Deep Brain Stimulation of Caudal Zona Incerta and Subthalamic Nucleus in Patients with Parkinson's Disease: Effects on Diadochokinetic Rate

The hypokinetic dysarthria observed in Parkinson's disease (PD) affects the range, speed, and accuracy of articulatory gestures in patients, reducing the perceived quality of speech acoustic output in continuous speech. Deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) and of the caudal zona incerta (cZi-DBS) are current surgical treatment options for PD. This study aimed at investigating the outcome of STN-DBS (7 patients) and cZi-DBS (7 patients) in two articulatory diadochokinesis tasks (AMR and SMR) using measurements of articulation rate and quality of the plosive consonants (using the percent measurable VOT metric). The results indicate that patients receiving STN-DBS increased in articulation rate in the Stim-ON condition in the AMR task only, with no effect on production quality. Patients receiving cZi-DBS decreased in articulation rate in the Stim-ON condition and further showed a reduction in production quality. The data therefore suggest that cZi-DBS is more detrimental for extended articulatory movements than STN-DBS

Effect of posture on swallowing.

Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing. Objectives: To observe the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects. Methods: Participants were asked to swallow 25 ml of water in one go while sitting upright, sitting with head/neck flexed, head/ neck extended and lying supine. Following this, they had to rate their self-perceived difficulty while swallowing on a scale of 0-10, 0 being most easy and 10 being most difficult. Results: 186 subjects with mean age 32.7 SD 9.04 participated in this study. It was found to be least difficult to swallow when subjects were asked to swallow in upright sitting position. Statistically significant differences were found between sitting upright, sitting with head/neck flexed, head/neck extended and lying supine. Conclusion: Postural modification may help in rehabilitation of patients with dysphagia by affecting bolus flow to improve speed and safety of swallowing by closure of airways to prevent aspiration

Left Ventricular Systolic Dysfunction in Patients of Obstructive Sleep Apnea Syndrome

Objective: To determine the left ventricular systolic dysfunction and the association of various factors with this dysfunction in patients with obstructive sleep apnea syndrome. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: We included the patients diagnosed with sleep apnea syndrome by a consultant pulmonologist based on a sleep study. Patients were labelled as having left ventricular systolic dysfunction if the ejection fraction was less than 40% on echocardiography. Results: Eighty patients diagnosed with sleep apnea syndrome were included in the study. The mean age of the study participants was 48.551±9.971 years. Out of 80 patients, 19(23.75%) had left ventricular systolic dysfunction on echocardiography, while 61(76.25%) had no evidence of left ventricular systolic dysfunction. With the application of relevant statistical tests, we found that patients with high body mass index and the presence of comorbid illnesses had a statistically significant relationship (p-value<0.05) with the presence of left ventricular systolic dysfunction among patients with sleep apnea syndrome. Conclusion: Considerable number of patients suffering from obstructive sleep apnea syndrome showed the presence of left ventricular systolic dysfunction on echocardiography. High Body mass index and comorbid illnesses emerged as risk factors for left ventricular systolic dysfunction in our study population

Prevalence of work-related musculoskeletal disorders among dental students of King Saud University, Riyadh, Kingdom of Saudi Arabia

Aim: To evaluate the presence of work-related musculoskeletal disorders (WRMSDs) among undergraduate dental students of the College of Dentistry, King Saud University (KSU), Riyadh, Saudi Arabia. Materials and methods: A questionnaire-based cross-sectional survey was conducted in 2017 and distributed to150 undergraduate female, and male dental students of KSU who had started to work with patients in the clinic or with manikins. Data were collected related to WRMSDs. Results: Nearly, 142 (95%) students returned the completed questionnaire, 88 (62%) were females and 54 (38%) were males. The results of this study indicate that musculoskeletal symptoms among dental students of KSU are high. Females generally reported more WRMSDs. Seventy-two percent of females and 41% of males reported frequent headaches. Fourteen percent of females and 6% of males had some musculoskeletal pain disorders before joining the dental profession, whereas 68% of females and 43% of males reported pain attributed to their clinical dental work. In the majority of females (67%) and males (61%), the onset of pain was gradual. Commonly reported pain sites in both females and males were the neck, shoulder, upper and lower back. The most common pain sites, among females were shoulder and neck, and upper- and lower-back among males. Conclusion: The WRMSDs can affect the dental professionals from the early stages of their clinical carrier, even as dental students. Concrete steps are required to prevent the occurrence of WRMSDs among dental students by providing them the detailed knowledge about theoretical and practical aspects of dental ergonomics. Higher prevalence of WRMSDs among female dental students indicate that female dental professionals need to be extra vigilant to adhere to the principles of dental ergonomics from the very beginning of their clinical career. Clinical significance: The awareness to implement the principles of dental ergonomics among dental students can help to prevent early development of WRMSDs among them. The inclusion of dental ergonomics as a detailed stand-alone subject in the dental curriculum before the start of clinical training can contribute minimize the risk of WRMSDs throughout the professional life of the dentists

Incidence of orthodontic brackets detachment during orthodontic treatment : A systematic review

Objectives: To evaluate the incidence of orthodontic brackets detachment during orthodontic treatment. Methods: Using electronic databases; eligible studies up to January 2018 were retrieved, independently reviewed, and screened. The Coleman Methodology Scoring System (CMS) and Cochrane Collaboration's tool were used to assess quality and risk of bias in the included studies. Results: Of the seventeen studies included in the final synthesis, thirteen were categorized as randomized clinical trials (RCTs), one prospective cohort and retrospective survey each, whereas two studies could not be categorized. The number of patients in the selected studies ranged between 19 and 153; the mean age was between 10.5 to 38.7 years, and male to female ratio was 353:495. Almost all studies had a high risk of bias, and more than half of the studies had CMS score of 70 or above. The numbers of brackets examined in the studies ranged between 361 and 3336. The incidence of brackets detachment ranged from 0.6 to 28.3%. Conclusions: The incidence of brackets detachment during orthodontic treatment is high

Assessment of Knowledge about Dental Ergonomics among Dental Students of King Saud University, Riyadh, Kingdom of Saudi Arabia

Aim: To assess the knowledge about dental ergonomics and work-related musculoskeletal disorders (WRMSDs) among dental students of King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia, undergoing practical clinical training. Materials and methods: A self-designed questionnaire after pre-testing was distributed to 150 dental students of KSU undergoing clinical training, to collect data related to (a) basic knowledge about dental ergonomics; (b) any course/workshop about dental ergonomics attended; (c) basic knowledge about WRMSDs; (d) familiarity about preventive measures to decrease the risk of WRMSDs; and (e) knowledge about treatment options for WRMSDs. Results: One hundred forty-two students (95%) returned the completed questionnaires, of them 54 (38%) were males and 88 (62%) were females. The main findings of the study are that only 30% of the students knew about dental ergonomics; 93% of students have not attended any course/workshop about dental ergonomics; about half the students knew about WRMSDs; 62% of the students did not know about preventive measures to decrease the risk of WRMSDs, and 80% of students did not have knowledge about treatment options for WRMSDs. In general, female students had a better understanding of dental ergonomics and WRMSDs than male students. Conclusion: The basic knowledge of the dental ergonomics among dental students at King Saud University, Riyadh, Kingdom of Saudi Arabia is not adequate. Clinical significance: There is a need for introducing dedicated theoretical and practical courses covering all aspects of dental ergonomics in the undergraduate curriculum of dental education

Assessment of knowledge about dental ergonomics among dental students of King Saud University, Riyadh, Kingdom of Saudi Arabia

Aim: To assess the knowledge about dental ergonomics and work-related musculoskeletal disorders (WRMSDs) among dental students of King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia, undergoing practical clinical training. Materials and methods: A self-designed questionnaire after pre-testing was distributed to 150 dental students of KSU undergoing clinical training, to collect data related to (a) basic knowledge about dental ergonomics; (b) any course/workshop about dental ergonomics attended; (c) basic knowledge about WRMSDs; (d) familiarity about preventive measures to decrease the risk of WRMSDs; and (e) knowledge about treatment options for WRMSDs. Results: One hundred forty-two students (95%) returned the completed questionnaires, of them 54 (38%) were males and 88 (62%) were females. The main findings of the study are that only 30% of the students knew about dental ergonomics; 93% of students have not attended any course/workshop about dental ergonomics; about half the students knew about WRMSDs; 62% of the students did not know about preventive measures to decrease the risk of WRMSDs, and 80% of students did not have knowledge about treatment options for WRMSDs. In general, female students had a better understanding of dental ergonomics and WRMSDs than male students. Conclusion: The basic knowledge of the dental ergonomics among dental students at King Saud University, Riyadh, Kingdom of Saudi Arabia is not adequate. Clinical significance: There is a need for introducing dedicated theoretical and practical courses covering all aspects of dental ergonomics in the undergraduate curriculum of dental education

Effects of Head-Neck Positions on the Hand Grip Strength in Healthy Young Adults: A Cross-Sectional Study

Background. Assessment of hand grip strength is vital for the evaluation of upper limb impairments and effective exercise prescription. Present study primarily aimed to investigate the effect of head-neck positions on the hand grip strength in healthy young adults. Secondarily, the present study compared hand grip strength between left versus right hand in different head-neck positions. Methods. Healthy young adults (age 19 – 30 year; n = 40) participated in this cross-sectional study. Hand grip strength was assessed in three head-neck positions (neutral, rotation left, and rotation right) using the standard adjustable Jamar hand dynamometer. Results. Hand grip strength in both sides (left and right) was greatest in the head-neck neutral position. Hand grip strength measured in head-neck left rotation position displayed the least strength in both sides. There was no significant difference noted between left and right side hand grip strength measured in head-neck neutral and right rotation positions. However, there was a significant difference noted between left and right side hand grip strength measured in head-neck left rotation positions. There was no significant effect of head-neck positions on hand grip strength noted in both sides. Conclusions. Hand grip strength was highest in the head-neck neutral position followed by head-neck rotation to the right. However, head-neck positions did not significantly affect hand grip strength in healthy young adults. Further studies assessing the hand grip strength in different neck positions in patients with neck pain and upper limb dysfunction may have significant implications for the assessment of hand grip strength

Work-related musculoskeletal disorders among dental professionals in Saudi Arabia

[Purpose] Musculoskeletal disorders are common causes of work-related disability in different professions involving the frequent practice of lifting, stooping, twisting, prolonged sitting, or standing. The dental profession is one such profession. Our aim was to determine the prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia, the factors associated with them, and their consequences and to propose preventive measures for them. [Subjects and Methods] A self-administered online questionnaire was sent to 225 members of the Saudi Dental Association. It included questions on demographic and professional characteristics, general medical history, and history of work-related musculoskeletal disorders before and after joining the dental profession. [Results] The questionnaire was completed by 65% of the respondents. Among them 85% reported that they had developed some pain due to work after joining the dental profession, and 42% reported that they were suffering pain at the time of the survey. Besides lower back, shoulder, and neck regions, the hands, upper back, and other regions like the elbows, buttocks, thighs, leg, and feet were areas in which they pain. [Conclusion] The prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia is high, affecting their daily activities, sometimes even forcing them to change their work setting. Age, gender, specialty of work, work setting, number of contact hours with patients, etc., were all found to be related to their work-related pain. We need to emphasize the role of ergonomics, counseling, proper techniques of patient handling, etc., during the training of dental professionals so that they can work efficiently

Can jaw position affect the fine motor activity of the hand during writing?

Background: Jaw and neck systems have been shown to be functionally related and changes in either system can modulate gross motor functions, such as posture control. It remains to be seen if any change in jaw position can affect fine motor skills. The objective of this study was to determine the effect of resting, open and clenched jaw positions on various handwriting parameters while standing on firm and unstable surfaces. Methods: Handwriting samples were collected from 36 healthy male participants (age, 15-35 years) using a digitizer tablet (WACOM Intuos 4) with noninking pen in the resting, open and clenched jaw positions while standing on firm and unstable surfaces. The measured handwriting parameters included duration, vertical size, horizontal size, absolute size, average absolute velocity, and absolute jerk. Recordings and analyses were performed using NeuroScript MovAlyzeR software. Results: All handwriting parameters varied among the resting, open, and clenched jaw positions on both the firm and unstable surfaces. However, based on statistical analyses, there were no significant differences in the handwriting parameters among three jaw positions on both surfaces (p &gt; .05). Conclusion: This study revealed that all handwriting parameters varied among the resting, open, and clenched jaw positions on both the firm and unstable surfaces, showing that change in the jaw motor system may potentially affect the fine motor skills. However, on statistical analysis, there was no significant effect of 3 studied jaw positions on fine motor skills as seen on gross motor skills among healthy individuals