Multidisciplinary Team Working in Rehabilitation Medicine: Advantages and challenges.

Healthcare is delivered in a very complicated environment where numerous variables affect the patient related outcomes. A multidisciplinary team that places a high priority on patient satisfaction and healthcare quality can help to simplify and manage the environment of complex healthcare delivery. The foundation of rehabilitation treatments is a multidisciplinary team approach to provide interventions and care for the patients. Regardless of the population studied, multidisciplinary rehabilitation has been shown to be more effective than therapy delivered by individual therapists in a number of different populations. Due to the patient's complex impairments, a team-based approach is necessary for assessments and facilitates coordinated care planning in the rehabilitation settings. The aim of this paper is to offer a narrative review of the advantages and challenges of multidisciplinary team working. The key components of teamwork in rehabilitation are the individualization of patient care and effective team communication.

Green synthesis of ZnO nanocubes from Ceropegia omissa H. Huber extract for photocatalytic degradation of bisphenol An under visible light to mitigate water pollution.

Plastic pollution has become a major environmental problem because it does not break down and poses risks to ecosystems and human health. This study focuses on the environmentally friendly synthesis of ZnO nanocubes using an extract from Ceropegia omissa H. Huber plant leaves. The primary goal is to investigate the viability of these nanocubes as visible-light photocatalysts for the degradation of bisphenol A (BPA). The synthesized ZnO nanocubes have a highly crystalline structure and a bandgap of 3.1 eV, making them suitable for effective visible-light photocatalysis. FTIR analysis, which demonstrates that the pertinent functional groups are present, demonstrates the chemical bonding and reducing processes that take place in the plant extract. The XPS method also studies zinc metals, oxygen valencies, and binding energies. Under visible light irradiation, ZnO nanocubes degrade BPA by 86% in 30 min. This plant-extract-based green synthesis method provides a long-term replacement for traditional procedures, and visible light photocatalysis has advantages over ultraviolet light. The study's results show that ZnO nanocubes may be good for the environment and can work well as visible light photocatalysts to break down organic pollutants. This adds to what is known about using nanoparticles to clean up the environment. As a result, this study highlights the potential of using environmentally friendly ZnO nanocubes as a long-lasting and efficient method of reducing organic pollutant contamination in aquatic environments.

Comparative phytochemical study of methanolic and ethanolic extracts of Thymus linearis and their antibacterial and antioxidant potential.

Thymus linearis (Thyme) is a medicinal plant widely distributed throughout Asia. Various parts of thyme are utilized for diverse medicinal purposes, including its use as a tonic and diuretic, for cough relief, as a flavoring agent, in treating dysentery, and for alleviating stomach disorders. Numerous studies have been conducted to explore the unexploited potential of thyme. Thyme was collected from the northern region of Pakistan, and sun-mediated extraction was conducted. Phytochemical analysis, utilizing GC-MS, revealed numerous bioactive phytochemical constituents with disease-preventing roles, including detoxifying agents, antioxidants, anticancer compounds, dietary fiber, neuropharmacological agents, and immunity-potentiating agents, in the methanolic and ethanolic (14 days) extracts of the flower, leaf, and stem. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay results indicated that the ethanolic and methanolic extracts of the stem exhibited the highest antioxidant activity, reaching up to 67.34% and 62.73%, respectively, while the values for the flower and leaf extracts (both methanol and ethanol) were around 60%. The IC50 (half maximal inhibitory concentration) values were also calculated for all the samples, ranging between 7 and 9 µg/mL. Positive antibacterial and antifungal effects against Bacillus subtilis and Escherichia coli, as well as Aspergillus niger (fungi), were observed only in the extracts of the flower (both methanol and ethanol). The sun-mediated technique was used for extraction for the first time in this study. Therefore, this study introduces a novel approach to the extraction of bioactive compounds from medicinal plants, ultimately contributing to the development of herbal drugs with more convenient and cost-effective methods.

Effectiveness of Distal Sodium Channel Block in Managing Lumbosacral Radicular Syndrome: A Pilot Study.

OBJECTIVE: To find the effectiveness of distal sodium channel blocks in managing lumbosacral radicular syndrome. STUDY DESIGN: Open-labelled, non-randomised, single-group, prospective, pilot study. Place and Duration of the Study: Pain Clinic of Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi, Pakistan, from January to June 2022. METHODOLOGY: Patients having low back pain radiating to L5/S1/both dermatomes with severity of numerical rating scale (NRS) score of more than 4/10 were included. Straight leg raise (SLR) and NRS score were noted down at baseline and at 30 minutes, 24 hours, 1 week, and 4 weeks post-distal sodium channel block (DSCB). DSCB was performed at beta 1, 2, 3, and 5 portals using 2 ml of 2% injection plain lignocaine + 1 ml (40 mg) injection triamcinolone + 7 ml distilled water. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) 21. RESULTS: Out of 50 patients, 24 (48%) were females and 26 (52%) were males. No serious procedural complications were noted. Post-DSCB, follow-up was done for 4 weeks. A significant fall in NRS and an increase in SLR score were observed at every visit. Results were statistically significant (p<0.001) when mean NRS and SLR scores at every follow-up were compared for pre- and post-DSCBs. CONCLUSION: DSCB reduced pain and improved SLR in patients even at 4 weeks of follow-up. Advantages included immediate pain relief, easy to perform as outdoor procedure, cost-effective and a time buying alternative procedure allowing for the analgesic effect of medicine to kick in. KEY WORDS: Radiculopathy, Low-back pain, Epidural spinal injection, Sciatica, Pain management, Distal sodium channel blocks.

Hydrothermal synthesis of V2O5/TiO2 decorated graphitic carbon nitride nanocomposite for biomolecule oxidation inhibition and dye degradation applications.

Oxides of vanadium, titanium and graphitic carbon nitride (g-C3N4) are well known for their catalytic activities. In order to achieve synergic catalytic effects, a novel nanocomposite (NC) i.e. V2O5/TiO2/g-C3N4 has been synthesized by a very simple, ecofriendly and nonhazardous hydrothermal method. The fabricated NC was characterized employing UV-Visible, FTIR, SEM, and XRD techniques. UV-Visible and FTIR analysis indicated the formation of the nanocomposite and XRD analysis confirmed the association of V2O5 and TiO2 with g-C3N4 in nanocomposite. SEM study indicated the hetero-structure of NC having size ranging from 50 to 80 nm and it was found having hexagonal crystallite structure. The synthesized nanocomposite exhibited excellent scavenging of free radicals DPPH● (91%) and ABTS●+ (64%) that are responsible for the oxidation of biomolecules. Therefore, NC can be claimed having biomolecule oxidation protective potential. In addition, photocatalytic ability for the degradation of methylene blue (MB) and methyl orange (MO) was also achieved up to 94% and 89% respectively. The synthesized novel nanocomposite exhibited excellent potential to remove free radicals and dyes from aqueous medium which can be further used for the environmental remediation.

Biodegradable and hemocompatible alginate/okra hydrogel films with promising stability and biological attributes.

Currently, combinations of natural polymers and semi-synthetic biomolecules have gained attention for food-packaging, drug delivery, coatings, and biomedical applications. In this work, cross-linking property of two biopolymers was employed for the fabrication of hydrogel films. Sodium alginate (SAlg) and Okra gel (OkG) were used in different ratios (95:05, 75:25 and 85:15) to synthesize hydrogel films by solvent-casting method. Formation of the films was confirmed by FTIR and Raman techniques which specified the interaction between biomolecules of SAlg and OkG. XRD pattern has shown the presence of both amorphous and micro-crystalline phases in the hydrogel films and SEM studies have shown porosity, amorphousness and agglomerated morphology. TGA and DSC analyses revealed degradation of the film at 420 °C and stability studies using PBS buffer indicated stability and hydrophilic nature of hydrogel films. In-vitro degradation test was also performed for 10 weeks through the incubation of hydrogel-films in simulated body fluid and the effect of pH and temperature was also studied. Results have shown worth-some influence of okra gel on the fabricated films. Hemolytic and antioxidant activities of the gels were also determined and being non-toxic, all these ratios were found suitable for biomedical applications; especially 85:15 have shown maximum potential.

Biomolecule Protective and Photocatalytic Potential of Cellulose Supported MoS2/GO Nanocomposite.

In the current study, cellulose/MoS2/GO nanocomposite has been synthesized by a hydrothermal method. Reports published regarding efficiency of Mo and graphene oxide-based nanocomposites for environmental remediation motivated to synthesize cellulose supported MoS2/GO nanocomposite. Formation of nanocomposite was initially confirmed by UV-visible and FTIR spectroscopic techniques. Particle size and morphology of the nanocomposite were assessed by scanning electron microscopy (SEM), and it was found having particle size ranging from 50 to 80 nm and heterogeneous structure. The XRD analysis also confirmed the structure of the nanocomposite having cellulose, MoS2, and GO. The synthesized nanocomposite was further tested for biomolecule protective potential employing different radical scavenging assays. Results of radical DPPH● (50%) and ABTS ●+ (51%) scavenging studies indicate that nanocomposites can be used as a biomolecule protective agent. In addition, nanocomposite was also evaluated for photocatalytic potential, and the results showed excellent photocatalytic properties for the degradation of 4-nitrophenol up to 75% and methylene blue and methyl orange up to 85% and 70%, respectively. So, this study confirmed that cellulose supported/stabilized MoS2/GO nanocomposite can be synthesized by an ecofriendly, cost-effective, and easy hydrothermal method having promising biomolecule protective and photocatalytic potential.

Recyclable Cu-Ag bimetallic nanocatalyst for radical scavenging, dyes removal and antimicrobial applications.

An ecofriendly and cost effective green method has been used for the synthesis of recyclable, high functional nanoparticles. Bimetallic nanoparticles (BmNPs), Cu-Ag, have been synthesized using beetroot extract as reducing and capping agent. Formation of BmNPs was initially confirmed by UV-visible analysis, having distinct peaks of Ag at 429 nm and Cu at 628 nm. FTIR analysis also confirmed the association of bioactive phytochemicals with Cu-Ag nanoparticles. Crystallinity and morphology of BmNPs was determined through X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), dynamic light scattering (DLS) and energy dispersion X-ray spectroscopy (EDAX). The size of spherical shape Cu-Ag BmNPs was found to be 75.58 nm and EDAX studies confirmed the percent elemental composition of Cu and Ag in synthesized nanocatalyst. Results of different analysis provided supported evidences regarding the formation of BmNPs. Catalytic potential of BmNPs was tested for the degradation of rhodamine B (Rh-B), methylene blue (MB) and methyl orange (MO) dyes. Cu-Ag BmNPs exhibited outstanding catalytic activity for the degradation of selected organic dyes and percent degradation was recorded more than 90% for each dye. In addition, antiradical property of BmNPs was tested employing DPPH● and ABTS●+ assays and it was found to be promising. Synthesized BmNPs also exhibited strong antimicrobial activity against Salmonella typhimurium and Bacillus subtilis. Recyclability of nanoparticles was also evaluated and recovery from dye degradation reaction mixture was successfully achieved. The recovered nanoparticles exhibited same catalytic potential for the degradation of Rh-B. The objective of the current study was to synthesize BmNPs Cu-Ag employing a cost effective green method having promising catalytic, antiradical and antimicrobial potential. Further, BmNPs were reused after recovery from catalytic reactions, proving that BmNPs can be recycled having the same efficiency as that of a freshly prepared Cu-Ag BmNPs.

Green synthesis of graphene-based metal nanocomposite for electro and photocatalytic activity; recent advancement and future prospective.

The presence of pollutants in waste water is a demanding problem for human health. Investigations have been allocated to study the adsorptive behavior of graphene-based materials to remove pollutants from wastewater. Graphene (GO) due to its hydrophilicity, high surface area, and oxygenated functional groups, is an effective adsorbent for the removal of dyes and heavy metals from water. The disclosure of green synthesis opened the gateway for the economic productive methods. This article reveals the fabrication of graphene-based composite from aloe vera extract using a green method. The proposed mechanism of GO reduction via plant extract has also been mentioned in this work. The mechanism associated with the removal of dyes and heavy metals by graphene-based adsorbents and absorptive capacities of heavy metals has been discussed in detail. The toxicity of heavy metals has also been mentioned here. The Polyaromatic resonating system of GO develops significant π-π interactions with dyes whose base form comprises principally oxygenated functional groups. This review article illustrates a literature survey by classifying graphene-based composite with a global market value from 2010 to 2025 and also depicts a comparative study between green and chemical reduction methods. It presents state of art for the fabrication of GO with novel adsorbents such as metal, polymer, metal oxide and elastomers-based nanocomposites for the removal of pollutants. The current progress in the applications of graphene-based composites in antimicrobial, anticancer, drug delivery, and removal of dyes with photocatalytic efficacy of 73% is explored in this work. It gives a coherent overview of the green synthesis of graphene-based composite, various prospective for the fabrication of graphene, and their biotoxicity.

Recent advances in the management of hemiplegic shoulder pain.

Stroke is a debilitating neurological disorder with hemiplegia as most common presentation. Hemiplegic shoulder pain (HSP) affects a large number of stroke survivors and is associated with significant morbidity and low quality of life (QoL). The etiology is multifactorial and therefore the management is multipronged. Traditionally, oral analgesics have been advised with physical therapy and intra-articular steroid injections. This narrative review discusses emerging treatment strategies for HSP. It focuses on four key new treatments; electric stimulation, the use of robotics, intraarticular injections of novel anti-inflammatory agents, and pulsed radiofrequency treatment. Multiple studies have assessed the efficacy of these techniques and have found the efficacy and side effect profile to be comparable or superior to current management strategies for HSP. Integrating these interventions in the multidisciplinary rehabilitation programmes for stroke patients, can improve the management of HSP and reduce stroke related morbidity and disability.

Fabrication of graphene-oxide and zeolite loaded polyvinylidene fluoride reverse osmosis membrane for saltwater remediation.

Incorporation of inorganic and organic materials in polymer has contributed well towards the development of advanced reverse-osmosis membranes; with greater permeation, and salt rejection potential. We are reporting, Zeolite/GO/PVDF based thin-film composite membranes that were successfully synthesized by solution casting process, an eco-friendly, low-cost, and biocompatible technique. PVDF membranes modified with different ratios of GO/Zeo (0.03, 0.05 and 0.07) were characterized by FTIR, SEM, XRD, TGA, and DSC. Membranes were then tested for its potential for water permeation and salt rejection abilities. As prepared membranes owe better pore-distribution, a moderate degree of crystallinity and high absorption capability that is highly needed for micro-filtration phenomena used for desalination of saline water. The modified membranes exhibited enhanced water permeability up to 28.9 L/m2h as compared to pure PVDF membrane having water permeability flux of 15.6 L/m2h. Salt-rejection ability was found increasing for the membranes (up to 98%) modified with different concentration of GO/Zeo, as compare to pure PVDF membrane (82%). During water permeation and salt rejection studies, no deleterious impact was noted for modified PVDF membranes. This development will entail an efficient approach to furnish high-level performance reverse-osmosis membranes, with greater osmotic-pressure bearing capacity and higher stability.

Graphene based composite membranes for environmental toxicology remediation, critical approach towards environmental management.

Graphene-based composite membranes, as laminated, stacked, and assembled architectures of graphene, have surpassed other conventional membranes with their advanced and preeminent structural specialization and potential use in a wide range of sustainable and environmental applications. The characteristic membrane features such as distinct laminar morphology, tailored physicochemical properties, as well as extraordinary molecular properties have fascinated scientists. Due to remarkable mechanical properties, these membranes can be easily fabricated. Recent progress has been achieved by graphene and its derivatives-based membranes to purify water and gases for environmental remediation. This review explained the latest and groundbreaking advances in chemical design, fabrication, and application of graphene-based membranes. Special attention is paid to the recent developments on graphene-based composites into membranes with various forms: free-standing, layered, and graphene-based nanocomposite membranes. Furthermore, a unique approach on environmental management with as-fabricated membranes is provided by discussing the effect of physicochemical properties. Consequently, their full-scale use for environmental management, water purification, gas purification, and biological treatments will pave the way for their promising features and realize their future prospects.

Rehabilitation of hemispatial neglect in stroke.

Hemi-spatial neglect (HSN) is a debilitating post stroke cognitive deficit resulting in reduced attention to stimuli presented in the contra-lateral hemi-visual field. It adversely impacts patient's medical recovery, activities of daily living and quality of life. Early referral to Rehabilitation Medicine specialist for thorough evaluation, prompt recognition of functional impairments and formulation of a comprehensive rehabilitation plan unique to patient is important. It is part of the comprehensive and holistic management of stroke patients with HSN. We summarize the current management strategies used for post-stroke HSN rehabilitation with the options including non-invasive brain stimulation, visuomotor feedback training, robotic rehabilitation and trans-dermal nicotine patch.

Solifenacin-induced acute urticaria and angioedema: a rare adverse effect.

Antimuscarinics are first-line medication for management of overactive bladder with solifenacin being commonly prescribed. Angioedema is the swelling of mucosa and submucosal tissue. There are no published case reports of drug-induced angioedema involving solifenacin. We report a case of a 41-year-old man with spinal cord injury who presented with oedema of face, lips, tongue and associated pruritic urticaria after taking 5 mg of solifenacin. All other possible causes including food allergy, insect bite, hereditary angioedema, use of NSAIDs, ACE inhibitors and antibiotics were ruled out. The temporal association between solifenacin and angioedema and complete resolution of symptoms after discontinuing the drug suggest that solifenacin was the most probable cause of angioedema in our patient.

Amalgamation and Scrutinizing of Leucine Derivatives Schiff Bases Complexes as Antimicrobial Agent.

The enhanced applications of Schiff bases metal complexes of amino acid derivatives have captured the attention of researchers for the synthesis of leucine derivatives of Schiff bases metal complexes. Amino acids are considered to be essential part of food supplements as well as derivatives of Schiff bases in coordination chemistry due to their donor ability. The leucine derivatives Schiff bases ligand have been synthesized by condensation reaction between amine of leucine with aldehyde or ketone bearing molecules attached with them. These complexes were characterized by different spectroscopic tools in order to confirm their structural geometries. The structural geometries are considered to be very important in order to improve the antimicrobial potential of leucine derivative metal complexes. By taking into account the antimicrobial potential of titled compounds, a comprehensive review of leucine derivatives of Schiff bases metal complexes has been compiled.

Enhanced visible light photocatalytic activity of TiO2 co-doped with Fe, Co, and S for degradation of Cango red.

The photocatalytic activity of TiO2 was enhanced under visible light when it was co-doped with Fe, Co, and S through the sol-gel method. The resultant nano photocatalysts were characterized by XRD, EDX coupled with SEM, FT-IR, UV-Vis, and UV-DRS. The concentration ratio of precursor salts of Fe and S was kept at 1% each and of Co varied between 0.5% -1.5%. The photodegradation of Congo red was carried out and various factors like the concentration of catalyst, initial concentration of dye, pH, and irradiation time were also investigated to optimize the degradation process. Under optimized degradation conditions, 99.3% of Congo red (30 ppm) was degraded at slightly acidic pH, with 0.14 g of photocatalyst within 70 min of irradiation time.

Biosynthesis and characterisation of nano-silica as potential system for carrying streptomycin at nano-scale drug delivery.

A growing trend within nanomedicine has been the fabrication of self-delivering supramolecular nanomedicines containing a high and fixed drug content ensuring eco-friendly conditions. This study reports on green synthesis of silica nanoparticles (Si-NPs) using Azadirachta indica leaves extract as an effective chelating agent. X-ray diffraction analysis and Fourier transform-infra-red spectroscopic examination were studied. Scanning electron microscopy analysis revealed that the average size of particles formed via plant extract as reducing agent without any surfactant is in the range of 100-170 nm while addition of cetyltrimethyl ammonium bromide were more uniform with 200 nm in size. Streptomycin as model drug was successfully loaded to green synthesised Si-NPs, sustain release of the drug from this conjugate unit were examined. Prolong release pattern of the adsorbed drug ensure that Si-NPs have great potential in nano-drug delivery keeping the environment preferably biocompatible, future cytotoxic studies in this connection is helpful in achieving safe mode for nano-drug delivery.

Cinnamon bark deodorised aqueous extract as potential natural antioxidant in meat emulsion system: a comparative study with synthetic and natural food antioxidants.

Cinnamon deodorised aqueous extract (CinDAE) was prepared and evaluated for its total phenolic (315.3 ± 35.4 mg GAE/g) and flavonoid (99.3 ± 9.6 mg RE/g) contents. Stabilizing efficiency of CinDAE, for chicken meatballs, was measured against oxidative deterioration as function of storage time under chilled conditions. For this purpose, oxidative stability [2-thiobarbituric acid reactive substances (TBARS); peroxide value (PV)], colour and sensory acceptability were measured in the control meatballs (C), and those stabilized with 200 ppm of: CinDAE (T1), ascorbic acid (T2), BHA/BHT (50/50; w/w) (T3). In comparison to "C", induction period (IP) and redness (a* value) of the stabilized samples (T1, T2 and T3) were increased, while PV and TBARS were decreased throughout storage (8 ± 1 °C) significantly (p < 0.05). Meanwhile, CinDAE slightly decreased L* value of the meatballs as compared to other tested samples. Conclusively, CinDAE improved stability and redness of chicken meatballs without negatively affecting its sensory acceptability (Hedonic test) up to a comparable extent to that of ascorbic acid/BHA/BHT and may potentially function as a dietary antioxidant for meat products.

Growth and antioxidant response of Brassica rapa var. rapa L. (turnip) irrigated with different compositions of paper and board mill (PBM) effluent.

Current study presents the effect of irrigation with different compositions (0%, 20%, 40%, 60%, 80% and 100%) of PBM effluent on growth and antioxidant potential of Brassica rapa var. rapa L. plants. Seeds were exposed to different PBM effluent compositions, which resulted in significant decrease in their germination potential with elevated delay index. Significant changes in growth parameters (plant height, number of leaves and leaf area) were recorded for turnip plants at regular intervals (25, 50 and 75 d) as function of PBM effluent proportion. Response of biochemical and antioxidant constituents in different parts of turnip, against stress induced by PBM effluent, was assessed by estimating the contents of chlorophyll (a+b), carotenoids, protein, phenolics, flavonoids, ascorbic acid and malondialdehyde. Antioxidant activity was evaluated by measuring DPPH radical scavenging potential. The results of this study suggest that the impact of PBM effluent irrigation is dependent on concentration of effluent in irrigation mixture and is very clear on plant growth and antioxidant attributes. Maximum benefits were secured at 40% PBM effluent to irrigate turnip plants till maturity while higher concentrations were found useful for shorter period (25-50 d).

Proximate composition and antioxidant potential of leaves from three varieties of Mulberry (Morus sp.): a comparative study.

In this study, leaves of three indigenous varieties of Mulberry namely, Morus alba L., Morus nigra L. and Morus rubra L. were investigated for their antioxidant potential and their proximate composition was determined. The yields of 80% methanolic extracts ranged between 8.28-13.89%. The contents of total phenolics (TPC), total flavonoids (TFC) and ascorbic acid (AA) ranged between 16.21-24.37 mg gallic acid equivalent (GAE)/g, 26.41-31.28 mg rutin equivalent (RE)/g and 0.97-1.49 mg/g, respectively. The antioxidant activity of leaf extracts was evaluated by measuring 1,1-diphenyl-2-picrylhydrazyl (DPPH(•)) radical scavenging actity, 2,2'-azino-bis-(3-ethylbenzthiazoline-6-sulphonic acid (ABTS(•+)) radical cation scavenging capacity and ferric ion reducing power and values ranged between 1.89-2.12, 6.12-9.89 and 0.56-0.97 mM Trolox equivalent/g of dried leaves, respectively. The investigated features reveal good nutritive and antioxidant attributes of all the varieties with mutually significant differences.