Effect of Ankle Kinesio Taping on Dynamic Balance in Stroke Patients- A Pilot Study

Background: Stroke causes partial brain loss, which leads to a functional abnormality of the brain, which produces a variety of symptoms the most prevalent of which is balance affection. Kinesio tape is a thin, light and elastic material which does not immobilize the joint and allows for free movement irrespective of the tape. It serves to facilitate or inhibit the muscle as needed and provides joint stability which will help improve balance function. It is also used to reduce pain, which is a typical complaint in stroke patients. Objective: To assess for immediate and post effects of kinesio tape in stroke patients using Berg Balance Scale and 10 Meter walk test. Method: A total of 15 participants were chosen based on inclusion and exclusion criteria. Before application of kinesio tape, the Berg balance scale and a 10-meter walk test were performed and recorded. Following the application, the subjects were reassessed, and the outcomes of the 5-day follow-up were recorded. These scores were statistically analyzed. Result: The statistical analysis showed that there is a significant increase in the dynamic balance function post kinesio tape application. An average increase of 5 scores in BBS was noted and average improvement of 5.70 seconds in 10MWT. Conclusion: This study concludes that there is a significant improvement on dynamic balance after application of kinesio tape in stroke patients. Key words: Stroke, kinesio tape, dynamic balance.

Functional Abnormality Associated With Tau Deposition in Alzheimer’s Disease – A Hybrid Positron Emission Tomography/MRI Study

Objective: To investigate the characteristics of tau deposition and its impact on functional connectivity (FC) in Alzheimer’s disease (AD).Methods: Hybrid PET/MRI scans with [18F]-THK5317 and neuropsychological assessments were undertaken in 26 participants with AD and 19 healthy controls (HC). The standardized uptake value ratio (SUVR) of [18F]-THK5317 PET imaging was compared between the AD and HC groups. Significant clusters that revealed higher tau deposition in the AD group compared to the HC group were selected as regions of interest (ROI) for FC analysis. We evaluated the difference in the FC between the two groups for each ROI pair. The clinical and radiological characteristics were compared between the AD patients with negative FC and AD patients with positive FC for exploratory analysis.Results: The bilateral inferior lateral temporal lobe, dorsal prefrontal cortex, precuneus, posterior cingulate cortex, hippocampus, and occipital lobe showed significantly higher [18F]-THK5317 accumulation in AD patients. Decreased FC in regions with higher SUVR was observed in AD patients, and the FC strength was negatively correlated with regional SUVR. Patients with a positive FC exhibited older ages, better cognitive performances, and a lower SUVR than patients with a negative FC.Conclusions: An impact of tau deposition was observed on FC at the individual level in AD patients. Our findings suggested that the combination of tau-PET and rs-fMRI might help predict AD progression.

Epicardial adipose tissue is associated with exercise intolerance in patients with diabetes with asymptomatic left ventricular structural and functional abnormalities

Background The volume of epicardial adipose tissue (EAT), which is an index of visceral fat, is high in patients with type 2 diabetes mellitus (T2DM) and may affect the myocardial performances. However, the association between EAT and left ventricular (LV) structure and function, and exercise capacity in patients with asymptomatic heart failure has not been studied. Aims To elucidate whether the volume of EAT deteriorates the exercise capacity in patients with T2DM. Methods EAT thickness and LV structural and functional abnormality components (e.g., global longitudinal strain, E/e', LV mass index, relative wall thickness) were measured with echocardiography in 176 patients with asymptomatic heart failure (Stage A and B) and 62 healthy controls (HC). To evaluate exercise capacity, peak oxygen uptake (peakVO2) was measured by using the cardiopulmonary exercise testing. Results Lipid metabolism, glucose metabolism, brain natriuretic peptide and estimated glomerular filtration rate at cystatin were worse in the heart failure (HF) group than in the HC. The EAT was significantly thicker and peakVO2 was lower in patients with LV structural and functional abnormalities than in individuals without these abnormalities (p<0.001). As the number of LV structural and functional abnormality components increased, the thickness of the EAT increased and peakVO2 decreased (p<0.001). The EAT thickness (β=−0.207) was negatively correlated with peakVO2, even after adjusting for multivariates (R2=0.724). Conclusions In patients with T2DM with asymptomatic heart failure, EAT is associated with LV structural and functional abnormalities. It also suggests that increase of visceral fat around myocardium contributes to exercise intolerance. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National University Corporation Tsukuba University of Technology education and research Grant

The burden of subclinical cardiovascular disease in children and young adults with CKD and on dialysis

Introduction Cardiovascular disease (CVD) is a common cause of morbidity and mortality even in young people with chronic kidney disease (CKD). We examined structural and functional cardiovascular changes in patients with CKD stages 4-5 and on dialysis under 30 years of age. Methods 79 children and 21 young adults underwent cardiac CT for coronary artery calcification (CAC), ultrasound for carotid intima media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and echocardiography. Differences in structural [CAC, cIMT z-score, left ventricular mass index] and functional [carotid distensibility z-score, cfPWV z-score] measures were examined between CKD stages 4-5 and dialysis patients. Results Overall the cIMT z-score was raised (median 2.17, IQR 1.14-2.86) and 10 (10%) had CAC. 16/23(69.5%) of CKD4-5 and 68/77(88.3%) on dialysis had at least one structural or functional CV abnormality. There was no difference in the prevalence of structural abnormalities in CKD or dialysis cohorts, but functional abnormalities were more prevalent in patients on dialysis (p < 0.05). The presence of > 1 structural abnormality was associated with a 4.5-fold increased odds of > 1 functional abnormality (95% CI 1.3 to 16.6, p < 0.05). Patients with structural and functional abnormalities (cIMT z-score >2SD or distensibility <-2SD) had less carotid dilatation (lumen/wall cross sectional areas ratio) compared to those with normal cIMT and distensibility. Conclusion There is a high burden of subclinical cardiovascular disease in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared to CKD patients. Longitudinal studies are required to test these hypothesis generating data and define the trajectory of CV changes in CKD.

Study of Congenital Malformation in a Tertiary Care Teaching Hospital

Objective: Congenital anomaly is one of the most important causes & being the 5th most common cause of neonatal mortality & morbidity. It may present as a structural or functional abnormality. These defects occur due to defective embryogenesis. Associated factors may be maternal age, maternal TORCH infection, drugs, genetic factors. Antenatal USG reduces the incidence.Materials and Methods: A cross-sectional study was done in the Pediatric department over 1 year. Diagnosis of all congenital anomalies was done by the concerned pediatrician& pediatric surgeon. Data was collected in the specified format.Results: A total of 10205 cases of age group 1 month to 5 years presented to the paediatric OPD, out of which 193 children were diagnosed as congenital anomalies in 1 year. Males were found to be affected the most. The most common system involved was found to be the genitourinary system (36.78%). The second most common system involved was the gastrointestinal system (33.67%). The least common system involved was the musculoskeletal system.Conclusion: Congenital anomalies are a major cause of neonatal & infantile mortality & morbidity. Routine screening with a level II targeted scan for all the pregnant mothers should be mandatory. Adequate nutrition, parental education & Rubella vaccination of the mother can decrease the prevalence of congenital anomalies to some extend.

CLINICAL PROFILE OF ASTHMA IN MALE SMOKERS

Introduction: st Asthma is traditionally dened as a functional abnormality with reversibility in forced expiratory volume in 1 second of more than 15% as opposed to irreversible or xed airway limitation in chronic obstructive pulmonary disease (COPD).This study aims to the assess the clinical symptoms, physical ndings and laboratory results in smoker patients reporting with symptoms suggestive of bronchial asthma . Material and method: This study was conducted in department of Respiratory Medicine of National institute of Medical sciences and research, Jaipur on 50 outdoor male smokers presented with respiratory complaints during period of September 2020 to May 2021. Result: 100 patients enrolled in this study. And 50 patients were diagnosed as bronchial asthma on the basis of steroid trial. Mean age of patients in our study is 48.00+10.41. Shortness of breath (48%) was the commonest complaint followed by cough(24%), expectoration (20%) and last was chest pain (8%). There were more current smokers (48%) followed by ex smokers (32%0 and least were reformed (20%).The most common symptoms in past history of patient was seasonal variation (96%) followed by eye itching (32%), chest tightness (60%), sneezing (56%), dust allergy(32%), non respiratory allergy and wheeze (24%) and last was positive family history of asthma or allergy. Past history showed different variation in which any one symptoms was present in 100% of patients, followed by 2 symptoms (95%), 3 symptoms (84%) and 4 symptoms (52%). Conclusion: This study concludes that presence of any two of the above described past symptoms or variables suggestive of asthma in past are diagnostic of asthma in smoker patients even in the presence of irreversible or partially reversible airway obstruction

Malignant Osteopetrosis, a Rare Cause of Bicytopenia in Infants: A Case Report

Osteopetrosis is an autosomal metabolic bone disease caused by a functional abnormality of the osteoclasts. Two main forms exist, the dominant benign form and the recessive malignant form. We describe in our patient the recessive malignant form retained according to all the clinical, biological and especially radiological criteria. We also report in this work the elements of description of the disease in the literature in comparison with the data of our patient, which allows us to emphasize the severity of the ocular and bone damage requiring an early marrow transplant which alone seems to cure the disease.

Perivascular spaces and brain waste clearance systems: relevance for neurodegenerative and cerebrovascular pathology

Perivascular spaces (PVS) of the brain, often called Virchow-Robin spaces, comprise fluid, cells and connective tissue, and are externally limited by astrocytic endfeet. PVS are involved in clearing brain waste and belong to the “glymphatic” system and/or the “intramural periarterial drainage” pathway through the basement membranes of the arteries. Related brain waste clearance systems include the blood–brain barrier, scavenger cells, cerebrospinal fluid, perineural lymphatic drainage pathways and the newly characterised meningeal lymphatic vessels. Any functional abnormality of PVS or related clearance systems might lead to accumulation of brain waste. It has been postulated that PVS enlargement can be secondary to accumulation of β-amyloid. Lack of integrity of the vascular wall, microbleeds, cerebral amyloid angiopathy (CAA) and enlarged PVS often occur in the preclinical stages of Alzheimer’s disease, preceding substantial brain atrophy. PVS enlargement in the form of état criblé at the basal ganglia has also been considered to reflect focal atrophy, most probably secondary to ischaemic injury, based upon both pathological and imaging arguments. In addition, distinct topographic patterns of enlarged PVS are related to different types of microangiopathy: CAA is linked to enlarged juxtacortical PVS, whereas subjects with vascular risk factors tend to have enlarged PVS in the basal ganglia. Therefore, enlarged PVS are progressively being regarded as a marker of neurodegenerative and cerebrovascular pathology. The present review addresses the evolving concept of PVS and brain waste clearance systems, the potential relevance of their dysfunction to neurodegenerative and cerebrovascular pathology, and potential therapeutic approaches of interest.

Effectiveness of Closed Reduction in the treatment of nasal bone fractures

This study was conducted to investigate the effectiveness of closed reduction of nasal bone fracture according to severity. It was a retrospective study carried on 60 patients with mean age of 30.2 years (range 10-67 years) who have undergone a closed reduction of a nasal bone fracture at Gandaki Medical College Teaching Hospital from January 2017 to December 2019. The patient with nasal bone fracture who underwent surgical intervention with closed reduction under General anaesthesia were included in this study. Fracture severity was evaluated according to Hwang et al.’s classification method. All patients underwent closed reduction with external nasal splinting under General anesthesia. The patients were followed-up for at least three months to assess the complications, such as fracture recurrence and functional abnormality in the Department. The most common cause of nasal bone fracture was road traffic accidents 25 (41.6%) followed by physical assaults 18 (30%), fall injuries 12 (20%), other incidences 3 (5%), and industrial accidents 2 (3%). Forty-three (72%) cases underwent closed reduction within 24 hours of those who arrived within 4-6 hour of nasal injury in the hospital and the remaining 17 (28%) cases were reduced after 5 days of trauma. Concurrent fracture found in 8 (13%) cases and it included maxillary, zygomatic, orbital, frontal bone fracture. Nasal bone fracture mostly occurs in road traffic accidents. Closed reduction with good alignment is the preferred method. Septorhinoplasty and extracorporeal septoplasty should be applied in difficult and comminuted nasoseptal fracture.