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Background: Cerebral palsy is the most common chronic disability. Lesions or defects in the immature brain cause sensori motor impairment, which compromise the development of upper limb function in cerebral palsy. Restricted movement of the upper limbs may cause limitation in the functions and performance of ADL which affect their quality of life. Recent studies have proven that kinesiotape plays an important role in the management of hand functional activity. Design: Randomized controlled trail was conducted on 28 cerebral palsy children with impaired hand function were included in the study based on the inclusion and exclusion criteria. Participants were randomly divided into 2 groups, group a. kinesiotaping with functional hand activities and group b. sham taping (Kinesiotape without tension) along with functional hand activities. Control group received sham tape (kinesiotape without tension). Outcomes were measured using quality of upper extremity skill test (QUEST) and Upper limb physician rating scale (ULPRS). Conclusion: The study proved that the short term effect of kinesiotaping application along with functional hand activities has no significant effect on improving hand function in children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) is the most common chronic childhood disability of today. Health care needs are present in these children who require health services to manage their functional disability. It can change according to the age group and severity of the condition. In the current healthcare system, little is known about priorities and needs for the children with cerebral palsy especially in reference to Indian contextual situations and how these needs may differ based on the child's age and motor function. Methods: A cross sectional survey design is used in the study. 83 parents of children with cerebral palsy and their treating physiotherapists were selected in the study based on the inclusion and exclusion criteria. Participants were divided into 3 groups based on the age of the children. Self designed questionnaire was given to the parents and the physiotherapists to select the health care needs for the children. One time data collection was done over the period of 3 months. Conclusion: The study also shows that mostly parent's needs are considered by physiotherapists for their goal settings. Most of the time parents' needs and the physiotherapist's goals are found to be similar. [ABSTRACT FROM AUTHOR]

Background: Physical activity and exercises after stroke may prevent the disability and stroke recurrence; yet, psychological impairments like depression may inhibit post stroke exercise and subsequently limit recovery. Though it remains less clear how best is to encourage exercise uptake by individuals with depression after stroke. Objective: The objective of this study was to identify the perceived barriers and facilitators to physical activity and exercise participation among post stroke depressed individuals. Methods: Descriptive cross-sectional design was adopted using purposive sampling of stroke survivors. Fifty stroke survivors were screened and identified for depression using HAM-D.25 depressed and 25 non- depressed stroke survivors have been grouped into active and inactive groups based on exercise and physical activity guidelines. IPAQ scale has grouped them into physically active and physically inactive based on 3 METs. Using the EBBS scale, the percentage of positive responses for different domains for benefit and barrier scale was calculated. The significant difference in the percentage of response in barrier and benefit domains was analyzed using Chi-square test. Results: There was significant difference in percentage of response in each benefit domain of EBBS between depressed and non- depressed active groups. Similarly there was significant difference in percentage of response in each barrier domain of EBBS between depressed and non depressed inactive groups. Ten major perceived barriers were reported in depressed non-active group in which exercising cause fatigue (100%) was the highly reported response. Conclusion: The study concluded that interventions could be designed for promoting the facilitators more and addressing the barriers to exercise and time management which is likely to reduce the healthcare costs of management of stroke. [ABSTRACT FROM AUTHOR]

Background: With the rising incidence of diabetes and hypertension, the prevalence of end‑stage renal disease has increased greatly so as the need for renal replacement therapy. Availability of suitable living‑related donors is a major problem which increases the demand for deceased donor renal transplantation (DDRT), making it a lifeline for the patients on dialysis without any living donors. Methodology: This is a retrospective analysis of 118 DDRT done between 2012 and 2020, in a private quaternary care hospital in a south Indian state. All patients received basiliximab induction, with maintenance immunosuppression using steroids, mycophenolate mofetil (MMF) or mycophenolate sodium, and tacrolimus. Results: In our study, we report unadjusted graft survival of 93.2% and 81.3%, patient survival of 94.9% and 83.1% at the end of 1 and 5 years, respectively. The recipients with age < 60 years had 5 years graft survival of 87%. The study group consisted of 15.25% of the patients with panel reactive antibody (PRA) positive and 10.16% of them with donor‑specific antibody (DSA) during renal transplantation, and there was only one allograft loss in this subset of the patients. Conclusion: This study confirms that human leukocyte antigen matching is not very important with the current immunosuppressive protocol using tacrolimus and MMF. Early initiations of tacrolimus do not increase the incidence of delayed graft function. We report 91.6% graft survival in the DSA‑positive group, with basiliximab induction and desensitization protocol [ABSTRACT FROM AUTHOR]

Objectives: In India, post-stroke outcomes are determined using functional outcome measures (FOMs), the contents of which have not been validated for their relevance to the Indian population. In this study, we aimed to evaluate the cultural validity of five frequently used stroke-specific FOMs by comparing their contents with the problems reported by patients with stroke in India. Methods: Face-to-face structured interviews were conducted with 152 patients diagnosed with stroke in India. Problems and goals identified by the patients were compared to each item included in the FOMs used in stroke rehabilitation. Results: The Stroke Impact Scale (SIS) and the Frenchay Activities Index (FAI) include items related to the most frequently identified problems. However, neither covers problems related to the need for squatting and sitting on the floor. Use of public transport and community walking are not included in the SIS. Leisure and recreational activities (e.g. gardening, reading books), cognitive and speech functions (e.g. memory, thinking) and bowel and bladder dysfunctions were the common items identified as “not a problem” or “not relevant” by the patients. Discussion: Our findings suggest that the SIS and FAI are the most appropriate FOMs for patients with stroke in India as they include items related to the majority of problems identified by study participants. Many items on both measures, however, were identified as not a problem or not relevant. There is a need for developing culture-specific FOMs that incorporate all major concerns expressed by patients with stroke in India. [ABSTRACT FROM PUBLISHER]

The evolving fifth generation new radio cellular standardization efforts at the third generation partnership project brings into focus a number of questions on relevant research problems in physical-layer communications for study by both academia and industry. To address this question, we show that the peak download data rates for both WiFi and cellular systems have been scaling exponentially with time over the last 25 years. While keeping up with the historic cellular trends will be possible in the near-term with a modest bandwidth and hardware complexity expansion, even a reasonable stretching of this road-map into the far future would require significant bandwidth accretion, perhaps possible at the millimeter wave, sub-millimeter wave, or terahertz regimes. The consequent increase in focus on systems at higher carrier frequencies necessitates a paradigm shift from the reuse of over-simplified (yet mathematically elegant) models, often inherited from sub-6 GHz systems to a more holistic view, where real measurements guide, motivate, and refine the building of relevant but possibly complicated models, solution space(s), and good solutions. To motivate the need for this shift, we illustrate how the traditional abstraction fails to correctly estimate the delay spread of millimeter wave wireless channels and hand blockage losses at higher carrier frequencies. We conclude this paper with a broad set of implications for future research prospects at the physical-layer, including key use-cases, possible research policy initiatives, and structural changes needed in telecommunications departments at universities.

Polysorbates (PSs) are synthetic nonionic surfactants consisting of polyethoxy sorbitan fatty acid esters. PSs have been widely employed as emulsifiers and stabilizers in various drug formulations and food additives. Recently, various PS-based formulations have been developed for safe and efficient drug delivery. This review introduces the general features of PSs and PS-based drug carriers, summarizes recent progress in the development of PS-based drug formulations, and discusses the physicochemical properties, biological safety, P-glycoprotein inhibitory properties, and therapeutic applications of PS-based drug formulations. Additionally, recent advances in brain-targeted drug delivery using PS-based drug formulations have been highlighted. This review will help researchers understand the potential of PSs as effective drug formulation agents.

Introduction After a stroke, 55% of survivors do not regain the ability to completely use their arm in daily life functioning. Currently, evidence-based guidelines recommend functional training for improving the affected hand after stroke. However, promoting an optimal quantity and quality of functional training is influenced by personal and environmental contextual factors. Studies that comprehensively target multiple factors regulating arm use are limited. This study compares the effects of functional training to multifactorial context-enhancing functional training program for improving functional arm use and recovery after stroke.Methods and analysis This is a protocol for an observer-blinded, two parallel groups, randomised controlled trial. A total of 126 community-dwelling subacute and chronic stroke survivors will be included in the study. A tailor-made multifactorial context-enhancing intervention-incorporating education, environmental enrichment and behaviour change techniques to reinforce functional training will be provided to the experimental group. The functional training group will be provided with functional exercises. The intervention will be delivered for 2 months. The primary outcomes of functional arm use and recovery will be measured using Motor Activity Log, Goal Attainment Scale and Rating of Everyday Arm-use in the Community and Home scale. The secondary outcomes of arm motor impairment and function will be measured using Fugl-Meyer upper limb score, Action Research Arm Test, ABILHAND questionnaire and Stroke Impact Scale. These will be measured at three points in time: before, after 2 months and after 1-month follow-up. The outcome measures will be analysed using one-way analysis of variance and regression analysis will be performed to identify factors limiting optimal task practice.Ethics and dissemination The study has been approved by the Institutional Ethics Committee of Kasturba Hospital, Manipal, India. Participants will sign a written informed consent prior to participation. The results will be published on completion of the trial and communicated to community-dwelling stroke survivors.Trial registration number CTRI/2017/10/010108

Background: To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes., Methods: Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included. Survival analysis was stratified according to subsite, primary versus recurrent disease, and surgical versus nonsurgical treatment., Results: Data from 202 rHNSCC patients were derived from a cohort of 1488 patients submitted by 50 UK centers. Median age was 66 years (IQR 58-74), and 142 (70.3%) were male. The most common recurrence subsites were oropharynx (20.5%), oral cavity (19.5%), larynx (16.4%), and hypopharynx (14.9%). Ninety-three (48.4%) were managed curatively. Surgery was the most common treatment for laryngeal (59.4%), oral cavity (60.5%), hypopharyngeal (44.8%), and oropharyngeal (37.5%) cancers. Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local recurrence free survival (LRFS) were 41.1%, 39.1%, 42.2%, and 39.3%, respectively. rHNSCC treated with surgery had improved OS (p = 0.0005), DFS (p = 0.012), DSS (p = 0.0003), and LRFS (p = 0.007), over nonsurgical treatments. Compared to primary cancers, rHNSCC presents with more advanced T stage (p < 0.001) and distant metastasis (p < 0.001), receives less curative treatment (p < 0.001), and has worse survival outcomes (all p < 0.001). On multivariate analysis, salvage surgery, radiotherapy, and p16 status were independent prognostic factors of all survival outcomes., Conclusions: Recurrent HNSCC is associated with high rates of incurable disease and worse survival than primary cancers. Surgery remains the most common curative treatment in rHNSCC, however future studies are necessary to improve patient selection and optimize outcomes following salvage treatment., (© 2024 Wiley Periodicals LLC.)

Background: Radiological localization imaging aids in the identification of abnormal parathyroid glands resulting in primary hyperparathyroidism (PHPT), thereby facilitating minimally invasive parathyroid surgery. Sometimes initial imaging may fail to identify the abnormal gland and imaging may therefore be repeated. This study explored patient outcomes of repeated parathyroid localization imaging, after initial negative gland localization, at a United Kingdom institution., Methodology: Data was retrospectively collected and analyzed for patients with PHPT undergoing repeated imaging during a five-year period (2015-2020). The total number of episodes of scanning, types of scans performed, the time interval between scans and the imaging success of gland localization were recorded. We explored the reasons for repeated imaging and attempted to identify any factors that might predict subsequent positive radiological localization., Results: A total of 45 patients were identified who underwent repeated localizing imaging after first localizing imaging was negative. Of these, 39 did not undergo surgery despite repeat imaging being undertaken; 11 out of these 39 patients (28%) had subsequent positive localization scans. Again, a large proportion of patients were managed conservatively, despite the repeated sets of imaging being done. Patients undergoing three or four sets of repetitive imaging did not have imaging or surgical success., Conclusion: A streamlined parathyroid pathway should be followed whereby patients should be triaged for suitability for surgery prior to repeated imaging. A second set of scans should be offered when patients are unsuitable for conservative management and are willing and fit to undergo surgery. There is no merit to repeating imaging more than twice., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Karunaratne et al.)

Dermatoscopic white circles, seen with both non-polarized and polarized dermatoscopy, are a known clue to actinic keratosis in a flat lesion and invasive squamous cell carcinoma in a raised lesion. We have not discovered a previous published example of this clue in a melanoma. We present a case report of a 70-year-old Australian male with a pigmented superficial spreading melanoma on the face, Breslow thickness 1 mm, with dermatoscopic white circles displayed with both polarized and non-polarized dermatoscopy, and with dermatopathological correlation., (© 2023 Australasian College of Dermatologists.)

Aorto-oesophageal fistula (AOF) is a life-threatening condition that usually presents with upper gastro-intestinal haemorrhage. This case report details the emergency presentation and management of a 51-year-old male who presented with hematemesis secondary to an impacted denture (ingested two years previously) in the oesophagus that had led to an AOF. This necessitated urgent thoracic endovascular aortic repair followed by thoracotomy, oesophagotomy, T-tube insertion and oesophagostomy. This is the first documentation in the literature of the dual-modality management for this rare cause of AOF and demonstrates the multidisciplinary approach to successful management of this complex yet rare presentation., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2021.)

Laryngotracheal stenosis (LTS) is a rare but serious condition characterized by narrowing of the airway. Iatrogenic injury from endotracheal intubation or tracheostomy insertion is the most common cause of LTS. We present the first reported experience of managing a patient diagnosed with subglottic stenosis (a subtype of LTS) following previous intubation and tracheostomy for coronavirus disease 2019 (COVID-19). This patient required an urgent surgical tracheostomy and subsequent referral to a tertiary airway surgery unit for definitive treatment, which included microlaryngoscopy, laser excision and balloon dilatation. This case highlights that LTS should be included in the differential diagnosis for patients re-presenting with breathing difficulties after prolonged intubation or tracheostomy for COVID-19. Furthermore, it raises the concern of a rise in the incidence of this condition and an increased burden on the few units specializing in airway surgery., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2021.)