Low-level laser therapy versus local steroid injection in patients with idiopathic carpal tunnel syndrome: a single blind randomized comparative trial

The objective of this study was to compare corticosteroid injection with low-level laser therapy for the short-term treatment of mild or moderate idiopathic carpal tunnel syndrome. Single blind randomized clinical trial was conducted from May 2010 to October 2010 in outpatient clinic and research center at a university hospital. Thirty-eight patients (female to male ratio was 5.3 to 1) with a new episode of carpal tunnel syndrome of mild or moderate severity participated in this study. Corticosteroid injection and low level laser therapy were used as the interventions. Primary outcome measure was the severity of the disease. Based on the electrophysiological findings, we proposed three grades: mild, moderate and severe. Visual analogue scores were used to measure subjective severity of pain. We measured median distal motor and sensory latencies. All participants were followed for two months. Analyses showed favorable outcomes in both groups in terms of visual analogue scores and median distal motor and sensory latencies (p<0.001 for all comparisons). Electrophysiologic studies did not imply any significant difference in the severity (Chi-squared test p = 0.28), and change in the grade of the disease between the two groups. Also there was no significant difference between the groups in mean visual analogue scores (Mann-Whitney test p = 0.45), median motor distal latency (Mann- Whitney test p = 0.08), and sensory distal latency (Mann-Whitney test p = 0.70), 8 weeks after the treatments. Both corticosteroid and laser are advantageous in the short-term treatment of carpal tunnel syndrome and provide satisfactory pain relief, electrophysiological improvement, and are well tolerated by patients.Keywords: Carpal tunnel syndrome; Low level laser; Corticosteroid; Median nerve; Electrophysiologic studies; Peripheral compression neuropathy; Randomized clinical trial; Hydrocortison

Prevalence of Truncal Acne in High School Students: A Community Based Study

Background: Acne is one of the most common skin diseases especially in adolescence. Different studies have reported unequal rates of facial acne prevalence in different countries and populations. Only a few cases of acne in the trunk area (back and chest) have been reported in literature. Although our clinical experience shows lower prevalence of truncal acne in comparison with facial acne, a community based study is needed to support this experience. Methods: A total number of 1001 high school students, selected randomly from 5 out of 20 education-ministry subdivisions of Tehran, were included. In each area two high schools (one for boys and one for girls) with almost 100 students per high school were selected. Demographic data, family history and clinical findings were recorded in the questionnaires. Consensus Conference on Acne Classification was used for acne grading. Results: One thousand one high school students, 503 girls and 498 boys ,were included. Prevalence of acne was 91.1% for face (95%CI: 83-99%), 93.4% in boys and 88.6% in girls. It was 53.4% for back (95%CI: 46-62.2%), 58.5% in boys and 36.9% in girls. Whereas for chest the prevalence was 36% (95%CI: 27-45%), 34.9% in boys and 36.9% in girls. Mean age of the students with truncal acne was 16.1 years where as 15.9 in others. This difference was significant (P<0.05). Positive family history was higher in students with truncal acne (P<0.001). Conclusion: Truncal acne is less prevalent than facial acne. Acne on the back is significantly higher in boys than girls (P=0.002). Severe forms of acne in back may be more prevalent in boys. Positive family history can increase the risk of truncal acne

Bilateral responses of trapezius muscle to transcranial magnetic stimulation in normal subjects

Introduction: Motor evoked potentials (MEPs) can be elicited in trapezius and other axial musclesby ipsilateral transcranial magnetic stimulation (TMS).The purpose of this study is to compare therelative amplitudes and latencies of ipsilateral versus contralateral responses to TMS from trapeziusmuscle of normal subjects.Materials and Methods: MEPs were bilaterally recorded during complete relaxation and voluntarycontraction from upper trapezius muscle in 40 healthy right handed subjects by TMS in right and lefthemispheres. Base-to-peak amplitude and latency of MEP were measured for each muscle on bothsides.Results: At rest, a contralateral response was obtained in 45 trapezius muscles. Ipsilateralresponses were observed in 11 muscles (latency contra-lateral and ipsilateral 9.8ms and 15.5 ms,respectively, P <0.001). During contraction ipsilateral MEPs could be evoked in 37 muscles.Contralateral MEPs were obtained in 76 experiments on 40 subjects (latency contralateral andipsilateral 8.5ms and 12.6 ms, respectively, P <0.001).Conclusion: MEPs can be readily evoked by TMS over the ipsilateral motor cortex in a variety ofproximal muscles, such as trapezius. Ipsilateral MEPs have a later onset and lower amplitude thancontralateral responses. It is considered that oligosynaptic connections may be a common feature ofaxial muscles, such as trapezius. These patterns of connections are discussed in relation to thecontrasting bilateral functional roles of this muscle

A cross-sectional study using wireless electrocardiogram to investigate physical workload of wheelchair control in real world environments

The wheelchair is a key invention that provides individuals with limitations in mobility increased independence and participation in society. However, wheelchair control is a complicated motor task that increases physical and mental workload. New wheelchair interfaces, including power-assisted devices can further enable users by reducing the required effort especially in more demanding environments. The protocol engaged novice wheelchair users to push a wheelchair with and without power assist in a simple and complex environment using wireless Electrocardiogram (ECG) to approximate heart rate (HR). Results indicated that HR determined from ECG data, decreased with use of the power-assist. The use of power-assist however did reduce behavioral performance, particularly within obstacles that required more control