Exploration of correlation between multiple subjective and objective evaluation indicators in early stage with recovery time in combination of acupuncture and medication for treating facial neuritis / 重庆医学

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.

Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals

@#Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.

Scale development and validation of perimenopausal women disability index in the workplace

BACKGROUND@#Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period.@*METHODS@#In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale.@*RESULTS@#Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001).@*CONCLUSION@#We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.

Índice de discapacidad vocal en niños: autoevaluación. Traducción, transculturalización y validación al español de Latinoamérica / Children´s Voice Handicap Index: self-assessment. Translation, transculturalization and validation to Latinoamerican Spanish

Objetivo: Los trastornos de la voz son muy frecuentes en la población pediátrica, entre el 6% y el 23% de todos los niños presentan alguna forma de disfonía. La evaluación de la voz abarca los aspectos perceptuales, análisis acústico, métodos de diagnóstico visual, y cuestionarios que orientan al impacto sobre la calidad de vida. El objetivo de nuestro estudio es realizar la traducción, transculturalización y validación del cuestionario Children Voice Handicap Index (CVHI) a hispanohablantes latinoamericanos. Material y Método: El estudio se realizó en el Hospital Italiano de Buenos Aires, Argentina y en el Hospital de Niños Dr. Luis Calvo Mackenna de Santiago de Chile. Se incluyeron pacientes entre 8 y 15 años de edad. Se tradujo, transculturalizó y validó el CVHI para dicha población. Se realizó el cuestionario en dos grupos de pacientes: un grupo de niños con antecedentes de disfonías, n = 48 y el otro grupo pacientes de control, sin patología de la voz, n = 86. El cuestionario se aplicó a los niños, en presencia de sus cuidadores o padres, con la correspondiente conformidad. Resultados: Se encontró una diferencia significativa entre ambos grupos (p < 0,05) con una confianza interna óptima de 0,98 obtenida mediante alfa de Cronbach y una alta fiabilidad test-retest (correlación de Pearson = 0,96). Conclusión: La validación y transculturalización del CVHI para la población hispanohablante de latinoamérica presentó una adecuada validez y fiabilidad. Complementar la evaluación de la patología vocal con un sencillo cuestionario de auto-rrealización en población pediátrica, constituye una valiosa herramienta que completa el diagnóstico del impacto de la alteración de la voz en la calidad de vida.

Aim: Voice disorders are very common in the pediatric population, since between 6% and 23% of all children present some type of dysphonia. Voice evaluation includes perceptual aspects, acoustic analysis, visual diagnostic methods, and questionnaires that guide the impact on quality of life. The objective of this study is to carry out the translation, transculturalization and validation of the Children Voice Handicap Index (CVHI) questionnaire for Latin American Spanish speakers. Material and Method: The study was conducted at the Italian Hospital in Buenos Aires, Argentina and at the Dr. Luis Calvo Mackenna Children's Hospital in Santiago de Chile, Chile. Patients between 8 and 15 years of age were included. The CVHI was translated, transculturalized, and validated for said population. The questionnaire was carried out in two groups of patients: a group of children with a history of dysphonia, n = 48, and the other group, control patients, without voice pathology, n = 86. The questionnaire was applied to the children, in the presence of their caregivers or parents, with the corresponding consent. Results: A significant difference was found between both groups (p < 0.05) with an optimal internal confidence of 0.98 obtained using Cronbach's alpha and high test-retest reliability (Pearson's correlation = 0.96). Conclusion: The validation and transculturalization of the CVHI for the Spanish-speaking population of Latin America presented adequate validity and reliability. Complementing the evaluation of vocal pathology with a simple self-administration questionnaire in the pediatric population constitutes a valuable tool that completes the diagnosis of the impact of voice alteration on quality of life.

Different operation sequences between acupuncture and cupping therapy for lumbar muscle strain with cold and dampness: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy on lumbar muscle strain with cold and dampness between the different operation sequences of acupuncture and cupping therapy.@*METHODS@#Seventy-six patients with lumbar muscle strain with cold and dampness were randomly divided into an acupuncture + cupping group (A + C group, 38 cases) and a cupping + acupuncture group (C + A group, 38 cases, 1 case dropped off). In the A + C group, cupping therapy was delivered 10 min after the end of treatment with acupuncture, while in the C + A group, acupuncture therapy was exerted 10 min after the end of treatment with cupping. Acupuncture was applied to Mingmen (GV 4), Yaoyangguan (GV 3), ashi point and bilateral Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) and Yanglingquan (GB 34), and the needles were retained for 30 min in each intervention. Flash cupping was operated along the bilateral sides of the lumbar spine for 3 min, and the cups were retained for 10 min at bilateral Shenshu (BL 23), Dachangshu (BL 25) and ashi points. The intervention was delivered once every two days, 3 times weekly, for 3 weeks totally in each group. The scores of visual analogue scale (VAS) and Oswestry disability index (ODI), TCM syndrome score and the mean temperature of the lumbar region before and after treatment were compared between the two groups. The safety and the clinical efficacy were assessed for the interventions of the two groups.@*RESULTS@#Compared with the values before treatment, except for the sleep score of ODI, the VAS scores, ODI scores and TCM syndrome scores were decreased after treatment (P<0.01, P<0.05); while the mean temperature of the lumbar region was increased (P<0.01) in both groups. After treatment, the VAS score and the pain score of ODI in the C + A group were lower than those in the A + C group (P<0.05). The incidence rate of adverse reactions of the C + A group was lower than that of the A + C group (P<0.01). The effective rate in the A+C group was 92.1% (35/38), that in the C+A group was 94.6%(35/37), there was no statistical difference between the two groups (P>0.05).@*CONCLUSION@#Different operation sequences between acupuncture and cupping therapy obtain the similar efficacy on lumbar muscle strain with cold and dampness, but cupping therapy delivered prior to acupuncture has certain advantages in relieving pain and improving safety.

The posture decoding technique can improve the pelvis carriage and lumbar motion of patients with lower crossed syndrome, relieving back pain and relaxing the back muscles / 中华物理医学与康复杂志

Objective:To observe the clinical effectiveness of manual therapy based on posture decoding for patients with lower crossed syndrome (LCS).Methods:Thirty-six LCS patients were randomly divided into an observation group and a control group, each of 18. The observation group received manual therapy based on posture decoding, while the control group was treated with proprioceptive neuromuscular facilitation (PNF), both in 20min sessions, once a week for 4 weeks. Before the experiment, after one, two and four weeks of treatment and followed-up 4 and 8 weeks later, both groups were evaluated using a visual analogue scale (VAS), the Oswestry Disability Index (ODI) and finger-floor distance (FFD). Anterior pelvic tilt angles (ASIS-PSISs), sacral slopes (SS), lumbar curve index (LCI) and surface EMG flexion-relaxation ratios (FRRs) were also recorded from both groups before and after the treatment.Results:After one and four weeks of the treatment, the average VAS, ODI, and FFD had decreased significantly in both groups, with all significantly lower in the observation group, on average. At the final follow-up, the average VAS and ODI scores of both groups were significantly lower than before the treatment, with those of the observation group significantly lower than the control group′s averages. After 4 weeks of treatment significant differences were observed also in the group′s average ASIS-PSISs, SSs and LCIs compared with before the treatment. And right after the treatment the left and right surface electromyography FRRs of the observation group were significantly higher than those of the control group.Conclusion:Manual therapy based on posture decoding can significantly improve the pelvis forward angle and lumbar motion of LCS patients, relieving back pain and relaxing back muscles.

A survey on disability status of patients with inflammatory bowel disease in China / 中华消化杂志

Objective:To investigate the disability status of patients with inflammatory bowel disease (IBD) in China and to identify the influencing factors of the inflammatory bowel disease disability index (IBD-DI).Methods:From October 1 to December 31, 2021, a total of 1 170 IBD patients were recruited from 7 IBD centers and WeChat public platforms in China. All the patients were surveyed by the IBD-DI questionnaire, which included demographic information, disease activity, medication history, treatment and surgical history. Demographic information included gender, age, income status, etc. Multiple linear regression was used to analyze the influencing factors of IBD-DI.Results:Among the 1 170 IBD patients, 746 patients (63.76%) were male and 424 patients (36.24%) were female; there were 871 cases (74.44%) of Crohn′s disease(CD), 277 cases (23.68%) of ulcerative colitis (UC) and 22 cases (1.88%) of inflammatory bowel disease undassified (IBDU). The age was 36.00 years old (29.00 years old, 45.00 years old), and the IBD-DI score was 9.00 (5.00, 15.00). The results of multiple linear regression analysis revealed that the disease activity ( β=0.65, t=22.33, P<0.001), current treatment with enteral nutrition ( β=0.09, t=3.06, P<0.001), and history of perianal surgery ( β=0.06, t=2.12, P=0.034) were influencing factors of IBD-DI in the CD patients. Disease activity ( β=0.65, t=14.37, P<0.001), household per capita annual income ( β=-0.16, t=-3.59, P<0.001), current usage of immunosuppressants ( β=0.12, t=2.66, P=0.008), current treatment with enteral nutrition ( β=0.12, t=2.57, P=0.011), and the duration of each exercise ( β=-0.12, t=-2.67, P=0.008) were influencing factors of IBD-DI in UC patients. Conclusions:Disability is common in Chinese IBD patients, and their IBD-DI were different. Disease activity is the most important factor affecting IBD-DI. The IBD-DI is higher in IBD patients receiving enteral nutrition treatment, CD patients with a history of perianal surgery and UC patients with current usage of immunosuppressants. However, household per capita annual income and the duration of each exercise are negatively correlated with IBD-DI in UC patients.

Spinopelvic Parameters in the Clinical and Functional Outcomes of Patients Submitted to Lumbar Interbody Fusion Surgery ­ A Prospective Study / Parâmetros espinopélvicos nos resultados clínicos e funcionais de pacientes submetidos a fusão intersomática lombar: um estudo prospectivo

Objectives The relevance of spinopelvic parameters in the patients' clinical and functional outcomes has been widely studied in long spinal fusion. Yet, the importance of the spinopelvic parameters in short-segment fusion surgeries needs further investigation. We analyzed the spinopelvic parameters and surgical outcomes of patients undergoing short-segment lumbar interbody fusion. Materials and Methods An observational, prospective study was conducted between January and June 2021. We selected 25 patients with lumbar stenosis, with or without concomitant spondylolisthesis, undergoing transforaminal lumbar interbody fusion. Variables related to the patient, diagnosis, and surgery were collected. The clinical and functional outcomes were assessed using the Visual Analogue Scale for low-back and leg pain and the Oswestry Disability Index (ODI). The surgical outcomes and spinopelvic parameters were analyzed pre- and postoperatively. Results There was a significant clinical and functional improvement after surgery (p < 0.001), with a mean ODI decrease of 63.6%. The variables of obesity, concomitant spondylolisthesis, absence of osteotomy, and two-level fusion were all associated with lower levels of improvement after surgery (p < 0.05). Pelvic incidence minus lumbar lordosis (PI-LL) was the only parameter that significantly changed regarding the pre and postoperative periods (p < 0.05). Before surgery, PI-LL < 10° correlates with less low-back pain after surgery (r » 0.435; p < 0.05). Postoperatively, no correlation was found between surgical outcomes and all the spinopelvic parameters analyzed. Conclusions The clinical and functional outcomes significantly improved with the surgical intervention but did not correlate with the change in spinopelvic parameters. Patients with preoperative PI-LL < 10° seem to benefit the most from surgery, showing greater improvement in back pain.

Objetivos A influência dos parâmetros espinopélvicos nos resultados clínicos e funcionais dos pacientes tem sido amplamente estudada nas cirurgias de fusão espinhal que envolvem longos segmentos. Contudo, a literatura é escassa acerca da fusão de segmentos curtos. Analisamos assim os parâmetros espinopélvicos e os resultados cirúrgicos de pacientes submetidos a fusão intersomática lombar de segmentos curtos. Materiais e Métodos Realizou-se um estudo prospectivo observacional entre janeiro e junho de 2021. Selecionaram-se 25 pacientes com estenose lombar, com ou sem espondilolistese, submetidos a fusão intersomática lombar transforaminal. Colheram-se dados relacionados com o paciente, o diagnóstico e a cirurgia. Os resultados clínicos e funcionais foram avaliados por meio da Escala Visual Analógica para dor lombar e dos membros inferiores e pela Escala de Incapacidade de Oswestry (Oswestry Disability Index, ODI, em inglês). Os resultados cirúrgicos e os parâmetros espinopélvicos foram analisadas no pré e no pós-operatório. Resultados Verificou-se uma melhoria clínica e funcional significativa após a cirurgia (p < 0,001), com redução média do ODI de 63,6%. As variáveis obesidade, espondilolistese concomitante, ausência de osteotomia e fusão de dois níveis associaram-se a menor melhoria no pós-operatório (p < 0,05). O único parâmetro que mudou significativamente antes e após a cirurgia (p < 0,05) foi a incidência pélvica menos a lordose lombar (IP-LL). No pré-operatório, uma IP-LL < 10° correlacionou-se com menos dor lombar após a cirurgia (r » 0,435; p < 0,05). No pós-operatório, não houve correlação entre os resultados clínicos e funcionais e os parâmetros espinopélvicos. Conclusão Os resultados clínicos e funcionais melhoraram significativamente após a cirurgia, mas não se correlacionam com a mudança dos parâmetros espinopélvicos. Pacientes com IP-LL< 10° no pré-operatório apresentam maior melhoria da dor lombar no pós-operatório.

Management of Lumbar Disc Herniation with Radiculopathy Through Ayurveda - A Case Study

Lumbar disc herniation is a major health problem, affecting the most productive population globally. It has closest resemblance with Gridhrasi mentioned in Ayurvedic classics. Treatments available in conventional sciences have limitations such as relapse of acute episodes. Here an effort was made to treat a case of L5-S1 disc extrusion with radiculopathy using a comprehensive Ayurveda treatment protocol. The protocol includes a set of treatment procedures along with certain internal medicines. Changes were analysed with the help of VAS scale, SLRT and Oswestry disability index and showed significant improvements. This case is an evidence to demonstrate the effectiveness of Ayurveda treatments in case of LDH with radiculopathy.

Adaptación cultural y validación del índice de discapacidad vocal pediátrico al español chileno / Cultural adaptation and validation of the pediatric vocal handicap index to chilean spanish

Resumen Introducción: La prevalencia de patología vocal en niños fluctúa entre el 6% y el 23%. El cuestionario Pediatric Voice Handicap Index (pVHI) se ha transformado en el instrumento más utilizado a nivel internacional para determinar el impacto de la disfonía en la calidad de vida de los niños. Objetivo: Realizar la traducción, adaptación cultural y validación del Pediatric Voice Handicap Index al español chileno. Material y Método: Estudio transversal que incluyó a 151 niños y niñas entre 3 y 15 años. Se siguieron los 5 pasos recomendados por Beaton. La versión original del pVHI en inglés fue traducida al español por dos traductoras. Posteriormente, la versión traducida y unificada fue revisada por una lingüista chilena quien realizó la adaptación cultural al idioma español chileno. El cuestionario se aplicó a dos grupos de estudio, un grupo de niños con disfonía (n = 51) y un grupo control de niños sin alteraciones de la voz (n = 100) para obtener la versión final. Resultados: Se encontraron diferencias significativas entre el grupo de niños con disfonía y el grupo control en la puntuación global del pVHI y las diferentes subescalas (p < 0,001). Se encontró una consistencia interna óptima con un excelente alfa de Cronbach (α = 0,93), con una alta fiabilidad test-retest (puntuación de correlación de Pearson = 0,95). Conclusión: La versión chilena del cuestionario pVHI presenta un alto grado de validez y confiabilidad. Recomendamos su uso e implementación como protocolo estándar en la evaluación y seguimiento de la voz pediátrica.

Abstract Introduction: The prevalence of vocal pathology in children fluctuates between 6% and 23%. The pediatric voice handicap index (pVHI) questionnaire has become the most widely used instrument to determine the impact of dysphonia on the quality of life of children. Aim: Perform the translation, cultural adaptation, and validation of the pediatric voice handicap index into Chilean Spanish. Material and Method: Cross-sectional study that included 151 boys and girls between 3 and 15 years old. The 5 steps recommended by Beaton were followed. The original version of the pVHI in English was translated into Spanish by two translators. Subsequently, the translated and unified version was reviewed by a Chilean linguist who made the cultural adaptation to the Chilean Spanish language. The questionnaire was applied to two study groups, a group of children with dysphonia (n = 51) and a control group of children without voice disorders (n = 100) to obtain the final version. Results: Significant differences were found between the group of children with dysphonia and the control group in the global pVHI score and the different subscales (p < 0.001). Optimal internal consistency was found with excellent Cronbach's alpha (α = 0.93), with high test-retest reliability (Pearson's correlation score = 0.95). Conclusion: The Chilean version of the pVHI questionnaire presents a high degree of validity and reliability. We recommend its use and implementation as a standard protocol in the evaluation and monitoring of pediatric voice.