RNA-Small-Molecule Interaction: Challenging the "Undruggable" Tag.

RNA targeting, specifically with small molecules, is a relatively new and rapidly emerging avenue with the promise to expand the target space in the drug discovery field. From being "disregarded" as an "undruggable" messenger molecule to FDA approval of an RNA-targeting small-molecule drug Risdiplam, a radical change in perspective toward RNA has been observed in the past decade. RNAs serve important regulatory functions beyond canonical protein synthesis, and their dysregulation has been reported in many diseases. A deeper understanding of RNA biology reveals that RNA molecules can adopt a variety of structures, carrying defined binding pockets that can accommodate small-molecule drugs. Due to its functional diversity and structural complexity, RNA can be perceived as a prospective target for therapeutic intervention. This perspective highlights the proof of concept of RNA-small-molecule interactions, exemplified by targeting of various transcripts with functional modulators. The advent of RNA-oriented knowledge would help expedite drug discovery.

Development and Validation of Wheelchair-Based Yoga Module for Individuals with Paraplegia.

Spinal cord injury causes temporary or permanent loss of motor, sensory, or autonomic functions, leading to long-term impairments that are not only confined to physical attributes but also restrict individuals' participation in major domains of life. Around 60%-80% of individuals with spinal cord injuries depend on a wheelchair for mobility. Numerous studies have reported yoga's beneficial role in alleviating spinal cord injury symptoms; however, a validated wheelchair-based yoga module was unavailable. Thus, the present study aimed to develop and validate a wheelchair-based yoga module that comprises a printed protocol for individuals with paraplegia. The study was conducted in four phases: The first three phases were the steps for the formulation of a wheelchair-based yoga module, and in the last phase the content validity of the designed module was determined by a panel of 10 experts, who were asked to rate the preliminary module for its necessity and relevance using a Likert scale. A total of 17 yoga practices with high content validity were included in the final wheelchair-based yoga module, and 10 practices with lower content validity were excluded from the designed module. Data analysis revealed the mean content validation index of the designed module to be 0.81. This study concludes that the formulated wheelchair-based yoga module is valid for individuals with paraplegia. However, future studies need to be conducted to determine the protocol's feasibility and effectiveness.

Automated Detection and Segmentation of Exudates for the Screening of Background Retinopathy.

Exudate, an asymptomatic yellow deposit on retina, is among the primary characteristics of background diabetic retinopathy. Background diabetic retinopathy is a retinopathy related to high blood sugar levels which slowly affects all the organs of the body. The early detection of exudates aids doctors in screening the patients suffering from background diabetic retinopathy. A computer-aided method proposed in the present work detects and then segments the exudates in the images of retina acquired using a digital fundus camera by (i) gradient method to trace the contour of exudates, (ii) marking the connected candidate pixels to remove false exudates pixels, and (iii) linking the edge pixels for the boundary extraction of exudates. The method is tested on 1307 retinal fundus images with varying characteristics. Six hundred and forty-nine images were acquired from hospital and the remaining 658 from open-source benchmark databases, namely, STARE, DRIVE MESSIDOR, DiaretDB1, and e-Ophtha. The exudates segmentation method proposed in this research work results in the retinal fundus image-based (i) accuracy of 98.04%, (ii) sensitivity of 95.345%, and (iii) specificity of 98.63%. The segmentation results for a number of exudates-based evaluations depict the average (i) accuracy of 95.68%, (ii) sensitivity of 93.44%, and (iii) specificity of 97.22%. The substantial combined performance at image and exudates-based evaluations proves the contribution of the proposed method in mass screening as well as treatment process of background diabetic retinopathy.

A Modified Murine Heterotopic Heart Transplant Protocol Matching Contemporary Standards of Aseptic Technique, Anesthesia, and Analgesia.

The development of experimental models of cardiac transplantation in animals has contributed to many advances in the fields of immunology and solid organ transplantation. While the heterotopic vascularized murine cardiac transplantation model was initially utilized in studies of graft rejection using combinations of mismatched inbred mouse strains, access to genetically modified strains and therapeutic modalities can provide powerful new preclinical insights. Fundamentally, the surgical methodology for this technique has not changed since its development, especially with respect to important factors such as aseptic technique, anesthesia, and analgesia, which make material impacts on postsurgical morbidity and mortality. Additionally, improvements in perioperative management are expected to provide improvements in both animal welfare and experimental outcomes. This paper reports upon a protocol developed in collaboration with a subject matter expert in veterinary anesthesia and describes the surgical technique with an emphasis on perioperative management. Additionally, we discuss the implications of these refinements and provide details on troubleshooting critical surgical steps for this procedure.

Antimicrobial and cytotoxicity properties of Plumeria alba flower extract against oral and periodontal pathogens: A comparative in vitro study.

Context: Plumeria alba, commonly known as frangipani or West Indian jasmine, is a traditional and ancient folklore medicine known for its antimicrobial, anti-inflammatory, and antioxidant properties. The extracts from P. alba obtained from the leaves, bark, and flowers, are commonly used to manage bacterial, fungal, and viral infections such as herpes, scabies, and fungal infections. The constituents of the P. alba plant have shown promising antihelmintic, antipyretic, and antirheumatic properties. Although studies have confirmed that extracts from Plumeria species are effective against microbial infections and cancer, its role in managing oral diseases, particularly the chronic inflammatory disease of the gums (gingivitis and periodontitis), has never been explored. Therefore, the current study aimed to explore the antimicrobial and cytotoxic properties of the P. alba flower extract against oral and periodontal pathogens compared to chlorhexidine and doxycycline. Settings and Design: This was an in vitro study. Materials and Methods: The ethanolic extract was prepared from the freshly plucked P. alba flowers. The antimicrobial properties of the extract were evaluated by testing the minimal inhibitory concentration, minimal bactericidal concentration, and well-diffusion assay against Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia, Streptococcus mutans, Actinomyces viscosus, Streptococcus salivarius, and Candida albicans. The results were compared to chlorhexidine and doxycycline. The cytotoxicity was checked by the against human-derived gingival fibroblast and keratinocytes. Statistical Analysis Used: One-way ANOVA for the mean zones of inhibition against all the microorganisms was done. Results: P. alba extract inhibited the growth for all the tested oral and periodontal pathogens at 25 µg/ml. The well-diffusion assay of P. alba extract was comparable to chlorhexidine but was not statistically significant compared to doxycycline. Conclusion: P. alba can be used as a promising alternative to chlorhexidine for the management of oral and periodontal infections.

Tools, techniques, datasets and application areas for object detection in an image: a review.

Object detection is one of the most fundamental and challenging tasks to locate objects in images and videos. Over the past, it has gained much attention to do more research on computer vision tasks such as object classification, counting of objects, and object monitoring. This study provides a detailed literature review focusing on object detection and discusses the object detection techniques. A systematic review has been followed to summarize the current research work's findings and discuss seven research questions related to object detection. Our contribution to the current research work is (i) analysis of traditional, two-stage, one-stage object detection techniques, (ii) Dataset preparation and available standard dataset, (iii) Annotation tools, and (iv) performance evaluation metrics. In addition, a comparative analysis has been performed and analyzed that the proposed techniques are different in their architecture, optimization function, and training strategies. With the remarkable success of deep neural networks in object detection, the performance of the detectors has improved. Various research challenges and future directions for object detection also has been discussed in this research paper.

Quality of life in Indian patients with functional dyspepsia: Translation and validation of the Hindi version of Short-Form Nepean Dyspepsia Index.

BACKGROUND/PURPOSE: Patients with functional dyspepsia (FD) have poor health-related quality of life (HRQOL), but Indian data are  lacking. Also, there is non-availability of validated disease-specific questionnaire to assess HRQOL in Hindi-speaking patients with dyspepsia. We aimed to develop and validate a reliable translation of Short-Form Nepean Dyspepsia Index (SF-NDI) in Hindi, and assess the impact of FD on HRQOL in Indian patients. METHODS: Cross-cultural adaptation of English version of SF-NDI, translation to Hindi, and adaptation of Hindi version were performed using standard procedures. English and Hindi versions were assessed against Short Form-36 (SF-36), examining for internal consistency, test-retest reliability, and validity. RESULTS: Total 211 FD patients (144 Hindi speaking, 67 English speaking) were enrolled (mean age 40.8 ± 11.7 years; male:female = 115:96). Median total SF-NDI scores for both languages were 38.75 and 40.0, respectively. Test-retest reliability intraclass correlation coefficients were 0.85 (Hindi) and 0.89 (English). Internal consistency evaluation revealed Cronbach's α coefficient of 0.79-0.86 (Hindi) and 0.78-0.89 (English). SF-NDI sub-scales showed moderate to good correlation with various domains of SF-36 (content validity). There was significant (p < 0.001) decline of HRQOL in patients with severe dyspepsia relative to those with mild dyspepsia (construct validity). On multivariate analysis, factors independently associated with HRQOL were duration of symptoms and dyspepsia severity. CONCLUSION: Both English and Hindi versions of SF-NDI are reliable and valid for HRQOL assessment in Indian FD patients, and will be useful in future epidemiological and clinical studies. Indian FD patients have poor HRQOL, being worse in those with severe dyspepsia and longer duration of symptoms.

Cervical Spinal Lesion, Completeness of Injury, Stress, and Depression Reduce the Efficiency of Mental Imagery in People With Spinal Cord Injury.

OBJECTIVES: The aims of this study were to assess the relationships of (1) clinical variables (age, level of injury, time since injury [TSI], and completeness of injury) and (2) psychological variables (stress and depression) with mental imagery ability in individuals with spinal cord injury. STUDY DESIGN: This was a cross-sectional study. Participants with spinal cord injury (N = 130) were requested to fill the Kinesthetic and Visual Imagery Questionnaire and Vividness of Motor Imagery Questionnaire. They also completed the Perceived Stress Scale and Patient Health Questionnaire 9 for the assessment of stress and depression, respectively. RESULTS: Mental imagery scores were found to be significantly low in cervical injuries (P < 0.001) as compared with thoracic injuries (P < 0.001). Furthermore, higher levels of spinal injuries resulted in lower mental imagery scores. Completeness of injury (according to Asia Impairment Scale) also had a significant relationship (P < 0.001) with the mental imagery ability among spinal cord injury participants. Presence of stress (P < 0.001) and depression (P < 0.001) also associated with reduced efficiency of mental imagery in these individuals. CONCLUSIONS: Injury type and psychological factors were associated with mental imagery in SCI patients. Imagery-based interventions should be designed after consideration of identified factors yielding effect on their outcomes. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Determine the impact of clinical variables such as level of injury, completeness and chronicity of injury on mental imagery ability in spinal cord injury; (2) Discuss the role of stress and depression on mental imagery ability in spinal cord injury; and (3) Describe the various dimensions of mental imagery ability and its variability among individuals who have spinal cord injury. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Effect of Temperature on Disease Severity and Growth of Fusarium oxysporum f. sp. apii Races 2 and 4 in Celery.

Fusarium oxysporum f. sp. apii race 4, which is in F. oxysporum species complex (FOSC) Clade 2, causes a new Fusarium wilt of celery. We compared F. oxysporum f. sp. apii race 4 with race 2, which causes Fusarium yellows of celery and is in FOSC Clade 3. Optimal temperatures for celery yield are 16 to 18°C. Soil temperatures in California celery production areas can range up to 26°C, and the maximal rate of hyphal extension of F. oxysporum f. sp. apii races 2 and 4 in culture are 25 and 28°C, respectively. Here, we compared the effect of temperatures from 16 to 26°C on growth of F. oxysporum f. sp. apii races 4 and 2 in two celery cultivars: Challenger, which is resistant to F. oxysporum f. sp. apii race 2 and susceptible to race 4; and Sonora, which is susceptible to both F. oxysporum f. sp. apii races 2 and 4. Based on linear regressions, as temperature increases, there is an increase in the log of F. oxysporum f. sp. apii race 4 DNA concentration in celery crowns and in the reduction in plant height. Based on logistic regressions, as temperature increases, the incidence of vascular discoloration increases in celery with either F. oxysporum f. sp. apii race 2 or 4 infection. In both cultivars, temperatures of 22°C and above resulted in a significantly (α = 0.05) greater concentration of F. oxysporum f. sp. apii race 4 than race 2 in planta. The concentration of F. oxysporum f. sp. apii race 2 in crowns in 'Challenger' is temperature-independent and comparatively low; consequently, 'Challenger' is, at least partly, resistant rather than tolerant to F. oxysporum f. sp. apii race 2.

Comparative Evaluation of Efficacy and Safety of Tacrolimus and Dinoprostone Following Dermabrasion in Stable Vitiligo.

BACKGROUND: Dinoprostone (DNP), a prostaglandin E2 (PGE2) analogue, has been found to cause repigmenation in vitiliginous lesions. Combined medical and surgical therapy might be more useful for successful treatment of vitiligo. OBJECTIVES: In this study, we aimed to evaluate the efficacy and safety of dermabrasion followed by dinoprostone gel and to compare it with tacrolimus ointment following the same procedure in the treatment of localized stable vitiligo. METHODS: 40 patients of stable vitiligo were enrolled which were divided in two groups of 20 patients each. In group 1, dermabrasion followed by tacrolimus 0.1% ointment was done and in group 2, dermabrasion followed by dinoprostone gel was done. RESULTS: Group 1 patients showed slightly better response (P=0.039), whereas the side effect profile was better for group 2. CONCLUSION: DNP and tacrolimus have immunomodulatory and melanocyte stimulating effect and are well tolerated when combined with dermabrasion. Their effect on skin pigmentation could be enhanced by dermabrasion. J Drugs Dermatol. 2021;20(5):519-522. doi:10.36849/JDD.5751.

Nucleic acid therapeutics: a focus on the development of aptamers.

INTRODUCTION: Aptamers provide exciting opportunities for the development of specific and targeted therapeutic approaches. AREAS COVERED: In this review, the authors discuss different therapeutic options available with nucleic acids, including aptamers, focussing on similarities and differences between them. The authors concentrate on case studies with specific aptamers, which exemplify their distinct advantages. The reasons for failure, wherever available, are deliberated upon. Attempts to accelerate the in vitro selection process have been discussed. Challenges with aptamers in terms of their specificity and targeted delivery and strategies to overcome these are described. Examples of precise regulation of systemic half-life of aptamers using antidotes are discussed. EXPERT OPINION: Despite their nontoxic nature, a variety of reasons limit the therapeutic potential of aptamers in the clinic. The analysis of adverse effects observed with the pegnivacogin/anivamersen pair has highlighted the need to screen for preexisting PEG antibodies in any clinical trial involving pegylated molecules. Surprisingly, and promisingly, the ability of nucleic acid therapeutics to breach the blood brain barrier seems achievable. The recognition of specific motifs, e.g. G-quadruplex in thrombin-binding aptamers, or a 'nucleation' zone while designing aptamer-antidote pairs, is likely to accelerate the discovery of therapeutically efficacious molecules.

Saroglitazar in patients with non-alcoholic fatty liver disease and diabetic dyslipidemia: a prospective, observational, real world study.

Saroglitazar, a dual peroxisome proliferator activated receptor α/γ agonist, approved for diabetic dyslipidemia (DD), is potential therapeutic option for non-alcoholic fatty liver disease (NAFLD). This prospective, observational, real-world study aimed to determine efficacy and safety of Saroglitazar in patients with NAFLD and DD. We included patients with DD and NAFLD who received Saroglitazar 4 mg once daily for 24 weeks. Blood investigations, liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) (FibroScan) were compared at baseline and 24 weeks. Of 163 patients screened, 107 were included, and 101 completed 24 weeks treatment (mean age 50.4 ± 12.3 years, 78.5% males, mean body mass index 28.8 ± 4.2). After 24 weeks, alanine transaminase (ALT) reduced significantly from 94 (47-122) to 39 (31-49) (p < 0.0001) and aspartate aminotransferase (AST) (U/L) from 89 (43-114) to 37 (30-47) (p < 0.0001) and LSM (kPa) from 8.4 (7.1-9.3) to 7.5 (6.4-8.4) (p = 0.0261). CAP, glycated hemoglobin and lipid parameters also improved significantly. On linear regression, there was significant association between percent change in ALT and AST with TG reduction after treatment (p = 0.024 and 0.037 respectively).We conclude that Saroglitazar leads to significant improvement in transaminases, LSM, and CAP in NAFLD patients with DD.

Mental Imagery as a Rehabilitative Therapy for Neuropathic Pain in People With Spinal Cord Injury: A Randomized Controlled Trial.

BACKGROUND: Pain of neuropathic origin in spinal cord injury (SCI) is unbearable and challenging to treat. Research studies conducted in the past have shown that mental imagery (MI) techniques have a significant impact on the reduction of symptoms of central neuropathic pain in people with SCI. OBJECTIVES: The objective of this study was to evaluate the effect of MI training on pain intensity, neuropathic pain symptoms, and interference of pain with function in SCI. METHODS: A total of 42 SCI participants with central neuropathic pain (duration 6-12 months) were recruited and randomly allocated to MI or control groups. A MI training protocol was administered to MI group and for 30 min/d for 5 days. Outcome measures were assessed at baseline and at the end of 4 weeks. RESULTS: There was significant reduction in differences of mean [95% CI] scores of numeric rating scale (-2.1 [CI -2.78 to -1.41]; P < .001) between groups. Mean [95% CI] total scores of Neuropathic Pain Symptom Inventory declined in MI group as compared with control group (-4.52 [CI -5.86 to -3.18]; P < .001). Similarly, Brief Pain Inventory interference scale total dropped significantly (P < .001) in MI group. Majority of participants in the MI group (55%) reported improvement in scores of Patients' Global Impression of Change scale as compared with control group where most of the participants (52%) reported no change. CONCLUSIONS: This study shows the effectiveness of the MI protocol developed as a rehabilitative approach in improving central neuropathic pain in SCI. Trial Registration. Clinical Trials Registry-India under Indian Council of Medical Research; CTRI/2018/07/014884. Registered July 16, 2018.

Construction of benchmark retinal image database for diabetic retinopathy analysis.

Diabetic retinopathy, a symptomless medical condition of diabetes, is one of the significant reasons of vision impairment all over the world. The prior detection and diagnosis can decrease the occurrence of acute vision loss and enhance efficiency of treatment. Fundus imaging, a non-invasive diagnostic technique, is the most frequently used mode for analyzing retinal abnormalities related to diabetic retinopathy. Computer-aided methods based on retinal fundus images support quick diagnosis, impart an additional perspective during decision-making, and behave as an efficient means to assess response of treatment on retinal abnormalities. However, in order to evaluate computer-aided systems, a benchmark database of clinical retinal fundus images is required. Therefore, a representative database comprising of 2942 clinical retinal fundus images is developed and presented in this work. This clinical database, having varying attributes such as position, dimensions, shapes, and color, is formed to evaluate the generalization capability of computer-aided systems for diabetic retinopathy diagnosis. A framework for the development of benchmark retinal fundus images database is also proposed. The developed database comprises of medical image annotations for each image from expert ophthalmologists corresponding to anatomical structures, retinal lesions and stage of diabetic retinopathy. In addition, the substantial performance comparison capability of the proposed database aids in analyzing candidature of different methods, and subsequently its usage in medical practice for real-time applications.

Effect of inspiratory muscle training (IMT) on aerobic capacity, respiratory muscle strength and rate of perceived exertion in paraplegics.

Objectives: The purpose is to study the effect of inspiratory muscle training on aerobic capacity, respiratory muscle strength and rate of perceived exertion in paraplegics.Study Design: Randomized controlled trial.Settings: Rehabilitation department in Indian Spinal Injuries Centre, New Delhi.Participants: A sample of 30 paraplegics (T1-T12) were randomly allocated into two groups: inspiratory muscle training (IMT) group and control group.Interventions: The IMT group received inspiratory muscle training for 15 minutes 5 times a week for 4 weeks whereas the control group was given breathing exercises.Outcome measures: Maximal inspiratory pressure(MIP), maximal expiratory pressure (MEP), modified Borg's scale (MBS), 12 minute wheelchair aerobic test (12MWAT), multistage fitness test (MSFT), and 6 minutes push test (6MPT).Results: Out of 30 participants, 27 completed the study. The results show that after four weeks of IMT training, there were significant improvements in mean change scores of IMT group as compared to control group. Participants in IMT group performed better on 12MWAT (P = 0.001), MSFT (P = 0.001) and 6MPT (P = 0.001). Improvements in MIP scores (P = 0.001), MEP scores (P = 0.001) and MBS scores (P = 0.004) were also seen in IMT group.Conclusion: Both groups showed significant improvements, however inspiratory muscle training was seen to be more effective than deep breathing exercises for improving aerobic capacity, respiratory muscle strength and rate of perceived exertion in paraplegics.

Mental imagery training for treatment of central neuropathic pain: a narrative review.

Mental imagery is a quasi-perceptual experience in the absence of external stimuli. This concept has intrigued psychologists, sportspersons, neurologists and other scientists for over a decade now. Imagery has been used in rehabilitation and the results have been promising. Researchers refer to this as healing the body through the mind. However, the challenge is lack of standardized protocols, homogeneity and consistency in application of mental imagery in different populations. The purpose of this review is to discuss and understand the role of mental imagery in the treatment of central neuropathic pain (CNP). Treatment options of CNP are inadequate and their benefits are short lived. We conducted an extensive search on various databases using combinations of different keywords and reviewed the available literature in this area. We were able to finalize twelve studies where mental imagery was used for treating CNP in spinal cord injury (SCI), stroke and multiple sclerosis. However, the methodology and techniques of mental imagery training used in these studies were non-homogeneous and inconsistent. This review provides a guiding framework to further explore the different techniques of mental imagery and their roles in treating CNP.

Evaluation and Comparison of Stress Distribution in Restored Cervical Lesions of Mandibular Premolars: Three-dimensional Finite Element Analysis.

OBJECTIVES: Restorative materials are used in the treatment of cervical lesions and restoration of the dental tooth. The objective of this study was to assess the suitability of the three commonly used restorative materials by dentists and the evaluation of stress distribution and deformation using Von Mises stress in cervical lesions of mandibular premolars under varying loading condition. MATERIALS AND METHODS: A computerized model of restored class V cavity of mandibular premolar tooth was created using three dimensional modeling software SpaceClaim. It was subjected to occlusal pressure load of 100, 150, 200 and 250MPa at right angle to buccal cusp and was analyzed for stress distribution and deformation in different restorative materials using Finite Element analysis, ANSYS Workbench. RESULTS: The analysis carried on the class V restored tooth from biomechanical point of view indicates that restorative material glass-ionomer cement exhibited better bonding with the tooth structure using ionic bonds with the calcium ion present in the tooth structure. The variation of 8%-9% of stress concentration is observed in cavity region across varied pressure loads with glass-ionomer cement to Cention N. CONCLUSION: Glass-ionomer cement had showed better results than amalgam in terms of biomechanical property which is in agreement with the clinical findings. The stress values of Cention N were comparable to that of glass-ionomer cement.

Recent Developments in the Synthesis and Antimicrobial Activity of Indole and its Derivatives.

BACKGROUND: Heterocyclic compounds containing nitrogen have been known to possess a very important role in the field of medicinal chemistry. Indole and its derivatives displayed a wide range of biological properties such as anti-inflammatory, analgesic, anti-microbial, anti-convulsant, antidepressant, anti-diabetic, antihelmintic and anti-allergic activities etc. The diverse biological activities exhibited by compounds containing indole moiety has provided the impetus to explore its anti-microbial activity in order to save the valuable life of patients. OBJECTIVE: The review focuses on the advances in the synthesis of indole derivatives and antimicrobial properties exhibited by them. CONCLUSION: A great deal of work has been done in order to synthesize indole derivatives and to evaluate antimicrobial potential, as indicated by the review. The information provided in this article may be helpful for the researchers for the development of efficient antimicrobial drugs.

Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke.

The purpose of this study was to evaluate the effects of core strengthening combined with pelvic proprioceptive neuromuscular facilitation (PNF) on trunk impairment, balance, gait, and functional ability of chronic stroke patients. Twenty-three participants with chronic stroke were recruited and randomly allocated to one of the two groups: core strengthening combined with pelvic PNF (group 1, n=13), and pelvic PNF with trunk flexibility exercises (group 2, n=10). Intervention was given to both groups for 60 min per session 5 times per week for 4 weeks. Performance of both groups was evaluated on Trunk Impairment Scale, Tinetti Performance Oriented Mobility Assessment (Tinetti-POMA), Balance Evaluation Systems Test (Mini-BESTest), Wisconsin Gait Scale, and Barthel Activities of Daily Living Index prior to and after the completion of the intervention. The comparison between postintervention scores of Tinetti-POMA between group 1 (18.76±1.78) and group 2 (16.8±1.87) and Mini-BESTest group 1 (16.15±1.28) and group 2 (14.7±1.41) showed significant difference (P=0.018). The results indicated that core stabilisation combined with pelvic PNF was more effective for improving trunk impairment, balance and gait of chronic stroke patients.

Development and validation of Incontinence - Activity Participation Scale for spinal cord injury.

INTRODUCTION: We aimed to develop and validate an Incontinence - Activity Participation Scale (I-APS) for measurement of activity limitation and participation restriction due to bladder problems in spinal cord injury (SCI). MATERIALS AND METHODS: The process of development was initiated by formation of open-ended questions after thorough review of literature which were then administered to SCI participants, caretakers, and professionals working with SCI. Items were generated based on their responses and initial draft of scale was formulated. This initial draft of the scale containing 77 items was then administered to 56 SCI participants for reduction of items using factor analysis, and a prefinal version of the scale was obtained containing thirty items only. Content validity and face validity was then established. RESULTS: The I-APS is both health professional and self-administered questionnaire including two domains: Activities of daily living and occupation with 16 items having a content validity of 0.84. The overall internal consistency reliability was 0.86. CONCLUSION: The I-APS is a valid, comprehensive instrument that measures the activity limitation and participation restrictions due to bladder problems in SCI.