Functional Aspects of Gait in Essential Tremor: A Comparison with Age-Matched Parkinson’s Disease Cases, Dystonia Cases, and Controls

Background: An understanding of the functional aspects of gait and balance has wide ramifications. Individuals with balance disorders often restrict physical activity, travel, and social commitments to avoid falling, and loss of balance confidence, itself, is a source of disability. We studied the functional aspects of gait in patients with essential tremor (ET), placing their findings within the context of two other neurological disorders (Parkinson’s disease [PD] and dystonia) and comparing them with age‐matched controls. Methods: We administered the six‐item Activities of Balance Confidence (ABC‐6) Scale and collected data on number of falls and near‐falls, and use of walking aids in 422 participants (126 ET, 77 PD, 46 dystonia, 173 controls). Results: Balance confidence was lowest in PD, intermediate in ET, and relatively preserved in dystonia compared with controls. This ordering reoccurred for each of the six ABC‐6 items. The number of near‐falls and falls followed a similar ordering. Use of canes, walkers, and wheelchairs was elevated in ET and even greater in PD. Several measures of balance confidence (ABC‐6 items 1, 4, 5, and 6) were lower in torticollis cases than in those with blepharospasm, although the two groups did not differ with respect to falls or use of walking aids. Discussion: Lower balance confidence, increased falls, and greater need for walking aids are variably features of a range of movement disorder patients compared to age‐matched controls. While most marked among PD patients, these issues affected ET patients as well and, to a small degree, some patients with dystonia

Synthesis and characterization of transition metal complexes derived from some biologically active furoic acid hydrazones

Two new physiologically active ligands, N’-2-[(E)-1-hydroxy-4-methyl-2-oxo-2H-8-chromenyl) ethylidene)-2-furan carbohydrazide (HMCFCH) and N’-2-[(Z)-1-(4-hydroxy-6-methyl-2-oxo-2H-pyranyl) ethylidene]-furan carbohydrazide (HMPFCH) and their VO(II), Mn(II), Fe(II), Co(II), Ni(II) and Cu(II) complexes have been prepared. The ligands and the metal complexes have been characterized by elemental analyses, electrical conductance, magnetic susceptibility measurements, UV-Vis, IR, and ESR spectroscopic data. Basing on the above data, Fe(II) and Co(II) complexes of HMCFCH and HMPFCH have been assigned a dimeric octahedral geometry. VO(II) complexes of HMCFCH and HMPFCH have been assigned sulfate bridged dimeric square pyramidal geometry. Mn(II) complex of HMCFCH has been assigned a dimeric octahedral geometry, where as Mn(II) complex of HMPFCH has been ascribed to monomeric octahedral geometry. Cu(II) and Ni(II) complexes of HMCFCH have been ascribed to a polymeric structure. Ni(II) complex of HMPFCH has been assigned a dimeric square planar geometry. Cu(II) complex of HMPFCH has been proposed an octahedral geometry. The ligands and their metal chelates were screened against S. aureus and P. aeruginosa. The ligands and the metal complexes have been found to be active against these microorganisms. The ligands show more activity than the metal complexes.  KEY WORDS: N’-2-(E)-1-hydroxy-4-methyl-2-oxo-2H-8-chromenyl) ethylidene)-2-furan carbohydrazide (HMCFCH), N’-2-[(Z)-1-(4-hydroxy-6-methyl-2-oxo-2H-pyranyl) ethylidene]-furan carbohydrazide (HMPFCH), 3-Acetyl-6-methyl-2H-pyran-2,4(3H)-dione, 8-Acetyl-4-methyl-Umbelliferone, Furoic acid hydrazide, Anti microbial activity  Bull. Chem. Soc. Ethiop. 2007, 21(1), 63-73.

Four Essential Tremor Cases with Moderately Impaired Gait: How Impaired Can Gait Be in This Disease?

Background A body of literature is emerging regarding gait/balance impairments observed in essential tremor (ET) patients. Although impairment is generally mild, the full extent of the spectrum remains undefined. We present four ET cases with more severe gait/balance impairment. Methods A battery of subjective and objective gait/balance assessments was performed: the Activities-specific Balance Confidence Scale, the Berg Balance Scale, and the Tinetti Performance Oriented Mobility Assessment (POMA). Tandem missteps during 10 steps were counted. Quantitative gait testing was performed (GAITRite) to quantify gait speed, dynamic balance, gait symmetry, and gait variability. Results Two patients were middle‐aged (38 and 52 years) and two were older (70 and 79 years). All had longstanding classic ET (duration 22-60 years). The mean POMA score was 21.5, which is indicative of moderate fall risk. On average, there were five missteps during tandem gait, which was higher than observed in substantially older ET cases (age 86.0 plus or minus 4.6 years), and four times higher than seen in ET patients of comparable age. On quantitative gait analysis, patients demonstrated significant balance impairment. Discussion We present a sample of ET patients with a level of gait difficulty that would not be characterized as mild. The existence of such cases raises a number of questions, one of which is how impaired can gait be in ET

Tandem gait performance in essential tremor patients correlates with cognitive function

Emerging yet separate literatures have highlighted gait/balance impairments (i.e., mild ataxia) and cognitive problems in patients with essential tremor (ET). However, the relationship between the two has not been studied. The goal of these analyses was to study the relationship between gait/balance impairments and cognitive problems in ET. One-hundred-twenty ET cases were enrolled in an epidemiological study at Columbia University Medical Center. A Telephone Interview for Cognitive Status (TICS, range = 0–41 [no deficits]) was administered and a videotaped assessment of tandem gait was performed, during which the number of missteps during 10-steps was counted. The mean TICS score was 35.7 (range 25–39), and mean number of tandem mis-steps was 2.9 (range 0–10). The number of tandem mis-steps was correlated with the TICS score (Spearman’s r = −0.245, p = 0.011, i.e., individuals who had more tandem gait difficulty also had more cognitive difficulty). In a multivariate analysis, tandem mis-steps were associated with TICS score (p = 0.04) independent of age and other factors. More cognitive difficulty was associated with more tandem gait difficulty in ET. Ambulation often requires the concurrent use of both cognitive and motor neural systems; hence it is possible that the cognitive and gait problems in ET reflect an underlying pervasive disorder affecting both cognitive and motor circuits

Influence of varied crop residues and green biomass composts to rabi sorghum growing soils on uptake of major nutrients, microbial biomass and soil fertility status

A field experiment was conducted on vertisols (pH of 7.56 with organic carbon content of 0.55%) at Re- search Institute on Organic Farming, University of Agricultural Sciences, Raichur coming under northern Karnataka during rabi season of 2015-16 to study the Influence of varied crop residues and green biomass composts to rabi sorghum growing soils on uptake of major nutrients, organic carbon and soil fertility status. In general application of Cotton stalks, Redgram stalks, Glyricidia, combination of cotton and redgram stalks composts, FYM and combina- tion of organic and inorganic fertilizers helped to buildup soil nutrients with respect to organic carbon, available nitro- gen and phosphorus. Significantly higher nitrogen (227.3 kg ha-1), phosphorous (75.7 kg ha-1) and potassium (141.7 kg ha-1) uptake by rabi sorghum was recorded with combined application of recommended FYM (3 t ha-1) and NP fertilizers (50:25 kg N, P2O5 ha-1) (T14) followed by Cotton stalks +Redgram stalks + Glyricidia sp. with C:N ratio of 30:1 compost @ 50 kg N equivalent (T12: 222.0, 74.0 and 132.3 kg ha-1). The least uptake was recorded with abso- lute control (T15: 127.0, 42.0 and 71.7 kg ha-1). Similar trend was observed with organic carbon, available nitrogen and phosphorus. Combined application of recommended FYM (3 t ha-1) and NP fertilizers (50:25 kg N, P2O5 ha-1) followed by Cotton stalks +Redgram stalks + Glyricidia sp. with C:N ratio of 30:1 compost @ 50 kg N equivalent at the time of sowing recorded higher major nutrients uptake, microbial biomass and soil fertility status

An unusual termination of facial vein and anterior division of retromandibular vein into external jugular vein: a case report.

Facial vein, being the largest vein of the face forms the common facial vein after joining with the anterior division of retromandibular vein below the angle of the mandible. Usually, it drains into the internal jugular vein. During routine dissection of head and neck region of a male cadaver, aged approximately 50 years, an unusual pattern in the termination of veins on the left side of the neck was observed. The formation, course and termination of external jugular vein were normal. The anterior division of retromandibular vein joined with external jugular vein about 5 cm above the clavicle and the facial vein opened into the external jugular vein about 2.5 cm above the clavicle. In addition, there was a thin venous communication between anterior division of retromandibular vein and external jugular vein. The superficial veins of the neck are often used for cannulation; either for intravenous infusion or for central venous pressure monitoring. Furthermore, these venous segments are used as a patch for carotid endarterectomies. Hence, a thorough knowledge of the normal anatomy and their variations may be useful for performing these procedures

Effect of educational intervention in reducing exposure to second hand tobacco smoke among 12-year-old children as determined by their salivary cotinine levels and knowledge, attitude and behavior - a randomized controlled trial

BackgroundTobacco use is one of the most important public health concerns, with approximately 8.7 million tobacco-related deaths each year, primarily in low- and middle-income countries. Even more concerning is the fact that 1.3 million of these deaths are seen in nonsmokers, including babies and children. This study was performed to determine whether a school-based “tobacco-free” educational intervention program among 12-year-old children would be effective in reducing their exposure to second-hand tobacco smoke (SHS) by improving their knowledge, attitude and behavior post intervention and estimating salivary cotinine levels as markers of SHS exposure.Materials and methodA randomized controlled trial was performed by a cluster random sampling technique, with 30 participants each in the experimental and control arms. A knowledge, attitude, avoidance behavior and self-efficacy of avoidance questionnaire was administered, followed by estimation of salivary cotinine levels. The experimental arm received the “tobacco-free” intervention, which comprised a 40-min health education session, with the first follow-up at 15 days and the second at 30 days after the intervention. After the intervention, the questionnaire was readministered, followed by re-estimation of salivary cotinine levels.ResultsOne month after the intervention, the number of participants who had a smoker who lived with them and the number of people who smoked inside the house were reduced in the experimental group compared to the control group. In the knowledge domain and the attitude domain, 80% and 60% of the items showed a statistically significant improvement in the experimental group compared to the control group. In the avoidance behavior domain and the Self-Efficacy of Avoidance Domain, all the items showed improvement in the experimental group compared to the control group. When the mean salivary cotinine levels were compared pre- and postintervention, it was found that although the mean postintervention salivary cotinine levels increased in both the experimental and control groups, the increase was less in the experimental group than in the control group.ConclusionThe present study has been shown to be effective in improving the knowledge, attitude and avoidance behavior of adolescents toward exposure to secondhand smoke

Microplastic content of over-the-counter toothpastes - a systematic review [version 1; peer review: 2 approved]

Background: Microplastic particles are used as ingredients in personal care products such as face washes, shower gels and toothpastes and form one of the main sources of microplastic pollution, especially in the marine environment. In addition to being a potential pollutant to the environment, the transfer of microplastics to humans can become a severe threat to public health. This systematic review was conceptualized to identify evidence for the presence of and characteristics of microplastics in toothpaste formulations. Methods: The PICOS Criteria was used for including studies for the review. Electronic databases of Scopus, Embase, Springer Link, PubMed, Web of Science and Google Scholar were searched, as well as hand and reference searching of the articles was carried out. The articles were screened using the software application, Covidence® and data was extracted. Results: This systematic review showed that toothpastes from China, Vietnam, Myanmar and the UAE, reported no evidence of microplastics and those from Malaysia, Turkey and India reported the presence of microplastics. The shape of the microplastics present in these toothpastes were found to be granular, irregular with opaque appearance and also in the form of fragments and fibers and the percentage weight in grams ranged from 0.2 to 7.24%. Malaysia releases 0.199 trillion microbeads annually from personal care products into the environment and toothpastes in Turkey release an average of 871 million grams of microplastics annually. Similarly, in India, it has been reported that 1.4 billion grams of microplastic particles are emitted annually from toothpaste. Conclusions: The findings of this systematic review provide evidence that toothpastes, at least in some parts of the world, do contain microplastics and that there is a great risk of increase in the addition of microplastics to the environment by the use of toothpaste

Physical therapy and exercise interventions in Huntington's disease: a mixed methods systematic review

Background. A number of studies evaluating physical therapy and exercise interventions in Huntington’s disease have been conducted over the past 15 years. However, an assessment of the quality and strength of the evidence in support of these interventions is lacking. Objective: The purpose of this systematic review was to investigate the effectiveness of physical therapy and exercise interventions in people with Huntington’s disease, and to examine the perceptions of patients, families and caregivers of these interventions. Methods: This mixed-methods systematic review utilized the Joanna Briggs Institute (JBI) approach and extraction tools to evaluate the literature from January 2003 until May 2016. The review considered interventions that included exercise and physical therapy interventions, and included both quantitative and qualitative outcome measures. Results: Twenty (20) studies met the inclusion criteria, including eighteen (18) that had quantitative outcome measures and two (2) that utilized qualitative methods. JBI Levels of evidence for the 18 quantitative studies were as follows: Eight studies were at evidence Level 1, seven were at Level 2, two were at Level 3, and one was at Level 4. Conclusions: Our review suggests that there is preliminary support for the benefits of exercise and physical activity in Huntington’s disease in terms of motor function, gait speed, and balance, as well as a range of physical and social benefits identified through patient-reported outcomes. Variability in mode of intervention as well as outcome measures limits the interpretability of these studies, and high-quality studies that incorporate adaptive trial designs for this rare disease are needed