severe stenosis were included. Patients who underwent endovascular treatment before END were excluded. END was defined as an increase in total NIHSS≥4 or NIHSS≥2 for any item within 72 hours, without evidence of parenchymal hemorrhage. Collateral flow was rated as the Tan scale (leptomeningeal collaterals) and cerebral blood volume (CBV) index (cerebral blood flow reserve). A good leptomeningeal collateral score (goodCS) was defined as Tan scale≥2 (poorCS: Tan scale &lt;2). CBVindex was calculated as the ratio of mean CBV within Tmax&gt;6s lesion over the mean CBV of Tmax&lt;4s area. Results: A total of 237 AIS patients with mild symptoms due to anterior circulation LVO or severe stenosis were included and END occurred in 22% of the patients. Stepwise logistic regression analysis revealed that higher CBVindex and poorCS were associated with the increased risk of END occurrence. The optimal threshold of CBVindex predicting END was 0.735 (sensitivity: 0.83; specificity:0.48). Accordingly, patients were divided into four groups: group1: CBVindex&lt;0.735+ poorCS; group2: CBVindex&lt;0.735+goodCS; group3: CBVindex&gt;0.735+goodCS; group4: CBVindex&gt;0.735+ poorCS. Further analysis showed that that patients with CBVindex&gt;0.735 and poorCS (group 4) were most likely to present with END (logistic OR[95%CI]: 5.18[1.22,22.18] P=0.026). Conclusions: Higher CBVindex and poor leptomeningeal collaterals were independent predictors of END in patients with mild symptoms due to anterior circulation LVO or severe stenosis. Therefore, we hypothesize that though higher CBVindex reflects favorable collaterals at baseline, higher CBVindex combined with the absence of goodCS indicates insufficient blood flow reserve, leading to collapse of collateral flow during acute phase, therefore, the occurrence of END.

Clinical predictors of surgical selection for individuals with neck pain

BackgroundNeck pain is one of the leading causes of disability in the United States. However, the nature of cervical spine surgery is multi-factorial and often based upon clinical opinions, leaving clinical indications still to be clearly defined. ObjectiveTo predict which clinical variables most influenced trends toward surgical or conservative management for individuals with neck pain. DesignRetrospective analysis on prospectively collected data. MethodsTwo-hundred seventy individuals participated in the study. A retrospective chart review was performed to identify qualifying participants. Variables captured during data collection included the following: patient demographic information, physical examination (e.g., neurologic examination), physical performance measures, patient-reported outcome measures (Numeric Pain Rating Scale and Neck Disability Index), and chronicity of symptoms. Group allocation was determined by referring physician’s medical diagnosis. A forward step-wise multiple logistic regression analysis was used to develop a final predictor model with p<0.05 considered significant. ResultsThe model showed older age (beta=0.022; Exp(beta)=1.022; p=0.037), longer chronicity of symptoms (beta=0.000; Exp(beta)=1.000; p=0.012), and greater neck disability (beta=0.027; Exp(beta)=1.028; p<0.001) were significant predictors of the operative group. Most notably, patients with a positive neurologic examination were almost four times more likely to be referred to surgery (beta=1.368; Exp(beta)=3.927; p<0.001). ConclusionIn general neck pain patients, older age, longer chronicity of symptoms, greater disability, and a positive neuro exam are clinical predictors of surgical selection, with positive neuro exam increasing the likelihood of surgery four-fold.

Do specific myelin autoantibodies and increased cerebral dopamine neurotrophic factor in the context of inflammation predict the diagnosis of attention deficit hyperactivity disorder in medication-free children?

BackgroundThe aim of this study was to investigate the serum levels of anti-myelin basic protein (anti-MBP), anti-myelin oligodentrocyte glycoprotein (anti-MOG), myelin-associated glycoprotein (MAG), high-sensitivity C-reactive protein (hs-CRP), cerebral dopamine neurotrophic factor (CDNF), cerebellin-1, and reelin and their relationships with clinical severity and irritability behaviours in children with attention deficit (AD) hyperactivity disorder (ADHD) and typically developing (TD) healthy controls. MethodsIn this study, 141 children with ADHD between the ages of 8 and 14 years who were medication-free and 135 TD healthy controls were included. The serum levels of anti-MBP, anti-MOG, MAG, CDNF, hs-CRP, cerebellin, and reelin were measured using enzyme-linked immunosorbent assay kits. The Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-based Screening and Evaluation Scale for Attention Deficit and Disruptive Behavior Disorders–Parent Form (TDSM-IV-O) and the affective reactivity index (ARI) scale were used to assess clinical severity and irritability behaviours in the children. ResultsThe MAG, CDNF, hs-CRP, reelin, and cerebellin levels were significantly higher in the ADHD group than in the control group, but no significant differences in anti-MBP and anti-MOG levels were found between the groups. Compared with the controls, the patients with ADHD showed significantly higher scores on the ARI self- and parent-report scales. The reelin, hs-CRP, and MAG levels were significantly associated with the TDSM-IV-O AD scores, AD and oppositional defiant (OD) disorder scores and hyperactivity, and OD and conduct disorder scores, respectively. Hs-CRP was significantly associated with anti-MBP and cerebellin levels. In an analysis of covariance, the results were unchanged even after controlling for potential confounders such as age, body mass index, and sex. ConclusionThis study demonstrates that MAG, CDNF, hs-CRP, reelin, and cerebellin levels may play a potential role in the pathogenesis of ADHD.

Effects of inflammatory bowel diseases on sexual function in women.

Inflammatory bowel disease (IBD) is a chronic disease that includes Crohn's disease and ulcerative colitis. Studies found that 40-60% of women diagnosed with IBD have sexual dysfunction (SD). To determine SD and associated factors in women with IBD. Female patients diagnosed with IBD in the Gastroenterology Department who volunteered and healthy volunteers who were examined by a general practitioner were included in the study as the control group. After appropriate training was provided by the researcher, patients and volunteers were asked to fill out the Clinical and Sociodemographic Questionnaire, Hospital Anxiety Depression Scale and Female Sexual Function Index. There were 255 patients in the patient group and 240 patients in the control group. The mean ages of the patient and control groups were 40 ± 12 and 38 ± 11years, respectively. Mean disease duration in IBD patients was 9 ± 5.6years. The SD rate in the patient group (63.5%) was higher than in the control group (23.8%) (p < 0.01). The prevalence of SD was significantly lower in mildly active IBD patients than in moderate and severe IBD patients (p < 0.05). Active disease (OR: 3.82), active perianal disease (OR: 2.15), and severe depression (OR: 3.19) were predictive factors for SD in univariate logistic regression analysis. Previous abdominal surgery was found to be predictive for SD in multivariate analysis (OR: 5.13). The prevalence of SD was high in female IBD patients and its prevalence increased as disease activity increased. History of abdominal surgery in IBD was found to be associated with SD.

Investigation and analysis of sleep and mental health status among MEFCs

ObjectiveTo investigate the sleep status and mental health of migrants elderly who followed their children (MEFC) and analyze the influencing factors.MethodsA total of 583 MEFCs were surveyed using a general demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) scale, and the Symptom Checklist 90 (SCL90) scale.ResultsThe mean PSQI score for MEFCs was 6.98 ± 0.17, and the average SCL90 score was 64.06 ± 2.03. Multiple linear regression analysis indicated that health status and adaptation to the migration destination were associated with PSQI scores (P &amp;lt; 0.05). Health status, adaptation to the migration destination, and family harmony were associated with SCL90 scores (P &amp;lt; 0.05). The association coefficient between the total PSQI and SCL90 scores was r=0.462 (P &amp;lt; 0.05).ConclusionThe sleep and mental health of MEFCs were at a normal level. Health status and adaptation influenced sleep status, while health status, adaptation, and family harmony impacted mental health. However, the association between mental health and sleep status was weak.

Exploring the effects of aromatherapy and acupoint herbal patching on fatigue and sleep disorders in people living with HIV: a pilot randomized trial

ABSTRACT The purpose of this study was to investigate the effects of aromatherapy and acupoint herbal patching on fatigue and sleep disorders in people living with HIV (PLWH). Aromatherapy and acupoint herbal patching are ancient alternative therapies in traditional Chinese medicine. We randomly selected 90 patients from the Nanjing Public Health Medical Center in China and divided them into three groups: aromatherapy group, acupoint herbal patching group and control group. They were supposed to fill in the Pittsburgh Sleepiness Index Scale (PSQI), the Piper Fatigue Scale (PFS), and the Liver Depression and Spleen Deficiency Insomnia Symptoms Scale (LDSSIPS) before and after the intervention. The results showed that the difference between the PSQI score and fatigue score of the aromatherapy group and acupressure group before and after the intervention was statistically significant (P < 0.05), and the difference between the scores of the three groups after the intervention was statistically significant (P < 0.05). This study found that aromatherapy and acupoint herbal patching could effectively alleviate fatigue of PLWH and improve the quality of sleep, and that the therapeutic effect of the aromatherapy group was comparable with that of the acupoint herbal patching group.

Self Stretching Exercise Lebih Efektif Dibandingkan Mckenzie Exercise Dalam Mengurangi Keluhan Low Back Pain Non-Spesifik

Introduction: The activities of garment workers who work with repetitive movements over a long time can influence the emergence of musculoskeletal complaints, one of which is low back pain, which is non-specific. Low back pain non-specific complaints impact functional activities and affect workers' work. Purpose: This study aims to determine the effect of the stretching exercise and McKenzie exercise in reducing pain and increasing functional activity in garment workers with non-specific low back pain. Methods: This type of research is experimental with a pre-test and post-test control group design. Treatment is given in 12 sessions over 4 weeks and carried out from April to May 2024. The research subjects were garment workers who met the inclusion and exclusion criteria with 22 people, divided into group I (n = 11 people) given the stretching exercise and group II (n = 11 people) given the McKenzie exercise. Results: The results of the difference test between groups I and II used the Mann-Whitney U test on the Visual Analog Scale (p &lt; 0.05) and Oswestry Disability Index values (p &lt; 0.05). Methods: It was concluded that self-stretching exercise was more effective than McKenzie exercise in reducing pain and increasing functional activity in garment workers with non-specific lower back pain

Instrumented Facet Fusion in the Lumbosacral Spine: Long-Term Clinical and Radiographic Results.

Surgical treatments for degenerative lumbar spinal disorders involve decompression of neural structures and arthrodesis to address pain from unstable intervertebral segments. Lumbar instrumented facet fusion (IFF), a less invasive technique, has shown positive short-term outcomes, but reports on its long-term outcomes are scarce. This study aims to report its long-term biomechanical stability and clinical outcomes. This single-center retrospective observational case-series included patients who underwent single or two-level IFF for degenerative lumbar spinal disorders from January 1996 to January 2021. Patient demographics, Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores, and radiographic fusion were assessed using flexion-extension radiographs and CT scans. Instrument failures and fusion segment angles were measured. A total of 494 patients underwent instrumented facet fusion during the studied period. Of those, 208 were followed up for more than 24 months (mean follow-up of 89.96 +/- 55.59 months). The overall fusion rate was 92.05%. Revision surgery due to adjacent segmental disease was done in 11.06% of patients. Screw loosening was observed in 6 patients, of whom 2 underwent revision surgery. Significant improvements in ODI and VAS were observed. Instrumented facet fusion is a safe and less invasive alternative method of lumbar spinal arthrodesis with comparable fusion rate and clinical outcome. This method show relatively low revision rate.

Anterior Lumbar Interbody Fusion (ALIF) Versus Full-Endoscopic/Percutaneous TLIF With a Large-Footprint Interbody Cage: A Comparative Observational Study.

Exploratory prospective observational case-control study. Aim of this study was to compare clinical and radiologic outcome, as well as peri-operative complications, of anterior lumbar interbody fusion (ALIF) and full-endoscopic/percutaneous trans-Kambin transforaminal lumbar interbody fusion (pTLIF) with a large-footprint interbody cage. Patients that underwent elective ALIF and pTLIF with a large-footprint interbody cage were prospectively evaluated. Clinical follow-up was measured pre- and post-operatively with Visual Analogic Scale and Oswestry Disability Index scores. Radiologic outcome was assessed with a computed tomography scan and standing films at 12months. 44 patients underwent ALIF and 43 pTLIF surgery (total 87 cases). Clinical pre- and post-operative scores were comparable between both groups with 33.4months mean follow-up. Median surgical time was significantly lower for pTLIF (28minutes) compared to ALIF (72minutes). Radiologic outcome was favorable for ALIF with a significantly higher increase in segmental lordosis compared to pTLIF. Fusion rates did not significantly differ between both groups. ALIF showed significantly less cage subsidence than pTLIF. Complications included 9 (21%) cases with transitory post-operative radiculitis for ALIF and 12 (28%) for pTLIF; post-operative partial muscle weakness 3(6%) cases for ALIF and 4 (9%) for pTLIF. Two (4%) cases required revision surgery for pTLIF. ALIF and trans-Kambin pTLIF obtained comparable clinical outcome and fusion rates, while segmental lordosis restoration was favorable for ALIF. pTLIF required less surgery time and presented less intra-operative complications, while ALIF reported lower rates of post-operative subsidence, revision surgery and complications during follow-up.

The effect of turmeric-Boswellia formulation (Rhuleave-K) in posture-related low back soreness and discomfort: A randomized double blinded placebo controlled trial

Background Poor posture from work or lifestyle habits is a common cause of low back soreness and discomfort. This study investigates the potential of Rhuleave-K, a turmeric-Boswellia formulation for managing these symptoms. Objective To evaluate the efficacy of Rhuleave-K (500 mg) over 15 days in alleviating posture-related low back soreness and discomfort in human participants. Methods This randomized, placebo-controlled, double-blinded, parallel arm study involved 52 subjects aged 18–70 years, with an equal male to female ratio of 1:1, and a 15 days intervention period. The inclusion criteria were a posture-related low back soreness and discomfort for at least 2–3 weeks with a pain intensity of greater than or equal to 5 on numerical rating scale. The primary outcome measure was a pain intensity difference from baseline to day 7 and day 15. Secondary outcome measures were a categorical pain relief scale and Oswestry disability index (ODI). Results There was a significant decrease in the pain intensity (p &lt; 0.001) compared to placebo at the end of 15 days of study in the Rhuleave-K group. After 7 days of supplementation of Rhuleave-K, there was a 56% reduction in pain intensity and by the end of the study, there was 98.5% reduction. In the responder profile of those having greater than or equal to 50% of max total pain relief, all 26 was in Rhuelave-K group and 3 were in placebo group. The ODI had significant 27% and 98% reduction in the disability index at day 7 and 15 respectively for Rhuleave-K group and placebo group had 1% and 3% change. Conclusion Posture-related low back soreness and discomfort was significantly reduced by Rhuleave-K at 500 mg dose. It is hence evident from this study's outcome that the Rhuleave-K can be a safe and effective alternative for the short-term management of lower back discomfort.

ACTION Teens Global Survey-Türkiye Report: More Worry and Less Motivation for Adolescents Living with Obesity.

ACTION Teens (NCT05013359) surveyed adolescents living with obesity (ALwO), their caregivers, and healthcare professionals (HCPs) in 10 countries to identify attitudes, perceptions, behaviors, and barriers preventing effective obesity care. This subanalysis identified key findings from Türkiye. In Türkiye, 700 ALwO (aged 12-<18 years), 700 caregivers, and 324 HCPs completed a cross-sectional survey (September-November 2021). ALwO had poor mean World Health Organization-5 Well-Being Index (36.7) and Rosenberg Self-Esteem Scale (14.6) scores. Most ALwO (85%) were worried about their weight, and many ALwO (92%) and caregivers (96%) worried about weight affecting their/their child's future health. Additionally, many respondents agreed weight loss is completely the ALwO's responsibility (ALwO: 70%; caregivers: 47%; HCPs: 42%). Despite this, only 24% of ALwO reported being highly motivated to lose weight, although 59% reported a weight-loss attempt in the past year. Their most common weight-loss barrier was being unable to control hunger, according to ALwO (76%) and caregivers (73%). HCPs reported discussing weight with 42% of ALwO, on average, with 34% indicating insufficient time during appointments prevents them from discussing weight. Compared with the global ACTION Teens analysis, a greater proportion of ALwO in Türkiye worried about weight impacting future health (92% vs 85%), yet a similar proportion had made a recent weight-loss attempt (59% vs 58%), perhaps due to lower motivation (24% vs 45%). Our results suggest ALwO in Türkiye require greater weight-management support, particularly support with controlling hunger; therefore, measures should be taken to reduce HCPs' time constraints.

Efficacy of Orthognathic Surgery in OSAS Patients: A Systematic Review and Meta-Analysis.

Obstructive sleep apnea syndrome (OSAS) is a prevalent condition characterised by repeated episodes of partial or complete obstruction of the upper airway during sleep, leading to disrupted sleep and associated morbidities. Orthognathic surgery (OGS) has been proposed as a treatment option for OSAS, aimed at anatomically repositioning the maxillofacial structures to alleviate airway obstruction. This systematic review and meta-analysis aimed to evaluate the efficacy of OGS in reducing apnea-hypopnea index (AHI) and Epworth Sleepiness Scale (ESS) scores among OSAS patients. We conducted a comprehensive literature search across multiple databases for studies assessing the outcomes of OGS in OSAS patients, focusing on changes in AHI and ESS scores. The inclusion criteria encompassed observational studies, cohort studies, and randomised control trials. Data extraction and quality assessment were performed independently by two reviewers. Random-effects meta-analysis was utilised to pool mean differences (MD) of AHI and ESS scores preoperatively and postoperatively, with 95% confidence intervals (CI) calculated. A total of 8 studies met the inclusion criteria, where OGS was shown to be slightly more effective in correcting OSAS than the other modalities assessed, primarily CPAP. The pooled MD for AHI demonstrated a significant reduction in scores post-OGS (MD = 29.84, 95% CI: 14.17-45.50, p < 0.0001) with substantial heterogeneity (I2 = 95%). For ESS, the pooled MD indicated a non-significant reduction (MD = 1.91, 95% CI: -1.29 to 5.12, p = 0.24) with high heterogeneity (I2 = 81%). Orthognathic surgery appears to be an effective intervention for reducing AHI in patients with OSAS, suggesting a potential to improve the objective measures of sleep apnea. However, the effect on subjective sleepiness scores, as evaluated by ESS, was not statistically significant. The high heterogeneity among studies warrants individualised patient assessment when considering OGS for OSAS. Further research is needed to identify factors contributing to the variability of outcomes and to assess the long-term benefits and risks associated with the procedure.