ఇంటర్నేషనల్ జర్నల్ ఆఫ్ న్యూరో రిహాబిలిటేషన్

Aim: The rate of postdural puncture headache (PDPH) was compared after caesarean section with spinal anesthesia using the 25 gauge spinal needle with the 27 gauge.

Methods: Present study is a randomized clinical trial and 220 full term women entered for caesarean section. We entered full term women randomly for spinal anesthesia with the 25 gauge (group A) and 27 gauge (group B) Quincke spinal needles. In 3 postoperative days, we fallowed and compared Participants in 2 groups for the rate and severity of PDPH. PDPH was defined occipital or frontal headache that made hard the position on sitting or standing.

Results: Data of 220 patients were analyzed. The rate of PDPH was significantly higher in women in group A compared to group B at first (P=0.015), second (P=0.037) and third (P=0.005) follow up days. The severity of the PDPH was not significantly different between 2 groups in three follow up days. The rate of success in spinal anesthesia achievement was not significantly different between 2 groups.

Conclusion: The results of present study recommended that the size of spinal needle can effect on the rate of PDPH after caesarean section.

Aim: The rate of postdural puncture headache (PDPH) was compared after caesarean section with spinal anesthesia using the 25 gauge spinal needle with the 27 gauge.

Methods: Present study is a randomized clinical trial and 220 full term women entered for caesarean section. We entered full term women randomly for spinal anesthesia with the 25 gauge (group A) and 27 gauge (group B) Quincke spinal needles. In 3 postoperative days, we fallowed and compared Participants in 2 groups for the rate and severity of PDPH. PDPH was defined occipital or frontal headache that made hard the position on sitting or standing.

Results: Data of 220 patients were analyzed. The rate of PDPH was significantly higher in women in group A compared to group B at first (P=0.015), second (P=0.037) and third (P=0.005) follow up days. The severity of the PDPH was not significantly different between 2 groups in three follow up days. The rate of success in spinal anesthesia achievement was not significantly different between 2 groups.

Conclusion: The results of present study recommended that the size of spinal needle can effect on the rate of PDPH after caesarean section.

Aim: To evaluate the comparison between magnesium sulfate (MgSO4) and placebo for prevention of seizures in mild pre-eclamptic patients. (Clinical trial code: 2016052111020).

Methods and material: This double blind randomized clinical trial study was conducted on 500 patients with mild Pre-eclampsia admitted in Arash Hospital in during 2014-2016. The patients entered to equal two groups, 250 patients in group A, received MgSO4 and 250 patients in group Breceived Placebo. Primary outcome was occurrence of convulsion in mild pre-eclamptic patients. Secondary outcomes were 1 and 5 min Apgar scores in infants and number of caesarean section in each group.

Results: Mild pre-eclamptic patients in group A did not experience any convulsion; however 3 patients (1.2%) had experienced convulsion in group B. There were no significant differences in convulsion rate (p=0.08), one-min (p=0.43) and five-min Apgar score (p=0.34) between two groups but there was significant differences in numbers of caesarean section, 123 in group A (49.2%) versus 92 in group B (36.8%) between two groups (P=0.005).

Conclusion: Our results suggest that the magnesium sulfate and placebo groups are not statistically differ for prevention of seizure.

Aim: To determine the frequency and severity of post-dural puncture headache (PDPH) in women undergoing spinal anaesthesia for caesarean section who received an infusion of Voluven or Ringer before the procedure.

Methods: We enrolled 240 full term women scheduled for elective caesarean section in this study. Participants were randomly allocated equally to Ringer (A) and Voluven (B) groups. After arrival in the operating room 500 ml of ringer solution was infused within 10-15 min before spinal block in the Ringer group, but in the Voluven group 500 ml of 6% Hydroxyethyl starch solution was infused to the patients. The frequency and severity of headache were compared between two groups.

Results: The frequency of PDPH was higher in patients in Ringer group compared to Voluven group at first day (P=0.01), but there were no significant differences between two groups in second (p=0.23) and third days (p=0.30). The severity of headache in Ringer group was significantly more than patients in Voluven group in every three days significantly. Hypotension occurred in 95 patients in Ringer Group (79.17%) and in 76 patients in Voluven Group (%63.33) (P=0.007). The frequency of nausea and vomiting was seen in 27 patients in Ringer group (22.5%) vs. in 18 patients in Voluven group (15%) (p=0.10).

Conclusion: Hydration with hypertonic solutions (Voluven) before caesarean section under spinal anaesthesia can decrease the rate and severity of PDPH compared with hydration with Ringer solution.

Introduction: MNRI offers non-invasive neuromodulating techniques to activate reflex patterns which awaken the body’s natural resources and support functioning of sensory, motor, and cognitive systems. Amniotic band syndrome (ABS) is a rare congenital disorder attributed to the anomalous amniotic bands that entangle fetal parts during intrauterine life leading to a wide range of physical abnormalities in a newborn infant, in this case, located at the superior third portion of the right arm. Due to the severity of the constricting band observed and assessed at birth, the microvascular surgeon opted for immediate post-birth surgery and Occupational and Physical Therapies were respectively initiated at 8 and 10 weeks post-surgery.

Objective: This article describes early physical therapy intervention (post-surgery) using the MNRI method and discusses the effectiveness of MNRI techniques in the recovery of arm function.

Results: Early intervention using the MNRI neuromodulation techniques with ABS disorder demonstrated unique and faster motor milestones development including voluntary motor and cognitive control of the immobile limb in an infant with the ABS.

Summary: The use of the ready patterns of the brain-primary inherent reflexes-can be a key method and an important cornerstone for professionals to build upon for infants with the ABS.

Psychological rehabilitation to religious terrorism offenders consists of efforts to reestablish human capacity and function in society, restore for a good condition, achieve self-efficacy, and be able to re-integrate into society. It focuses on character building and well-being of violent offenders, in order to have more peaceful state of mind and favorable attitudes to society. Practically, there are two types of rehabilitation to terrorism offenders, exclusiveness and inclusiveness, which can be combined in performing psychological rehabilitation. This paper explains steps in rehabilitating religious terrorism offenders, psychological treatment process, and behavioral transformation seen in religious terrorism offenders. There are ten steps in rehabilitating religious terrorism offenders and five phases of psychological treatment process. In terms of behavioral transformation, religious terrorism offenders experience two kinds of process namely natural and designed behavioral transformation.

Background: Spinal cord injury and its health related complications pose a major impact on the overall morbidity and mortality as well as cause economic constrains. It was aimed at looking into the demographic distribution, diagnosis, as well as complications in patients with spinal cord injury.

Methods: The study was conducted at Centre for the Rehabilitation of the Paralysed (CRP) between 2012 and 2013 from 201 respondents with the help of a structured preformed pretested questionnaire by face to face interview.

Results: Out of 201 respondents 176 (87.6%) were male and 25 (12.4%) were female; majority of the patients were in their 3rd decade which consisted 28.6%, followed by 27.4% in between 21-30 years and 26.8% in between 41-50. Most of the respondents of this study had traumatic paraplegia (56.5%) and Buttock was found to be the predominant site for developing site pressure sore as evident form 67.5%.

Conclusion: Productive males are more prone to spinal cord injury and the most common diagnosis is paraplegia with the most risky area is buttock for developing pressure sore. The findings may add in the way of developing awareness among stakeholders regarding demography, diagnosis and the pattern of the complications in a country like Bangladesh.

Carbamazepine is one of the classical antiepileptic drugs, chemically related to the Tricyclic Antidepressants. There are different methods to detect Carbamazepine in plasma i.e. Therapeutic Drug monitoring (TDM). Various studies claim the usefulness of TDM of Carbamazepine but clear-cut guidelines for TDM are still lacking. This article is authors’ endeavour to summarize facts in different publications on TDM of Carbamazepine. Electronic databases MEDLINE/PubMed, Google Scholar, IMSEAR (Index Medicus for South-East Asia Region) and Scopemed were extensively searched with Mesh (Medical Subject Headings) terms “Carbamazepine” AND “drug monitoring” from earliest possible date (1966) to December, 2016. Articles in any language especially those published in recent years were given preference. For non-English articles, Google translation was used and only abstracts were included. Review is mostly centred on toxic effects, poorly adjusted therapies and poor seizure control. Individualization of drug dose with the help of plasma level detection is a must in case of Carbamazepine therapy. TDM helps better outcome by minimizing the risk of under or overdosing due to drug/food interaction or genetic polymorphism of enzymes and transporters involved in the metabolism of Carbamazepine.

High anxiety is the base not only for depression development but also to impulsive aggression manifestation. In the previous study we revealed the differences in neurohumoral status in animals with submissive and dominant behavioral types. Hypothalamic pituitary adrenal axis hyperactivity, the increase in noradrenaline and the decrease in serotonin levels in limbicocortical regions were observed in submissive male rats (high anxiety). Due to these results, we studied the interrelation between anxiety level and aggressiveness index and its components. The research involved 138 participants: 121 young men aged 18 to 22 years and 17 male adolescents within the age range 15-16 years. They were asked to answer Buss-Durkee Hostility Inventory, Spielberger State-Trait Anxiety Inventory and Eysenck Personality Inventory. The anxiety level was assessed in points. The aggressiveness index, physical, verbal and indirect aggressions were estimated in a percentage of the maximum level. No correlation between the anxiety level and the aggressiveness index was found in whole group of young men. Whole group was separated into three subgroups depending on anxiety level: with high, moderate and low anxiety levels. Strong positive correlation between anxiety level and aggression index in men with high anxiety level and negative correlation between these two parameters in men with low anxiety level were revealed. In last subgroup the correlation was statistically insignificant. In men with moderate anxiety level no correlation between anxiety level and aggression index was observed. This interrelation may be taken into account in anxiety treatment and in the prevention of impulsive aggression manifestation. In whole group of male adolescents no correlation between anxiety and aggressiveness index was found. Obtained data indicate the necessity of participants division depending on anxiety level and using the closed age groups to study the mechanisms of aggression development.