Effectiveness of Pilates exercises on non-specific low back pain to determine pain and disability

Introduction and Aim: Low back discomfort is one of the commonest musculoskeletal problems. The Pilates exercises are an approach to stretching and strengthening techniques and specifically train all the core muscles. The intend of the current study was to verify the influences of the Pilates exercises among pain and disability among patients with Non-specific Low Back Pain (NSLBP). Materials and Methods: A 100 non-specific low back pain subjects were randomly selected for this experimental study. The study includes of non-specific LBP age group between 25 to 40 years, both male and female patients with pain and disability and this study excludes spinal fractures and Pregnant Women. The estimations were taken utilizing Visual Analogue scale (VAS), Patient Specific Functional Scale (PSFS) and Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Subjects are allotted in two groups, Group A (Pilates group) receives Pilate’s exercise and Group B (conventional group) receives conventional exercise. Exercises were given for 3 times a week for 12 weeks and a regular follow up was done for every 4 weeks. Results: Group A (Pilates group) were found to be more effective than Group B (conventional group). It shows a highly significant difference in mean values at P ? 0.001. This implies that Pilates exercise is more beneficial in decreasing pain and functional disability. Conclusion: On comparing the mean values, Group A (Pilates group) showed significant improvement at the end of the study when compared with Group B (conventional group).

ENHANCED RECOVERY PATHWAYS (ERAS) IMPLEMENTATION IN MINIMALLY INVASIVE ESOPHAGECTOMY; AN EARLY EXPERIENCE

Objective: To evaluate the impact of enhanced recovery pathways (ERAS) on hospital stay and postoperative outcomes in patients undergoing minimally invasive esophagectomy in comparison to conventional pathway. Study Design: Quasi experimental study. Place and Duration of Study: Thoracic Surgery Department, Combined Military Hospital Rawalpindi Pakistan, from Jul 2018 to Mar 2020. Methodology: A total of 80 patients who underwent minimally invasive esophagectomy were divided in two groups. Group A underwent ERAS pathway and group B underwent conventional pathway. Both groups were compared for demographic characteristics, mean ICU stay, length of hospital stay, commencement of oral intake, and time of chest drain removal, readmission rates, postoperative morbidity and mortality. Results: There was no significant difference in age, gender and diagnostic indication among both groups. ERAS group was found to have shorter mean ICU stay (1.18 ± 0.55 vs 2.06 ± 1.10 days p<0.012), shorter hospital stay (7.50 ± 1.23 vs 11.6 ± 3.65 days, p<.001), earlier commencement of oral feeding (4.30 ± 1.41 vs 9.10 ± 4.26 days, p<0.001) and early removal of chest drains (3.22 ± vs 4.11 ± 1.52 p<0.001); when compared to conventional group. Overall morbidity in ERAS group was 50 (40%) versus 65% (81.25%) in conventional group. Mortality was same in both groups (2.5%). There was no readmission in ERAS group. Conclusion: ERAS in minimally invasive esophagectomy is safe and has positive impact on postoperative outcomes with marked reduction in overall morbidity in comparison to conventional regime. Results can be enhanced by ensuring better compliance to its.......

Safety Comparison of Conventional Versus Extended Infusion of Pulse Methylprednisolone in Multiple Sclerosis Exacerbation Retrospective Study

Objective: - To ascertain the adverse events and changes in vital signs (heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and serum potassium level during and after intravenous methylprednisolone (IVMP) in multiple sclerosis exacerbation.Design: retrospective review study conducted at Hamad General Hospital (HGH), all patients who are admitted 2019-2020 with MS exacerbation without any other comorbidities will be categorized into 2 groups depending on infusion rate, one group received conventional intravenous methylprednisolone pulse dose over 30minutes to one hour, while the second group received methylprednisolone pulse dose intravenously over an extended period)(four to six hours). Multiple readings of vital signs and, potassium level through steroid administration time will be assessed to determine if there is an infusion-related significant difference in adverse events between both groups.Methods: 74 adult patients with MS relapse who have been admitted at Hamad General Hospital (HGH) and satisfied pre-specified inclusion criteria were invited to participate in the study.Results: 74 patients with MS included in the study, 61 patients (83.6%) were received methylprednisolone dose 500 mg -1000 mg in conventional infusion rate while 12 patients (16.4%) were received pulse steroid in extended duration. There was no significant difference in mean blood pressure before and after IVMP in both groups. There was a small but statistically significant increase in mean heart rate in the conventional group immediately after first and second but not 3rd dose of IVMP compared to baseline 3.5± 8.9 and 4.85± 13.9 P < 0.003. There was a minimal non-significant increase in potassium level in the conventional group (P = 0.17), while there is a non-significant decrease in potassium level in the extended group (P=0.72).Conclusion: IVMP is considered safe and effective in the treatment of MS exacerbation regardless of intravenous infusion duration. There was no significant difference in vital signs among different infusion rates. However, there was a small but statistically significant increase in mean heart rate in the conventional group immediately after first and second but not 3rd dose of IVMP compared to baseline. No significant difference was observed in potassium levels before and after IVMP. We, therefore, recommend that potassium level monitoring should be only restricted to patients with other risk factors of hypokalemia.

Evaluation of the Effect of PDCA in Hospital Health Management

PDCA plays a very important role in the hygienic management of hospital operating rooms. Before the PDCA management from February 2018 to February 2019, routine hygiene management in the operating room was adopted; after the PDCA management from February 2018 to February 2019, PDCA cycle management was adopted. 500 surgical patients were randomly selected from both groups. We compare the quality control checklist scores of hand hygiene management, environmental hygiene management, medical waste management, and disinfection and isolation management in the routine group and the PDCA group. We also compared the detection rate of pathogenic bacteria in surgical incisions of the routine group and the PDCA group and the infection rate of various surgical incisions, air samples, surface samples, disinfectants, and sterilization rates of sterile items. The PDCA group’s hand hygiene management score, environmental hygiene management score, medical waste management score, and disinfection and isolation management score were higher than those in the conventional group ( P < 0.05 ). The detection rate of pathogenic bacteria in the PDCA group, the infection rate of type I, type II, and type III incisions, and the total infection rate of surgical incisions were lower than those in the conventional group, and the difference was statistically significant ( P < 0.05 ). The qualified rate of air samples and surface samples in the PDCA group was higher than that in the conventional group ( P < 0.05 ), and the difference in the qualified rate of disinfectants and sterile items between the two groups was not statistically significant ( P > 0.05 ). The hygiene management of the operating room adopts PDCA sustainable improvement management measures to effectively increase the qualification rate of disinfection and sterilization, reduce the detection rate of pathogenic bacteria and infection rate of surgical incisions, and strengthen the management quality of hand hygiene, environmental hygiene, medical waste, and disinfection and isolation.

Ambulatory Endoscopic Thyroidectomy via a Chest-Breast Approach Has an Acceptable Safety Profile for Thyroid Nodule

IntroductionWith the growing esthetic requirements, endoscopic thyroidectomy develops rapidly and is widely accepted by practitioners and patients to avoid the neck scar caused by open thyroidectomy. Although ambulatory open thyroidectomy is adopted by multiple medical centers, the safety and potential of ambulatory endoscopic thyroidectomy via a chest-breast approach (ETCBA) is poorly investigated.Material and MethodsPatients with thyroid nodules who received conventional or ambulatory ETCBA at Xiangya hospital, Central South University from January 2017 to June 2020 were retrospectively included. The incidence of postoperative complications, 30-days readmission rate, financial cost, duration of hospitalization, mental health were mainly investigated.ResultsA total of 260 patients were included with 206 (79.2%) suffering from thyroid carcinoma, while 159 of 260 received ambulatory ETCBA. There was no statistically significant difference in the incidence of postoperative complications (P=0.249) or 30-days readmission rate (P=1.000). In addition, The mean economic cost of the ambulatory group had a 29.5% reduction compared with the conventional group (P&lt;0.001). Meanwhile, the duration of hospitalization of the ambulatory group was also significantly shorter than the conventional group (P&lt;0.001). Patients received ambulatory ETCBA showed a higher level of anxiety (P=0.041) and stress (P=0.016). Subgroup analyses showed consistent results among patients with thyroid cancer with a 12.9% higher complication incidence than the conventional ETCBA (P=0.068).ConclusionAmbulatory ETCBA is as safe as conventional ETCBA for selective patients with thyroid nodules or thyroid cancer, however with significant economic benefits and shorter duration of hospitalization. Extra attention should be paid to manage the anxiety and stress of patients who received ambulatory ETCBA.

An Empirical Analysis of the Structuration of American Ideologies About Economic Justice

A consensus has been forming among structural social psychologists that most Americans hold beliefs in both individualistic and structural explanations of inequality. Yet, even many who espouse structural beliefs nonetheless emphasize individual-level explanations of inequality to disproportionate extents. This study is aimed to identify common trends in the logic used by a conventional group of Americans – MBA students – to rationalize their more general political and economic beliefs. While a large number of studies have emphasized the prevalence of dominant ideology beliefs, and others have speculated theoretically on how such beliefs are reproduced, this study aims to bring these bodies of work together. I sought to build an initial understanding of how contradictions in Americans’ political and economic ideologies are transmuted, and to identify heuristic concepts fundamental to this process. Findings suggest that particular assumptions about human nature serve to “fill” the cognitive “gap” which would otherwise present individuals with insurmountable ambiguities in their ideologies about economic justice. Respondents also reflected some level of awareness of the impact of ideology on their thought processes, even as they accept such processes, and the realities they constitute, as inevitable.

Correlation Analysis of Chaige Qinlian Decoction and Acupuncture Combined Intervention on Prognosis of Children with Pneumonia

Background. Traditional Chinese medicine (TCM) treatment is of great importance to improve the clinical symptoms of children with pneumonia, and this study was conducted in this context. Methods. The clinical data of 82 child patients with pneumonia admitted to our hospital from February 2019 to February 2020 were retrospectively analyzed, and the patients were divided into the conventional group and the combined group according to the parity of their admission numbers, with 41 cases each. Conventional Western medicine therapy was given to children in the conventional group, and on this basis, acupuncture combined with Chaige Qinlian decoction was performed on children in the combined group, so as to evaluate the clinical application value of combined treatment and analyze its relationship with prognosis by recording the recovery time of each symptom, serum indicators, and immune indicators. Results. Children in the combined group had significantly shorter recovery time of each symptom and lower mean CPIS scores after treatment than the conventional group ( P < 0.001 ); the TCM symptom scores at T1 (1 d after treatment), T2 (3 d after treatment), T3 (7 d after treatment), and T4 (10 d after treatment) of children in the combined group were significantly higher than those in the conventional group ( P < 0.05 ); various immune indicators of the combined group before and after treatment were significantly different ( P < 0.001 ), and after treatment, the combined group obtained significantly higher IgG levels and lower IgA, complement C3, and complement C4 levels than the conventional group ( P < 0.001 ); and there was a positive correlation between the CPIS scores and serum IL-8, IL-6, and CRP levels at the first day (r = 0.706, 0.712, 0.734, P < 0.001 ). Conclusion. Acupuncture combined with Chaige Qinlian decoction can effectively shorten the course of disease, reduce the levels of serum inflammatory factors, and improve the immune function of body for child patients with pneumonia. Serum IL-8, IL-6, and CRP levels in child patients can reflect the clinical prognosis, with higher levels indicating worse prognosis.

Study on Risk Factors for Death from Cardiomyopathy and Effectiveness of Health Information Management

Objective. To explore risk factors for death from cardiomyopathy and the effectiveness of health information management (HIM). Methods. A total of 80 patients with cardiomyopathy admitted in ICU of our hospital (January 2016–January 2020) were selected as study subjects, and the clinical data of the patients were retrospectively analyzed. The patients were divided into the survival group (n = 72) and the death group (n = 14) according to the treatment outcome. Then, according to the management mode, the survival group was further equally divided into the conventional group and the HIM group to investigate the influence of risk factors on prognosis of patients with cardiomyopathy and the effectiveness of HIM. Results. No significant difference was found in baseline body mass, myocardial enzymes, troponin, infection factors, history of heart disease, and gender between the survival group and the death group ( P > 0.05). Compared with the survival group, the patients of the death group were older ( P < 0.05), LVEF of the death group was obviously lower ( P < 0.05), and the scores of APACHE II and SOFA of the death group were obviously higher ( P < 0.05). Further logistic regression analysis of the univariate factors influencing the risk of death from cardiomyopathy led to the conclusion that LVEF was an independent risk factor for death in patients with cardiomyopathy. LVEF below 24.69% examined by echocardiography had a high predictive value, with a sensitivity of 98.6% and a specificity of 78.6%. No obvious difference was found in general data between the conventional group and the HIM group ( P > 0.05). Compared with the conventional group, the disease remission rate, complication rate, awareness rate of health knowledge, ICU length of stay, and scores of self-management efficacy of the HIM group were obviously better ( P < 0.05). No significant difference was found in 5-year mean survival rate between the conventional group and the HIM group ( P > 0.05). Conclusion. Older age, lower LVEF, and higher scores of APACHE II and SOFA are all risk factors for death from cardiomyopathy. Lower LVEF is an independent risk factor, and LVEF below 24.69% is an important indicator of increased risk of death. Moreover, HIM can effectively improve short-term treatment efficacy but has little effect on the long-term survival rate.

Peer instruction versus conventional group work-based teaching in a laboratory exercise on respiratory physiology: a randomized study

Collaborative teaching strategies such as peer instruction and conventional group work have previously been shown to enhance meaningful learning, but they have not previously been compared. In this present study, we compared the impact of solving quizzes with peer instruction and conventional group work on immediate learning in a laboratory exercise. A total of 186 second-year medical students were randomized to solve two quizzes by either a peer instruction strategy ( n = 93) or conventional group work ( n = 93) during a mandatory laboratory exercise on respiratory physiology, after which all students completed an individual test. There was no difference in total test scores between groups, but students randomized to peer instruction obtained the highest test scores in solving simple integrated questions. Conversely, students randomized to conventional group work provided the best evaluations of the overall assessment of the laboratory exercise. In conclusion, different collaborative teaching strategies implemented during a laboratory exercise appear to affect immediate learning and student satisfaction differently.

Long-term effectiveness of behavioural intervention in preschool children with attention deficit hyperactivity disorder in Southeast China – a randomized controlled trial

Background Attention-deficit hyperactivity disorder (ADHD) is the most common behavioral disorder. Behavioural intervention in preschool children with ADHD is considered effective. This study discussed the long-term effectiveness of behavioural intervention in the context of nondrug therapy. Methods The study was a prospective, randomised controlled trial in which 201 preschoolers diagnosed with ADHD who were not receiving any treatment were assigned to two groups from January 2018 to May 2019, 101 were assigned to the conventional group and 100 to the behavioural intervention group. The behavioural intervention group included parental training, behavioural therapy, attention training, relief therapy and game therapy, in addition to the conventional group offerings. Children were evaluated at a baseline, at the end of the 12-month intervention and six months after the intervention. The primary and secondary outcome variables included attention time, the impulse-hyperactivity and hyperactivity index from Conners parent symptom questionnaire (PSQ), full-scale attention quotient (FAQ) and full-scale response control quotient (FRCQ) from integrated visual and auditory comprehensive continuous performance tests. The attention time was observed and recorded by parents, and others were performe(PSQ)d by physicians in the clinic. All statistical analyses were conducted using SPSS V26.0 (IBM), including the descriptive statistics and mixed-effects models and so on. Results The participants’ mean age was (66.17±9.00) months in the behavioural group and (67.54±6.22) months in the conventional group .A total of 190 participants completed a follow-up six months after the intervention. The attention time, Conners parent symptom questionnaire (PSQ), full-scale attention quotient (FAQ) and full-scale response control quotient (FRCQ) increased significantly over time, and the behavioural group improvements were higher than those of conventional group. There was a significant main effect of time (pretest/posttest/follow-up) and group on all outcome measures (t =-12.549-4.069, p<0.05), and a significant interaction of time and group on attention time, impulsivity/hyperactivity, FAQ and FRCQ (t =-3.600-3.313, p<0.05). Conclusion Behavioural intervention can effectively improve behaviour management and relieve symptoms in children with ADHD. These effects lasted at least six months. This study provides a promising approach for improving clinical efficacy with preschool children with ADHD.