Effect of Aerobic Exercise Versus Vestibular Stimulation on Lipid Profile in Premenstrual Syndrome

Objective:  To determine the effect of aerobic exercise versus vestibular stimulation on lipid profile in premenstrual syndrome. Subjects and Methods: Sixty patients with premenstrual syndrome had regular menstrual cycles were participated in this study. Their ages were ranged between 23-30 year. Their body mass index did not exceed 30 kg/ m2. They were not participating in physical therapy exercise program at the last 3 months. Patients with cardiovascular problems, pulmonary problems and endometriosis are excluded from the study. All patients were divided randomly into two equal groups (A&B). Group A: It consisted of thirty patients with premenstrual syndrome. They were treated by aerobic exercises in the form of treadmill training at moderate intensity of 60- 70% of the maximum heart rate, 3 times per week for 2 months. Group B: It consisted of thirty patients with premenstrual syndrome. They were treated by vestibular stimulation, 3 times per week for 2 months. Outcome measures: Total cholesterol level, HDL, LDL, triglycerides were assessed for all patients before and after treatment in both groups (A&B). Premenstrual syndrome scale was used to confirm the diagnosis of PMS before study and to evaluate the severity of PMS symptoms for all patients in both groups (A&B) before and after treatment. Results:  Results revealed that, between groups; pretreatment, there was no significant difference between both groups A and B in total cholesterol, triglycerides, HDL, LDL and premenstrual syndrome scale. While post treatment, there was significant difference between both groups A and B in total cholesterol, triglycerides, HDL, LDL and premenstrual syndrome scale (with favour of group A; more decrease in total cholesterol, triglycerides, LDL and premenstrual syndrome scale and more increase in HDL). Conclusion: Aerobic exercise was found to be effective more than vestibular stimulation on lipid profile in premenstrual syndrome, in relieving stress and symptoms of PMS

Effect of Foot Refelexology on Preeclampsia

Purpose: This study was conducted to investigate the effect of foot reflexology on mean arterial blood pressure, Serum Cortisol level, proteinuria and quality of life in pregnant women suffering from mild preeclampsia. Subjects and Methods: Sixty mild preeclamptic pregnant women were selected randomly from Out Patient Clinic of Obstetrics Department in Minia University Hospital in Minia to participate in this study. Their ages were between 20-36 years old. Their body mass index less than 35 kg/m2. They were divided randomly into two equal groups (A & B); Group A (control group): It comprised thirty pregnant women with mild preeclampsia who were treated by antihypertensive drugs only while group B (study group): It comprised thirty pregnant women with mild preeclampsia who were treated by antihypertensive drugs and foot reflexology sessions (25 minutes, 2 sessions weekly for 8 weeks). Assessment: Mean arterial blood pressure (MABP), Serum Cortisol level and proteinuria were assessed before and after treatment for all patients in both groups (A&B), as well as quality of life was evaluated through World Health Organization quality of Life Questionnaire (WHOQOL). Results: revealed that, between groups; pretreatment, there was insignificant difference between both groups A & B in MABP, serum cortisol level, proteinuria and WHOQOL questionnaire scores. While post treatment, there was significant difference between both groups A &B in MABP, serum cortisol level, proteinuria and WHOQOL questionnaire scores [in favor of group B (more decrease in MABP, serum cortisol level and proteinuria; and more increase in WHOQOL questionnaire scores)]. Conclusion: Foot reflexology is an effective modality in decreasing MABP, serum cortisol level and proteinuria, as well as enhancing the quality of life of mild preeclamptic pregnant women

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication