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Traditional, complementary and integrative medicine (TCIM) is sought by more than 50% of patients with osteoporosis. Despite this, many healthcare providers lack the knowledge to adequately counsel patients on safe and effective TCIM use. The purpose of this study was to determine the quantity and quality of TCIM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of osteoporosis.
MEDLINE, EMBASE and CINAHL databases, in addition to the Guidelines International Network, and the National Center for Complementary and Integrative Health website were searched from 2009-2020. CPGs making TCIM recommendations for the treatment/management of osteoporosis were assessed with the AGREE II instrument.
Of 536 unique search results, 27 osteoporosis CPGs made mention of TCIM therapies. From highest to lowest, scaled domain percentages of all eligible CPGs averaged to 92.59% for scope and purpose, 88.79% for clarity in presentation, 55.04% for stakeholder involvement, 47.84% for Gs found, those requiring improvement may benefit from their guideline development panel utilizing the AGREE II instrument to inform future updates.
The first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD.
Thirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment.
The primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067).
A clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD.
The protocol was registered at Korean Clinical Trial Registry (CRIS-KCT0001810).
The protocol was registered at Korean Clinical Trial Registry (CRIS-KCT0001810).
to determine the rate of the vasovagal reaction (VVR) in ultrasound guided musculoskeletal injections (USGIs) and to investigate effect of injection site, age, and gender on this rate.
Retrospective analysis of all USGIs performed from the 1st of January 2019 to the 31st of December 2019 in single tertiary orthopaedic hospital. Two thousand four hundred and sixty two consecutive subjects undergoing USGIs were included. Statistical analysis used to determine the rate of the overall VVR in USGIs and to determine if site of the injection or joint injected has an effect on this rate as well as age and gender effect.
Overall rate of VVR was 2.3% with shoulder and small joints of the hands and feet are more commonly affected than other sites. Females and patients aged younger than 65 years may be subjected to higher rate of VVR.
VVR has an overall low occurrence in USGI. The higher rate of VVR for shoulder and small joints of hands and feet procedures. Care should be taken when positioning a patient prior to the procedure to allow for a VVR in case it happens. VVR are more likely to occur in females and less likely in age more than 65 years.
VVR has an overall low occurrence in USGI. The higher rate of VVR for shoulder and small joints of hands and feet procedures. Care should be taken when positioning a patient prior to the procedure to allow for a VVR in case it happens. VVR are more likely to occur in females and less likely in age more than 65 years.
Malalignment in total knee arthroplasty has been associated with poor implant longevity and clinical outcomes. The aim of this study was to investigate the accuracy of accelerometer-based navigation in restoring the mechanical axis.
106 primary total knee arthroplasties performed during February 2016 to September 2017at a tertiary care centre in India were enrolled in this observational study. We noted the intra-op tourniquet time. Two separate blinded observers measured the preoperative mechanical axis and the post operative radiological results (mechanical axis, coronal and sagittal alignment of femoral and tibial components) and the mean value was taken as final data. Interclass correlation was done to look for variability between the two observers.
The mean pre operative mechanical axis was 13.74±10.44. The mean tourniquet time was 53.14±7.42min 91.5% (96/106) knees were within ±3° of neutral mechanical axis with a mean of 1.00°±2.68°. The femoral and tibial components with coronal alignment within ±3° perpendicular to the mechanical axis were 93.39% (99/106) and 89.62% (95/106) respectively. In the sagittal plane 89.62% of the femoral components and 87.73% of the tibial components were within ±3° perpendicular to the axis of tibia.
The Accelerometer based portable navigation system effectively reduces the coronal and sagittal alignment outliers in total knee arthroplasty and has no role in rotational alignment of components.
The Accelerometer based portable navigation system effectively reduces the coronal and sagittal alignment outliers in total knee arthroplasty and has no role in rotational alignment of components.
Postoperative Tibial chronic osteomyelitis is one of the most challenging orthopaedic conditions especially when extensive, the anatomy of subcutaneous anteromedial part of the tibia with less soft tissue coverage complicates the situation. The extent of infected tibial part varies in size and duration from one patient to another. We report our experience using Bifocal and Monofocal bone transport techniques with regard to clinical outcome, recurrence of infection and re-fracture rate.
This is a retrospective observational review of 49 patients with postoperative Tibial chronic osteomyelitis which were treated using either Bifocal distraction compression BFDCO technique group I (31 patients) or Monofocal compression osteosynthesis MFCO technique Group II (18 patients). The average age of the patients was (41.6±13.1 years), (range 17-67 years). Leg length discrepancy was measured in 33 (58.9%) patients with an average of (1.4±1.7cm). Contracture of the ankle joint and equinus deformity were detected in 36 eased to (15.06±2.88) at the final follow-up which corresponded to a "satisfactory" result.
Treatment of Tibial chronic osteomyelitis using either Bifocal or Monofocal bone transport is an effective method. However our results have demonstrated better functional outcome and less infection recurrence and re-fracture rates when using the Bifocal distraction compression technique (BFDCO).
Treatment of Tibial chronic osteomyelitis using either Bifocal or Monofocal bone transport is an effective method. However our results have demonstrated better functional outcome and less infection recurrence and re-fracture rates when using the Bifocal distraction compression technique (BFDCO).
Amidst the adversities of the COVID 19 pandemic, the health care system has seen a new paradigm shift towards e-health services. In the advent of catering to the geometrically increasing health care needs of the patients suffering from various chronic health conditions when in social isolation, the need for the shift seems to be paramount. Patients with Ankylosing spondylitis under immunosuppressants and variable degrees of disabilities are at higher risk. This study aims to assess the efficacy of e-Yoga as a treatment option for these patients in need.
This is a single-center, parallel-group prospective randomized, open-blinded end-point trial. Patients aged between 30 to 50 years will be recruited from the members of Antardhwani A society of ankylosing spondylitis, Ahmedabad, Gujarat. The yoga experts will administer a scientifically developed and validated Yoga module via e-Yoga modalities. A total of 135 patients will be recruited and randomly allocated to Yoga and control groups. selleck compound Data will be recorded at baseline and three months on disease activity, degree of functional limitations in patients, quality of life, inflammatory biomarkers, depression, and anxiety using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index
BASFI), AS Quality of Life index
ASQOL), C reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Physical health questionnaire-4 (PHQ-4), respectively.
The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst Covid 19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215).
The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst Covid 19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215).Since the seminal paper of Rohwedder and Willis (2010), the effect of retirement on cognition has drawn significant research interest from economists. Especially with ongoing policy discussions about public pension reforms and the increasing burden of dementia, it is indisputably an important research question with significant policy implications. Building on this growing literature, our paper makes two important contributions. First, we explicitly consider cognitive demands of jobs in studying hetereogeneity of the retirement effect. As the primary explanation for the potential adverse effect of retirement is that cognition is better maintained through mental exercise (Salthouse, 2006), by investigating the cognitive demands of the job one retires from we can directly test the hypothesized relationship. Second, we avoid biases associated with omitted variables, particularly by controlling for endowed cognitive ability. While endowed, genetic differences in cognitive ability is an important omitted variable that can explain individual differences in cognitive performance as well as selection into a particular type of job, this inherited characteristic has not been controlled for in the prior literature. Taking advantage of the polygenic risk score of cognition (Davies et al., 2015), we control for individual differences in genetic endowments in estimating the effect of retirement on cognition. We find supporting evidence for differential effects of retirement by cognitive demands of jobs after controlling for innate differences in cognition and educational attainment.