Comparison between Right and Left Hemisphere Lesion of Stroke Patients for Functional Gait Assessment

Objective: To compared the functional gait among left and right hemisphere lesion patients of stroke. Methods: This cross sectional comparative study included 126 patients with right and left sided hemispheric lesion. The study was conducted from December 2019 to March 2020. Patients were selected consecutively from different hospitals and rehabilitation centers of Lahore, Pakistan on the basis of inclusion & exclusion criteria. Functional gait assessment (FGA) scale was used to measure functional gait performance and disturbance related to balance in stroke patients. Independent sample t-test was used for comparison of functional gait between left and right hemispheric lesions. A p-value ≤ .05 was taken statistically significant. Results: A total of 126 patients of stroke with right and left sided hemisphere lesion were assessed for functional gait assessment. The mean age of patients in group A and B was 54.19±8.54 years and 51.46±8.57 years, respectively. The mean weight of patients in group A and B was 61.95±8.82 kg and 58.67±5.83 kg, respectively. Functional gait assessment mean score in group A was 12.56±2.60 and in group B was 15.59±4.17 points with p-value of 0.001. There was a significant difference of FGA scores present between the two groups. Conclusions: The study concluded that ambulatory functions differ with respect to site of hemisphere lesion. The site of hemisphere lesion impact on patient's functional gait has statistically significant

Effectiveness of transcutaneous bilirubin measurement in managing neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan

Introduction: Neonatal jaundice is a common cause of concern in immediate newborn period for parents as well as for the caregivers. Babies with visible jaundice are identified by the healthcare provider, and blood samples are sent for confirmation. Clinical expertise varies from person to person and may lead to sending excessive blood sampling. Obtaining blood bilirubin samples is a painful procedure; it predisposes the baby to infections and requires skilled health personnel. Moreover, laboratory tests are costly and time consuming, leading to unnecessary delays in commencing phototherapy and discharge from hospital. Transcutaneous bilirubinometer has been in use for a long time as screening tool in postnatal wards. With passage of time, its accuracy and validity have improved tremendously.Methodology: We aim to implement a quality improvement initiative to reduce the number of blood bilirubin samples using transcutaneous bilirubin (TcBR) nomogram in full-term, low-risk babies who are born at our hospital and are admitted in postnatal ward after birth. Using preanalysis and postanalysis study design, this study will be performed in two phases of 6 months each. Data regarding total number of admissions in postnatal wards, demographics, serum bilirubin(TSBR) samplings and need for phototherapy will be recorded in both phases. TcBR will be done and recorded in postimplementation phase.Analysis And Results: Comparisons between the two groups will be made. Primary outcome will be reduction in blood bilirubin samples for TSBR after the implementation of TcBr protocol. The proportion of infants having TSBR performed in both periods will be compared. Crude sampling cost of TSBR will be obtained from laboratory, and cost comparison between two phases will be done to look for difference

PEPPERMINT OIL, ITS USEFUL, AND ADVERSE EFFECTS ON HUMAN HEALTH: A REVIEW

Fundamental oil of Mentha piperita are perplexing blends detached from sweet-smelling plants which may have antimicrobial, cooling receptor trigger, pesticidal, anticancer, hack, asthma, and use in painkiller, exercises of enthusiasm for the sustenance and corrective enterprises just as in the human well-being field in pharmaceutical. According to the German Commission E monographs, peppermint oil is greatly employed as an antispasmodic in the stomach and intestine in bile channel and for the treatment of peevish entrails disorder, inflammation of the respiratory tract, and aggravation of the oral mucosa. Remotely, M. piperita has been employed for myalgia and neuralgia. As indicated by German Commission E, M. piperita may likewise go about as a carminative, disinfectant, and pectolytic, having soothing activity. Enteric-covered peppermint oil containers (Colpermin) are mostly employed as an orally controlled antispasmodic premedication in the study of large intestine

The impact of chemotherapy-induced inner ear damage on quality of life in cancer survivors: a qualitative study

PURPOSE: This study aimed to explore the burden of inner ear damage (ototoxicity) on adults living with and beyond cancer treated with chemotherapy and  the impact on their quality of life (QoL). Furthermore, this study aimed to explore patient awareness surrounding chemotherapy-induced inner ear damage, known as ototoxicity, and assess what support they had been offered. METHODS: Participants were adults who had undergone chemotherapy, recruited from cancer clinics, charities and social media. Using semi-structured interviews and fieldnotes, an inductive thematic analysis was used to develop key themes surrounding this topic. RESULTS: Twenty participants from the UK were interviewed. Two key themes were developed from the thematic analysis, cancer-related QoL and ototoxicity-related QoL, with each one including 5 subthemes. Subthemes consisted of impact of ototoxicity, hearing, tinnitus, clinical experience, audiological assessments, and impact of treatment, cancer and chemotherapy, other toxicities, information and patient reflections. CONCLUSIONS: Ototoxicity can have a negative impact on QoL, specifically on social life and the fear of hearing loss and/or tinnitus worsening. There are opportunities for increased awareness by patients and clinicians, including improved information sources, and hearing monitoring not only for those undergoing platinum-based chemotherapy but many others surviving after treatment for cancer. IMPLICATIONS FOR CANCER SURVIVORS: Better monitoring of hearing and information about ototoxicity during chemotherapy could potentially reduce the fear of the symptoms of ototoxicity worsening. Furthermore, hearing monitoring would facilitate the detection of hearing loss at early stages of survivorship, which would facilitate earlier access to clinical interventions and longer term counselling

Effects of mental imagery on lower limb function in sub-acute stage of stroke patients; a randomized controlled trial

Introduction: Stroke is the most common type of cerebrovascular injury caused by sudden decrease in blood supply that can lead to weaknesses and other associated problems. Many treatment options are available for stroke with promising results. This trial was designed to explore the role of mental imagery (visual) in the sub-acute stage, considering the stroke patient, especially in evaluating its effects on the lower extremities. Material & Methods: An experimental randomized controlled trial was performed from July to August 2018 in physiotherapy departments of National Hospital and Aadil Hospital Defence Lahore. A total of 80 patients having sub-acute stroke with strong perceptions having a score of 25 or more in the Mini Mental Score Exam and a 3 +/5 manual muscle testing grade system in the lower extremity were taken using non-probability consecutive sampling procedure. All the patients were divided into 2 groups randomly. Conservative treatment including strengthening and balance training were given to one group and conservative treatment with addition of visual imagery to the second group. Independent t-test was used to assess significant differences between the two groups. Results: Comparison of Berg Balance Scale at pre-intervention between the experimental group and the controlled group was not significant, 13.76 ± 2.85 vs 13.84 ± 3.26 (p=0.927), respectively. After intervention the effects of treatment were significant in both groups, 18.64 ± 2.33 vs 17.80 ± 2.94(p=0.007), respectively. Comparison of Time Up and Go test at pre-intervention between groups was not significant, 6.28 ± 1.86 vs 6.68 ± 0.99(p=0.347), respectively. The intervention effects after treatment in both groups were significant, 1.84 ± 1.28 vs 3.56 ± 1.26 (p=0.001), respectively. Conclusion: It is concluded that mental imagery along with conservative treatment plays a vital role in construction of neural circuit in sub-acute stroke patients

Enhancing Security of Health Information Using Modular Encryption Standard in Mobile Cloud Computing

Despite the numerous and noticeable inherited gains of Mobile Cloud Computing (MCC) in healthcare, its growth is being hindered by privacy and security challenges. Such issues require the utmost urgent attention to realize its full scale and efficient usage. There is a need to secure Health Information worldwide, regionally, and locally. To fully avail of the health services, it is crucial to put in place the demanded security practices for the prevention of security breaches and vulnerabilities. Hence, this research is deliberated on to provide requirement-oriented health information security using the Modular Encryption Standard (MES) based on the layered modeling of the security measures. The performance analysis shows that the proposed work excels, compared to other commonly used algorithms against the health information security at the MCC environment in terms of better performance and auxiliary qualitative security ensuring measures

Influence of different formulation variables on the performance of transdermal drug delivery system containing tizanidine hydrochloride: in vitro and ex vivo evaluations

The present study was aimed at preparation of transdermal patches of tizanidine HCl, evaluation of the effect of polymers on in vitro release pattern of the drug, and the effect of permeation enhancers on the penetration of the drug through the rabbit skin. Various proportions of hydrophilic (HPMC) and hydrophobic (Eudragit L-100) polymers were used with PEG 400 as film-forming agent, and Span 20 or DMSO as permeation enhancer. The formulations were assessed for physicochemical characteristics and in vitro drug release studies using USP paddle over disc method in phosphate buffered saline (pH 7.4) at 32.0±1°C. On the basis of in vitro studies and physicochemical evaluations, S03-A and S04-A were selected at Eudragit : HPMC ratios of 8 : 2 and 7 : 3, respectively, for further ex vivo analysis. The effects of different concentrations of Span 20 and DMSO were evaluated on excised rabbit skin using Franz diffusion cell. Cumulative drug permeation, flux, permeability coefficient, target flux, and enhancement ratio were calculated and compared with the control formulations. Kinetic models and Tukey’s multiple comparison test were applied to evaluate the drug release patterns. Formulation SB03- PE containing Eudragit L-100:HPMC (7:3) with Span 20 (15% w/w) produced the highest enhancement in drug permeation, and followed zero order kinetic model with super case-II drug release mechanism

Genotoxic and cytotoxic potential of whole plant extracts of Kalanchoe laciniata by Ames and MTT assay

Lack of data on safety of herbal medicines have endangered human health and life. The present study evaluated the genotoxic and mutagenic effect of Kalanchoe laciniata to access the safety and usefulness of the medicinal plant. Aqua-methanolic and n-hexane extracts of K. laciniata were evaluated for the genotoxic potential using Ames assay and cytotoxicity was evaluated using MTT assay. Ames assay was conducted using two strains of Salmonella typhimurium TA-100 and TA-102 whereas MTT assay was performed on baby hamster kidney cell line BHK-21. Aqua-methanolic extract of K. laciniata exhibited significant mutagenicity when exposed to TA- 102 strain with a mutagenic index of 50.66 and 54.74 at maximum dose 150 mg/plate. The extract was also muta- genic to TA-100 strain but to a lesser extent. M.I of n-hexane extract was 12.15 and 15.51 for TA-100 and TA- 102 respectively. n-hexane extract was mutagenic but little difference was observed between results of two strains. Both extracts were found to be cytotoxic with an IC50 of 321.9 and 638.5 µg/mL for aqua-methanolic and n-hexane extracts respectively. On the basis of results it was concluded that aqua-methanolic and n-hexane extracts of K. mutagenic and cytotoxic potential. It is suggested to explore the plant further to evaluate its safety in rodents and other species

Doctoral Studies as part of an Innovative Training Network (ITN): Early Stage Researcher (ESR) experiences [version 2; peer review: 2 approved]

Background: The Marie-Skłodowska-Curie Actions’ (MSCA) Innovative Training Network (ITN) is a doctoral training programme jointly implemented by academic institutions and industries from countries across Europe and beyond. To our knowledge no study has examined the experience of students participating in MSCA-ITNs. This study aims to evaluate and report MSCA-ITN Early Stage Researcher (ESR) experiences. Methods: The Innovative Training Network - Evaluation Questionnaire (ITN-EQ) was developed to assess supervision, training, collaborations and experiences of ESRs and forwarded to two tinnitus-related ITNs and seven ITNs of other disciplines. Results: Key advantages identified included better career prospects, multidisciplinary research opportunities/collaborations, international exposure, personal/professional development, plus generous salaries and research budgets. However, lack of a common EU framework resulted in the experience being largely dependent on the host institution, country and supervisor. Moreover, managing the dual requirements of ITNs and host institutions while completing a three-year PhD seemed challenging for most ESRs. ESR involvement in workshop and training school planning was desirable. More than 80% of ESRs rated the overall ITN experience favourably and 98.3% would recommend the same to prospective PhD students. Conclusions: This report could provide valuable insights in planning and management of future ITNs and could assist prospective students in their decision of joining an ITN for their PhD

Doctoral Studies as part of an Innovative Training Network (ITN):Early Stage Researcher (ESR) experiences [version 2; peer review: 2 approved]

Background: The Marie-Skłodowska-Curie Actions’ (MSCA) Innovative Training Network (ITN) is a doctoral training programme jointly implemented by academic institutions and industries from countries across Europe and beyond. To our knowledge no study has examined the experience of students participating in MSCA-ITNs. This study aims to evaluate and report MSCA-ITN Early Stage Researcher (ESR) experiences. Methods: The Innovative Training Network - Evaluation Questionnaire (ITN-EQ) was developed to assess supervision, training, collaborations and experiences of ESRs and forwarded to two tinnitus-related ITNs and seven ITNs of other disciplines. Results: Key advantages identified included better career prospects, multidisciplinary research opportunities/collaborations, international exposure, personal/professional development, plus generous salaries and research budgets. However, lack of a common EU framework resulted in the experience being largely dependent on the host institution, country and supervisor. Moreover, managing the dual requirements of ITNs and host institutions while completing a three-year PhD seemed challenging for most ESRs. ESR involvement in workshop and training school planning was desirable. More than 80% of ESRs rated the overall ITN experience favourably and 98.3% would recommend the same to prospective PhD students. Conclusions: This report could provide valuable insights in planning and management of future ITNs and could assist prospective students in their decision of joining an ITN for their PhD