Study on occupational performance of the primary school children with special needs

Children's occupations are self-care, play, social participation and education. Their performance can be impaired by physical, developmental, sensory, attention and or learning challenges. In developed countries school-based therapy services are being provided for the school children with special needs. The evidence for the needs of these services in Malaysia is timely to be explored.This study aimed to investigate the occupational performance of the primary school children with special needs. This exploratory cross sectional study included 6 to 12 year old 121 children from special education program of 4 primary schools. Motor-Free Visual Perceptual Test 13 _ed (MVPT),5th,ed Beery-Buktenica Developmental Test of Visual Motor Integration (Beery-VMI), Test of Gross Motor Development - 2(TGMD-2), Test of hand writing Skills-Revised (THS-R) and School Function Assessment (SFA) were carried out to assess their occupational performance.Children with intellectual disability, autism, attention deficit hyperactive disorder, Down syndrome, speech impairment, visual impairment, hearing impairment and specific learning disorder were included. Results showed that 69.5% of the children scored low average to very low in MVPT-3; 69.4% scored below average to very low in Beery-VMI; 73.6% were with below age level raw score in TGMD-2; 72.8% were in below average in THS-R and 81 % were with below criterion cut off score in school function participation. Relationship was found between gross motor skill, VMI and visual perception to school function and VMI and visual perception to hand writing skill. The results revealed the needs of school-based therapy and other rehabilitation services in the school system. Early intervention program to improve motor skill, visual perception and visual motor integration is important for the preschool children with special needs regarding the occupational performance improvement in their school age

Unilateral Hemihyperhidrosis in a Stroke Patient and Literature Review on Its Clinicoanatomical Correlation Clinicoanatomical Correlation

Contralateral hyperhidrosis from the cardiovascular accident has been infrequently described in the stroke literature. The clinical significance and pathogenesis are yet well understood. This is a case of a 60-year-old man who developed excessive sweating of the paralyzed side with a pure division along the midline of the body secondary to a subcortical stroke, which region is supplied by branches of middle cerebral artery territory known as deep perforating lenticulostriate. To the best of our knowledge, a precise clinicoanatomic correlation between hyperhidrosis and subcortical stroke has not been widely reported. In this review, we summarize the existing literature of post-stroke hyperhidrosis to evaluate the correlation between clinical manifestation and its neuroanatomical location. According to the location of the infarction and clinical features, it can be concluded that both tracks en route through the ipsilateral internal capsule, after originating in the opercular cortex before crossing the brain stem and terminal connections with the contralateral thoracic spinal cord. Therefore, the phenomenon of hyperhidrosis in anterior circulation stroke might be postulated as due to the disruption of the sympathoinhibitory pathway that controls sweat glands, similarly like posterior circulation stroke

Case Report: Callosal disconnection syndrome manifesting as mixed frontal-callosal-posterior alien hand syndrome following extensive corpus callosum infarct [version 1; peer review: awaiting peer review]

Alien hand syndrome (AHS) is a rare neurological phenomenon first described by Goldstein over a century ago. The most widely recognized variants in literature are frontal, callosal, and posterior AHS. AHS due to the corpus callosum lesion can occur alone or as part of callosal disconnection syndrome (CDS). This report presents a unique CDS case manifesting clinical features from all three AHS variants, resulting from an extensive corpus callosum infarct. Our patient exhibited various clinical features from the three AHS variants, which include grasping, groping, and difficulty releasing objects from the hand (anterior); intermanual conflict (callosal); arm levitation, mild hemiparesis, and hemisensory loss (posterior). Additionally, the extensive disruption of the corpus callosal fibers produced neurological manifestations of CDS, such as cognitive impairment, ideomotor and constructional apraxia, behavioral disorder, and transcortical motor aphasia. We employed a range of rehabilitation interventions, such as mirror box therapy, limb restraint strategy, verbal cue training, cognitive behavioral therapy, bimanual hand training, speech and language therapy, and pharmacological treatment with clonazepam. The patient showed almost complete resolution of CDS and AHS features by nine months post-stroke Our case report highlights distinctive clinical variations of AHS and the challenging correlation between clinical manifestations and neuroanatomical substrates. Future studies are necessary to explore the intricate neural connections and the precise function of the corpus callosum. This can be achieved by combining comprehensive neuropsychological testing with diffusion tensor tractography studies. It is also essential to develop a validated tool to standardize AHS assessment. Finally, the scarcity of evidence in rehabilitation interventions necessitates further studies to address the wide knowledge gap in AHS and CDS management

Functional Outcomes in Spinal Tuberculosis: A Review of the Literature

Spinal tuberculosis often leads to neurological deficit and subsequent deterioration in functional outcomes. This review assesses the recent evidence on functional outcomes in spinal tuberculosis, highlighting functional recovery, assessment tools for functional measures, and associative factors for functional recovery. Using PubMed, a literature search was done using the terms “spinal tuberculosis,” “tuberculous spondylitis,” “tuberculous spondylodiscitis,” and “functional outcome” for original articles published between January 2010 and December 2019. A total of 191 search results were found. Detailed screening showed that 19 articles met the eligibility criteria: 13 of these focused on surgical methods, four on conservative management, and two on rehabilitation approaches. The outcome measures used for functional assessment were the Oswestry Disability Index (11 articles), Japanese Orthopaedic Association score (n=3), modified Barthel Index (n=2), Functional Independence Measure (n=2), and 36-item Short-Form Health Survey (n=1). Functional outcome was mainly affected by pain, spinal cord compression, and inpatient rehabilitation. No significant difference in functional outcome was found between conservative management and surgery for cases with uncomplicated spinal tuberculosis. Most studies focused on surgery as the mode of treatment and used pain-related functional measures; however, these assessed functional limitations secondary to pain, and not neurological deficits. Further studies may consider examining functional outcomes in spinal tuberculosis by utilizing spinal cord-specific functional outcome measures, to evaluate outcome measures as a prognostic tool, and to measure functional outcomes from specific rehabilitation interventions

Association between mobility spinal cord independence measure (MSCIM) and period of walking recovery in spinal tuberculosis

This study aimed to identify the association between initial Spinal Cord Independence Measure’s Mobility Sub-score (mSCIM) and the period of walking recovery in Spinal Tuberculosis (STB). This retrospective cohort study divided 36 STB patients into two groups by their initial mSCIM score: ‘mSCIM<13’ and ‘mSCIM≥13’. Both groups were retrospectively followed-up from diagnosis until one year via clinical records. Baseline characteristics, walking outcome and period of walking recovery were recorded. Logical regression tested the association between mSCIM and walking outcome while a timeto-event analysis was done to test the relationship between mSCIM and period of walking recovery. Both ‘mSCIM<13’ and ‘mSCIM≥13’ groups had 18 patients each. Logical regression showed the mSCIM≥13 group had higher probability of recovering their walking ability (p=0.021). Time-to-event analysis showed both groups had significantly different period of walking recovery (p=0.001), averaging 10.44 and 4.94 months in those with mSCIM<13 and mSCIM≥13 respectively. In conclusion, patients with mSCIM≥13 require significantly shorter period of walking recovery

Association between early mobility scim measures and walking function in spinal tuberculosis

Spinal Tuberculosis (STB) often led to walking impairment which could lower a patient’s quality of life. This study aimed to determine the association between the early mobility Spinal Cord Independence Measure (mSCIM) and walking function beyond one year of STB diagnosis. This cross-sectional analytical study was conducted by collecting data via focused history taking, clinical assessment, and clinical notes referencing of STB patients attended the rehabilitation follow-up at Queen Elizabeth Hospital, Kota Kinabalu. A total of 36 patients were recruited and grouped as “walking” or “non-walking” based on ability to achieve a minimal level of 6 based on the Walking Index for Spinal Cord Injury (WISCI). Significant difference in mSCIM between the two groups were analysed using logical regression. The results showed that the mSCIM scores between walking and non-walking patients were significantly different (pvalue=0.021, OR=14.9, 95% CI=1.515-147.404). The results were then compared with previous literature. In conclusion, individuals with a higher mSCIM (a score of more than or equal to 13) have higher likelihood of walking beyond one year of STB diagnosis

A Case Report on Core Muscles Training for Knee Osteoarthritis Through Core Muscles Activations and Gait Analysis

Knee osteoarthritis (OA) is a chronic joint disease that can affect all ages, but it is more common in the elderly. Pharmacological and non-pharmacological treatments have been invented evolutionarily over the years to halt this disease. Exercise is one of the first-line treatments for knee OA as well as for prevention. This case study features a 47-year-old man who has grade IV bilateral knee OA and has never had any surgery and takes fish oil daily as a supplement. His walking pattern was significantly impacted by the chronic knee discomfort he had in both legs. Thus, the walking gait of this patient was analyzed together with core muscle activation before and after two weeks of core resistance exercise intervention. The knee pain score was assessed using the Western Ontario and McMaster Universities Index (WOMAC). The outcomes of this research depict that core resistance training has the potential to be used as an alternative, non-surgical and non-pharmacological treatment for a patient with knee OA

XRD and SEM Analysis, and Semiconductor Type Determination of TiO2 for Dye-sensitized Solar Cell

Titanium dioxide (TiO2) is a wide band-gap n-type semiconductor. Anatase TiO2 is the most common structure used in high performance dye-sensitized solar cell (DSSC). Nanoporous TiO2 serves double-duty as an electron acceptor and a scaffold to hold large numbers of dye molecules in DSSC. The porosity of TiO2 is a key feature as it has roughly a thousand times greater a surface area than the equivalent flat area. In this work, TiO2 crystallite size (43.55 nm) has been calculated by using XRD data, and the morphology and the grain-size of TiO2 (average grain size of 0.2 mm ~ 0.3 mm) with different solvents have been also studied by SEM

Turban Pin Inhalation Syndrome with Unusually Mobile Pin from Series of Radiographs

Foreign Bodies (FB) dislodges are common in the ear, nose and throat especially among infants and children. Occasionally, they can accidentally be ended up in the bronchus as well. We describe a 13-year-old girl with accidental ingestion of a scarf needle pin after she was slapped on the back while biting the pin. Chest radiograph had confirmed the diagnosis of pin ingestion which is consistent with turban pin inhalation syndrome. In view of logistic and specialty issues, she was transferred to another tertiary hospital for further intervention. A series of chest radiograph showed a migratory metallic FB in different locations in the airway, which was considered as an extreme rarity. We discuss this rare entity with literature review of FB aspiration in general