Significant Reduction In Scores Research Articles

Assessment of Nasal Breathing Function and Tip Definition after the Implementation of the Cephalic Lateral Crural Advancement Flap Technique.

Cephalic trimming of the lower lateral cartilage (LLC) can result in the collapse of the internal and external nasal valves, pinched nose, and alar retraction. The cephalic lateral crural advancement flap (CLCAF) technique is introduced as a method to prevent these complications by avoiding grafts in the LLC. A retrospective study was conducted on 126 open-approach rhinoplasties (82 female and 44 male) employing the CLCAF technique between January 2021 and March 2022. Preoperatively, 20 patients exhibited collapse of the internal nasal valve. CLCAF was performed in all patients following cephalic incision, leaving 7 to 8 mm horizontally and caudally of LLC, and preserving the scroll ligament. The CLCAF was advanced onto the lateral crura to reinforce it and tension the scroll ligament. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess the technique. The average postoperative follow-up period was 14 months. Overall, 114 patients (90.5%) experienced improved nasal breathing on the NOSE scale, and the overall NOSE score significantly decreased from a mean of 30.4 to 14.0 (p < 0.001). A statistically significant reduction in NOSE scores was observed in groups with moderate, severe, and extreme obstruction (p < 0.001), with greater improvement seen in the patients with more severe preoperative nasal breathing obstruction. Postintervention, no patient exhibited collapse of the internal valve, and all patients with preoperative collapse of the internal nasal valve showed an increase of at least 40 points in the NOSE scale. Two patients required revision due to tip asymmetry related to CLCAF. Pinched nose or alar retraction was not observed postoperatively in any patient. The implementation of CLCAF, combined with other techniques, enhances nasal breathing function, prevents the collapse of the internal nasal valve, and leads to optimal nasal tip definition, resulting in a better-shaped and functioning nose.

Effects of Botulinum Toxin Type A Treatment on Clinical and Biophysical Parameters in Patients With Erythematotelangiectatic Rosacea: A Prospective, Randomized, Controlled, Double-Blind Study.

Erythematotelangiectatic rosacea (ETR) lacks a gold-standard treatment. Recent studies show that intradermal Botulinum Toxin-A (BoNT-A) is effective for erythema, though objective data are limited. This study aims to evaluate the efficacy and tolerability of intradermal BoNT-A in patients with ETR. In this randomized, double-blind, split-face study, 30 patients were enrolled. One side of the face received 15 units of BoNT-A, reconstituted in 10 mL of saline, while the control side received saline injections. Assessments were made at baseline and 1-month posttreatment. Clinician's Erythema Assessment (CEA) scale and Patient Self-Assessment (PSA) scores were recorded. Erythema and Melanin Index measurements using a Mexameter. Background erythema was assessed through dermatoscopy, while vascular structure and density were evaluated using Investigative Global Assessment (IGA) scores through videocapillaroscopy. The BoNT-A-treated side demonstrated significant reductions in CEA scores, Erythema Index, and dermatoscopic background erythema, while no significant changes were observed on the saline control side. IGA scores indicated a significant response to treatment on the BoNT-A side. Patient Self-Assessment scores improved on both sides. No serious adverse events requiring hospitalization were reported. Intradermal BoNT-A effectively reduces erythema and vascular density in patients with ETR and is well-tolerated.

Comparing the efficacy of oral apremilast, intralesional corticosteroids, and their combination in patients with patchy alopecia areata: a randomized clinical controlled trial.

Alopecia areata (AA) is a chronic, immune-mediated inflammatory disorder characterized by nonscarring hair loss. The management of AA poses challenges due to its unpredictable course and variable response to treatment. In this comparative study, we evaluated the efficacy and safety of oral apremilast, intralesional corticosteroids (ILC) and a combination of both in patients with patchy AA. Sixty patients with patchy AA were randomly assigned to three treatment groups: oral apremilast (Group A), ILC (Group B), and a combination of both (Group C). The Severity of Alopecia Tool (SALT) score was used to assess the extent of hair loss before treatment, after 3 months, and at 6 months of follow-up. Adverse events and complications were also monitored. The changes in SALT score from baseline between the three groups were assessed by using non-parametric statistical tests. The statistical significance was judged at 5% level of significance. Findings demonstrated significant higher reduction in median SALT scores after treatment i.e., 2.47 (1.76, 5.07), p < 0.001 as well as after six months follow up 5.08 (3.80, 7.53), p < 0.001 in patients treated with ILC compared to other two groups. Neither apremilast monotherapy nor its combination with ILC demonstrated statistically significant improvement, although individual responses were observed. Complications were minimal, with transient pain and burning sensation reported during ILC injections and a few cases of gastritis and relapse in the oral apremilast group. These findings suggest that ILC remains an effective treatment option for patchy AA. This study did not demonstrate statistically significant efficacy of oral apremilast, either as monotherapy or in combination with ILC, though larger studies may be needed to evaluate potential benefits in specific patient subgroups. Further research with larger sample sizes and longer-term follow-up is needed to validate these findings and optimize treatment approaches for AA.

Handheld fans for dyspnoea in respiratory failure: randomised controlled trial

ObjectiveFan therapy is widely acknowledged as an essential component in the management of dyspnoea with numerous studies supporting its efficacy in alleviating dyspnoea among patients with chronic illnesses. However, there...

Randomized controlled trial of bushen yinao pill combined with conventional therapy on intestinal flora imbalance and cognitive function improvement in older patients with Alzheimer's disease.

This study aimed to evaluate the effects of the Bushen Yinao Pill, combined with standard therapy, on gut flora imbalances, inflammatory markers, and cognitive function in older patients with Alzheimer's disease (AD). A total of 136 AD patients treated at the Department of Neurology from August 2022 to September 2023 were randomly assigned to two groups: 68 patients received standard treatment (control group, CTG), and 68 patients received the Bushen Yinao Pill plus standard treatment (intervention group, ITG). Outcomes included TCM syndrome scores, gut microbiota composition, inflammatory markers, cognitive function, overall efficacy, and safety. ITG showed significant reductions in syndrome scores as compared to CTG after treatment (P < 0.05). The ITG also showed significant increases in beneficial bacteria and decreases in harmful bacteria compared to the CTG (P < 0.05). Inflammatory markers (Aβ, IL-6, TNF-α) were reduced, and cognitive function improved more significantly in the ITG (P < 0.05). The effective rate was higher in the ITG, with no significant difference in adverse reactions between the groups (P > 0.05). The Bushen Yinao Pill, when combined with standard therapy, effectively regulates gut microbiota, reduces inflammatory markers, and enhances cognitive function in AD patients, showing a favorable safety profile. Further research is recommended to validate these findings in diverse populations.

The effects of Ramadan fasting on acne vulgaris: clinical, immunological, and oxidative status considerations.

Acne vulgaris, a prevalent inflammatory skin condition, is closely linked to the immune system's regulation and oxidative stress. During Ramadan, the practice of intermittent fasting-abstaining from food and drink from dawn to sunset-can impact both body and skin health, potentially influencing the pathophysiology of acne including the immune response and the oxidative status. The objective of this study was to investigate the impact of Ramadan fasting on disease severity, Th1/Th17 cytokine levels, and oxidative status in patients with acne vulgaris. The study involved 40 patients with acne vulgaris. The severity of the condition was evaluated using the Global Acne grading System (GAGS) score, body mass index (BMI) was calculated, and levels of interleukin (IL-17), interferon gamma (IFN-γ), and Malondialdehyde (MDA) were measured both before and after the fasting period. A significant reduction in GAGS score, IL-17, IFN-γ, and MDA levels was observed after Ramadan fasting compared to before Ramadan. Additionally, the percentage decrease in GAGS score showed a positive correlation with the percentage decrease in IFN-γ. Intermittent fasting during Ramadan could potentially benefit acne vulgaris by reducing the Th1/Th17 immune response and lowering oxidative stress.

Flexible endoscopic treatment of Zenker's diverticulum: a retrospective study in a single center from Turkey.

We aimed to contribute to the literature by sharing the findings of patients treated by cricopharyngeal myotomy with a flexible endoscopic septal division. This retrospective study included patients with Zenker's diverticulum who underwent cricopharyngeal myotomy with a traditional flexible endoscopic septal division at our center. Clinical success was defined as a significant reduction in dysphagia score, and relapse was defined as an increase in dysphagia score occurring at any time over 1 month after the procedure. Fifteen patients with symptomatic Zenker's diverticulum were treated with 16 cricopharyngeal myotomies. A dysphagia score of 100% indicated clinical success, but three (20%) of the patients experienced recurrence during follow-up. While advances in interventional flexible endoscopy have opened doors for novel treatments, cricopharyngeal myotomy based on traditional flexible endoscopic septal division remains a reliable approach for treating Zenker's diverticulum.

Comparison of the effects of in-person and internet-delivered mindfulness-based stress reduction on the burden of psychosomatic symptoms in nurses.

There is some evidence comparing the efficacy of telehealth to in-person mental health care, but there is limited research specifically comparing these modalities in nurses. The study aimed to compare the effects of Mindfulness-based Stress Reduction (MBSR) and Internet-delivered Mindfulness-based Stress Reduction (iMBSR) on burden of psychosomatic symptoms of nurses working at Al-Alhamzeh general hospital, Aldiwaniyeh, Iraq. The study was a semi-experiment study with a pre-posttest design on 72 registered nurses. Subjects were randomly allocated in group A, in-person MBSR and group B, internet-delivered MBSR. Intervention in two groups was held at 8 weekly sessions. The data collection instrument included sociodemographic, Patient Questionnaire Health-15 (PHQ-15), and General Health Questionnaire-12 (GHQ-12). Data were analyzed with SPSS version 24 by descriptive and non-parametric inferential tests. The study found that 50% of the nurses in both groups reported mild somatic symptoms, and 40% reported moderate symptoms, with the majority showing no signs of mental distress. A more significant reduction in GHQ scores compared to PHQ scores was observed from pre-to post-intervention. Notably, the online MBSR group showed a significant decrease in GHQ scores, both between groups (p = 0.04) and within the online MBSR group itself (p = 0.02), highlighting the greater impact of the intervention in this group. The study highlights the positive effects of both in-person and online MBSR interventions on reducing depressive symptoms and improving mental health outcomes among nurses. Online MBSR, in particular, shows promise in addressing medically unexplained symptoms and enhancing mental well-being.

Comparative Effectiveness of Modified Manual and Powered Toothbrushing Interventions in Individuals with Disabilities: A Randomized Controlled Trial Assessing Gingival Health

ABSTRACT Background: Individuals with disabilities face unique challenges in maintaining optimal oral health due to physical, cognitive, and sensory impairments. Gingivitis is a common oral health problem in this population, necessitating effective interventions tailored to their specific needs. Methods: Participants (n = 162) aged 18–65 years, diagnosed with gingivitis and varying disabilities, were recruited. They were randomly assigned to the modified manual toothbrush group or the powered toothbrush group. The interventions included comprehensive training programs that addressed the specific needs of each group. Gingival index and plaque index scores were recorded at baseline and at 4, 8, and 12 weeks. Patient-reported outcomes, including satisfaction, comfort, and ease of use, were assessed. Statistical analyses were performed, including t-tests, Chi-square tests, and subgroup analyses based on disability types. Results: Baseline characteristics did not demonstrate significant differences between groups. Over 12 weeks, both groups showed a significant reduction in gingival and plaque index scores (P &lt; 0.001). The powered toothbrush group exhibited a slightly greater reduction in gingival inflammation compared to the manual toothbrush group (P = 0.03). Patient-reported results favored the powered toothbrush group in satisfaction (P = 0.02) and ease of use (P = 0.04). Comfort levels did not show significant differences (P = 0.11). Conclusions: This randomized controlled trial provides evidence supporting the effectiveness of modified manual and powered toothbrushing interventions in reducing gingival inflammation among people with disabilities diagnosed with gingivitis.

Adalimumab Use in Severe Recalcitrant Vulval Lichen Sclerosus and Vulval Lichen Planus.

This case series aims to evaluate the demographic features, disease characteristics, and treatment outcomes of 8 patients receiving subcutaneous (SC) adalimumab for severe, refractory vulval lichen sclerosus (VLS) and/or vulval lichen planus (VLP). Both conditions are chronic inflammatory dermatoses that significantly impair quality of life, and although first-line treatment typically involves potent to ultrapotent topical corticosteroids, managing severe cases is challenging due to a lack of FDA-approved systemic therapies. Adalimumab, a TNF-α inhibitor, may offer a promising alternative by targeting the inflammatory cytokine implicated in the pathogenesis of both conditions. Eight patients received SC adalimumab for VLS and/or VLP at a tertiary referral vulvar disorders clinic from September 2020 to June 2024. Among the 8 patients, 4 had VLS/VLP clinical overlap, 2 had VLP, and 2 had VLS. Evaluation included patient-reported outcome measures (PROMs) namely the vulval life quality index (VLQI) and numerical rating scales for itch and pain, and objective clinical severity was assessed by a vulvar dermatologist based on cutaneous signs and architectural features. Adalimumab was well tolerated by 6 of 8 patients who received treatment for at least 9 months. Varying degrees of clinical improvement were observed in cutaneous signs and PROMs, including significant reductions in vulval life quality index scores for 6 patients. Architectural changes remained stable throughout treatment for all patients. This case series indicates that SC adalimumab may be a treatment option for patients with severe, refractory VLS and VLP, as demonstrated by significant improvements in PROMs. The observed clinical benefits suggest that adalimumab targets key inflammatory pathways in these conditions. Controlled trials are necessary to further validate these findings and define adalimumab's role in managing severe refractory VLS and VLP. Future research should also investigate long-term efficacy and safety, as well as potential predictors of treatment response, to optimize care for this challenging patient population.

Development of a forest healing program for individuals with musculoskeletal disease risk and verification of its preventive effects.

Preventive treatment is crucial in averting the onset of musculoskeletal diseases, particularly among individuals in high-stress occupations. This study aimed to develop a forest healing program and a standardized survey index to gauge its efficacy in mitigating stress and preventing musculoskeletal disorders. Service-oriented workers who engage in repetitive tasks but are not traditional office workers at risk of musculoskeletal issues were recruited. The forest healing program was crafted through a review of existing initiatives and identification of factors alleviating muscle tension and stress. A comprehensive survey index encompassing stress, depression, anxiety, quality of life, and somatization was designed. Participants were assessed using the Perceived Stress Scale (PSS), Somatization Scale (SOM), and the newly devised survey index before and after engaging in the developed forest healing program. Evaluation of 42 participants pre- and post-program revealed significant reductions in PSS (25.857 ± 8.120/17.905 ± 5.958; P < .001), SOM (27.905 ± 8.839/20.286 ± 8.019; P < .001), and standard survey index scores (33.857 ± 10.280/23.333 ± 8.703; P < .001). The developed forest healing program demonstrated substantial stress relief and muscle relaxation benefits, proving effective in preventing musculoskeletal diseases. Moreover, the standardized survey index emerged as a valuable tool for assessing stress related to such disorders, exhibiting correlations with PSS and SOM.

Effects of Ketamine vs. Midazolam in Adolescent Treatment Resistant Depression

Background: Adolescent treatment resistant depression (TRD) is increasing in recent years. While ketamine showed rapid antidepressant effects in adult TRD studies, research on its effectiveness in adolescents is limited. Methods: This study examines the effects of intravenous ketamine vs. midazolam on depressive and anxiety symptomatology assessed by the Montgomery–Åsberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), and Children’s Depression Inventory (CDI) at two time points—2 h after initial infusion (T0+2h) and 24 h after the end of the treatment (Te+24h) in a sample of 55 adolescent TRD females (27 receiving ketamine, 28 midazolam). Results: At T0+2h, within-group comparisons revealed a significant reduction in MADRS and HAM-A scores compared to baseline in the ketamine and midazolam groups. At Te+24h, both groups demonstrated similar significant reductions in MADRS, HAM-A, and CDI scores compared to baseline. The MADRS assessment in the ketamine group showed 33% and 59% responders, and in the midazolam group, 14% and 46% responders at T0+2h and Te+24h, respectively. HAM-A evaluation in the ketamine group revealed 33% and 56% responders, and in the midazolam group, 11% and 39% responders at T0+2h and at Te+24h, respectively. CDI rating discovered 11% and 44% responders in the ketamine group and 4% and 21% responders in the midazolam group at T0+2h and Te+24h, respectively. Moreover, inner tension significantly decreased in ketamine compared to the midazolam group at Te+24h. Conclusions: Ketamine showed a reduction in depressive and anxiety symptoms during a short-term period with particular efficacy in alleviating inner tension over midazolam, suggesting its potential advantages in specific symptom relief in rarely studied adolescent TRD.

The Effect of Immersive Virtual Reality on Dental Anxiety and Intraoperative Pain in Adults Undergoing Local Anesthesia: A Randomized Clinical Trial.

This study assessed the effect of immersive virtual reality (IVR) on anxiety and intraoperative pain in adult patients undergoing dental extractions with local anesthesia. In a single-blind, randomized clinical trial from September 2022 to December 2023 at a private dental clinic, 190 patients with dental anxiety were randomly assigned to either an IVR or a control group. Primary outcomes-dental anxiety and perioperative pain-were measured using the State-Trait Anxiety Inventory (STAI), Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS) before and after the procedure. Secondary outcomes included heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP), recorded at various stages. The IVR group showed significant reductions in total anxiety, state anxiety, and MDAS scores compared to the control group (p < 0.001). Pain intensity was also lower in the IVR group (p = 0.03). Additionally, heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were consistently lower in the IVR group across different stages. Post anesthesia, the IVR group showed notably lower mean SBP and DBP values (p < 0.001). After surgery, the IVR group also showed lower HR (p = 0.01), SBP (p < 0.001), and DBP (p < 0.001) compared to the control group. IVR significantly reduced STAI, STAI-S, and MDAS scores and decreased intraoperative pain compared to the control group.

Curricular Self-management for patients on ventricular assist device support decreases depression: A multicenter randomized controlled trial.

Utilization of ventricular assist device (VAD) support in patients with end-stage heart failure is well advanced. Recent studies emphasize the need to develop and evaluate evidence-based psychosocial support interventions for patients following VAD implantation. A national, multi-center study in four established German heart centers was initiated. An evidence-based VAD curriculum was developed; a randomized controlled trial evaluated the impact of the interprofessional intervention over time. Primary combined endpoint was the occurrence of adverse events (thromboembolic events, driveline infections, bleeding, rehospitalization, and death); secondary endpoints were psychosocial outcomes (anxiety, depression [HADS], quality of life [QoLVAD], social support [FSoZu], and self-management [SELMA]). A total of 140 patients were randomized block-wise to intervention (IG n = 70) or control (CG n = 70). Center-effects were considered. Instruments were completed at four time points (T0-T3). At baseline, intervention group (IG) patients were 19% female (control group [CG] 19%; p = 0.982); 58 ± 11 years. (CG 58 ± 11 years.; p = 0.966); 80% were implanted electively (CG 79%; p = 0.968). No significant difference in primary endpoint was found between IG versus CG (p > 0.05). For secondary endpoints, mixed linear regression revealed a significant reduction in depression scores in IG compared to CG (est. 1.18; 95% CI -2.17 to -0.18; p = 0.021). Clinically significant reductions in anxiety were greater in IG patients between T0 and T3 (IG 51.9%; CG 40.7%); increased anxiety was reported in 3.7% IG (11.1% CG). Mixed linear regression analyses favored IG (all >0.05) for QoL, social support, and self-management. A comprehensive curricular VAD intervention has potential to decrease depression levels and improve psychosocial outcomes of patients on VAD support.

Review of Current and Upcoming Second-Line Treatments for Primary Biliary Cholangitis.

Treatment for primary biliary cholangitis (PBC) was defined by its singular relationship with ursodeoxycholic acid (UDCA) for decades. However, nearly 40% of patients fail to achieve adequate biochemical response with UDCA, necessitating second-line therapies. The aim of our review was to assess the efficacy and safety of second-line therapies for PBC from phase three trials. We conducted a systematic review of PubMed, Medline, and ClinicalTrials.gov for published phase three trial data of second-line PBC therapies. Four phase three clinical trial evaluating obeticholic acid, bezafibrate, seladelpar, and elafibranor, were identified. All trials but one defined the treatment endpoints of an alkaline phosphatase (ALP) less than 1.67 times the upper limit of normal (ULN), a 15% decrease of ALP from baseline, and normal total bilirubin (TB) after 12months. All therapies demonstrated statistically significant achievement of primary endpoints relative to placebo. Reduction in ALP from baseline ranged from 113 to 133.9 U/L (-34.6% to -50%) across all trials. Primary endpoint treatment differences relative to placebo ranged between 31 and 47%. ALP normalization rates were described for three treatments and varied between 15 and 67% in treatment cohorts,compared to 0% to 2% of placebo cohorts. Only elafibranor and seladelpar demonstrated significant reduction in total 5D itch scale scores. Discontinuation rates across studies ranged from 1 to 14% due to adverse effects. All reviewed therapies met their respective study endpoints. Effective second-line therapies area available and continue to receive long-term evaluation in patients with PBC.

Efficacy and Safety of Dose Increase From 40 mg/d to 80 mg/d of Lurasidone in Patients With Schizophrenia: A Post Hoc Analysis of Extension Trial.

The primary objective of this study was to evaluate the efficacy and safety of increasing the dose of lurasidone from 40 mg/d to 80 mg/d in patients with schizophrenia. This post hoc analysis focused on patients who completed a 6-week double-blind, placebo-controlled trial of lurasidone and transitioned to a subsequent 12-week open-label extension trial. Patients initially assigned to lurasidone (40 mg/d) or placebo during the double-blind trial (DBT-LUR group or DBT-PLA group, respectively) received lurasidone (40 mg/d) during the extension. Clinicians could increase the dose to 80 mg/d based on clinical judgment. The efficacy outcomes included the change in the Positive and Negative Syndrome Scale (PANSS) total score from the start to the end of the lurasidone (80 mg/d) treatment period. Safety outcome was the rate of newly emergent adverse events. Of 287 patients in the intention-to-treat population, 153 received an increased dose of lurasidone from 40 mg/d to 80 mg/d. Significant reductions in the PANSS total scores were observed in both groups (all P values, ≤0.001). Additionally, 35.9% of the DBT-LUR group and 40.0% of the DBT-PLA group achieved a ≥20% reduction in the PANSS total score. New adverse events emerged in 47.4% of the DBT-LUR group and 48.0% of the DBT-PLA group during the lurasidone (80 mg/d) treatment period. Increasing the dose of lurasidone from 40 mg/d to 80 mg/d may be effective and well tolerated in patients with schizophrenia. Because of the lack of a control group and blinding, the results should be interpreted with caution.

Effectiveness of Vitamin D Supplementation in Reducing Atopic Dermatitis Severity in Children: A Meta-Analysis

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that commonly affects children, with increasing prevalence worldwide. Vitamin D has demonstrated immunomodulatory effects, suggesting a potential role in AD management. This meta-analysis aimed to evaluate the effectiveness of vitamin D supplementation in reducing AD severity in children. Methods: A systematic search of PubMed, Science Direct, and Cochrane databases was conducted for randomized controlled trials (RCTs) published between 2012 and 2024, investigating the effects of vitamin D supplementation on AD in children. The primary outcome was the change in SCORAD (SCORing Atopic Dermatitis) or EASI (Eczema Area and Severity Index) scores. Meta-analysis was performed using Review Manager (RevMan 5.4) software. Results: Four RCTs met the inclusion criteria, comprising a total of 234 participants. The meta-analysis revealed a significant reduction in SCORAD scores (-2.83; 95% CI: -4.9, -0.76) and EASI scores (-0.41; 95% CI: -0.70, -0.13) in the vitamin D supplementation groups compared to the control groups. A combined analysis of both scoring systems further confirmed the overall significant effect of vitamin D in reducing AD severity (-1.57; 95% CI: -2.78, -0.36). Conclusion: Vitamin D supplementation is effective in improving AD symptoms in children. Further large-scale RCTs are warranted to determine the optimal dosage and duration of vitamin D supplementation for AD management in children.

The Efficacy of Brainspotting and Sand Therapy to Reduce Anxiety Symptoms in Children Aged 8-9

This study explored the use of Brainspotting (BSP) in combination with Sand Therapy (ST) for use with 8–to 9-year-old children with anxiety symptoms in a school-based setting. Using the Spence Children's Anxiety Scales (SCAS), The Behavior and Feelings Survey (BFS), and the Top Problems Assessment (TPA), the research project measured anxiety as reported by parents/caregivers and students, internalizing, externalizing, and total concerns as reported by parents/caregivers, teachers, and students, and finally individually identified unique concerns as reported by parents/caregivers, teachers, and students. The researcher collected data from student participants (11) who experienced six sessions of BSP and ST. The quantitative data collected identified project signifiers for future researchers. Outcomes reflected statistical significance of a reduction in anxiety scores for parents in the subscale of generalized anxiety and a significant reduction of scores in children in the subscales of generalized anxiety and separation anxiety. Parents and teachers indicated significantly lower scores in internalizing and total concerns identified across time intervals. All three groups of reporters indicated a significant reduction of top problems identified across time intervals. Outcomes demonstrate the promise of the integrated practice of BSP and ST while laying a framework for future research of this method.

Outcomes associated with functional mobility and pain amelioration in 49 patients after sacroplasty: a single-center study

This study aimed to determine the predictive factors for analgesic reduction and amelioration of mobility following percutaneous sacroplasty in patients with insufficiency fractures or metastatic lesions. A single-center retrospective analysis of 49 patients who underwent percutaneous sacroplasty for insufficiency fractures and sacral pathological lesions was conducted. Visual analog scale (VAS), Functional Mobility Scale (FMS), and Oswestry Disability Index (ODI) were assessed. All data were accessed immediately before and 1month after the procedure. Thirty-one patients (63.3%) experienced a significant reduction in VAS score, 36 (73.5%) experienced amelioration of FMS, and 20 (40.8%) fell within the ODI at 1month. The mean VAS score was 7.8 (median [min-max]=8 [3-10]) preprocedure and 3.4 (median [min-max]=3 [0-8]) postprocedure. The mean ODI was 0.5 (median [min-max]=0.5 [0.3-0.8]) preprocedure and 0.3 (median [min-max]=0.3 [0-0.7]) postprocedure. The mean FMS was 2.6 (median [min-max]=3 [1-5]) preprocedure and 1.2 (median [min-max]=1 [0-4]) postprocedure. There was a statistically significant increase in VAS amelioration in patients without concomitant vertebroplasty (odds ratio=4.16, interval range [1.09; 15.79], P<0.05). Major complications were not observed. In terms of long-term satisfaction, only two patients reported that they would not undergo the same procedure again. Percutaneous sacroplasty was effective for pain relief, functional outcomes, and short-term satisfaction. The absence of concomitant vertebroplasty was significantly associated with VAS improvements.

Evaluation of the anti-psychotic and neuroprotective properties of &lt;i&gt;Bergenia ciliata &lt;/i&gt;root extract in rat models

Psychosis, a chronic mental illness, can be treated with plants and traditional herbs, which contain phytochemicals and counter oxidants to support body organs and reduce schizophrenia risk. The study aimed to evaluate the anti-psychotic potential of Bergenia ciliata by collecting, authenticating, and preparing a methanolic extract from its roots. Two experimental models were used to simulate psychotic symptoms in rats and assess the extract's influence on movement and activity patterns. The objective parameters included behavioral assessments of stereotypic and locomotor activities to quantify the effects of the extract. Biochemical analysis was conducted on brain tissue homogenates, focusing on glutathione (GSH) estimation, acetylcholinesterase (AchE) activity assay, and TNF-α measurement to evaluate inflammation levels. Histopathological analysis of the brain, particularly the frontal cortex and hippocampus, was also conducted to examine structural changes in brain tissues. Key observations: This analysis provided insights into the neuroprotective effects of the methanolic root extract on critical brain regions implicated in psychotic disorders. The results showed that the apomorphine control group had high stereotypy levels, while the apomorphine + standard drug group showed a significant reduction in stereotypy scores at 60 and 90 minutes. Both dosages of Bergenia ciliata showed significant reductions in stereotypy scores at 60 and 90 minutes, suggesting its potential in mitigating the stereotypy induced by apomorphine. The study also found significant differences in GSH, AchE, and TNF-alpha levels between the normal control (vehicle) and Apomorphine 1.5 mg/kg, the std drug (Haloperidol 1 mg/kg), and Bergenia ciliata (250 and 500 mg/kg). Recordings in an Actophotometer were taken on Days 1, 8, 15, and 23. The data revealed no significant differences between groups, except for the positive control, this exhibited a significant decrease in comparison to the healthy animals, a notable increase in locomotor activity was observed following the administration of diazepam in the B. ciliata group, particularly when contrasted with the positive control group. Additionally, B. ciliata exhibited significant effects on biochemical parameters compared to the positive control. The histology of the brain's cerebellar cortex, hippocampus, and frontal cortex under different conditions showed well-preserved layers and healthy neurons. Diazepam-treated brain showed mild neuronal degeneration with vacuolations and congested blood vessels. Oligodendrocytes and pyramidal cells were less affected, but some neuronal degeneration was evident. Both low and high doses of the test drug maintained normal cortical and hippocampal structure, with healthy neuronal architecture, oligodendrocyte presence, and adequate vascularization. The study suggests that Bergenia ciliata may be an effective anti-psychotic agent, potentially reducing inflammation and enhancing psychotropic effects.