ORIGINAL RESEARCH ARTICLE | June 16, 2020
Osteoarthritis Knee & Low Level Laser Therapy-Evidence from Northeast India
Dr. Sharat Agarwal
Page no 257-261
Although joint pain can be controlled with various modalities which includes the use of acetaminophen, NSAIDs and corticosteroid injections. It has been found that LLLT is an effective non invasive therapy to control inflammation and tissue degeneration and thus to relieve pain with subsequent quality of life improvement in various inflammatory & painful joint problems. Material & Methods: A retrospective analysis was done from the data on osteoarthritis knee patients (n=30) with chronic knee pain, treated with low level laser therapy applied at the knee joint line area over medial & lateral tibiofemoral condyles region. The various parameters like NRS; daily activities, work & leisure, anxiety & depression, social interaction (4 components of DALLAS pain questionnaire as found relevant for these patients to assess quality of life) were studied and analysed using appropriate statistical tools. Results: The majority patients were female (n=17) as against males (n=13). The paired t test revealed that there was significant difference in NRS score before and after laser therapy. The paired t test revealed that there was significant difference with positive improvement in daily activities, work & leisure, Anxiety & depression and social interaction scores before and after laser therapy. Conclusion: LLLT like Helium Neon (He-Le) laser has the potential to be used with efficacy in patients of chronic knee pain due to osteoarthritis irrespective of age and sex, especially in Kellgren lawrence OA grade 1, 2 & 3.
ORIGINAL RESEARCH ARTICLE | June 18, 2020
Risk Factors Associated With Acute Coronary Syndrome among Patients Admitted to the Coronary Care Unit in the Military Cardiac Center - Sana’a-Yemen
Dr. Ahmed Kaid Salem, Dr. Nouradden Aljaber, Dr. Akram Al-Haj, Dr. Khairallah Abdulah Al-Matari, Prof Amin Ablrub, Dr. Ali Ahmed Al-Zaazaai
Page no 262-267
Background: Acute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Worldwide acute coronary syndrome (ACS) is one of the main reasons for hospital admission and the leading cause of death. Several risk factors have been identified. However high blood pressure and hypercholesterolemia remain the most important risk factors in (ACS). Objective: To determine the risk factors associated with ACS among patients admitted to the coronary care unit (CCU) in the Military Hospital-Sana’a. Methodology: Study design according to a case-control study. Two groups of patients were included in this study, the first group was cases who have (ACS), and the second group was control cases admitted to CCU for other causes. All data were recorded in a special sheet including demographic, clinical presentation, investigation, and treatment plan. The data was entered into PC and analyzed statistically. Results: There were 124 patients with ACS versus 91 control patients without ACS. The majority of participants in the two groups were males (80 %). Their age ranged from 18 to 95 years old with a mean age of 53.9 ±13.6 years. (86.5 %) of them were 40 years old or above. The significant risk factors associated with ACS were hypertension, Khat chewing found in 71.6 %, 64.4%, of the patients, respectively. Another significant risk factor was dyslipidemia which was higher among ACS patients than the control group with a P-value of < 0.05. Conclusion: Preventing the program from avoiding risk factors that were associated with ACS may decrease the occurring of ACS and reduce the morbidity and mortality in Yemeni patients.
REVIEW ARTICLE | June 24, 2020
Bilateral Wyburn–Mason Syndrome Presenting with Macular Edema
Omer Othman Abdullah
Page no 268-271
The Wyburn-Mason or Bonnet-Dechaume-Blanc syndrome is a sporadic illness which is a type of phakomatosis, usually present as unilateral arteriovenous malformations (AVM), for the first defined by Magnus in 1874 as retinal AVM later in 1932 another description gave by Yates and Payne; as an AVMs of the retina and cerebral vasculature, while in 1937 Bonnet, Dechaume and Blanc defined as AVM involving facial, retinal and brain blood vessels, then in 1943 all literature revised by Wyburn-Mason to put together to his case reports, therefore, the name of Bonnet-Dechaume-Blanc syndrome given in France, but in English articles entitled as Wyburn-Mason syndrome . At that time, due to a deficiency in diagnostic imaging techniques, all the diagnosis were performed by clinical findings, operation, or autopsy . Usually, it is a unilateral disorder comprising of three distinct components: orbit, brain (ipsilateral to the retina) and face, in the face; the sensory region of the trigeminal nerve distribution involved, that takes the shape of naevi which might be wholly formed and illness, is complete, or the naevi might be faint or absent, the latter regarded as an incomplete disease [1, 3] but rarely a bilateral involvement encountered with an asymmetrical grade of malformation . The pathology starts in the early embryonic period, and if vascular dysgenesis encountered can lead to a wide range of neurocutaneous vascular defects in the cerebrum or ocular or both . When the disorder reaches the last stage, the AVM can compress the optic nerve causing impaired perfusion, ischemia eventually optic atrophy . Another explanation for visual loss is glaucoma as a result of elevated vascular pressure, neovascularization resulting from ischemia, which might lead to vitreous hemorrhage . Archer et al., staged the disease into three groups [6-8]: Group 1 (AVM cannot be detected clinically). Group 2 (Clinically seen as edema and hemorrhage due to direct AVM, i.e., no capillary network between them). Group 3 (Clinically, it is impossible to distinguish arteries from veins due to severely dilated blood vessels all over retina). We present a 41-year-old male presented with a gradual decrease in his visual acuity in both eyes.
ORIGINAL RESEARCH ARTICLE | June 30, 2020
Implementation and evaluation of an e-learning system - A Cross-Sectional Study in a Medical College, Pakistan
Saba Iqbal, Rabia Akram, Sameea Akram, Lamia Yusuf
Page no 272-275
The aim of this study was to investigate the current opinions of undergraduate Medical students at the Pak Red Crescent Medical College of Pakistan in respect to information communication technology (ICT), by implementing e-learning system by mixing different strategies, start the e learning program first time on regular bases and then assess the feedback by MBBS Medical students from the first, second, third, fourth, and fifth year and they were asked to complete a questionnaire presented in a e-docs at the end of the sixth week of the e-learning during the lock down due to covid-19 pandemic. Students give a mix response, they feel difficulty to understand medical education first time online but later on they enjoy the whole learning process especially non clinical subjects and e feedback results shows, and Students do not want e-learning as replacing traditional instructor-based training but as a additional component to it, forming part of a blended-learning strategy. Assessments are quickly assessed and quick respond and less chance of cheating. A major disadvantage of early e-learning system, it only covers the cognation process, skill and attitude component of medical teaching and training is not fully taught and hands on activities are impossible to assess through e-learning.