Plasma homocysteine levels in Indian patients with acute ischemic stroke

Background: Homocysteine has primary atherogenic and prothrombotic properties. The present study aimed to assess serum homocysteine levels in patients with ischemic stroke and to find association of serum homocysteine levels with various patient related variables.Methods: This observational study included patients who were admitted with the diagnosis of stroke in Sri Ventateswara Ramnarain Ruia Government General Hospital. Patients were evaluated for risk factors like hypertension, diabetes mellitus and hyperlipidemia. Total homocysteine estimation was done and survival of the patients was assessed at the time of discharge from the hospital.Results: Most common risk factor for stroke in our study population was dyslipidemia (40%), followed by hypertension (36%). Total homocysteine levels were raised in 92% of the patients. Patients with homocysteine levels less than 15mM/L had lacunar infarcts. Homocysteine levels higher than 100mM/L were found in 18% of the patients and they all had large sized lesions. Significantly higher mean homocysteine levels were found among patients with large lesions (70.15±2.65 vs 21.68±8.02, p value <0.05). Among various risk factors, higher mean homocysteine levels were found to be associated with dyslipidemia (p value <0.05). No association between hypertension, diabetes mellitus or smoking history was found with higher homocysteine levels. Patients who survived had significantly lower homocysteine levels as compared to non survivors (39.3±19.84 vs 100±18.82, p value<0.001).Conclusions: Further studies are needed on homocysteine and stroke fur using homocysteine as screening test and for initiation of preventive therapy of stroke based on homocysteine levels

Does drug‐induced sleep endoscopy predict surgical success in transoral robotic multilevel surgery in obstructive sleep apnea?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136419/1/lary26255_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136419/2/lary26255.pd

Exploring Symptoms of Post-traumatic Stress Disorders and Perceived Social Support among Patients with Burn Injury.

Introduction Burns are a serious public health problem globally, causing an estimated 265,000 deaths per year. Although the association of burn injuries with mortality and morbidity rates has been well established, data on their psychological consequences are scarce. The present study explores the frequency of post-traumatic stress disorder (PTSD) and perceived social support among patients with burn injuries in Pakistan. Methods This cross-sectional study was conducted at two teaching hospitals in Lahore, Pakistan from May 2015 to July 2015. Eighty patients with burn injuries were included by convenience sampling and interviewed with a specifically designed questionnaire with items on demographics, and the Impact of Events Scale-Revised (IES-R) and Multidimensional Scale of Perceived Social Support (MSPSS) instruments. Results Data were analyzed for a total of 80 participants: 56 women (70.0%) and 24 men (30.0%). Mean age was 35.74 (11.15) years. A high proportion of participants perceived highest social support from friends, reported high ego resiliency levels, had more severe symptoms of avoidance and intrusion, and had high overall PTSD scores. There were no differences between groups in the proportions of respondents who reported high perceived social support from significant others or family, overall social support or symptoms of hyperarousal. Conclusion The findings reflect a high frequency of PTSD symptomatology and poor social support among Pakistani patients with burn injuries in our sample. These factors can exacerbate the patient's physical injury, delaying both their physical and mental rehabilitation

EFFECTIVENESS OF CORE STABILIZATION EXERCISES AND MOTOR CONTROL EXERCISES IN PATIENTS WITH LOW BACK ACHE

Background: Motor control exercises are isolated strengthening exercise for the deep spinal muscles (transverse abdominus, multifidus) whereas Core stability is achieved by global strengthening of the core muscles. There are not much studies available in the literature done or studied the short term effect of the motor control and core stabilization on subjects with low back pain. Therefore, the purpose of this study to find the comparative effect of motor control exercises versus core stabilization exercises on improvement of pain and disability in subjects with mechanical low back pain. Method: An experimental study design, 30 subjects with non-specific mechanical low back pain were randomized into 2 groups with 15 subjects each in Group A and Group B. Subjects in Group A received Motor control exercises and subjects in Group B received Core stability exercises. Both the group received conventional exercises. The duration of intervention was given for two weeks. Outcome measurements such as pain using VAS, Functional disability using Oswestry Disability Index Questionnaire were measured before and after two weeks of intervention. Results: Analysis using paired ‘t’ test and wilcoxon signed rank test found that there is a statistically significant improvement (p<0.05) in pain, functional disability within the groups. Comparative analysis using independent ‘t’ test and Mann Whitney U test for comparison of difference in improvement in VAS and ODI between two groups, it was found that there was significant difference in improvement of VAS and ODI between groups. Group-A showed better improvement in VAS and ODI compared to Group B with an effect size of 1.47 and 0.99 respectively. Conclusion: It is concluded that the Motor control exercises showed statistically significant improvement in reducing back pain and disability when compared to the Core Stabilization exercises. Thus, performing Motor Control exercises reduces pain and disability significantly compared to Core stabilization among non specific mechanical low back ache subjects

The fluoro-less and contrast-less peripheral endovascular intervention: a concept for the future today

INTRODUCTION: Percutaneous endovascular revascularization requires fluoroscopic guidance and radiopaque contrast use. This approach becomes problematic, especially in patients with advanced renal disease or allergies to iodinated contrast medium. The direct (exposure) and indirect (lead garment) burden of radiation affects patients and operators alike. PURPOSE: We propose a completely contrast-free, fluoroscopy-free approach to endovascular diagnostic arterial imaging and percutaneous intervention using available technologies, and outline a timeframe for its implementation. PROJECT DESCRIPTION/METHODOLOGY: Ultrasound imaging of the leg creates a roadmap of the vessel and identifies the lesion of interest. Device-based sensors using a low-powered electromagnetic field allow for wiring of the vessel. This is followed by the use of intravascular ultrasonography and near infrared spectroscopy to characterize the lesion dimensions and composition. After completion of the diagnostic phase of the process, the interventional portion with deployment of an angioplasty balloon and/or stent is performed using the electromagnetic field-guided sensors. FEASIBILITY: The project uses already available technologies. BENEFITS/ANTICIPATED OUTCOMES: This project demonstrates the real potential of performing endovascular peripheral intervention without fluoroscopy or contrast in a practical, user-friendly way with the currently available technology. The prospects in renal function preservation and radiation avoidance for both patients and operators are extremely attractive

Non-linear biphasic mixture model : Existence and uniqueness results

This paper is concerned with the development and analysis of a mathematical model that is motivated by interstitial hydrodynamics and tissue deformation mechanics (poro-elasto-hydrodynamics) within an in-vitro solid tumour. The classical mixture theory is adopted for mass and momentum balance equations for a two-phase system. A main contribution of this study is we treat the physiological transport parameter (i.e., hydraulic resistivity) as anisotropic and heterogeneous, thus the governing system is strongly coupled and non-linear. We derived a weak formulation and then formulated the equivalent fixed-point problem. This enabled us to use the Galerkin method, and the classical results on monotone operators combined with the well-known Schauder and Banach fixed-point theorems to prove the existence and uniqueness of results