Weeks Of Conventional Therapy Research Articles

Effect of neural mobilisation in Bell's palsy: A randomised controlled trial.

Neural mobilisation technique is effective in spinal nerve rehabilitation. However, no study has reported the effect of facial nerve mobilisation in acute Bell's palsy. The objective of our study was to evaluate the effect of facial neural mobilisation over conventional therapy in improving facial symmetry in patients with acute Bell's palsy. A randomised controlled trial was conducted in the physical therapy department for 62 patients with acute Bell's palsy. The intervention included 10 days of drug therapy including 3 weeks of conventional therapy to the experimental and the control group. However, the experimental group received additional nerve mobilisation technique aimed at mobilising the facial nerve at the origin of external auditory meatus. All participants were assessed at baseline and after three weeks using the Sunnybrook facial grading system (SBS) and Kinovea Movement Analysis Software (KMAS). For primary outcome, analysis of covariance with baseline data as covariate showed a significant difference between groups for the post-test mean scores of SBS after 3 weeks (between-group difference, 9.2 [95% CI, 5.1-13.3], . Importantly, the effect size calculated by partial for neural mobilisation was 0.258 (small effect size). For secondary outcomes, independent sample t-test showed a significant difference between groups for the scores on KMAS after 3 weeks for zygomatic muscle (between-group difference, [95% CI, to ], ), frontalis muscle [95% CI, to ], , and orbicularis oris muscle [95% CI, to ], . Facial neural mobilisation is likely to be an effective adjunctive intervention in addition to conventional therapy in improving facial symmetry in acute Bell's palsy.

730-P: At-Home Randomized Crossover Comparison of Automated Insulin Delivery vs. Conventional Therapy with Scheduled Meal Challenges

Automated Insulin Delivery (AID) hybrid closed-loop systems have not been well studied in the context of prescribed meals. We evaluated our interoperable artificial pancreas system (iAPS) with scheduled meal challenges in a randomized crossover trial in an at-home setting. Ten adults with type 1 diabetes completed two weeks of AID-based control and two weeks of conventional therapy (sensor-augmented pump/predictive low-glucose suspend) at home in random order. During each period, subjects consumed pasta or white rice as part of a complete dinner meal on six different occasions (each meal three times in random order). The AID system increased time in range 70-180 mg/dL from 70.6 to 74.0% (3.4, 95% CI -2.3 to 9.1, p=0.22), while sensor time <70 mg/dL significantly decreased from 3.5 to 2.3% (-1.2, 95% CI -2.1 to -0.2, p=0.02). Postprandial glucose AUC difference between meals in conventional therapy was 10,919.0 mg/dL x min (95% CI 3,190.5 to 18,648.0, p=0.009) while for AID it was 6,522.1 mg/dL x min (p=0.24), highlighting the ability of AID to minimize glycemic excursions postprandially. The AID system decreased insulin delivery at 0-2h by 0.45 units (p=0.001) for pasta, while it increased at 2-4h by 0.47 units (p=0.18) for white rice (Table 1). The AID system improved postprandial glucose control over conventional therapy in the handling of challenging meals in the at-home setting. Disclosure J.E. Pinsker: Advisory Panel; Self; Medtronic. Consultant; Self; Eli Lilly and Company, Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Tandem Diabetes Care. Speaker’s Bureau; Self; Tandem Diabetes Care. S. Deshpande: None. M. Church: None. M. Piper: None. C.C. Andre: None. J.S. Massa: None. F.J. Doyle: Research Support; Self; DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Stock/Shareholder; Self; Mode AGC. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. D.M. Eisenberg: Consultant; Self; Barilla Center For Food and Nutrition, Italy. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. Funding Barilla Center for Food & Nutrition Foundation; National Institutes of Health (DP3DK104057, DP3DK113511); Harvard Accelerator; Dexcom, Inc. (IIS-2018-019)

Intralesional autologous platelet rich plasma therapy in chronic nonhealing cutaneous ulcers: an interventional study from a tertiary care centre in North Kerala

<p class="abstract"><strong>Background:</strong> Treatment of chronic nonhealing cutaneous ulcers is a challenge to clinicians. When wounds fail to achieve sufficient healing after 4 weeks of conventional therapy reassess the underlying pathology and consider advanced therapeutic options. Autologous platelet rich plasma is a novel treatment for nonhealing cutaneous ulcers, which can provide growth factors directly onto the wound.</p><p class="abstract"><strong>Methods:</strong> 34 patients with non-healing cutaneous ulcers satisfying inclusion and exclusion criteria were included in the study. All patients were treated with PRP therapy weekly for 6 weeks. Every week ulcer area and volume was measured and outcome expressed as improvement in area and volume of ulcers before and after PRP therapy.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study majority were males (64%) and the mean age of population was 51.0±10.4 years. Of 34 patients 18 had venous ulcers. All ulcers healed within 12 weeks and mean duration of healing was 7.51±2.9 weeks. 8 (24.24%) patients had their ulcer completely healed within 6 weeks. Larger ulcers took long duration to heal and smaller ones healed within short duration. The total improvement in area and volume of ulcers was 85.7% and 90.7% (median) respectively at the end of 6 weeks.</p><p class="abstract"><strong>Conclusions:</strong> PRP is an effective, safe, readily available and cheap outpatient procedure which can be widely used for the treatment of chronic recalcitrant ulcers which improves the quality of life and reduces the financial burden of patients. Further research and controlled, randomized prospective clinical trials on larger population are necessary to validate the results.</p>

THE USE OF MONOCLONAL ANTIBODIES IN THE TREATMENT OF AUTOIMMUNE COMPLICATIONS OF CHRONIC LYMPHOCYTIC LEUKEMIA

Autoimmune cytopenias are a frequent complication in CLL, occurring in approximately 5–10% of the patients. The most common manifestation is autoimmune haemolytic anaemia, followed by immune thrombocytopenia and only rarely pure red blood cell aplasia or autoimmune granulocytopenia. Initial treatment is as for the idiopathic autoimmune cytopenias, with most patients responding to conventional corticosteroid therapy. Patients, who do not respond to conventional therapy after 4–6 weeks, should be considered for alternative immunosuppression, monoclonal antibody therapy or splenectomy. While randomized trials demonstrating the benefit of rituximab in CLL-related autoimmune diseases are still lacking, there are considerable data in the literature that provide evidence for its effectiveness.The monoclonal antibody alemtuzumab also displays considerable activity against both the malignant disease and the autoimmune complication in patients with CLL, although at the expense of greater toxicity. A number of new monoclonal antibodies, such as ofatumumab, GA-101, lumiliximab, TRU-016, epratuzumab, and galiximab, are currently investigated in CLL and their activity in CLL-related autoimmune cytopenias should be evaluated in future studies.

Mycobacterium massiliense Keratitis

The aim of this study is to report a case of keratitis caused by Mycobacterium massiliense, which is a subtype of non-tuberculous mycobacteria. A 23-year-old Chinese man with a history of metal corneal foreign body removal was diagnosed with keratitis of his right eye 4 days after corneal trauma. He presented with intractable redness and continued corneal lesion with further vision loss after 2 weeks of conventional therapy. Pathogen testing and drug susceptibility testing were done. Corneal scraping and culture showed acid-fast staining positive bacilli. Polymerase chain reaction and sequencing confirmed that it was M. massiliense. The corneal ulcer was ultimately cured with 2 months treatment of amikacin and levofloxacin according to antibiotic susceptibility tests. Based on this case, multiple gene sequencing is required for identification of M. massiliense. Early diagnosis and prompt treatment will minimize the risk of sequelae, such as corneal scar and neovascularization.

The Rehabilitation of Gait in Patients With Hemiplegia: A Comparison Between Conventional Therapy and Multichannel Functional Electrical Stimulation Therapy

Gait rehabilitation in patients with severe hemiplegia requires substantial effort. Preliminary studies indicate potential beneficial effects of using multichannel functional electrical stimulation (MFES) for gait rehabilitation in these patients. In this study, a new method of gait rehabilitation for nonambulatory patients with hemiplegia by means of MFES added to conventional therapy was introduced. The results of the method's application were evaluated by comparing it with conventional therapeutic methods. The proposed rehabilitation method was tested on a group of 20 patients with severe hemiplegia secondary to cerebrovascular accident. Subjects were randomly assigned to one of two groups. One group received 3 weeks of MFES followed by 3 weeks of conventional therapy. The other group received 3 weeks of conventional therapy followed by 3 weeks of MFES. The effects of each therapeutic method were evaluated by measurements of temporal-distance variables and ground reaction forces and by assessment of each subject's physical status according to the Fugl-Meyer evaluation scale. There was improved performance of the subjects during MFES combined with conventional therapy as compared with conventional therapy alone. The superiority of the MFES method as compared with conventional therapy was mainly attributed to the enhanced motor learning accomplished by application of MFES. These results, however, are preliminary, and further research is needed.

Cyclosporin A treatment in inflammatory bowel disease.

The effect of cyclosporin A in acute and chronically active inflammatory bowel disease was tested in 11 patients with Crohn's disease and two with ulcerative colitis who had exhibited a poor response to at least eight weeks of conventional therapy. Trough levels of the drug in the therapeutic range were obtained in 12 of 13 patients. Cyclosporin A, which was usually added to the continued previous medication, including corticosteroids (11 of 13) or metronidazol (1 of 13), prompted an apparent clinical improvement in all but one patient. In six of the nine Crohn's disease patients with an initial Best index of greater than 150, a definite fall by at least 100 points was observed after 2-10 weeks of treatment, but the van Hees index declined only in two patients. All four patients with chronic perineal fistulation experienced symptomatic relief. Both patients with ulcerative colitis had a clinical remission. Erythrocyte sedimentation rate or serum albumin improved in eight of 13 patients. However, two of the nine responders with Crohn's disease relapsed during cyclosporin A therapy and three immediately after the medication was discontinued. Common side effects included hypertrichosis, tremor, and hyperesthesia; hypertension and epigastric pain each occurred only in one patient.