Effect of Integrated Survivorship Model on Physical Health for Breast Cancer Survivors in Rural Area.

OBJECTIVE: The objective of this study was to evaluate the effect of the integrated survivorship model on the physical health of breast cancer survivors in rural areas. METHODS:  Ninety-two patients who were breast cancer survivors were selected as per inclusion criteria and divided into two groups (control group and intervention group). The participants were randomly allotted to two groups of 46 each. A 12-minute walk test, assessment of quality of life, and difficulty in return to work were used as outcome measures. The integrated survivorship model was implemented in one group for 3 months while the other group was a supporting group and was involved in household activities only. Pre-assessment and post-assessment were taken to evaluate the effect of the integrated survivorship model. All the statistical analysis was done using SPSS statistical Software (version 23.0 for Windows; SPSS, Inc., Chicago, USA) and the results were obtained. RESULTS: The results revealed that the assessment of the 12-minute walk test, physical well-being, social/family well-being, functional well-being, and difficulty in returning to work showed extremely significant results in the intervention group with a p-value of less than 0.0001. Similarly, emotional well-being and additional concern domains showed significant results in the intervention group. Hence, the findings of this study revealed significance in post-assessment in all the outcome measures of the experimental group. CONCLUSION: The study showed that all the outcome measures such as the 12-minute walk test, assessment of quality of life, and difficulty in return to work were impaired in both groups before the study. The effect of the model showed a significant improvement in the intervention group after implementing the intervention.

Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study.

BACKGROUND: This study "Effectiveness of Mckenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: an experimental study" was conducted to study and find the effectiveness of Mckenzie approach and segmental spinal stabilization exercises on reduction of pain, correction of rounded shoulder, and disability. Pain, disability, and rounded shoulders are the major limiting factors as it affects the quality of life and reduces efficiency and social participation. MATERIALS AND METHODS: The study was conducted among 120 individuals with cervical postural syndrome, and fulfilling the inclusion and exclusion criteria was included. The outcome measures were Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Vernier caliper to evaluate pain, functional disability, and rounded shoulder, respectively. Subjects were randomly divided into two groups, Group A and Group B, by using SPSS software. Interventional training was given for 6 weeks to the patients. Group A subjects were given spinal stabilization exercises. Group B subjects were given Mckenzie approach. The statistical analysis was performed using SPSS; pre-test and post-test were used to calculate the results, followed by data presentation and analysis. RESULT: The result showed that at the end of the 6 weeks on comparison between pre- and post-intervention of Group A and Group B, both the techniques were effective, but group B was significantly effective than Group A. CONCLUSION: It was noted that McKenzie approach and segmental spinal stabilization exercises were effective on neck pain in individuals with cervical postural syndrome, but on comparing both techniques, Mckenzie protocol is more beneficial than segmental spinal stabilization exercises. The study accepts the alternate hypothesis that there is significant effect of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome.

Estimation of Spinal Muscle Performance in Work From Home Information Technology Professionals of Karad, India in 2021.

Background: It is seen that information technology (IT) professionals are at higher risk of developing mechanical low back pain due to numerous factors such as a sedentary lifestyle, attaining inappropriate posture for a prolonged period of time, work stresses, and inadequate exercise which lead to overload on the back musculature. Working from home has become the new normal for these professionals in which they attain abnormal posture which leads to pressure on the muscles and thus there is a need to estimate and analyze spinal muscle performance among IT professionals. Materials and Methods: Our main objectives were to estimate the spinal muscle performance in work-from-home IT professionals of Karad and to find the association between spinal muscle performance with respect to age, gender, and body mass index (BMI). Depending on inclusion and exclusion criteria, 120 IT professionals working from home were selected for this study by simple random sampling. Written consent was taken and a detailed outcome assessment was done by using the static and dynamic abdominal test, extensor test, internal/external oblique test, and back rotators test. Also, functional performance was measured using the back performance scale. SPSS version 20 was used to carry out the analysis of data and results were obtained. Results: In participants of sample size 120 (100%), 27 (26%) were normal, 30 (32%) good, 24 (20%) fair, 21 (14%) poor, 18 (8%) trace; whereas, static extensor strength was 16 (12%) normal, 9 (18%) good, 24 (28%) fair, 18 (36%) poor, 3 (6%) trace. For oblique's, static strength was 10 (20%) normal, 12 (24%) good, 15 (30%) fair, 9 (18%) poor, 4 (8%) trace; whereas, for back rotators strength was 10 (20%) normal, 17 (34%) good, 15 (30%) fair, 8 (16%) poor. The mean number of repetitions for the dynamic endurance test for extensors was 11, for abdominals wase 24 and for obliques was 12. A back performance scale was found with a minimum score of 6 and a maximum score of 11 for activity limitation. There was statistically significant found to be between spinal muscle performance and age (P = 0.041), BMI (P = 0.027). Conclusion: In this study it was found that spinal muscle performance was decreased in IT professionals. It was concluded that there was a significant reduction in static extensor performance compared to static abdominal muscle performance. Also, the spinal muscle performance of extensors was less as compared to that of abdominals. The data also revealed that there was a remarkable association that was seen between spinal muscle performance and age as well as spinal performance and BMI.

Effect of multi-component exercises program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint.

BACKGROUND: Osteoarthritis of the knee causes pain and gait disturbances, as well as a distinct gait pattern. Patients with knee OA have decreased range of motion (ROM) and increased ground reaction force. OA reduces stride length and walking speed. OBJECTIVES: To determine the effect of a multi-component exercise program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint and to compare the effect of multi-component exercises with traditional exercises on pain-related gait adaptations among individuals with osteoarthritis of the knee joint. MATERIALS AND METHODS: This was an experimental study done between 120 patients having knee OA, of both genders, and between the age group of 50-65 years. These individuals were residents of the city of Karad and they were randomly divided into group A (conventional/traditional) and group B (experimental). A pretest assessment was done and the treatment was given for 6 weeks. The later posttest assessment was done and further statistical tests like paired and unpaired t tests were used. RESULTS: Among the 120 subjects with OA knee, the age group of 60-65 years (44%) was found to be commonly affected. Thirty-nine were males (32.5%) and 81 were females (67.5%). Fifty-eight subjects (48%) were found to be commonly overweight. Thirty-two subjects (27%) had Genu Valgum deformity, and 88 subjects (73%) had Genu Varum deformity at the knee joint. The Pvalue within both group A and group B was found to be statistically significant for the entire outcome measures used for assessment. The pretest vs post test values of the WOMAC scale for patients with knee OA within both groups were found to be extremely significant (P < 0.0001). As for the MMT score in these patients, the Knee Flexors of Group A were not significant for right side (P = 0.7088) as well as for left side (P = 0.083) and in Group B they were extremely significant (P < 0.0001) for both sides. For the ROM scores within both groups, Knee Flexion of Group A for both sides was found to be extremely significant (P < 0.0001) for both sides. And for the pretest vs posttest values of within the groups'gait parameters among these patients with OA knees, for cadence both groups B were found to be extremely significant (P < 0.0001). The stride length for Group A was found to be very significant (P = 0.0060) and for Group B it was (P < 0.0001). Also, the P values of the various outcome measures between both groups were found to have statistical significance of their own. CONCLUSION: Effect of Multi-Component Exercise Program on Pain-Related Gait Adaptations Among Individuals with Osteoarthritis of the Knee joint was found to be significant in pain reduction, improving strength, range of motion, and the gait parameters such as an increase in cadence, stride length, step length and decrease in the step width.

Effect of Oral Nutritional Supplementation on Adequacy of Nutrient Intake among Picky-Eating Children at Nutritional Risk in India: A Randomized Double Blind Clinical Trial.

Nutrient inadequacies among picky-eaters have adverse effects on growth and development. Oral nutritional supplements (ONS) along with dietary counseling (DC), rather than DC alone as reported in our earlier publication, promoted growth among picky-eating Indian children aged from >24 m to ≤48 m with weight-for-height percentiles lying between the 5th and 25th (based on WHO Growth Standards) over 90 days. This paper presents the contribution of ONS to nutrient adequacy, dietary diversity, and food consumption patterns in children (N = 321). Weight, height, and dietary intakes, using 24-h food recalls, were measured at baseline (Day 1) and at Days 7, 30, 60, and 90. Nutrient adequacy, dietary diversity score (DDS), and food intake adequacy were calculated in both the supplementation groups (ONS1 + DC and ONS2 + DC; n = 107 in each group) and the control group (DC-only; n = 107). Supplements increased nutrient adequacy in both of the ONS + DC groups relative to control (p < 0.05). The proportions of children with adequate nutrient intakes increased significantly at Day 90 in the supplemented groups as compared to in the control group (p < 0.05), especially for total fat, calcium, vitamin A, vitamin C, and thiamin. Although no significant differences were observed in DDS in any of the groups, the percentage of children consuming ≥4 food groups in a day had increased in all the groups. Consumption of fruit and vegetables and cereals had increased significantly from baseline to Day 90. ONS along with dietary counseling was found to have improved nutritional adequacy without interfering with the normal food consumption patterns of picky-eating children at nutritional risk.

Effect of Neural Tissue Mobilization on Sensory-Motor Impairments in Breast Cancer Survivors with Lymphedema: An Experimental Study.

BACKGROUND: Breast surgery, Axillary Lymph Node Dissection (ALND), radiation and chemotherapy may develop several complications such as axillary web syndrome, frozen shoulder, numbness, shoulder pain and range of motion restriction, lymphostasis, and lymphedema. Up to 77% report sensory disturbance in the breast or arm after breast surgery. These short- and long-term consequences have dramatic impact on physical function and quality of life in this population. AIMS: The aim of the study was to determine the effect of neural tissue mobilization on sensory-motor impairments in breast cancer survivors with lymphedema. SUBJECTS AND METHODS: This study was carried out by analyzing total 100 breast cancer survivor women, with lymphedema aged between 30-65 years of age who had undergone breast surgery mostly lumpectomy along with chemotherapy or radiation therapy. Participants were divided into two groups by random allocation. One group underwent neurodynamic mobilization and the other group conventional physiotherapy.The treatment protocol was given for 6 weeks. Parameters such ROM, pain, lymphedema and sensory-motor impairments were assessed at the baseline before the treatment and 6 weeks after the treatment. RESULT: The result from this study shows that there is significant improvement (p<0.0001, t-value 4.69) in mTNS of patients undergoing neural tissue mobilization,whereas there was no significant improvement (p=0.05, t-value 1.951) seen in patients undergoing conventional physiotherapy. CONCLUSION: This study concludes that effect of neural tissue mobilization has significant impact on sensory motor impairments as compared to conventional treatment protocol in breast cancer survivors with lymphedema.Pain and ROM showed similar difference with both the treatment protocols. It was also observed that patients with mild and moderate lymphedema showed significant improvement as compared to patients with severe lymphedema.

Estimation of Temporomandibular Joint Dysfunction in Oral Cancer Survivors.

BACKGROUND: The Objective of this study was estimation of Temporomandibular joint dysfunction in oral cancer survivors. METHODS: The hundred patients with oral cancer who had undergone radiotherapy or chemotherapy were randomly selected as per inclusion criteria. Range of motion of temporomandibular joint(TMJ), visual analogue scale (VAS), Manual muscle testing (MMT), Auscultation test, Chvostek test and swelling over orofacial muscles were used as the  Outcome measures. RESULTS: The findings of this study revealed that the Temporomandibular joint was significantly dysfunctional. The group analysis demonstrated statistically significant impairments in all the Outcome measures. VAS (p<0.0001), ROM for all four motions (p<0.0001), Manual muscle testing (p<0.0001), Provocation test (52%), Auscultation test (92%), Chvostek Test (4%), and swelling (56%) were all shown significant dysfunction of TMJ. CONCLUSION: This study showed that pain was increased during activity than at rest based on the findings of VAS pain rating scale. It was found that the range of motion of TMJ was significantly reduced; however muscular strength was minimally affected. Majority of survivors were tested positive for the provocation test and auscultation test and few for Chvostek test which indicated the involvement of facial nerve.

Estimation of Neural Tissue Mobility in Breast Cancer Survivors with Lymphedema.

BACKGROUND: Lymphedema in breast cancer survivors is a very common condition which progressively may lead to entrapment  neuropathy. In lymphedema there is accumulation of fluid due to removal of lymph nodes which causes stretching of nerve fibres within the skin, compression on top of the nerve bundle leading to nerve entrapment. This will increase the neural mechanosensitivity and functional impairment of shoulder as a protective neural response to movement or traction. METHODS: This study was carried out by assessing the total 72 breast cancer survivor women, with lymphedema. Out of 72, 28 of women underwent lumpectomy, 12 underwent quadrantectomy and 32 underwent unilateral mastectomy.  These subjects were assessed for neural tissue mobility by taking pain assessment using visual analogue scale (VAS), range of motion (ROM) using goniometer, lymphedema measurement using an inch tape. The neural tissue mobility for  median nerve, ulnar nerve and radial nerve was measured using limb tension test. RESULT: The result obtained from this study showed that neural tissue mobility was significantly impaired in breast cancer survivors with lymphedema. The result of the upper limb tension tests showed 32 women with mild lymphedema had median nerve affected on the involved side 54.1%, about  21 women had moderate lymphedema with 75% of women had median and 25% ulnar nerve affected with median nerve affected in majority of women. Only 19 women with severe lymphedema had all the three nerves affected. CONCLUSION: This study of women who have undergone surgical intervention for breast cancer concludes that there was significant amount of neural tissue impairment noted to mechanical provocation test post operatively after 6 months of surgery. The study suggests that severity of lymphedema was directly related to the nerves affected due to neural tissue impairment.

Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors.

The problem of poor nutrition with impaired growth persists in young children worldwide, including in India, where wasting occurs in 20% of urban children (<5 years). Exacerbating this problem, some children are described by their parent as a picky eater with behaviors such as eating limited food and unwillingness to try new foods. Timely intervention can help prevent nutritional decline and promote growth recovery; oral nutritional supplements (ONS) and dietary counseling (DC) are commonly used. The present study aimed to determine the effects of ONS along with DC on growth in comparison with the effects of DC only. Enrolled children (N = 321) were >24 to ≤48 months old, at malnutrition risk (weight-for-height percentile 3rd to 15th), and described as a picky eater by their parent. Enrollees were randomized to one of the three groups (N = 107 per group): ONS1 + DC; ONS2 + DC; and DC only. From day 1 to day 90, study findings showed significant increases in weight-for-height percentile for ONS1 + DC and for ONS2 + DC interventions, as compared to DC only (p = 0.0086 for both). There was no significant difference between the two ONS groups. Anthropometric measurements (weight and body mass index) also increased significantly over time for the two ONS groups (versus DC only, p < 0.05), while ONS1 + DC significantly improved mid-upper-arm circumference (p < 0.05 versus DC only), as well. ONS groups showed a trend toward greater height gain when compared to DC only group, but the differences were not significant within the study interval. For young Indian children with nutritional risk and picky eating behaviors, our findings showed that a 90-day nutritional intervention with either ONS1 or ONS2, along with DC, promoted catch-up growth more effectively than did DC alone.

Analysis of Spinal Dysfunction in Breast Cancer Survivors with Lymphedema.

BACKGROUND: To study and analyse the spinal dysfunction in breast cancer survivors with lymphedema. METHODS: This study was carried out by analysing total 116 breast cancer survivor women, who were having lymphedema. Out of 116 subjects, 39 undergone radical mastectomy (RM), 39 undergone modified radical mastectomy (MRM) and 38 undergone breast conserving surgery (BCS). Thesesubjects were assessed for spinal function bytaking range of motionusing goniometer, lymphedema measurement usinginch tape, spinal stability test and functional rating index. RESULTS: The spinal range of motion wassignificantly reduced in patients suffering from lymphedema in breast cancer survivors. The strength and endurance were significantly reduced in abdominals, extensors and lateral muscles of spine. There wasmarked effect seen on quality of life of patients assessed by using functional rating index due to spinal dysfunction in lymphedema patients. CONCLUSION: This study showed that there is statistically significant spinal dysfunction caused due to lymphedema in breast cancer survivors.

Functional exercise capacity in young survivors of acute respiratory distress syndrome.

BACKGROUND: As survival rates improve among patients with the acute respiratory distress syndrome, there is a growing need to understand the long-term effects of pathology, treatment and complications in ARDS survivors. OBJECTIVES: To study and evaluate functional exercise capacity in young survivors of acute respiratory distress syndrome. METHODS: A total 35 ARDS survivors with age between 20 and 40 years were selected in ARDS survivor group; which had history of hospitalization for ARDS in last 6 months. Similarly 35 age-sexes matched normal individuals also selected in control group. Each subject assessed for functional exercise capacity with 6 minute walk test and 15 step oximetry test. RESULTS: After analysing the data the results showed significant decline functional exercise capacity. It is found that, 69% patients walked distance between 301 and 450m and 28% patients walked more than 451m and remaining 3% patients walked less than 300 m distance in 6 minute walk test. 69% patients done exercise in 45-65 seconds, 28% patients done exercise in 21-45 seconds, 3% patients took time more than 66 seconds in 15 step oximetry test. CONCLUSION: Young survivors of the acute respiratory distress syndrome have reduced functional exercise capacity 6 months after discharge from the intensive care unit.

An Immunohistochemical Study of HIF-1 Alpha in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma.

To evaluate and compare the expression of HIF-1 Alpha (HIF-1α) in oral epithelial dysplasia (OED) and various grades of Oral squamous cell carcinoma (OSCC). 30 cases each of OEDand OSCC were stained with HIF-1α antibody. Quantification of HIF-1α positive cellswas carried out and the data was statistically analysed. The mean % HIF-1α labeling index (HIF-1α LI) increased significantly from mild OED (32.11%), moderate OED (55.07%), to severe OED (64.58%). There was a statistically significant increase in the expression of HIF-1α as grades of OED increased. The mean HIF-1α LI % in well differentiated OSCC was 46.3%, Moderately differentiated OSCC-76.31% and Poorly differentiated OSCC-89.9%. The mean HIF-1α LI was found to increase with increasing grades of OSCC which was statistically significant (P < 0.05). Further a comparison of mean HIF-1α LI in OED with different histologic grades of OSCC by Independent samples t test was performed. We found statistically significant difference between OED and moderately differentiated OSCC and OED and poorly differentiated OSCC (P = 0.000). Progressive increase in expression of HIF-1α was noted from OED to OSCC. It can be postulated that epithelial dysplastic lesions with increased HIF-1α expression are at greater risk of malignant transformation, suggesting that the expression of HIF-1α is an early event in oral carcinogenesis.

Effect of oral nutritional supplementation on growth and recurrent upper respiratory tract infections in picky eating children at nutritional risk: a randomized, controlled trial.

Objectives To evaluate the effect of oral nutritional supplementation (ONS) plus dietary counselling (DC) (intervention) versus DC alone (control) on growth and upper respiratory tract infection (URTI) in nutritionally at-risk, picky eating children in India. Methods We performed a 90-day, prospective, randomized, controlled trial. A total of 255 children aged 24-72 months with a weight-for-age z-score ≥-2 and <-1, picky eating behaviour, and acute URTI were randomized to the control (n = 128) or intervention group (n = 127). The outcomes included the change in weight-for-age z-score from days 1 to 90 and the URTI incidence. Results The mean age was 44.0 ± 14.3 months. The intervention group showed a significantly greater increase in mean weight-for-age and body mass index-for-age z-scores compared with the control group from day 10 onwards. Higher energy intake in the intervention group was observed at all follow-up visits, except for day 10. The incidence of URTI in the control group was 2.01 times higher than that in the intervention group, controlling for confounding factors. Conclusions ONS plus DC is effective for improving weight and reducing the incidence of URTI in nutritionally at-risk, picky eating children with an acute URTI episode.

Continuation of oral nutritional supplementation supports continued growth in nutritionally at-risk children with picky eating behaviour: A post-intervention, observational follow-up study.

Objectives To evaluate the 120-day post-intervention growth trajectory of picky-eating children aged 2 to 6 years who previously completed a 90-day, randomized, controlled trial of oral nutritional supplementation (ONS) plus dietary counselling (DC) (SDC, n = 98) compared with DC alone (n = 105). Methods A total of 203 children were included. Children were free to consume ONS during follow-up. Information on ONS consumption was collected. Weight-for-age percentile (WAP) and height-for-age percentile (HAP) were measured at Day 90 (beginning) and Day 210 (end point). Results Despite continued weight gain, there was a significant decline in WAP in both groups during the post-intervention period. However, children who took ONS voluntarily had a smaller loss in WAP compared with those who did not. Children in the SDC group showed no difference in a decline in HAP between those who took ONS during follow-up and those who did not. However, children in the DC group showed a marginally larger decline in HAP in those who did not take ONS during the follow-up compared with those who did. Conclusions Continued parental self-administration of ONS to their children slows down the loss of growth percentiles, supporting continued weight gain in picky-eating children at nutritional risk.

Thermodynamic studies of ionic hydration and interactions for amino acid ionic liquids in aqueous solutions at 298.15 K.

Amino acid ionic liquids are a special class of ionic liquids due to their unique acid-base behavior, biological significance, and applications in different fields such as templates in synthetic chemistry, stabilizers for biological macromolecules, etc. The physicochemical properties of these ionic liquids can easily be altered by making the different combinations of amino acids as anion along with possible cation modification which makes amino acid ionic liquids more suitable to understand the different kinds of molecular and ionic interactions with sufficient depth so that they can provide fruitful information for a molecular level understanding of more complicated biological processes. In this context, volumetric and osmotic coefficient measurements for aqueous solutions containing 1-ethyl-3-methylimidazolium ([Emim]) based amino acid ionic liquids of glycine, alanine, valine, leucine, and isoleucine are reported at 298.15 K. From experimental osmotic coefficient data, mean molal activity coefficients of ionic liquids were estimated and analyzed using the Debye-Hückel and Pitzer models. The hydration numbers of ionic liquids in aqueous solutions were obtained using activity data. Pitzer ion interaction parameters are estimated and compared with other electrolytes reported in the literature. The nonelectrolyte contribution to the aqueous solutions containing ionic liquids was studied by calculating the osmotic second virial coefficient through an application of the McMillan-Mayer theory of solution. It has been found that the second osmotic virial coefficient which includes volume effects correlates linearly with the Pitzer ion interaction parameter estimated independently from osmotic data as well as the hydrophobicity of ionic liquids. The enthalpy-entropy compensation effect, explained using the Starikov-Nordén model of enthalpy-entropy compensation, and partial molar entropy analysis for aqueous [Emim][Gly] solutions are made by using experimental Gibb's free energy data and literature enthalpy data. This study highlights that the hydrophobic interaction persists even in the limit of infinite dilution where the hydration effects are usually dominant, implying importance of hydrophobic hydration. Analysis of the results further shows that the hydration of amino acid ionic liquids occurs through the cooperative H-bond formation with the kosmotropic effect in contrast to the usual inorganic salts or hydrophobic salts like tetraalkylammonium halides.

Synthesis and anti-inflammatory activity of some 3-(4,6-disubtituted-2-thioxo-1,2,3,4-tetrahydropyrimidin-5-yl) propanoic acid derivatives.

A series of 3-(4,6-disubtituted-2-thioxo-1,2,3,4-tetrahydropyrimidin-5-yl) propanoic acid derivatives has been synthesized by condensation of thiourea, 5-(4-subtituted phenyl)-5-oxopentanoic acid and substituted aldehyde. The synthesized compounds were screened for their anti-inflammatory activity using rat paw edema method. Most of the compounds from the series showed significant (p <0.05) anti-inflammatory activity.