Evaluation of health-related quality of life and muscular strength in children with beta thalassemia major

Background: Thalassemia is an inherited blood disorder that requires repeated blood transfusions and chelation regimes. This may lead to restrictions in physical activities, social participation as well as decreased muscle strength.Aim: The aim of this study was to evaluate the health-related quality of life (HRQoL), muscular strength and pain in children with β-thalassemia major.Patients and method: One hundred and twenty children (60 with β-thalassemia major and 60 age-matched healthy) were participated in a cross-sectional study from both sexes (57 girls and 63 boys) with ages ranging from two to twelve years. HRQoL (physical, emotional, social and school functioning), muscular strength and pain were evaluated for all children by using the pediatric quality of life inventoryTM (PedsQLTM) 4.0 generic core scale, hand-held dynamometer and visual analogue scale (VAS) respectively.Results: Children with β-thalassemia major showed a significant decrease in all domains of health-related quality of life and handgrip strength with a significant increase in VAS score (p ≤ 0.0001).Conclusions: The study concluded that thalassemia as a chronic disease has a negative impact on HRQoL and muscle strength of children in different age group.Keywords: Beta thalassemia, Quality of life, Handgrip strength, childre

Modification of Duval Triangle for Diagnostic Transformer Fault through a Procedure of Dissolved Gases Analysis

Dissolved gas-in-oil analysis (DGA) is a sensitive and reliable technique for the detection of incipient fault condition within oil-immersed transformers. When the mineral oil is subjected to high thermal or/and electrical stresses, it decomposes and, as a result, gases are generated.     This paper presents modification of Duval triangle DGA diagnostic graph to numerical method that is easy to use for diagnosing and the possibility to use for a Matlab program.    The evaluation is carried out on DGA data obtained from three different groups of transformers. A Matlab program was developed to automate the evaluation of  Duval Triangle graph to numerical modification, Also the fault gases can be generated due to oil decomposing effected by transformer over excitation which increasing thetransformer exciting current lead to rising the temperature inside transformer core beside the other causes

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of resistance and aerobic exercises on bone mineral density, muscle strength and functional ability in children with hemophilia

Background and purpose: Children with hemophilia are at risk for reduced bone mineral density (BMD), muscle strength and functional ability as a result of reduced leisure-time activity and less involvement in intense activities. So, the purpose of this study was to investigate the effect of resistance and aerobic exercise program on BMD, muscle strength and functional ability in children with hemophilia. Materials and methods: Thirty boys with hemophilia A ranging in age from 10 to 14 years had participated in this study. They were assigned randomly into two equal groups (control and study groups). Control group received a designed physical therapy program and aerobic exercise in the form of treadmill training, while the study group received the same program as the control group in addition to resistance training program in the form of bicycle ergometer training and weight resistance. Both groups received treatment sessions three times per week for three successive months. BMD, muscle strength of knee flexors and extensors and functional ability were evaluated before and after the 3 months of treatment program. Results: There was no significant difference between both groups in the pre-treatment mean values of all measured variables. Significant improvement was observed in BMD, knee extensors and flexors strength, and functional ability in the study group when comparing pre and post treatment measurements. There was a significant improvement in functional ability of the control group. Significant difference was also observed between both groups when comparing the post treatment measurements in favor of the study group. Conclusion: Based on obtained data, it can be concluded that, resistance and aerobic exercise training program is effective in increasing BMD, muscle strength and functional ability in children with hemophilia

39-45 of Sourdough on Shelf Life, Freshness and Sensory Characteristics of Egyptian Balady Bread

Abstract The present study was aimed to improve the quality characteristics of Egyptian balady bread by using sourdough containing (2% Saccharomyces cerevisiae+ 1, 2 or 3% Lactobacillus plantarum). Microbial contents i.e. lactic acid bacteria, total bacterial count and yeasts, pH, organic acids and antimicrobial activity were evaluated during sourdough fermentation. Results showed an increase in organic acids, antimicrobial activity and reduction in pH during the preparation of different sourdough samples. These metabolites were increased by increasing lactic acid bacteria ratio in sourdough (3%> 2%> 1% Lb. plantarum). A significant reduction in total bacterial count and a significant increase in LAB and yeast count during fermentation period was recorded. Bread characteristics showed an extension of shelf life for 8 days for bread samples containing sourdough (2 or 3% Lb. plantarum) comparing to 3 days for control bread. Addition of 20% sourdough containing 2 or 3% Lb. plantarum to wheat flour dough also retarded staling rate by 19.98% and 19.30% after 3 days comparing to control sample was (42.84%). Improvements in sensory characteristics and acceptability of balady bread were also recorded. Accordingly, this could reduce the bread losses and consequently reduce the amount of wheat flour used

Effect of Smartphone Usage on Neck Muscle Endurance, Hand Grip and Pinch Strength among Healthy College Students: A Cross-Sectional Study

In recent years, there has been a significant increase in global smartphone usage driven by different purposes. This study aimed to explore the effect of smartphone usage on neck muscle (flexors and extensors) endurance, hand grip, and pinch strength among young, healthy college students. In total, 40 male students were recruited for this study; 20 of them belonged to the smartphone-addicted group, while the other 20 were in the non-addicted group based on their smartphone addiction scale—short version (SAS-SV) scores (the threshold for determining smartphone addiction: 31/60). Neck flexor endurance time, the ability to perform a neck extensor muscle endurance test, and hand and pinch grip strength were assessed. Multivariate analysis of variance (MANOVA) was used to assess between-group differences in the mean values of neck flexor endurance time, hand grip, and pinch grip. A significant group effect (Wilks’ lambda = 0.51, F (5,34) = 6.34, p = 0.001, partial eta squared = 0.48) was found. A decrease in neck flexor endurance time was observed in the smartphone-addicted group compared with that of the non-addicted group (p < 0.001). However, there was no notable difference in the neck extensor muscle endurance test or in hand grip and pinch grip strength of both hands between groups (p > 0.05). Using a smartphone for a prolonged time might affect neck flexor muscle endurance; however, more research is needed to explore the long-term effects of using smartphones on neck muscle endurance and hand/pinch grip strength and the risk of developing upper limb neuromusculoskeletal dysfunction

Loaded Functional Strength Training versus Traditional Physical Therapy on Hip and Knee Extensors Strength and Function Walking Capacity in Children with Hemiplegic Cerebral Palsy: Randomized Comparative Study

Objective: This study’s objective was to see how loaded functional strengthening exercises using a plantigrade foot position and a shoe supporter affected muscle strength and walking ability in spastic hemiplegic children. Methods: Seventy-two children with spastic hemiplegic cerebral palsy, both sexes, aged ten to twelve years, were randomly assigned into two groups equal in number (control and intervention groups). The control group received a specially designed physical therapy program, whereas the intervention group received a loaded functional strengthening exercises program using a shoe supporter to maintain a plantigrade foot position. The training program was carried out for 60 min, three times per week for three consecutive months. All participants were evaluated both before and after the therapy program by using a Medical Commander Echo Manual Muscle Tester dynamometer to assess isometric muscle power of hip and knee extensors on the affected side. To assess functional walking capacity, a 6 min walking (6MWT) test was used. Results: Study groups were comparable with respect to all outcome measures at entry (p > 0.05). Within-group comparison showed significant improvements in all measured variables. Furthermore, between-group comparison revealed significantly greater improvements (p < 0.05) in hip and knee extensors strength as well as the functional walking capacity in favor of the intervention group. Conclusions: In all the analyzed variables, loaded functional strength exercises from the plantigrade foot position were found to be considerably more effective in the intervention group than in the control group

Concurrent radiochemotherapy versus surgery followed by radiotherapy for hypopharyngeal carcinoma: A single-center study

AbstractBackgroundHypopharyngeal cancer is a rare disease representing about 0.5% of all human malignancies and constituting only 3–5% of all head and neck cancer. Concurrent radiochemotherapy has been recommended as a standard of care in patients with locally advanced squamous cell head and neck carcinomas. There were very few reports about these tumors arising from North Africa.ObjecttiveThis work was a retrospective study at the Ain Shams University hospitals comparing induction chemotherapy and concomitant radiochemotherapy to surgery followed by radiotherapy as regards over all survival.MethodsThis study included 49 patients with hypopharyngeal carcinoma, twenty-three (46.93%) were treated surgically. Surgical excision of the tumor was by pharyngo-laryngo-esophagectomy, except for 2 patients treated by conservative surgery. Postoperative radiotherapy was given to all patients. Twenty sex patients (53.07%) were treated by induction chemotherapy and concomitant radiochemotherapy.ResultsThe mean age was 52.6years (range 25–82). In the present study, females (55.1%) dominated males (44.9%).The most commonly involved subsite, in this study, was the postcricoid area (31 patients=63.3%), followed by the pyriform sinus (16 patients=32.6%), while the posterior pharyngael wall was the site of origin in only two patients (4.1%). According to the AJCC-TNM staging system, 40 patients (81.6%) were advanced stages III and IV, while only 9 patients (18.4%) had an early presentation as stages I and II. Cox proportional-hazard regression was used to compare survival in the two study groups. There was no statistically significant difference in the failure function (death) between patients treated with concomitant radiochemotherapy or surgery followed by radiotherapy after adjusting for the age category, tumor grade, T stage and N stage (proportional hazard, 1.114; 95% CI, 0.574 to 2.163; P, 0.751).Of the variables included in the model, only N1 stage was an independent predictor for the hazard of death after adjusting for the treatment group, age category, tumor grade and T stage (proportional hazard, 2.321; 95% CI, 1.073–5.022; P, 0.033). The model had a −2 log likelihood (likelihood ratio statistic, LRS) of 277.316, which was not statistically significant (P, 0.0501) indicating adequate fit of the full model.ConclusionPostcricoid carcinoma comprises the majority of hypopharyngeal tumors in Egypt. Females are more commonly affected by these tumors, especially postcricoid carcinoma. There was no survival difference between the intended therapy for organ preservation and radical surgery groups. Patients who received concurrent radiochemotherapy had a better chance of survival with a preserved larynx compared with patients who underwent surgery