Significant Reduction In Scores Research Articles

Evaluating Effectiveness of Group Intervention Working on Executive Function for Children with Attention Deficit Hyperactivity Disorder: A Prospective Observational Cohort Study

Introduction: The objective of this study is to evaluate the effectiveness of Simon says program (SSP), a strategy-based group intervention program working on executive function (EF) for children with attention deficit hyperactivity disorder (ADHD). Methods: A prospective observational cohort study was conducted from December 2021 to July 2022 recruiting 21 SSP participants, either they were on stimulant or not on stimulants, and 12 other ADHD patients who are on stimulant medication only without prior participation in SSP, using convenience sampling method, from Child Development Clinic Hospital Sultan Ismail. NICHQ Vanderbilt Assessment Follow Up Scales (VAS) were used to measure its effectiveness and the significance of score differences before and after SSP were assessed using paired sample t-test of Statistical Package for Social Science (SPSS) version 28.0 software. Results: Total of 33 children participated in the study. From our study, only those participants on behavioural therapy alone showed statistically significant reduction in inattentive score, hyperactivity score and total symptoms score at the third month and sixth month after joining SSP from parents-rated VAS. There were no statistically significant differences in the average VAS performance score for both groups. Conclusion: SSP could be an effective behavioral intervention for children with ADHD children. Limitations included lacking clear generalizability due to the convenience sampling method and potential inter-rater variability.

The effectiveness of tumor necrosis factor-α blocker therapy in patients with axial spondyloarthritis who failed conventional treatment: a comparative study focused on improvement in ASAS Health Index.

The purpose of this study is to evaluate the impact of tumor necrosis factor (TNF)-α blocker therapy on the Assessment of SpondyloArthritis international Society Health Index (ASAS-HI) among patients who have failed conventional nonsteroidal anti-inflammatory drugs. A comparative study was conducted involving axial spondyloarthritis (axSpA) patients treated with either TNF-α blocker or conventional therapy. Patient data, including demographics, disease characteristics, and ASAS-HI scores, were collected before and after treatment. Statistical analysis was performed to compare changes in ASAS-HI scores between the TNF-α blocker and the conventional therapy group. The study population consisted of patients with axSpA, with a mean age of 38.3 years in conventional treatment group and 29.3 years in TNF-α blocker group. Most variables, including C-reactive protein levels, other comorbidities, and disease assessment scores showed no significant difference between groups. Longitudinal analysis within each treatment group from Week 0 to 12 showed no significant change in the conventional treatment group, whereas the TNF-α blocker group experienced a significant reduction in ASAS-HI scores, demonstrating the effectiveness of the treatment. The TNF-α blocker group exhibited a significantly greater improvement in ASAS-HI scores compared to the conventional therapy group. The Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Disease Activity Index demonstrated strong positive correlations with ASAS-HI scores, indicating higher disease activity and functional limitation are associated with worse health outcomes in patients. The research demonstrates that ASAS-HI scores significantly improve with TNF-α blocker therapy in axSpA patients, underscoring ASAS-HI's effectiveness as a tool for evaluating drug responses.

Feasibility and acceptability of a community health worker administered behavioral activation intervention for postpartum depression: a single arm pilot study from India.

Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral activation intervention addressing PPD among women in Belagavi, South India? 2) What impact did the brief behavioral activation intervention have on PPD? The mixed methods evaluation used interviews with participants and interventionists, and depression scores were assessed before and after the evaluation. After a 2-day training with 17 ASHAs that focused on understanding PPD, screening using the Edinburgh Postnatal Depression Scale (EPDS), and implementing the BA protocol, ASHAs and researcher supervisors screened the mothers 6-12 weeks postpartum presenting at pediatric immunization clinics. Mothers who screened positive were invited to participate in an ASHA-led 5-week BA intervention, with ASHAs visiting the mothers' homes. We assessed post-intervention EPDS scores and conducted satisfaction assessments and individual interviews. All 26 women who screened positive on the EPDS agreed to be enrolled in the study. All participants had a significant reduction (p < 0.001) in PPD scores. Both ASHAs and mothers had high enthusiasm for the intervention methods and activities. This ASHA-delivered BA intervention was found to be feasible, acceptable, and effective in treating PPD in rural Indian mothers. This corroborates literature that demonstrates the efficacy of a BA intervention among individuals with generalized depression in South Asia. In communities with minimal mental health resources, interventions led by trained community workers have the potential to address PPD.

Effects of Preoperative Intravenous Versus Subcutaneous Tranexamic Acid on Postoperative Periorbital Ecchymosis and Edema Following Upper Eyelid Blepharoplasty: A Prospective, Randomized, Double-Blinded, Placebo-Controlled, Comparative Study.

To compare the effects of preoperative tranexamic acid (TXA) administered intravenously (IV) versus subcutaneously on postoperative ecchymosis and edema in patients undergoing bilateral upper eyelid blepharoplasty. A prospective, double-blinded, placebo-controlled study of patients undergoing bilateral upper eyelid blepharoplasty at a single-center. Eligible participants were randomized to preoperatively receive either (1) 1 g of TXA in 100 ml normal saline IV, (2) 50 µl/ml of TXA in local anesthesia, or (3) no TXA. Primary outcomes included ecchymosis and edema at postoperative day 1 (POD1) and 7 (POD7). Secondary outcomes included operative time, pain, time until resuming activities of daily living, patient satisfaction, and adverse events. By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), ecchymosis scores were significantly lower on POD1 (1.31 vs. 1.56 vs. 2.09, p = 0.02) and on POD7 (0.51 vs. 0.66 vs. 0.98, p = 0.04) among those that received TXA. By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA), significant reductions in edema scores occurred in those that received TXA on POD1 (1.59 vs. 1.43 vs. 1.91, p = 0.005) and on POD7 (0.85 vs. 0.60 vs. 0.99, p = 0.04). By comparison (IV TXA vs. local subcutaneous TXA vs. no TXA) patients treated with intravenous and local subcutaneous TXA preoperatively were more likely to experience shorter operative times (10.8 vs. 11.8 vs. 12.9 minutes, p = 0.01), reduced time to resuming activities of daily livings (1.6 vs. 1.6 vs. 2.3 days, p < 0.0001), and higher satisfaction scores at POD1 (8.8 vs. 8.7 vs. 7.9, p = 0.0002). No adverse events occurred were reported. In an analysis of 106 patients, preoperative TXA administered either IV or subcutaneously safely reduced postoperative ecchymosis and edema in patients undergoing upper eyelid blepharoplasty. While statistical superiority between intravenous versus local subcutaneous TXA treatment was not definitively identified, our results suggest clinical superiority with IV dosing.

A Randomized Controlled Trial Comparing Efficacy and Safety of Antidepressant Monotherapy.

The majority of mainstream antidepressants lack the promise of complete amelioration of symptoms. Other pitfalls include the latency period and side effects. These issues prompted investigations concerning thevarious roles of serotonin (5-HT) neurotransmissions in the etiology of depression. In this study, each study participant received vilazodone, vortioxetine, and escitalopram monotherapy for major depressive disorder (MDD)for 16 weeks. After that, the subject's scores on the Hamilton Depression Rating Scale (HDRS)-17 item version and the Montgomery Åsberg Depression Rating Scale (MADRS) were evaluated. In the study population, we kept track of the incidence of adverse events. Ninety-six patients with MDD participated in this open-label, randomized, three-arm study. Participants were allotted into three groups according to a 1:1:1 ratio and given vilazodone (20-40 mg/day), vortioxetine (5-20 mg/day), or escitalopram (10-20 mg/day) for 16 weeks. Vortioxetine and vilazodone are test medications, with escitalopram serving as the control. After the baseline visit, follow-up appointments were scheduled every four weeks. Per-protocol (PP) and intent-to-treat (ITT) populations served as means for efficacy and safety evaluations, respectively. We prospectively registered this research in the Clinical Trial Registry, India (CTRI) (2022/07/043808). Out of the 134 patients we screened, 109 (81.34%) were eligible. Ninety-six (88.07%) of them completed the 16-week trial. In the PP population (n = 96), we analyzed efficacy. They had a mean age of 46.3 ± 6.2 years. At baseline, each group's median HDRS score was 30.0 (p = 0.964). Following 16 weeks of antidepressant therapy, these scores dropped to 15.0, 14.0, and 13.0 (p = 0.002). Baseline MADRS scores for all groups were 36.0 (p = 0.741). They had corresponding values of 20.0, 18.0, and 17.0 at 16 weeks (p < 0.001). Regarding both efficacy endpoints, the post-hoc analysis with the Bonferroni correction demonstrated statistically significant differences (p < 0.001). We performed the safety assessments within our ITT population (n = 109). Ninety-six adverse events were recorded. Nonetheless, none of them seemed serious. Still, five participants opted out because of their side effects. Vomiting and nausea were the most frequent side effects. Compared to escitalopram and vilazodone, vortioxetine demonstrated a statistically significant reduction in HDRS and MADRS scores. It also had fewer and milder side effects. We recommend conducting studies involving a broader population to investigate the antidepressant effects of these medications further.

Study of potency determination of 3X antimuonium crudum in patients with corn

Background: Corn is a hyperkeratotic lesion and present under the area of pressure such as the metatarsal head. The thickening of the stratum corneum suggested that the normal physiological phenomena to protect under lying soft tissue from the mechanical pressure or stress. Methods: 32 patients taken data from OPD, IPD and frequently organized camps by department according to inclusion criteria and as per principles of homeopathy, follow up done every 15 days. Size of corn measured with measuring scale/tape and vernier caliper by Measuring the height, width and diameter of corn pre and post treatment. Results: Statistical analysis done using paired Student’s t test, considering degree of freedom=16. We find a table value 2.120 (p=0.05) and 2.921 (p=0.011) and the null hypothesis got rejected. Conclusions: There is significant reduction of disease intensity score, after the homoeopathic treatment. Which shows the efficacy and potency of 3X Antimuonium crudum in the treatment of corn.

Teknik Grounding untuk Mengurangi Kecemasan pada Remaja

Anxiety is a common mental disorder in adolescents that can have a negative impact. This study evaluated the effectiveness of grounding technique psychoeducation in reducing anxiety in 30 adolescents aged 14-17 years. Using a quasi-experimental design with pre-test and post-test measurements, participants were divided into an experimental group that received grounding technique psychoeducation and a control group. Results showed the experimental group experienced a significant reduction in anxiety scores after the intervention, with a large effect size. These findings are consistent with previous research and suggest that grounding technique psychoeducation can be an effective intervention to reduce anxiety in adolescents. However, further research is still needed to evaluate the long-term effects, compare with other interventions, and investigate the underlying mechanisms.

Evaluating post-rhinoplasty nasal obstruction treatment: The efficacy of VivAer radiofrequency ablation

PurposeNasal obstruction is a prevalent issue affecting up to one-third of adults, often requiring surgical intervention. Low-temperature radiofrequency (RF) treatment, specifically VivAer, has emerged as a promising alternative, especially for the treatment of nasal valve collapse (NVC). However, its efficacy in patients with a history of rhinoplasty or nasal valve repair remains unexplored. MethodsA single-center retrospective chart review was conducted on 37 patients with a history of rhinoplasty or nasal valve repair who underwent VivAer RF treatment. Treatment outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale. The primary outcome was defined as a decrease in NOSE score by at least one severity category or a 20 % reduction in total NOSE score. ResultsThe study found a statistically significant average reduction in NOSE score of 22.4 points or 36.6 %. Among patients with a positive treatment response (21 patients or 56.8 %), the average NOSE score reduction was 34.7 points or 55.6 %. Repeat RF treatment in non-responders resulted in a 50 % response rate. No significant difference was observed in treatment outcomes based on the type of prior rhinoplasty or NVC. ConclusionsTemperature-controlled RF treatment with VivAer can effectively alleviate nasal obstruction in patients with a history of rhinoplasty or nasal valve repair, offering a viable alternative to revision surgery. The study also highlights the potential benefit of repeat RF treatment in non-responders. Further research, including randomized controlled trials, is needed to validate these promising results and expand the treatment options for this complex patient population.

A study of potency determination of 3C antimuonium crudum in the treatment of corn

Background: Planter skin is anatomically different from the normal skin of the body due to prominence of keratin filaments such as k6, k7, k9, k16 and k17. As per Hahnemann statement in chronic disease, Antimuonium crudum is basically the native ore (persulphuric of antimony) found in blocks of parallel block needle with a metallic lustre and are composed of twenty-eight parts of sulphur combined with 100 parts of metallic antimony. Methods: An observational comparative prospective open label study was conducted from September 2019 to September 2020. 32 patients were included in the study. Follow up of the cases were done after every 15 days where the size of the corn was measured using a vernier caliper. Height, width and diameter of the corn was also measured pre and post-treatment to analyse the results. Results: A total of 32 patients were studied. The size of the corn was considerably reduced after taking the medication. There was a significant reduction in the intensity of the pain due to corn after medication as well. Conclusions: There is a significant reduction of disease intensity score, after the homoeopathic treatment. Which shows the efficacy and potency of 3C Antimuonium crudum in the treatment of corn.

A prospective open-label study to evaluate the effectiveness of intravenous ketamine as an adjunct in treating severe depression

BackgroundKetamine, an emerging pharmacotherapeutic agent for depression, has demonstrated rapid and substantial improvement in mood and suicidal ideation, particularly in severe cases. While previous studies have established its efficacy, the current study aims to delve into the effectiveness of intravenous ketamine in treating severe depression.MethodsAn open-label prospective study enrolled 49 consecutive patients with severe depression. Baseline assessments using the Hamilton Depression Rating Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS), and Modified Scale for Suicidal Ideation (MSSI) were conducted. Intravenous (IV) ketamine, administered at 0.5 mg/kg in 100-ml normal saline over 40 min, was given during sessions spaced on alternate days. Each patient received at least five sessions alongside their regular antidepressants. Close monitoring occurred during the infusion, and disease rating scale scores were recorded. Data was analyzed; employed paired Student t-test and graphical were used for visual clarity.ResultsFollowing the initiation of IV ketamine, a significant reduction in scores was observed from baseline. Response rates were achieved in over half of the patients by the third session and in nearly all by the end of fifth session. Remission rates were attained in nearly half of the patients by the fourth session and in almost all by the fifth session.ConclusionsIV ketamine could be considered as an adjunct to antidepressants in treating severe depression especially among those with suicidal ideations to obtain rapid improvement. However, the need for long-term studies is emphasized to determine the duration of its effect.

Clinical Analysis of Microwave Ablation Combined with Decompression and Pedicle Screw Fixation in the Treatment of Spinal Metastases.

There is still controversy over the choice of treatment for end-stage spinal metastases. With the continuous development of microwave technology in spinal tumors, related studies have reported that microwave combined with techniques such as pedicle screw fixation and percutaneous vertebroplasty can achieve the purpose of tumor ablation, relieving spinal cord compression, enhancing spinal stability, effectively relieving pain, and reducing recurrence rates. This study aimed to analyze the effectiveness of microwave ablation combined with decompression and pedicle screw fixation in the palliative management of spinal metastases with pathological fractures. This retrospective study enrolled 82 patients with spinal metastases and pathological fractures treated between January 2016 and July 2020, with 44 patients undergoing pedicle screw fixation along with laminectomy (fixation group) and the remaining 38 receiving microwave ablation in addition to the treatment provided to group fixation (MWA group). Before surgery, all patients underwent pain assessment using the visual analogue scale (VAS) and evaluation of spinal cord injury using the Frankel classification. After surgery, the patients' prognoses were assessed using the Tomita score, modified Tokuhashi score system, and progression-free survival. Additionally, we compared operative time and blood loss between the two groups. Survival analysis utilized the Kaplan-Meier method with a log-rank test for group comparisons. Paired t-tests and the Mann-Whitney U test were applied to metric and non-normally distributed data, respectively. Neurological function improvement across groups was evaluated using the χ2 test. All patients were followed up for a median duration of 18 and 20 months in the fixation and MWA groups, respectively, with follow-up periods ranging from 6 to 36 months. Statistically significant reductions in postoperative VAS scores were observed in all patients compared with their preoperative scores. The MWA group exhibited reduced blood loss (t = 2.74, p = 0.01), lower VAS scores at the 1- and 3-month follow-ups (t = 2.34, P = 0.02; t = 2.83, p = 0.006), and longer progression-free survival than the fixation group (p = 0.03). Although the operation times in the MWA group were longer than those in the fixation group, this difference was not statistically significant (t = 6.06, p = 0.12). No statistically significant differences were found regarding improvements in spinal cord function between the two groups (p = 0.77). Compared with decompression and pedicle screw fixation for treating spinal metastases with pathological fractures, microwave ablation combined with decompression and pedicle screw fixation showed better outcomes in terms of pain control, longer progression-free survival, and lower blood loss without increasing operative time, which has favorable implications for clinical practice.

Efficacy and predictive factors of clinical response to hyaluronic acid ＋ chondroitin sulfate bladder instillations for the treatment of BPS/IC

Aim of the study:To assess the efficacy of intravesical hyaluronic acid and chondroitin sulfate (HACS) instillations in treating patients with bladder pain syndrome/interstitial cystitis (BPS/IC), as well as to identify predictive factors for clinical response. Materials and methods:Patients diagnosed with BPS/IC and treated with Ialuril® (HACS) bladder instillations between January 2018 and August 2020 were included. Data collected included Visual Analog Scale (VAS) scores, number of pain episodes, 3-day frequency volume chart measurements (at baseline and last follow-up), Patient Global Impression of Improvement (PGI-I) questionnaire responses, age, history of urinary tract infections (UTIs), and endoscopic findings from cystoscopy with hydrodistension. Statistical analyses included Mann–Whitney’s non-parametric U-test and chi-square test with a 95% confidence interval (p ≤ 0.05) to identify predictive factors of treatment success. Results:A total of 104 patients were treated with a median follow-up of 29 months (IQR 14–40), predominantly female with a mean age of 60 ± 16 years. At the last follow-up, there was a median reduction of 1 point in the VAS score (IQR 1–1), whilst only 20% experienced a reduction of ≥2 points. A statistically significant correlation was observed in the reduction of days with pain per month before and after treatment (ΔDPV) (median reduction: 6 days, IQR 2–7, p < 0.001). No adverse events were reported during treatment. Regarding prognostic factors, three statistically significant correlations were found: between PGI-I success and age (p=0.050), between ΔVAS score and recurrent UTIs (p=0.044), and between ΔDPV and recurrent UTIs (p=0.04). Discussion:The study did not demonstrate any significant reduction of VAS score or diurnal and nocturnal voiding frequency after treatment, on the contrary it did show a reduction in the number of days with pain. Consequently, 88.3% of patients reported positive subjective improvement on the PGI-I questionnaire, and none discontinued treatment. Endoscopic findings did not appear to correlate with treatment response. Conclusions:Age and the presence of recurrent UTIs may influence the response to intravesical HACS therapy in terms of PGI-I, VAS score, and reduction in days with pain.

Surgical interventions for intractable migraine: a systematic review and meta-analysis

Background: Migraine affects approximately 14-15% of the global population, contributing to nearly 5% of the world’s health burden. When drug treatments prove ineffective for intractable migraines, highly specific surgical interventions emerge as potential solutions. We aimed to analyze surgical approaches for these refractory or intractable migraines through a systematic review and meta-analysis. Methods: We conducted a literature search across databases such as PubMed, Scopus, Web of Science, and Embase, focusing on studies related to migraines and surgical outcomes. We considered clinical trials or observational studies that included any surgical intervention for refractory or intractable migraines, emphasizing key outcomes such as reductions in migraine intensity, Migraine Disability Assessment scores (MIDAS), and 50% Migraine Headache Index (MHI) reduction rates. Statistical analyses were performed using R version 4.3. Results: Eleven studies were included in the systematic review. A meta-analysis of four studies involving overall 95 patients showed a significant reduction in mean migraine intensity scores using ONS (−2.27, 95% CI: −3.92 to −0.63, P=0.021). Three studies with 85 patients showed an average MIDAS score reduction of −52.3, though this was not statistically significant (95% CI: −136.85 to 32.19, P=0.116). Two additional studies corroborated these reductions in MIDAS scores. Nerve decompression surgery showed a substantial decrease in the average migraine intensity (from 8.31 down to 4.06). Median MIDAS score dropped from 57 to 20. Two studies indicated a success rate of 40% and 82%, respectively, in achieving a 50% reduction in the Migraine MHI through nerve decompression. Findings from two studies suggest that septorhinoplasty and sinus surgery effectively decrease migraine intensity scores. Conclusion: The existing evidence emphasizes the potential advantages of surgical interventions as a promising approach to managing intractable or refractory migraines. However, robust and comprehensive research is crucial to refine and solidify the efficacy of these surgical methods, aiming for widespread benefits for patients, considering cost-effectiveness factors.

Comparative analysis of treatment options for chronic heart failure and depression: a systematic review and Bayesian network meta-analysis.

Different interventions have been evaluated for the treatment of depression in heart failure (HF) patients. However, clear and established recommendations are lacking. PubMed, Scopus, and Web of Science databases were systematically searched for randomized controlled trials (RCT) evaluating the effect of various treatment options on depression scores in heart failure patients. The primary outcome was a change in depression scores presented as standardized mean difference (SMD). A Bayesian network for meta-analysis was constructed. Twenty-five RCTs were included, randomizing 6014 patients with confirmed heart failure and depression between 2003 and 2022. Compared to treatment as usual (TAU), only cognitive behavioral therapy (CBT) (SMD - 0.60, CI95% [- 1.0, - 0.17]) leads to a significant reduction in depression scores. Other interventions did not improve depression scores significantly. Our results show that for patients with HF and depression, CBT can significantly improve measures of depression, being the most efficacious treatment.

Head Injury Treatment With Healthy and Advanced Dietary Supplements: A Pilot Randomized Controlled Trial of the Tolerability, Safety, and Efficacy of Branched Chain Amino Acids in the Treatment of Concussion in Adolescents and Young Adults.

Concussion is a common injury in the adolescent and young adult populations. Although branched chain amino acid (BCAA) supplementation has shown improvements in neurocognitive and sleep function in pre-clinical animal models of mild-to-moderate traumatic brain injury (TBI), to date, no studies have been performed evaluating the efficacy of BCAAs in concussed adolescents and young adults. The goal of this pilot trial was to determine the efficacy, tolerability, and safety of varied doses of oral BCAA supplementation in a group of concussed adolescents and young adults. The study was conducted as a pilot, double-blind, randomized controlled trial of participants ages 11-34 presenting with concussion to outpatient clinics (sports medicine and primary care), urgent care, and emergency departments of a tertiary care pediatric children's hospital and an urban tertiary care adult hospital, between June 24, 2014 and December 5, 2020. Participants were randomized to one of five study arms (placebo and 15 g, 30 g, 45 g, and 54 g BCAA treatment daily) and followed for 21 days after enrollment. Outcome measures included daily computerized neurocognitive tests (processing speed, the a priori primary outcome; and attention, visual learning, and working memory), symptom score, physical and cognitive activity, sleep/wake alterations, treatment compliance, and adverse events. In total, 42 participants were randomized, 38 of whom provided analyzable data. We found no difference in our primary outcome of processing speed between the arms; however, there was a significant reduction in total symptom score (decrease of 4.4 points on a 0-54 scale for every 500 g of study drug consumed, p value for trend = 0.0036, [uncorrected]) and return to physical activity (increase of 0.503 points on a 0-5 scale for every 500 g of study drug consumed, p value for trend = 0.005 [uncorrected]). There were no serious adverse events. Eight of 38 participants reported a mild (not interfering with daily activity) or moderate (limitation of daily activity) adverse event; there were no differences in adverse events by arm, with only two reported mild adverse events (both gastrointestinal) in the highest (45 g and 54 g) BCAA arms. Although limited by slow enrollment, small sample size, and missing data, this study provides the first demonstration of efficacy, as well as safety and tolerability, of BCAAs in concussed adolescents and young adults; specifically, a dose-response effect in reducing concussion symptoms and a return to baseline physical activity in those treated with higher total doses of BCAAs. These findings provide important preliminary data to inform a larger trial of BCAA therapy to expedite concussion recovery.

Comparative study between Patrangasava and Pradararipu Rasa in the treatment of Leucorrhoea

Leucorrhoea is a common and significant issue that affects women, particularly during their reproductive years, often experiencing it at least once. It manifests as a discharge of white fluid from the vagina. In this study, we evaluated the comparative efficacy of Patrangasava and Pradararipu Rasa in treating Leucorrhoea. Sixty patients with clinical symptoms including white vaginal discharge, vulva itching, vaginal burning pain, low back pain, and general weakness were selected and divided into two equal groups: Group A and Group B. Group A received treatment with Patrangasava for 3 months, while Group B received treatment with Pradararipu Rasa for the same duration. This prospective, comparative, observational study aimed to assess the effectiveness of these treatments in both groups. The study observed a significant reduction in mean scores of clinical symptoms, particularly white vaginal discharge, in both groups. Overall compliance with the treatment was good in both groups, with a highly significant p-value of &lt; 0.001.

Laparoscopic floppy Nissen fundoplication with valve calibration: a safe and efficient procedure.

A floppy Nissen fundoplication with valve calibration (FNF-VC) performed by laparotomy has been described, to reduce postoperative dysphagia and gas bloating after 360°-fundoplication. As laparoscopy is the gold standard for fundoplication, this study reports the first results of a modified FNF-VC adapted for laparoscopy (LFNF). Seventy-two consecutive patients, who underwent LFNF for refractory GERD between 2012 and 2021, were included. Postoperative outcomes and quality of life (QoL) by GERSS, GERD-HRQL, and GIQLI scores before and after surgery were assessed. The main symptoms were pyrosis (81%), regurgitation (39%), Ear-Nose-Throat symptoms (22%), and thoracic pain (24%). Hiatal hernia was present in 85% (n = 61) of the patients. There was no postoperative mortality, and the severe postoperative morbidity rate (Dindo-Clavien ≥ III) was 6%. After a median follow-up of 3.6years, only 8% of patients were still taking proton-pump inhibitors. Long-term residual dysphagia was noted in 15% of the patients, but none required reoperation or interventional endoscopic procedures. QoL improved, with a significant reduction in GERSS and GERD-HRQL scores and a postoperative GIQLI of 101.75 (75-117.5). This series reports the safety and efficacy of an FNF-VC adapted for laparoscopy to treat GERD with a limited rate of residual dysphagia.

Effectiveness of Tailor-Made Physiotherapy Protocol in Smartphone-Addicted Individuals With Text Neck Syndrome and Short Message Service (SMS) Thumb.

Background Smartphone usage has led to an increase in text neck syndrome (TNS) and short message service (SMS) thumb, causing neck, shoulder, and thumb pain, affecting daily activities. Limited treatment options are available for these conditions, and early intervention is crucial to prevent chronic pain and musculoskeletal issues.This study sought to determine the impact of a personalized physiotherapy treatment plan on alleviating TNS and SMS thumb in individuals who demonstrate excessive smartphone usage. Method The study utilized a single-group, pre- and post-study design with a sample size of 54 smartphone-addicted individuals. The intervention involved a personalized physiotherapy protocol for three weeks, and data was collected using a visual analog scale (VAS), Neck Disability Index (NDI), Smartphone Addiction Scale (SAS), Cornell Hand Discomfort Questionnaire (CHDQ), and range of motion (ROM). Results Descriptive statistics showed a significant reduction in mean scores from pre- to post-rehabilitation, indicating the potential effectiveness of the treatment. Hypothesis testing revealed significant improvements in VAS, NDI, and CHDQ scores post-rehabilitation, with a p-value of <0.05. Correlation analysis demonstrated moderate to strong correlations between pre- and post-rehabilitation scores for VAS, NDI, and CHDQ, with age showing minimal influence on treatment outcomes. Conclusion The findings emphasize the efficacy of personalized interventions in addressing smartphone-related musculoskeletal disorders and underscore the need for further research to optimize treatment protocols and long-term outcomes.

Secondary Benefits of Microsurgical Intervention on the Vertebral Artery (V1 Segment) for Refractory Vertebrobasilar Insufficiency: Alleviation of Parkinsonism-Like Symptoms

ObjectiveTo investigate the outcomes of micro-neurosurgical interventions on V1 segment of vertebral artery (VA) in patients with refractory vertebrobasilar insufficiency (VBI) due to dolicoarteriopathy and external compressions and to assess the secondary benefits of Parkinsonism-like symptoms. MethodsRetrospective analysis encompassed 101 patients treated for VA dolicoarteriopathy or compression-related refractory VBI from 2016-2023. Of these, 16 patients exhibited drug-resistant Parkinsonism-like symptoms. The diagnostic evaluation included cerebral CT/MR angiography or DSA and brain CT or MR perfusion studies, corroborated by preoperative and 6- and 12-month postoperative MDS-UPDRS Part 3 assessments. Data was analyzed through Turkey's 'E-nabız' system, employing Stata16 for statistical scrutiny. ResultsA significant reduction in MDS-UPDRS scores was observed (preoperative: 26.75 ± 10.91; 6 months: 23.09 ± 9.24; 12 months: 22.5 ± 8.73; P<0.001). Postoperative follow-up denoted that 43.7% of patients ceased medication, and 50% reduced antiparkinsonian drugs. The micro-neurosurgical approach resulted in complete remission of VBI-related symptoms in 84.6% of patients, with the rest showing partial or marked improvement. At six months post-operation, perfusion studies revealed posterior border zone or cerebellar perfusion enhancements in 81% (13 out of 16) of patients, with full symptom resolution, while the remaining 19% (3 out of 16) showed partial perfusion and clinical improvements, particularly in regions supplied by the posterior cerebellar artery (PCA) or posterior inferior cerebellar artery (PICA). The absence of operative mortality and minimal transient morbidities underscored the procedure's safety. ConclusionMicroneurosurgery for VA anomalies in refractory VBI patients, particularly those with concomitant parkinsonian-like syndromes, has demonstrated potential in symptom remission and medication reduction.

Predictive factors for response to viscosupplementation in patients with knee osteoarthritis: an analysis of clinical and imaging factors

IntroductionDespite the widespread use of viscosupplementation in the treatment of knee arthritis, the factors that may influence its effectiveness or failure are still controversial and little explored in the literature. ObjectiveTo identify clinical, radiographic, and magnetic resonance imaging (MRI) predictive factors associated with viscosupplementation failure in the treatment of knee osteoarthritis. DesignIn this prospective study, patients with knee osteoarthritis were evaluated for predictive factors before the intervention, including radiographic images (KL classification and femorotibial angle), magnetic resonance images (MRI) Osteoarthritis Knee Score (MOAKS) and meniscal extrusion), joint effusion, BMI, previous surgery, sex, and age. All patients received a single intra-articular dose of Synolis-VA® 4 ml (80 mg hyaluronic acid + 160 mg sorbitol). The WOMAC, VAS, and SF-12v2 questionnaires were administered at baseline, fifteen days, three months, and six months of clinical follow-up. ResultsThe results showed a significant reduction in WOMAC and VAS scores for all evaluated times after viscosupplementation compared to baseline. Using the OMERACT-OARSI criteria, 53 patients were classified as the "success group" and 55 patients as the "failure group." The KL classification and MOAKS score showed a significant difference between these two groups, p = 0.042 and p = 0.009, respectively. Univariate logistic regression analysis revealed that a KL classification of 3 or 4 and MOAKS score predicted a higher risk of failure. ConclusionPatients with a KL classification of 3 or 4 or a high MOAKS score were more likely to fail viscosupplementation, while the other analyzed factors showed no significant difference.