• Journal of Chest Surgery
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• 제52권6호
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• pp.409-415
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• 2019

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.183-188
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• 2013

Background: Breast cancer (BC), the most common female cancer in Pakistan, is associated with a very high mortality. However, the roles of individual risk factors for BC among Pakistani women are still controversial. To assess potential risk factors for BC, a matched case-control study was conducted in two tertiary care hospitals of Karachi, Pakistan. Materials and Methods: The study population included 297 pathologically confirmed incident cases of BC patients diagnosed between January 2009 and December 2010. 586 controls without any history of BC were matched on hospital and ${\pm}5$ years of ages. Results: Positive family history of BC (MOR=1.72; 95%CI: 1.10, 2.80 for first degree vs. none), single marital status (MOR=1.55; 95%CI: 1.10, 2.39 for single/divorced/widowed women vs. married women), older age at menopause (MOR=3.92; 95%CI: 2.52, 6.18 for menopausal women aged below 45 years, MOR=6.42; 95%CI: 3.47, 11.98 for menopausal women above 45 years of age compared with premenopausal women) conferred an increased risk of BC for women. Increasing parity decreased the risk of BC (MOR=0.90; 95%CI: 0.85, 0.97 for each live birth). Intake of Vitamin D supplements (MOR=0.30; 95%CI: 0.12, 0.81 for ${\leq}3$ years and MOR=0.27; 95%CI: 0.13, 0.56 for >3 years) was protective compared to non-users of Vitamin D. Conclusions: This study confirmed only few of the recognized risk factors in Pakistani women. The protective effect of Vitamin D is important from public health perspective and needs to be further explored through a randomized controlled trial.

• 셀메드
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• 제6권1호
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• pp.5.1-5.5
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• 2016

Combating anaemia is a global public health challenge of the developing world. Nutritional anaemia is a serious health problem faced by Indian school children. An investigation was taken up to study the effect of non iron containing Ayurvedic preparation Sootshekhar Rasa (SR) plus Sitopaladi Churna (SC) along with iron and folic acid (IFA) for improving nutritional anaemia among adolescent school going students of Dehradun district in Northern India. The blinded, controlled randomized trial comprised of 820 adolescents anaemic students aged 11 - 18 years. The anaemic students were randomly divided into 4 groups, students of group I (control) received starch, group II, III, and IV students received daily dose of (SR 250 mg + SC 400 mg), IFA and (SR 250 mg + SC 400 mg) + IFA, respectively. All the students received treatment for 90days and were followed up for next 180days. At the end of follow-up (day 270), significant increase of haemoglobin (Hb) level from the base line was recorded in all treatment groups. The maximum gain in Hb concentration was noted in group IV (10.1 ± 0.6 g/L), which was significantly higher than any other group. There were 123 drop-outs; however, no major side effect of treatment was noted in any student. We conclude that daily dose of (SR 250 mg + SC 400 mg) along with IFA can produce sustainable improvement of nutritional anaemia in adolescent students.

• Journal of Gastric Cancer
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• 제17권4호
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• pp.354-362
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• 2017

Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months. Inclusion criteria were histologically proven gastric adenocarcinoma treated with laparoscopic distal or total gastrectomy and Billroth II or Roux-en-Y reconstruction. The primary endpoint was the incidence of duodenal stump leakage within the first 30 postoperative days. The secondary endpoints were early postoperative outcomes until discharge. Results: One hundred patients were enrolled between February 2016 and March 2017. The study groups consisted of 65 male and 35 female patients with a mean age (years) of 62.3. Of these, 63 (63%) patients had comorbidities. The mean number of retrieved lymph nodes was 38. The mean operation time was 145 minutes including 7.8 minutes of mean LARS time. There was no occurrence of duodenal stump leakage. Thirteen complications occurred, with one case of reoperation for splenic artery rupture and one case of mortality. Conclusions: Based on the results of this prospective phase II study, LARS can be safely performed in a short operation period without development of duodenal stump leakage. A future randomized prospective controlled trial is required to confirm the surgical benefit of LARS compared to non-LARS.

• 대한치과교정학회지
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• 제51권5호
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• pp.313-320
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• 2021

Objective: The purpose of this study was to evaluate the effects of chewing gum and low-level laser therapy in alleviating orthodontic pain induced by the initial archwire. Methods: Patients with 3-6 mm maxillary crowding who planned to receive non-extraction orthodontic treatment were recruited for the study. Sixty-three participants (33 females and 30 males) were randomly allocated into three groups: laser, chewing gum, and control. In the laser group, a gallium aluminum arsenide (GaAlAs) diode laser with a wavelength of 820 nm was used to apply a single dose immediately after orthodontic treatment began. In the chewing gum group, sugar-free gum was chewed three times for 20 minutes-immediately after starting treatment, and at the twenty-fourth and forty-eighth hours of treatment. Pain perception was measured using a visual analog scale at the second, sixth, and twenty-fourth hours, and on the second, third, and seventh days. Results: There were no statistically significant differences between the groups at any measured time point (p > 0.05). The highest pain scores were detected at the twenty-fourth hour of treatment in all groups. Conclusions: Within the limitations of the study, we could not detect whether low-level laser therapy and chewing gum had any clinically significant effect on orthodontic pain. Different results may be obtained with a higher number of participants or using lasers with different wavelengths and specifications. Although the study had a sufficient number of participants according to statistical analysis, higher number of participants could have provided more definitive outcomes.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.74-78
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• 2019

Objective: Myofascial release (MFR) is used to restore tissue extensibility of the fascia tissue and is considered to be useful in a number of clinical settings, such as low back pain (LBP). Dynamic myofascial release (DMFR) is the manual therapy, which combined the conventional MFR with the joint mobilization. The purpose of this study was to investigate the effects of the DMFR on trunk mobility, and furthermore, whether the increase of trunk mobility can carry over the improvement of dynamic standing balance in persons with chronic nonspecific LBP. Design: Randomized controlled trial. Methods: Thirty persons with chronic non-specific LBP participated in the study and were randomly assigned to the DMFR group (n=15) or the control group (n=15). DMFR was performed for two sessions (15 minutes/session) per week for four weeks for the treatment group. Both the DMFR and control groups were allowed to perform low-intensity physical activities during the treatment period. The Modified-modified $Sch{\ddot{o}}ber$ test (MMST) for trunk mobility and the Functional Reach Test (FRT) for dynamic standing balance were measured before and after the treatment period in both the DMFR group and the control group. Results: The MMST value of DMFR group increased significantly in all trunk range of motion (flexion, extension, lateral flexion, and rotation) after treatment, compared with the control group (p<0.05). Additionally, the FRT value of the DMFR group improved significantly after treatment, compared with the control group (p<0.05). Conclusions: We suggest that DMFR have a positive effect on trunk mobility and standing balance in persons with chronic LBP.

• 국제물리치료학회지
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• 제11권4호
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• pp.2221-2228
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• 2020

Background: Shoes cover the feet and ankle joints and come into contact with the ground directly during walking, and the shape of shoes is related to the muscle tone of the lower extremity muscles. However, no study has been conducted on the muscle tone of the lower extremity after wearing combat boots. Objectives: To compare and analyze the effects of walking in combat boots and in athletic shoes on muscle tone and stiffness, to identifying the effect of the characteristics of shoes on the muscle tone. Design: Randomized controlled trial. Methods: Thirty subjects were randomly divided into a combat boots group and an athletic shoes group, and interventions were implemented. Both groups walked for 30 minutes on a treadmill at 4.2 km/h. MyotonPRO was used to measure the muscle tone and stiffness of the lower extremity. The measuring sites were set to five muscles on both legs. Results: In the combat boots group, muscle tone and stiffness of the medial gastrocnemius on the dominant side, the muscle tone and stiffness of rectus femoris, and the muscle stiffness of hamstring on the non-dominant side significantly decreased after walking. In the athletic shoes group, there was no significant change in the muscle tone and stiffness. Conclusion: The results of this study can be used to inform the wearing combat boots while walking on a treadmill reduces the muscle tone and stiffness of the lower extremity compared to athletic shoes. It indicates that the restriction of joint movement occurring when wearing combat boots influences reducing muscle tone and stiffness.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.295-304
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• 2022

Background: The first dental experience is vital in molding a child's attitude towards dentistry and dental outcomes. The cooperation of a child during dental treatment is essential to render successful and high-quality treatment. Dental anxiety is common in children undergoing dental treatment. The success of pediatric dental treatments and patient comfort depends on controlling the levels of patient anxiety in clinical settings. This study aimed to compare the effectiveness of the recorded maternal voice and virtual cognitive tool (Roogies application) in the management of pediatric dental patients. Methods: The study was carried out with children aged of 4-7 years [n = 80, (40 male and 40 female)], without any past dental history, and were randomly allocated into two groups. After informed consent was obtained, the entire procedure was explained to the parents. Anxiety was assessed pre-, during, and post-treatment by measuring pulse rate, and recording Venham Picture Test (VPT) scores. Group A [n = 40; 20 boys and 20 girls)] was provided with a headphone that played a recorded maternal voice. Group B [n = 40; 20 boys and 20 girls)] was administered the virtual cognitive tool. After conditioning the children, oral prophylaxis was performed for both groups. A comparative evaluation was conducted for each treatment session. Results: The intra-group comparison of VPT scores and heart rate for patients assigned to the recorded maternal voice showed a statistically significant difference in dental anxiety (P-value ≤0.001). Conclusion: This study demonstrated that a reduction in dental anxiety with the help of recorded maternal voice forms an important component of non-pharmacological behavior management. Alternatively, the use of a virtual cognitive tool as an anxiety-reducing technique can also be advocated.

• 대한한방부인과학회지
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• 제35권1호
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• pp.34-58
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• 2022

Objectives: This study was performed to analyze the interventions of Oriental Medicine which had been commonly used for postpartum disease and postpartum care. Methods: We searched research on the interventions for postpartum disease and postpartum care in 4 domestic search engines. After that, we conducted eligibility screening based on inclusion and exclusion criteria. Results: 1. We selected total 50 studies. There were 2 randomized controlled trial (RCT), 5 non-RCT, 35 case reports, 8 case series within the 6~8 weeks after childbirth. 2. Of the 35 case reports, several interventions were used : acupuncture (22), moxibustion (11), cupping therapy (7), pharmacopuncture (5), chuna manipulation (4), herbal medicine (34). The most common symptoms were musculoskeletal symptoms (8), followed by postpartum depression (7). Various prescriptions and acupoints of oriental medicine were used depending on the diseases or symptoms. 3. Of the 8 case series, 382 subjects in 5 case series had taken Saenghwa-tang-gagam. And Acupuncture, moxibustion, cupping therapy (5), pharmacopuncture (1) were used as an intervention. 4. The most commonly used acupoint is 腎兪 (BL23) in the pain including postpartum back pain and 三陰交 (SP6), 關元 (CV4) in the postpartum care. 關元 (CV4) is the most commomly used moxibustion point not only the postpartum disease but also the postpartum care. Conclusions: In clinical studies of oriental medicine related to postpartum disease and postpartum care, pain-related clinical studies that belong to or progress to Sanhupung were the most common (30%), and among them, postpartum low back pain studies were the most common (20%). Based on this, we believe that large-scale clinical studies with high quality using oriental interventions including chuna and pharmacopuncture are needed to establish guidelines for the management of pain treatment including postpartum back pain.

• 대한물리치료과학회지
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• 제29권3호
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• pp.75-84
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• 2022

Background: This study was to investigate the effect of non-invasive transcranial direct current stimulation due to hemiplegic patients due to stroke on temporal and spatial gait ability. Design: Randomized sham controlled trial. Methods: For the study method, 42 patients with hemiplegia due to stroke were randomly assigned to 14 patients each, and the general walking group, tDCS walking group, and tDCS (sham) walking group were subjected to 5 times a week, 30 minutes a day, and 6 weeks. In the temporal gait variables of hemiplegic patients due to stroke, the effect of the gait time, gait cycle, single support, double support, swing phase, stance phase, gait speed, cadence were measured. In spatial variables, one step length and one step length were measured. Results: As a result of the study, the EG group significantly increased in the step time, gait velocity, and cadence of the paralysis side in the comparison of temporal walking variables between groups according to the application of tDCS of walking ability in hemiplegic patients due to stroke patients(p<.05). In the change in spatial walking variables between groups according to the application of tDCS, the step length and stride length of the EG group showed a significant increase. Both the comparison of temporal and spatial symmetry walking variables between groups according to tDCS application was not significant(p>.05) Conclusion: As a result, tDCS has an effective effect on the improvement of the gait ability of stroke patients. In particular, it is an effective method of physical therapy that can improve the cadence and speed of gait, which can be combined with the existing gait training to effectively increase the gait of hemiplegia due to stroke patients.