Effectiveness of neck stabilization and Contrology training in comparison to conventional therapy amongst individuals with text neck syndrome.

OBJECTIVE: Cell phones are carried by 79% of people between 18 and 44 years of age for nearly the entire day. Smartphone users spend an average of three hours/per day on their devices, whereas heavy smartphone users spend 8-10 hours/per day on their devices. Text neck is a dangerous disorder that can accelerate the degeneration of the spine. This study aimed to investigate the efficacy of neck stabilization training vs. Contrology or Pilates training in individuals with Text Neck Syndrome. PATIENTS AND METHODS: Participants (n=75) with a history of recurrent neck pain in the previous four months, having moderate pain (at least 4/10 on the numeric pain rating scale, NPRS), and constantly using mobile phones (>4 hours/day) were randomly allocated to one of three groups: a control group (neck isometric training) and two intervention groups (neck stabilization training and Contrology). They were assessed for craniovertebral angle (CVA), NPRS, and neck disability index (NDI) at baseline and at 4 weeks post-intervention. RESULTS: There was a significant difference in the CVA, NPRS, and NDI among individuals with Text Neck Syndrome following intervention as compared to the control. Both the neck stabilization and Contrology training increased CVA and reduced neck pain and neck disability in individuals with Text Neck Syndrome. The two intervention groups showed similar effects in all the clinical outcome measures, suggesting almost equivalent effectiveness in the individuals with Text Neck Syndrome. CONCLUSIONS: Neck stabilization seems to work better than Contrology training when it comes to increasing the craniovertebral angle, reducing pain intensity, and making it easier for individuals with Text Neck Syndrome to move their necks.

Author Correction: Association of monomeric C-Reactive Protein (m-CRP) with hypothalamic neurons after CRP hippo-campal administration in a model of dementia.

Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (22): 8713-8718. DOI: 10.26355/eurrev_202212_30543- PMID: 36524490-published online on December 15, 2022. After publication, the authors applied a correction to the funding statement: The authors extend their appreciation to the deputyship for Research & Innovation, Ministry of Education in Saudi Arabia for funding this research work through the project number (lFP-2020-36). There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/30543.

Association of monomeric C-Reactive Protein (m-CRP) with hypothalamic neurons after CRP hippo-campal administration in a model of dementia.

OBJECTIVE: The ensuing ischemia due to the disruption of blood supply to the brain is one of the most common causes of stroke. Evidence suggests a clear association of the ischemic injury with vascular dementia and Alzheimer's disease (AD). In response to the brain ischemia, a cascade reaction starts leading to neuronal damage due to oxidative stress and other inflammatory mediators. A pilot study was done, which showed that following stroke, monomeric-C-reactive protein (mCRP) is expressed in large quantities around the infarcted zone and this CRP is able to induce neurodegeneration and inflammation potentially perpetuating dementia. MATERIALS AND METHODS: We examined both patient brain samples and excised mouse brain tissue, previously injected with 1.75 mg/mL mCRP into the CA1 area of the hippocampus through the stereotactic surgical procedures and followed them over a period of over 6 months. The distribution of mCRP was examined through immunohistochemistry (mouse anti-human mCRP-specific antibodies 8C10). RESULTS: We observed a novel finding: those micro vessels close to the injection location were strongly stained with mCRP only in the mice that had been injected with mCRP, indicating that this small blood vessel can spread it throughout the brain. CONCLUSIONS: mCRP found in the brain after a hemorrhagic stroke promotes damage over a large area via the induction of inflammation and degeneration of perivascular compartments.

Xanthogranulomatous pyelonephritis presenting as a pseudotumor in a 2-month-old boy.

The authors report on a 2-month-old boy presenting with a right renal mass. Investigations including ultrasound scan and computed tomogram were suggestive of a renal tumor. A right nephrectomy was performed with great difficulty because of dense adhesions to the adjacent structures. Cut section of the specimen showed the entire kidney to be replaced by cheesy-yellow areas. Histological examination was suggestive of xanthogranulomatous pyelonephritis. Although rare at this age, xanthogranulomatous pyelonephritis should be considered in the differential diagnosis of a renal mass in children. The lesion is unique among the inflammatory conditions in closely mimicking renal tumours clinically. A thorough histological examination also is suggested because the features can get confused easily with those of renal tumors.

Anterior urethral valves: a rare cause of infravesical obstruction in children.

PURPOSE: The aim of this study was to report the clinical presentation, mode of diagnosis, and treatment of patients with anterior urethral valves (AUV), a rare congenital anomaly causing infravesical obstruction in children. METHODS: Three patients with anterior urethral valves were admitted in the Pediatric Urology Unit at The Children's Hospital, Lahore, Pakistan, during the period 1997 through 1998. Main clinical features included difficulty in voiding, dribbling of urine, incontinence, poor urinary stream, hematuria, and urinary tract infections. The diagnosis was confirmed by voiding cysto-urethrogram (VCUG) in 2 patients and retrograde urethrogram in 1 patient. A total of 4 valves were found; 1 patient had 2 valves. Two patients had associated vesico-ureteric reflux. Endoscopic resection was performed in all patients. RESULTS: Postoperatively, all patients were able to pass urine with good stream. At 9 to 24 months' follow-up, all patients remain well and asymptomatic. CONCLUSIONS: Although rare, AUV must be considered in the differential diagnosis of lower urinary tract obstruction. They present with all degrees of severity depending on the age of patient and the degree of obstruction. A properly performed and carefully interpreted VCUG is essential for diagnosis. Transurethral resection is the treatment of choice.

Simple incision: a safe and definitive procedure for congenital duodenal diaphragm.

BACKGROUND: Duodenal diaphragms generally are treated by either a duodeno-duodenostomy or excision. The former is a bypass procedure that involves a major anastomosis with its inherent postoperative problems, whereas the latter may result in inadvertent damage to the biliary and pancreatic ducts. To circumvent these problems, the authors used the technique of incision of the diaphragm on its lateral aspect. METHODS: Medical records of five children who underwent surgery for a perforate duodenal diaphragm during the period of 1992 through 1994 were reviewed retrospectively. All patients underwent a similar procedure. A longitudinal duodenotomy was made and the diaphragm incised on its anterolateral aspect. The cut edges of the diaphragm were oversewn, and the duodenotomy closed in "Heineke-Mikulicz" fashion. RESULTS: At a follow-up ranging from 1 to 3 years, all patients are growing normally and remain free of any obstructive symptoms. CONCLUSIONS: This simplified approach is a safe and physiological way of restoring the duodenal continuity and is associated with a highly satisfactory outcome.

Congenital anterior urethral diverticula in children.

The author reports his experience with five children with an anterior urethral diverticulum. Their ages ranged from 22 days to 3 years and presenting features included a penile mass, dribbling of urine, poor urinary stream, urinary-tract infection, and haematuria. Transurethral resection (TUR) of both the proximal and distal rims was performed in four patients, resulting in immediate relief of obstruction post-operatively. In a neonate both rims were incised endoscopically with a wire electrode, resulting in slight improvement of the urinary stream. The author recommends TUR as the treatment of choice for this uncommon anomaly in children.

Currarino's triad: an unusual cause of constipation in children.

A 6-year-old girl presented with intractable constipation. On investigation, she was found to have an association of anorectal stenosis, anterior sacral defect, and anterior meningocoele (Currarino's triad). The meningocoele was excised and a Duhamel pull-through procedure performed after resection of a massively distended rectosigmoid. Post-operatively, she started having spontaneous bowel action. Early diagnosis and management is recommended to avoid the high mortality and morbidity associated with this condition.

Cushing's syndrome caused by an adrenal adenoma.

A 10-year-old boy presented with features of Cushing's syndrome. Investigations, including ultrasound scan and computed tomography scans, demonstrated a right adrenal tumor. The tumor was excised and histologically found to be an encapsulated adrenal adenoma. Surgical excision is the treatment of choice for adrenal tumors. However, because it is often difficult to differentiate benign from malignant lesions on histopathologic grounds, these patients need a regular long-term follow-up.

Fluconazole for treatment of fungal infections of the urinary tract in children.

Two children with fungal urinary tract infections (UTI) were treated with fluconazole. One had bilateral megaureters, an almost non-functioning right kidney, and a moderately functioning left kidney because of severe vesicoureteric reflux. He underwent a ureteric reimplantation procedure but developed a fungal UTI postoperatively. The other child had bilateral refluxing megaureters, one of which appeared to open ectopically into the urethra. He acquired a fungal infection during intensive and prolonged antibiotic therapy for a bacterial UTI and septicaemia in the neonatal period. Both fungal infections were cured successfully. We recommend fluconazole as a safe and effective antifungal agent that may be used as a drug of choice for this difficult problem.

Rectal ectasia associated with anorectal anomalies.

Rectal ectasia may be associated with anorectal anomalies. If not recognized at the time of surgical reconstruction it may lead to megarectosigmoid, resulting in severe constipation and overflow incontinence postoperatively. The authors treated four patients presenting with this condition. One patient born with a low anorectal anomaly and two with high anorectal anomalies experienced intractable constipation caused by megarectum despite otherwise adequate primary reconstructive procedures. A fourth patient had rectal stenosis in association with megarectosigmoid. The ectatic megarectum had to be resected in all the patients to achieve normal bowel actions. The authors feel that resection or tailoring of the ectatic segment should be an integral part of the primary reconstructive procedure.

Management of perineal canal anomaly.

A 6-year-old girl presented due to passage of stool through her vulva since birth. Examination revealed a fistulous tract between vestibule of the vagina and an otherwise normally formed anal canal. The tract was successfully excised through an anterior sagittal approach with a defunctioning sigmoid colostomy, which was closed 12 weeks later. The embryology, morbid anatomy, and treatment of this rare congenital anomaly are discussed along with a review of the literature.