Could the Addition of Alexander Technique Improve the Effectiveness of Physical Therapy in Reducing Violinists' Neck Pain in Comparison to Physical Therapy Alone?

One hypothesis for the mechanism of neck pain in musicians, particularly string players, is changed behavior of the superficial neck flexor muscles and impairment of the cervical stabilization system. To restore the supporting capacity of neck muscles and reduce neck pain, various types of physical therapies and pain educational modalities have been recommended. However, considering the physio-psychological nature of violinists' neck pain, its treatment may benefit from addition of therapies that address postural and movement habits. In this regard, we suggest that management of violinists' neck pain might benefit from additional approaches that may help to decrease muscle overactivity during performance movements.

Comparative clinical trial between Ciaglia and Griggs techniques during tracheostomy performed in patients admitted to intensive care unit.

Percutaneous dilatation tracheostomy (PDT) is one of the most frequent interventions in ventilator dependant ICU patients. Ciaglia and Griggs are two common PDT techniques. Few studies are available comparing these two methods, but there is no data available to compare these two techniques in Iranian population. The aim of this study was to compare Ciaglia and Griggs technique in our population in order to recognize advantages and disadvantages of each technique in order to identify the most beneficial one. This study is a comparative clinical trial conducted on 100 consecutive ICU admitted patients who needed prolonged intubation; half of them underwent PDT with Ciaglia method and other half with Griggs method. Procedural time and short term complications including bleeding, vital signs instability and technical errors were compared in both two methods. Both groups were comparable in demographic characteristics. Griggs method performed significantly faster than Ciaglia method (P=0.001). Complications such as high grade bleeding (P=0.01) and cardiac dysrhythmias (P=0.07) were less in Ciaglia technique than Griggs. Skin incision smaller than required was reported more with Griggs method than Ciaglia (P=0.03). We conclude that PDT with Ciaglia method is safer with less complications than the Griggs method. We suggest use of Ciaglia for less experienced operators.

Association of zinc deficiency and depression in the patients with end-stage renal disease on hemodialysis.

INTRODUCTION: Depression is a common psychological symptom in patients undergoing chronic hemodialysis. In the general population, low serum zinc level is associated with major depression. The current study surveys the possible relationship between the prevalence of depression and plasma level of zinc in patients on hemodialysis (HD). PATIENTS AND METHODS: A total of 135 patients with end-stage renal disease (ESRD) on HD were enrolled in the study. The severity of depression was assessed using Beck Depression Inventory (BDI). Plasma zinc level was measured from fasting samples. RESULTS: Mean age of the patients was 52.45 (standard deviation: 15.33) years. In all, 76% of the patients had some degree of depression according to BDI scoring system (BDI >14). The mean level of plasma zinc in the depressed patients was significantly lower than the rest of the patients (67.46 ± 29.7 vs. 85.26 + 40.05). DISCUSSION: Zinc deficiency may be a reversible cause which might contribute to the increased rate of depression in HD patients. This is the first study reporting the association of zinc deficiency with the presence of depression in HD patients; therefore, these findings need further investigations.

Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis.

BACKGROUND: Sexual dysfunction in chronic renal failure patients undergoing hemodialysis is common. It is demonstrated that the zinc level is significantly lower in the hemodialysis patients. OBJECTIVE: In this clinical trial, we investigate the effect of zinc supplement therapy on the serum levels of sexual hormones in hemodialysis male patients. PATIENTS AND METHODS: We carried out a clinical trial study including 100 of our male patients with end-stage renal disease on hemodialysis. Testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and zinc plasma level were measured in all of the patients. The patients received zinc supplement (zinc sulfate, 250 mg/day) for 6 weeks, and sex hormones and zinc plasma level were checked again. RESULTS: Serum level of FSH and prolactin did not have any significant changes before and after intervention, but serum level of testosterone, LH, and zinc increased significantly. DISCUSSION: These results suggest that although zinc administration did not have a definite effect on hemodialysis patients with sexual dysfunction, it can cause increase in the serum level of sex hormones which may improve the sexual function of the patients in some aspects.

Colchicine is effective for short-term treatment of slow transit constipation: a double-blind placebo-controlled clinical trial.

PURPOSE: Although colchicine has been tested in clinical trials for treatment of constipation, the index groups in those trials were composed of special patient groups with developmental neuromuscular defects or failed surgical management. The aim of this study is to investigate the efficacy of colchicine in patients with refractory slow transit constipation. MATERIALS AND METHODS: Sixty patients with chief complaint of chronic constipation due to slow transit consented to be included in the double-blind placebo-controlled clinical trial. These patients were randomly divided into two groups (each containing 30 patients) to receive either colchicine, 1 mg QD, (group A) or placebo (group B) for 2 months. At the end of the study, Knowles-Eccersly-Scot symptom (KESS, a valid technique to assist in the diagnosis and evaluation of symptoms in constipation) scores were compared between the case and control groups. RESULTS: The mean KESS score measured at the end of 2 months was 11.67 +/- 3.91 for colchicine and 18.66 +/- 3.72 for placebo group (p = 0.0001). CONCLUSION: This trial shows that low-dose colchicine is effective in treatment of slow transit constipation.