Neurostimulation After Stroke.

Neural stimulation technology aids stroke survivors in regaining lost motor functions. This article explores its applications in upper and lower limb stroke rehabilitation. The authors review various methods to target the corticomotor system, including transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and vagus nerve stimulation. In addition, the authors review the use of peripheral neuromuscular electrical stimulation for therapeutic and assistive purposes, including transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, and functional electrical stimulation. For each, the authors examine the potential benefits, limitations, safety considerations, and FDA status.

A progressive-individualized midstance gait perturbation protocol for reactive balance assessment in stroke survivors.

Restoration of balance control is a primary focus of rehabilitation after a stroke. The study developed a gait perturbation, treadmill-based, balance assessment protocol and demonstrated that it can be used to quantify improvements in reactive balance responses among individuals post-stroke. The protocol consists of a sequence of fifteen 90-second treadmill walking trials, with a single perturbation applied during the middle third of each trial. Gait was perturbed by rapid acceleration-deceleration of the treadmill belt at mid-stance of the unaffected leg during a randomly selected gait cycle. The initial perturbation magnitude was based on the participant's maximum walking speed and increased or decreased in each trial, based on success or failure of recovery, as determined from an instrumented harness. The protocol was used before and after a 10-week period of therapy in twenty-four stroke survivors. Outcomes included maximum recoverable perturbation (MRP), self-selected gait speed, levels progressed through the algorithm, and falls versus recoveries.Participants were able to take recovery steps in response to the perturbation. Twelve participants completed the full assessment protocol before and after the therapeutic intervention. After the intervention, they had fewer falls and more recoveries (p < 0.001), progressed through more algorithm levels (p = 0.043), had a higher MRP (p = 0.005), and had higher gait speeds. The protocol was found to be feasible in stroke survivors with moderate gait deficits. The data supports the conclusion that this protocol can be used in clinical research to quantify improvements in balance during walking.

Effectiveness of Echinacea purpurea extract on immune deficiency induced by azathioprine in male albino rats

This study was performed to evaluate the effectiveness of Echinacea purpurea (E.P.) on azathioprine (AZA)-induced immune deficiency in albino rats. Thirty six male albino rats were divided into six equal groups. The first group served as normal control, the second and third groups were treated with two doses of AZA (3 and 5mg/kg/b.w/day IP), respectively for six weeks. The fourth group was treated with 50 mg kg/b.wt/day of Echinacea. The fifth and sixth groups were treated with3 and 5 mg AZAm respectively followed by50 mg E.P. administration. At the end of the experimental period, both doses of AZA revealed a significant reduction in total body and spleen weights, increase in tissue total protein with a significant increase in serum total protein and albumin, a marked decrease in the number of WBCS associated with a decrease in the number of lymphocytes, a significant decrease in serum total anti-oxidant capacity. Also,concentration of immunoglobulins (IgG and IgM) and interleukins (IL4 &IL6) showed a significant increase, while the level of IL10 decreased significantly in splenic tissue. The dose of AZA (5 mg /kg b.wt.) only resulted in a highly significant increase in serum level of T3 and T4. However, treatment with Echinacea purpurea extract had a significant influence on immune deficiency induced by azathioprine. These findings demonstrated that E.P. extract is a promising immunomodulatory agent with a potent therapeutic value in stimulating the immune response.

Anti-ulcerogenic activity of Gum Arabic in gastric mucosal injury induced by ethanol in male albino rats.

The present study was performed to evaluate the anti-ulcerogenic activity of Acacia senegal (Gum Arabic) against ethanol-induced gastric mucosal injury in rats. Thirty-six adult male albino rats were divided into 4 groups: group 1 served as a control; group 2 consisted of rats that received 15% of gum in drinking water for 2 weeks; group 3 comprised ulcerated animals administered 5 mL of ethanol/kg body weight by gavage; and group 4 consisted of rats received 15% of gum in drinking water for 2 weeks before ethanol administration. Superoxide dismutase (SOD) glutathione peroxidase (GPx), malondialdehyde (MDA), prostaglandin E2 (PGE2), tumor necrosis factor alpha (TNF-α), interleukin (IL)-B1), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total protein, and albumin were assayed in addition to histological study. The results revealed that ethanol decreased SOD, GPx, and PGE2 in tissue and serum total protein and albumin, while increased MDA in tissue, serum TNF-α, IL-B1, PGE2, ALT, AST, and ALP. Histological findings showed less edema and leucocytes infiltration compared with ulcer group. Furthermore, gum administration elevated PGE2, SOD, and GPx and significantly reduced MDA, TNF-α, and IL-B2. In conclusion, Gum Arabic can enhance gastric protection and sustain the integrity of the gastric mucosa. Novelty The selected dose of Gum Arabic has the ability to decrease the pro-inflammatory cytokines in plasma and gastric tissue, thus enhancing gastric protection and maintaining the integrity of the gastric mucosa. Gum Arabic can compensate for the loss of antioxidants.

Type 2 diabetes in Sudanese children and adolescents.

The objective of this study was to determine the prevalence of T2 DM among children and adolescents attending a paediatric and adolescent diabetic clinic in Khartoum -Sudan and to find out the etiological factors, clinical presentation, management and associated co morbidities. This was a retrospective, descriptive hospital based study. The records of all children attending the clinic at Jabir Abu Izz Diabetic Center from January 2006 to December 2009 were reviewed and those who were diagnosed as type 2 DM were identified. Out of 985 patients 38 (4%) were labeled as having type 2 DM. Out of these, 35 (92.1%) had onset between 11-18 years of age and were all pubertal. Three patients (7.9%) were under 10. Female to male ratio was 1.2: 1. Thirty two (84.2%) were from tribes of Arab origin. There were no cases from tribes of southern Sudan of African origin. Risk factors for obesity included: diabetes during pregnancy 15 (39.5%), large for dates 16 (43%) small for dates 12(32%), family history of obesity 10 (26.3%), lack of exercise 32 (87.6%), TV watching for long hours 32(84.3%) and consumption of fast foods. Almost 70% were symptomatic at presentation. Co morbidities included hypertension 22(57.9%), microalbuminuria 7 (18.4%), hyperlipidaemia 6(7%) and none had retinopathy. The mean HbA1C was 9.1% gm/dl. This data confirms that T2 DM is emerging as a health problem among children and adolescents in Sudan mostly as a result of obesity particularly among high socioeconomic group in urban areas and more prevalent in certain ethnic groups.

Helicobacter pylori and its role in vocal folds' minimal lesions.

BACKGROUND: Chronic laryngitis and/or vocal fold minimal lesions (VFMLs) are common associations with gastro esophageal reflux disease. Helicobacter pylori (HP) is a Gram-negative spiral organism accused of being a common cause of gastritis, gastroesophageal reflux disease and peptic ulcer. HP has been recently isolated from tonsils, adenoids, sinus and middle ear mucosa in patients with chronic sinusitis or chronic middle ear effusion. OBJECTIVE: The objective of this study is to assess the presence of HP in VFMLs. METHODS: The study included 14 patients with VFMLs [six cases with vocal fold polyps and four cases with vocal fold nodules, and four cases with posterior granulomas; one of them associated with right vocal fold (VF) nodule]; all underwent carbon-13 urea breath test, esophago-gastro-duodenoscopy with gastric biopsy and direct laryngoscopy with microlaryngosurgery to extract the VF lesions. Biopsies were subjected for two tests: detection of the 23S ribosomal RNA gene of HP by real-time polymerase chain reaction (RT-PCR) and immunohistochemical reactions (IHC). RESULTS: HP was detected by RT-PCR in 10 of 14 patients with VFML; HP was also detected by IHC in the same number of VFML and gastric mucosa specimens. CONCLUSION: HP is a common finding in cases of VFML; its eradication should be considered when dealing with a patient with VFML.