The Efficacy of Vestibular Rehabilitation Therapy for Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis.

OBJECTIVE: Mild traumatic brain injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of vestibular rehabilitation therapy (VRT) as a treatment option for mTBI. METHOD: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. It included randomized controlled trials and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). RESULTS: Eight articles met the inclusion criteria, from which 6 randomized controlled trials were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program as shown by Dizziness Handicap Inventory (DHI) scores (standardized mean difference [SMD] = -0.33, 95% confidence interval [CI]: -0.62 to -0.03, P = .03, I2 = 0%). However, no significant reduction in DHI was evident after 2 months of follow-up (SMD = 0.15, 95% CI: -0.23 to 0.52, P = .44, I2 = 0%). Quantitative analysis also depicted significant reduction in both Vestibular/Ocular Motor Screening (SMD = -0.40, 95% CI: -0.60 to -0.20, P < .0001, I2 = 0%) and Post-Concussion Symptom Scale (SMD= -0.39, 95% CI: -0.71 to -0.07, P = .02, I2 = 0%) following the intervention. Finally, there was no significant difference between intervention groups on Balance Error Scoring System scores (SMD = -31, 95% CI: -0.71 to 0.10, P = .14, I2 = 0%) and return to sport/function (95% CI: 0.32-30.80, P = .32, I2 = 82%). CONCLUSIONS: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provides evidence that supports the role of VRT in improving perceived symptoms following concussion. Although findings from this analysis suggest positive effects of VRT on included outcomes, the low certainty of evidence limits the conclusions drawn from this study. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.PROSPERO registration number: CRD42022342473.

Assessment of mental health and various strategies among Health Professions' (HP) students: A cross sectional study in King Saud Bin Abdulaziz University for Health Sciences.

BACKGROUND: The education environment of medical colleges is known to have a burdensome effect on the overall mental health of the students. This study aimed to investigate the immediate impact of the medical education environment on mental health and quality of life among Health Profession students and to identify various coping strategies used by students to mitigate the stress. MATERIALS AND METHODS: An online survey was conducted between April 1 and May 10, 2021, using a validated questionnaire based on DASS-42, employing a snowball sampling technique. RESULTS: A total of 338 students filled the questionnaire. The respondents had a high level of depression and anxiety scores, categorized as very severe which were significantly different among level of education (P < .05), for example, 88.9% of sixth year students had very severe depression compared to just 37% of first year ones. Gender-wise very severe scores varied from lowest 45.8% to 70.3% with comparable results for both males and females. Additionally, more than 30% of the students listed that the amount of material to be covered, lack of time to study the material to be tested, heavy demand to study, concern about trying to learn all the content, and competitiveness among students to be the top reason which affect their mental state of mental health. CONCLUSIONS: This study identifies the need to provide the free professional and psychological services to help cope with stress to the health profession students.

Heads up Sutureless Chandelier assisted scleral buckle.

PURPOSE: This study aims to describe chandelier assisted scleral buckle (CSB) using 3D visualizing system in phakic uncomplicated Rhegmatogenous Retinal Detachment (RRD). METHODS: This technique was performed in 6 eyes of 6 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling with scleral tunnels. Heads up display 3D system was used for visualization and localization of the breaks, and Chandelier Endoillumination was used as a light source was inserted through a 27 G needle sclerotomy 3.5mm from the limbus. A partial-thickness scleral "belt-loop" tunnels in the four quadrants were created using crescent knife angle beveled (2.3 mm in width) to facilitate the smooth passage of the band a 240-silicone band as encircling circumferential buckle. Cryopexy was performed and the incision was closed with cautery or absorbable sutures. RESULTS: Primary attachment success of 5 out of 6 and overall success was 100%. No intraoperative or postoperative complications observed although fellows in training performed half the procedures. CONCLUSIONS: Heads up Sutureless Chandelier assisted Scleral Buckle can achieve excellent anatomical success while improving ergonomics and training. Furthermore, it is a safe procedure with less risk of complications and retinal phototoxicity.