Search

Purpose: To compare safety and efficacy of isolated and combined UV‐light corneal crosslinking (CXL) and fine‐needle diathermy (FND) to regress pathological corneal vessels in vivo. Methods: Mice with inflamed and pathologically vascularized corneas received CXL or FND as monotherapy or a combination of both treatments. Corneal pathological blood and lymphatic vessels, immune cells and the morphology of anterior segment structures were evaluated. Results: All three approaches were able to regress blood and lymphatic vessels in mice. A comparative analysis of the three methods revealed that the FND monotherapy and the CXL + FND combination were significantly more effective than the CXL monotherapy, one and 2 weeks after therapy and especially in regressing lymphatic vessels. Furthermore, the combination therapy induced significantly less immune cell recruitment compared to the monotherapies. All three methods were safe to use in regards of corneal integrity. Conclusions: A combination of FND and CXL led to regression of pathological corneal lymphatic and blood vessels and reduced the infiltration of immune cells into inflamed murine corneas. This approach offers a new effective, safe and clinically usable strategy to treat eyes with mature pathological blood vessels and even more so for lymphatic vessels, for example prior to high‐risk corneal transplantation. [ABSTRACT FROM AUTHOR]

Overpopulation of stray and unwanted cats has been a serious issue in every country and different individuals have different motivations for their spaying or neutering. The current experiment aimed to evaluate the feasibility and safety of ovarian cauterization compared to CaCl2 injection for ovarian tissue damage in female cats. Each ovary of three cycling normal cats in reproductive age was punctured at four sites and 40 W was applied to 5 seconds at each point using monopolar electro-coagulation, resulting in 800 J (Joules) of thermal energy. Ovaries of another three cats were injected with 0.25 ml of 20% CaCl2 in 95% ethanol solution. Macroscopic and microscopic lesions were assessed depending on a number of evaluating criteria. Operative time, intraoperative and postoperative complications, and estrogen level estimation showed significant difference between both techniques. The cauterization technique proved easy applicable and safe, and there were no intra-abdominal thermal injuries. Histologic evaluation proved essential to clarify the ovarian functional activity. Ovarian cauterization seems to be feasible and safe, and 40 W (800 J) thermal energy allowed incomplete ovarian thermal damage. [ABSTRACT FROM AUTHOR]

Osteoarthritis is generally recognized as a common musculoskeletal condition in Indonesia, characterized by the degeneration of joint cartilage and narrowing of the joint space. The form of therapy that can be given to knee OA patients is a combination of TENS therapy and ultrasound diathermy (USD). WOMAC is an index used to measure osteoarthritis patiens based on pain, stiffness, and physical function. Patut Patuh Patju General Hospital is the only hospital in West Lombok district where physical medicine and medical rehabilitation have recently been introduced. This research aims to determine the effects of administering TENS and ultra sound diathermy on OA patients in the physical medicine and rehabilitation unit of Patut Patuh Patju Hospital, a newly established district hospital in NTB, which has been operational for the past year. This type of research uses a pre-experimental design with a one group pretest-posttest method. Sampling was taken using a purposive sampling technique with a total sample of 30. The research population was knee osteoartritis patients undergoing physiotherapy treatment at the Medical Rehabilitation Unit of Patut Patuh Patju General Hospital. Data was collected using the WOMAC questionnaire before and after 6 until 8 times therapy. The distribution of research data was analyzed using the Shapiro-Wilk test. If the data distribution is normal, it is analyzed using the paired t-test, whereas if it is not normal, it is analyzed using the Wilcoxon test. The combination of TENS therapy and ultra sound diathermy results in improvement of WOMAC scores in knee osteoarthritis patients with pvalue = 0.000 (p < 0.05). [ABSTRACT FROM AUTHOR]

Objective: The use of energy during minimally invasive surgery is associated with thermal damage that can affect the process of wound healing. Methods: This was a randomized clinical trial including 78 women who underwent total laparoscopic hysterectomy. Patients were randomized based on the device used for colpotomy, monopolar hook versus harmonic scalpel. The thickness of the cauterized margins in the cervicovaginal tissues of the hysterectomy specimens was measured by the pathologist. Results: The primary outcome was the amount of lateral thermal damage based on histologic assessment. Secondary endpoints included postoperative pain scores and postoperative complications. Baseline characteristics were comparable between the two groups. The amount of thermal injury in the monopolar group was significantly greater in only one region, the right lateral order of the cuff (3.85 ± 1.01 mm vs. 3.08 ± 0.95 mm (p = 0.001)). With regard to secondary outcome measures, there was no significant difference between the two groups. Conclusion: The use of the harmonic device was associated with significantly less tissue damage during colpotomy in the right lateral cuff region. This is especially important in overweight and obese women in whom the distance between the cervix and the ureter is shorter. Trial Registration https://en.irct.ir/trial/33902?revision=61236. IRCT20180130038567N2. [ABSTRACT FROM AUTHOR]

Copyright of Current Retina Journal / Güncel Retina Dergisi is the property of Anadolu Kitabevi Basim Yayim Medikal Turizm Kirtasiye Tic. Ltd. Sti. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic low back pain can severely affect quality of life. While several treatments are available, the combination of therapies often results in better outcomes. This study delves into the comparative effectiveness of combining monopolar dielectric diathermy radiofrequency (MDR) with supervised therapeutic exercise against the latter treatment alone. A randomized single-blind controlled trial was conducted. The intervention group (n= 30) received MDR with supervised therapeutic exercises for eight weekly sessions for four weeks. The control group (n= 30) received only the same exercise protocol. The following self-report measures were assessed before the first treatment session, at four, and 12 weeks: disability, pain, kinesiophobia, quality of life, sleep quality, emotional distress, isometric trunk strength, and trunk flexion range. Repeated ANOVA measures revealed significant time*group interactions for the McQuade test (p= 0.003), the physical role (p= 0.011), vitality (p= 0.023), social function (p= 0.006), and mental health subscales (p= 0.042). Between-group analyses showed significant differences for all outcomes at each follow-up: RMDQ (post-treatment, p= 0.040), ODI (post-treatment and 12-week, p= 0.040), VAS (p< 0.001), TSK (p< 0.001), and McQuade Test (p< 0.020). The combination of diathermy radiofrequency with supervised therapeutic exercise significantly surpasses the efficacy of supervised therapeutic exercise alone, showcasing improvements in pain, disability, kinesiophobia, lumbar mobility in flexion, and overall quality of life in patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

As the age profile of our population expands, we can expect subsequent increase in patients presenting with intracapsular fracture. The onus remains on the surgeon to make all reasonable efforts to find new and innovative means of reducing associated morbidity and mortality of the treatment of these injuries. This challenge is particularly relevant in the elderly and in patients with multiple co-morbidities. In this study, 100 patients were randomly allocated into two groups. One group had dissection to the level of the hip joint under direct diathermy control; the other group had dissection using a scalpel with supplementary electrocautery. Intraoperative total blood loss prior to dissection of the abductors was measured by collecting blood using wound swabs using a local protocol and results were statistically analysed using PROC GLM SAS. We demonstrate a clear advantage in the use of diathermy to create a hip incision showing a significant reduction in wound-related blood loss and a reduction, whilst not statistically significant, in total operative blood loss using diathermy incision. Larger randomised prospective trials are necessary to study the effects of this intervention in a larger patient population so that these end-points can be adequately assessed. [ABSTRACT FROM AUTHOR]

Introduction: Removing ventricular catheters, particularly those implanted for extended periods, poses significant challenges for neurosurgeons due to potential complications such as bleeding from adhesions to the ependyma or choroid plexus. Objective: This study aimed to review various techniques for safely removing ventricular catheters, emphasizing methods that minimize the risk of hemorrhagic complications. Methods: A comprehensive narrative review focused on techniques developed and documented in the literature for safely detaching ventricular catheters adhered to brain structures. Results: Various techniques have been identified that enhance the safety of catheter removal. Notably, the use of monopolar diathermy to coagulate and release adhesions has proven effective. Innovations such as insulated suction devices and the strategic use of flexible endoscopes have also contributed to safer removal procedures, minimizing the risk of damaging surrounding cerebral tissue and preventing catastrophic hemorrhage. Conclusion: The removal of ventricular catheters, especially those with long-term implantation, requires precise and cautious techniques to avoid severe complications. The study underscores the importance of adopting advanced surgical techniques and the continuous evolution of safer practices in neurosurgery. These methods not only ensure patient safety but also facilitate the handling of potentially complex and life-threatening situations during catheter removal. [ABSTRACT FROM AUTHOR]

Objective To observe the promoting effect of pulsed shortwave therapy on wound healing in pediatric patients with upper limb burns and explore its underlying mechanisms. Methods A total of 40 children with deep Ⅱ° upper limb burns treated in our hospital from June 2021 to June 2023 were enrolled, and randomly divided into a control group and an observation group, with 20 cases in each group. The control group received conventional dressings, and the observation group received conventional dressings combined with pulsed shortwave therapy. The wound healing time, first appearance of skin islands on the wound, and initial number of skin islands were observed and recorded using a camera. The proportion of granulation tissue area in the wound was observed using eKare inSight 3D. The positive rate of wound bacteria was detected by collecting wound secretions for bacterial culture examination. Blood flow perfusion on the wound was measured using a blood flow meter. Results The observation group showed significantly faster wound healing and initial appearance of epithelialization (P < 0.05), and obviously higher rate of granulation tissue growth than the control group (P < 0.05). Moreover, the observation group demonstrated better control of bacterial infection in the wounds than the control group (P < 0.05). Blood flow measurement results revealed no significant increase in blood flow perfusion after pulsed shortwave therapy in the observation group (P>0.05). However, with the elapse of time, both groups exhibited an increasing trend in blood flow perfusion (P < 0.05). Conclusion Pulsed shortwave therapy effectively promotes wound healing in pediatric patients with burns, by facilitating necrotic tissue clearance and granulation tissue regeneration, which may be associated with its non-thermal effects.

Abstract Monopolar capacitive diathermy is a physiotherapy technique that uses high-frequency currents to generate heat in deep tissues. This heat can have several therapeutic effects, especially in the treatment of chronic low back pain (CLBP), however, until now there is little evidence of this type of diathermy. The purpose was to evaluate the efficacy of a pulsed monopolar dielectric radiofrequency diathermy (PRF)-capacitive type versus simulated treatment on symptomatology of patients with CLBP. A single-blind randomised controlled trial was conducted. Sixty patients with CLBP were randomly assigned to a PRF-capacitive or a simulated treatment group. All participants received 3 sessions per week for 3 weeks. Disability, pain intensity, movement phobia, lumbar anteflexion, quality of life, and sleep quality were assessed at baseline, after treatment, and at two months. The application of 9 sessions of PRF-capacitive showed significant improvements compared to simulated therapy during the entire follow-up for disability (F = 26.99, p

Objective: To compare the cold steel method and bipolar diathermy in tonsillectomies in terms of posttonsillectomy hemorrhage. Study Design: Randomized Controlled Trial. Setting: Department of ENT, Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad. Period: 29th October 2020 to 1st June 2022. Methods: A total of 102 patients of both genders with ages 3 to 59 years undergoing tonsillectomy were included. Patients undergoing antiplatelet therapy, experiencing bleeding diathesis, possessing a high anesthetic risk, having uncontrolled medical conditions, suffering from anemia, or currently dealing with acute infections were not included in the study. Patients were divided into two groups A & B. Group A patients were operated by the Cold steel method and Group B were operated by Bipolar diathermy. All the surgeries were performed by the same surgical team. Both tonsils were fully exposed by Boyl Devi's mouth gag under general anesthesia. Complete removal of both tonsils was done with the Cold steel method in group A and by using Bipolar diathermy in group B. Post-operative hemorrhage (occurring 24 hours after surgery) without the necessity to return to the operation theatre for intervention was assessed. Results: The mean age of patients in group A was 20.0 ± 13.83 years and in group B was 19.12 ± 13.17 years. The majority of the patients 79 (77.45%) were between 3 to 30 years of age. Out of 102 patients, 63 (61.76%) were males and 39 (38.24%) were females with male to female ratio of 1.6:1. Frequency of secondary hemorrhage in Group A (cold steel method) was found in 01 (1.96%) while in Group B (bipolar diathermy) was 06 (11.76%) (p-value = 0.050). Conclusion: This study concluded that the frequency of post-tonsillectomy hemorrhage is higher in patients operated by bipolar diathermy as compared to the cold steel method. [ABSTRACT FROM AUTHOR]

BACKGROUND: Currently, the use of radiofrequency diathermy for the treatment of neck pain is booming. OBJECTIVE: This study aimed to evaluate the clinical efficacy of Digital Capacitive Diathermy (DCD®) on stiffness, pain, cervical range of motion, and cervical disability and to compare it with ultrasound (US) in patients with latent myofascial trigger point (MTrP) in the upper trapezius. METHODS: Nineteen participants with latent MTrPs in the upper trapezius were included in the assessor-masked, randomized, clinical crossover trial. Subjects were exposed to both interventions: US and DCD® and treatment effectiveness was measured by myotonometric variables, pressure pain threshold (PPT), visual analog scale (VAS), cervical side-bending flexion ranges, and the neck disability index scale (NDI). RESULTS: There were no significant differences between US and DCD® interventions regarding changes in outcome measures. The US group achieved a statistically significant difference of 2.16 to 1.13 points (p = 0.005; r = 0.646) for the VAS. The DCD® intervention showed a statistically significant improvement of 1.11 points for the NDI at 1-week following intervention (95% CI 0.14–2.07; p = 0.27; d = 0.217). CONCLUSION: Our findings suggest that DCD® and US can both be considered effective modalities for the treatment of latent MTrPs, having a longer duration of action with DCD® therapy. [ABSTRACT FROM AUTHOR]

Copyright of Fizioterapija is the property of Slovenian Association of Physiotherapists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: The main characteristic of fibromyalgia (FM) is generalized musculoskeletal pain. This may be accompanied by muscle and joint stiffness, sleep and mood disorders, anxiety and depression, cognitive dysfunction, and chronic fatigue. It is endemic in developed countries, with a higher prevalence among women than men, and its etiology is still unknown. Diagnosis is made based on chronic generalized pain and through the presence of tender points. The objective of this study was to analyze the efficacy of diathermy on pain in patients with fibromyalgia. (2) Methods: A single, blind, randomized experimental study was developed with a sample of 31 participants. Measurements were taken and recorded at three different intervals using the following measurement tools: the pressure pain threshold (PPT) at the tender points (TP) of the right and left trochanteric prominence with an algometer, the pain measurement scale, the Fibromyalgia Impact Questionnaire, the sleep quality index (PSQI, Pittsburgh), the Multidimensional Fatigue Inventory (MFI-S), and the scale for anxiety and depression (Hospital Anxiety and Depression Scale). Sociodemographic data were collected through Google Forms (age, height, weight, Body Mass Index). The intervention took place twice weekly across four weeks of sessions. (3) Results: Statistically significant results were obtained in the right and left trochanter PPT, as well as for anxiety and fatigue in the experimental group. The results obtained show that this treatment has managed to improve the quality of sleep, the impact of disease, chronic fatigue, and anxiety in patients with FM. (4) Conclusions: Diathermy is a tool that can help reduce pain. It can also improve the baseline levels of chronic fatigue, anxiety, the impact of the disease, and sleep quality in patients with fibromyalgia. [ABSTRACT FROM AUTHOR]

The cause of nasal obstruction in most of the patients is either nasal septal deviation or turbinate hypertrophy owing to vasomotor or perennial allergic rhinitis. Most cases of hypertrophic turbinate are usually mild and respond to antihistamine therapy, local decongestions, or allergy desensitization; however, surgery is required in some cases. In our present study, three surgical methods were used for inferior turbinoplasty i.e. Sub-mucous Diathermy, Coblation and Micro-debrider and patients were divided randomly in these groups. The efficacy and outcomes of these methods was compared on the basis of subjective and objective relief of symptoms and their safety, recurrence and post-operative morbidity. Out of 45 patients, highest number of patients belonged to 20–40 years of age with the mean age of 28.7 years and male female ration 0.78:1. All the patients were evaluated on the basis of preoperative Endoscopic grading of inferior turbinate and SNOT22 symptom scores (Sino Nasal Outcome Test 22), intra-operative timing and bleeding and post-operative pain, crusting, SNOT22 scores (Sino Nasal Outcome Test 22) and Endoscopic grading improvement in inferior turbinate. On comparing all the above methods, we found that Coblation and Micro- debrider were more or less equally effective and better than Sub-mucous diathermy for inferior turbinoplasty. Submucous diathermy has least benefits, still most commonly used method because of its simplicity, conventionality and least cost factor while other two methods need capital investment and higher learning curve of the surgeon. [ABSTRACT FROM AUTHOR]

Objective: To compare the use of Titanium clips and Monopolar diathermy for laparoscopic appendectomy mesoappendix closure in terms of operative time and cost. Study Design: Quasi-experiment study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Nowshera Pakistan, from Jul 2021 to Jun 2022. Methodology: A total of 70 patients who were diagnosed with acute appendicitis and were admited for laparoscopic appendectomy were randomly divided into two groups via the lotery method. In Group-A, the closure of the mesoappendix was done using Titanium clips, and in Group-B, the ligation of the mesoappendix was done using Monopolar diathermy. Patient outcomes in terms of operative time and procedure cost were assessed. Results: Out of 70 patients, 49(70.0%) were males and 21(30.0%) were females, aged 18 to 60 years, with a mean age of 37.57±7.71 years. The overal mean weight of the patients was 65.29±12.14 kg; height was 1.71±0.12 metres; and BMI was 24.96±5.23 kg/m2, respectively. Prolonged operative time was observed in 16(45.71%) patients in Group-A, compared to 7(20.0%) in Group-B (p-value 0.022). In Group-A, the total cost of the operation was Rs. 32,000, whereas in Group-B, it was Rs. 30,000 (p-value=0.001). Conclusion: This study concluded that Monopolar diathermy for the closure of the mesoappendix is beter in terms of operating time and cost as compared to the use of Titanium clips. [ABSTRACT FROM AUTHOR]

Objective: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions. Data sources: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years. Review methods: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts. Results: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain. Conclusions: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5–10 years. [ABSTRACT FROM AUTHOR]

Corneal neovascularization can impair vision and result in a poor quality of life. The pathogenesis involves a complex interplay of angiogenic factors, notably vascular endothelial growth factor (VEGF). This review provides a comprehensive overview of potential therapies for corneal neovascularization, covering tissue inhibitors of metalloproteinases (TIMPs), transforming growth factor beta (TGF-β) inhibitors, interleukin-1L receptor antagonist (IL-1 Ra), nitric oxide synthase (NOS) isoforms, galectin-3 inhibitors, retinal pigment epithelium-derived factor (PEDF), platelet-derived growth factor (PDGF) receptor inhibitors, and surgical treatments. Conventional treatments include anti-VEGF therapy and laser interventions, while emerging therapies such as immunosuppressive drugs (cyclosporine and rapamycin) have been explored. Losartan and decorin are potential antifibrotic agents that mitigate TGF-β-induced fibrosis. Ocular nanosystems are innovative drug-delivery platforms that facilitate the targeted release of therapeutic agents. Gene therapies, such as small interfering RNA and antisense oligonucleotides, are promising approaches for selectively inhibiting angiogenesis-related gene expression. Aganirsen is efficacious in reducing the corneal neovascularization area without significant adverse effects. These multifaceted approaches underscore the corneal neovascularization management complexity and highlight ideas for enhancing therapeutic outcomes. Furthermore, the importance of combination therapies and the need for further research to develop specific inhibitors while considering their therapeutic efficacy and potential adverse effects are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE: The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS: A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, 17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS: Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p < 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION: HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cervical radiculopathy is a common condition encountered in clinical practice and is characterized by compression or irritation of the nerve roots in the cervical spine. OBJECTIVE: To compare the effectiveness of manual intermittent cervical longitudinal mobilization (mICLM) and therapeutic modalities in managing acute, sub-acute and chronic radiculopathy pain. METHODS: This was a multicenter, double-blinded, randomized controlled trial. Individuals with radiculopathies were randomized into interventional; (IG, n = 18) receiving mICLM and control group; (CG, n = 17), receiving Microwave Diathermy (MWD) and transcutaneous electrical nerve stimulation (TENS) at the cervico-dorsal area daily for two weeks. The neck pain disability index (NPDI), numeric pain rating scale (NPRS), and global rating of change score (GRoC) were used as outcome measures. Statistical analysis was conducted using SPSS version 23.0. RESULTS: Both mICLM and MWD with TENS were equally effective in reducing the pain and disability in either group. However, it was noted that mICLM had a better impact on acute, sub-acute and chronic cases of radiculopathy pain comparatively. Mean age was 42.3 (SD = ± 10.9) years. 54.3% were between the age group of 40–60 years out of which 51.4% were male and 48.6% were female. 51.4% were in IG and 48.6% were in CG. The mean comparison of NPAD and NPRS within groups was significant with p < 0.01*. Post treatment mean comparison of NPAD outcomes in IG and CG remain significant with p = 0.004* and p < 0.01* respectively. The post NPAD and NPRS between IG and CG were found statistically insignificant with p = 0.75 and p = 0.57 respectively. CONCLUSION: mICLM and therapeutic modalities showed similar outcomes in managing radiculopathy pain. The study highlights the need for further research to understand the effectiveness of these interventions in larger patient populations. [ABSTRACT FROM AUTHOR]

Introduction: An incision is a slit or cut used to get access to deeper tissues. Electro cautery is a medical procedure that involves burning a specific portion of the body to remove or close it. Although worries of severe scarring and slower wound healing have limited its use for skin incision, electro-cautery is becoming increasingly often used for tissue dissection. Materials and methods: In this prospective randomised study, 60 patients undergoing mesh plasty for inguinal hernia were divided into two groups. In Group A, a skin incision is produced using electrocautery, while Group B uses a scalpel. The two groups are compared in terms of postoperative discomfort, wound complications, and the use of analgesics. Finally, the Mann-Whitney U Test is used to assess and compare the results for the two groups. Results: Pain will be measured six, twelve, and twenty-four hours after surgery using a graphical visual analogue scale. In the event that the pain score exceeds 4, INJ.DICLOFENAC 50 mg IM will be administered. In the post-operative phase, complications recorded in hospital stay are quantified by means of Seroma-discharge of serous collection at suture site, and Hematoma-blood collection. Conclusion: The outcomes of both groups, namely the diathermy and Scalpel groups, have been proven to be equivalent based on the findings of this research of the following: 1) postoperative pain, 2) the need for analgesics, and 3) wound complications after surgery. [ABSTRACT FROM AUTHOR]

Background. Edematous fibrosclerotic panniculopathy (EFP), commonly known as cellulite, is a cosmetic concern affecting a large percentage of women. Radiofrequency diathermy (RFD) and focused ultrasound (FUS) are noninvasive treatments proposed for the reduction of EFP. Objective. This study aimed to evaluate the efficacy of RFD versus FUS, both combined with intermittent pneumatic compression (IPC) for the treatment of EFP in female thighs. Methods. A randomized intrasubject assessor-blind trial was conducted (NCT03474523) on 40 lower limbs of 20 women with EFP grades I, II, or III according to the Nürnberger & Müller scale. Each lower limb was randomly assigned to receive either seven RFD sessions or seven FUS sessions, both combined with IPC. Measurements were collected at baseline and post-treatment, including lower limb circumferences at different levels, weight, grade of EFP, and physical activity level. Results. Both RFD and FUS treatments, both combined with IPC, showed significant intragroup reduction in thigh circumference measurements for RFD at 15 cm (p = 0.001), 20 cm (p = 0.024), and midpoint (p = 0.008) and for FUS at 15 cm (p = 0.001), 20 cm (p = 0.010), midpoint (p = 0.008), 30 cm (p = 0.020), and 40 cm (p = 0.048). No statistically significant differences were observed between the two treatments. Weight did not change with treatment, and physical activity levels did not significantly affect EFP improvement. Conclusion. Both RFD and FUS, combined with IPC, were effective noninvasive methods for treating EFP. This study found that there was no significant difference between RFD and FUS in terms of efficacy in reducing EFP in the thighs. Therefore, both techniques can be used to treat EFP from a clinical perspective. Further studies with objective measurements are required to confirm these results and to guide clinical decision-making. This trial is registered with NCT03474523. [ABSTRACT FROM AUTHOR]

Objective: To compare different tonsillectomy techniques in terms of postoperative bleeding incidence and postoperative pain. Methods: An arm‐based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were postoperative bleeding incidence and mean postoperative pain score. Results: A total of 6464 patients were included for five different interventions (cold dissection tonsillectomy; extracapsular coblation tonsillectomy; intracapsular coblation tonsillectomy [ICT]; bipolar diathermy tonsillectomy [BDT]; monopolar diathermy tonsillectomy). ICT showed the lowest absolute risk (4.44%) of postoperative bleeding incidence (73.31% chance of ranking first) and the lowest mean postoperative pain score (1.74 ± 0.68) with a 94.0% chance of ranking first, whereas BDT showed both the highest absolute risk of bleeding incidence (10.75%) and the highest mean postoperative pain score (5.67 ± 1.43). Conclusions: ICT seems to offer better postoperative outcomes, in terms of reduced risk of bleeding and reduced pain. Further prospective studies are advised to confirm these findings. Level of Evidence: NA Laryngoscope, 134:1696–1704, 2024 [ABSTRACT FROM AUTHOR]

The evidence-based treatment of patellofemoral pain (PFP) suggests that therapeutic exercise (TE) focused on improving muscle strength and motor control be the main conservative treatment. Recent research determined that the success of the TE approach gets improved in the short term by the addition of neuromodulation via radiofrequency diathermy (RFD). As there is no follow up data, the objective of this research is to assess the long-term effects of adding RFD to TE for the pain, function and quality of life of PFP patients. To this aim, a single-blind randomized controlled trial was conducted on 86 participants diagnosed of PFP. Participants who met the selection criteria were randomized and allocated into either a TE group or an RFD + TE group. TE consisted of a 20 min daily supervised exercise protocol for knee and hip muscle strengthening, while RFD consisted of the application of neuromodulation using a radiofrequency on the knee across 10 sessions. Sociodemographic data, knee pain and lower limb function outcomes were collected. The RFD + TE group obtained greater improvements in knee pain (p < 0.001) than the TE group. Knee function showed statistically significant improvements in Kujala (p < 0.05) and LEFS (p < 0.001) in the RFD + TE group in the short and long term. In conclusion, the addition of RFD to TE increases the beneficial effects of TE alone on PFP, effects that remain six months after treatment. [ABSTRACT FROM AUTHOR]

Introduction: The subject of thermometry and impact of thermal effect on the human body is still a topic known and discussed in medical care. One of the basic methods in clinical diagnosis is the measurement of body temperature. In biological tissues, there are two main types of reactions caused by optical radiation: photochemical and thermal. The effects of radiation exposure depend on its properties and physical parameters, including the amount of absorbed dose and the duration of exposure. In the case of thermotherapy as a therapeutic method, the appropriate choice of radiation type and the selection of physical parameters is a necessary condition for obtaining desired, beneficial therapeutic effects. The aim of the study is to investigate the thermal effect of non-ionizing radiation: infrared (IR), ultraviolet (UV) and electromagnetic field (EMF) induced in short-wave diathermy (MD), measured with classical thermometers and a thermal imaging camera. The thermal effect, as a result of overheating with three different factors: IR, UV, MD; and under the same conditions, is studied. The variation in temperature distribution in different phantoms is evaluated in order to delve into the subject of thermal effect regarding each radiation separately and to consider its suitability for medical diagnosis and therapy. Material and methods: The thermal effect study was carried out on two phantoms. The first phantom F1 - a wooden cuboid (27.0 x 7.0 x 7.5 cm) with five holes drilled at 5 cm intervals, into which thermometers were inserted (depth 5 cm). The second phantom - F2 was a biological tissue, the lower part of pork ham cut off along with the bone with fat covering and skin. Phantoms F1 and F2 were treated with an infrared heater (P1), a lamp emitting ultraviolet radiation (P2) and short-wave diathermy (P3); C and irradiation - 20 minutes, temperature measurements at intervals of 5 minutes, i.e. 5, 10, 15 and 20 minutes for the examined factors. During the experiment, temperature measurements were periodically made with the IR Thermal Radiometric Camera MobIR® M3. For obtaining reliability of the measurements, the whole trial was repeated 10 times. Before the thermograms were made, two-hour intervals were applied between successive measurements, maintaining a constant ambient temperature of 23°C. Results: With regard to UV radiation, there was an increase in the average temperature among the thermometers. This was particularly noticeable in the first thermometer with a 1.9% increase (up to 25.11 ± 0.29°C) above the ambient temperature (24.65 ± 0.34°C) after 15 minutes of measurements. After 20 minutes, the average temperature increase in thermometer 1 was 2.2% (up to 25.18 ± 0.23°C). A temperature increase in subsequent thermometers may be related to thermal conductivity and an increase of ambient temperature. In turn, for IR, an average 1.7% (to 25.16 ± 0.87°C) temperature increase of all thermometers was observed at 15 minutes and at 20 minutes, by 2.9% (to 25.48 ± 1.35°C) compared to baseline temperature (24.75 ± 0.47°C). Comparing the average temperature of thermometer 1 with the ambient temperature (24.75 ± 0.49°C), the highest increase of 12.8% (to 27.93 ± 0.69°C) was noted after 20 minutes of measurements. In diathermy, after 10 minutes, an increase in the average temperature in thermometer 1 was observed by 2.8% (to 25.69 ± 0.46°C) above the ambient temperature. The highest increase in average temperature was recorded in thermometers 1 and 5 in the 20th minute of measurements. Conclusions: All of the applied methods caused temperature increases in the used phantoms. The temperature distribution in the wooden phantom corresponds to that in the biological tissue for the interaction of infrared radiation (IR) and short-wave diathermy (MD), which was confirmed by thermovision. The increase in the internal temperature of the superheated biological structure corresponds to the increase in the distribution of the phantom's internal temperature. [ABSTRACT FROM AUTHOR]

Background: Electrosurgical devices are commonly used during mastectomy for simultaneous dissection and haemostasis, and can provide potential benefits regarding vessel and lymphatic ligation. The aim of this prospective RCT was to assess whether using a vessel-sealing device (LigaSure™) improves perioperative outcomes compared with monopolar diathermy when performing simple mastectomy. Methods: Patients were recruited prospectively and randomized in a 1 : 1 manner to undergo simple mastectomy using either LigaSure™ or conventional monopolar diathermy at a single centre. The primary outcome was the number of days the drain remained in situ after surgery. Secondary outcomes of interest included operating time and complications. Results: A total of 86 patients were recruited (42 were randomized to the monopolar diathermy group and 44 were randomized to the LigaSure™ group). There was no significant difference in the mean number of days the drain remained in situ between the monopolar diathermy group and the LigaSure™ group (7.75 days versus 8.23 days; P = 0.613) and there was no significant difference in the mean total drain output between the monopolar diathermy group and the LigaSure™ group (523.50 ml versus 572.80 ml; P = 0.694). In addition, there was no significant difference in the mean operating time between the groups, for simple mastectomy alone (88.25 min for the monopolar diathermy group versus 107.20 min for the LigaSure™ group; P = 0.078) and simple mastectomy with sentinel lymph node biopsy (107.20 min for the monopolar diathermy group versus 114.40 min for the LigaSure™ group; P = 0.440). Conclusion: In this double-blinded single-centre RCT, there was no difference in the total drain output or the number of days the drain remained in situ between the monopolar diathermy group and the LigaSure™ group. Registration number: EudraCT 2018-003191-13 BEAUMONT HOSPITAL REC 18/66. In this double-blinded single-centre RCT, there was no difference in the total drain output or the number of days the drain remained in situ between the monopolar diathermy group and the LigaSure™ group. Monopolar diathermy is at least as effective and significantly cheaper compared with LigaSure™. [ABSTRACT FROM AUTHOR]

Background: Many factors might lead to the development of patellofemoral pain syndrome (PFPS), a prevalent cause of anterior knee discomfort. Overuse from intense athletics or training, as well as issues with the alignment of the kneecap, are frequently important contributors. Purpose: The purpose of this article is to analyse the effectiveness of capacitive resistive diathermy on patellofemoral pain syndrome among the adult population. Methodology: Fifty subjects were based on inclusion and exclusion standards. The study's safety measures, risk considerations, and methodology were disclosed to the participants. The participants were all chosen using a practical sampling approach. The subjects were tested with Clarke's grind test and Vastus medialis coordination test and the treatment given to the patient is TECAR therapy for the duration of 15 minutes each day regularly for a period of 10 days under RET mode with the intensity of temperature according to patients sensitivity and tolerance. Results: The subjects who received TECAR therapy were significantly improved, the pain was much more reduced with the p value of <0.001 Conclusion: This study concluded that TECAR therapy was effective in subjects with patellofemoral pain syndrome. [ABSTRACT FROM AUTHOR]

Summary: Operating theatre fires are rare but can result in significant morbidity. A 76‐year‐old male with complex airway disease sustained superficial facial burns during an elective airway debulking procedure. His airway was being managed with high‐flow nasal oxygen at 70 l.min−1 and FiO2 1.0 delivered by Optiflow™ (Fisher and Paykel Healthcare Limited, Auckland, New Zealand). When suction monopolar diathermy was used to excise hyperkeratotic tissue beside his epiglottis, an arc was created to the tip of the suspension laryngoscope, followed by a jet of flame as the Optiflow circuit ignited. This resulted in burns to the patient's face and shoulder. He required admission to the intensive care unit and had a complicated postoperative course that included the need for surgical tracheostomy to facilitate weaning from mechanical ventilation. This case highlights the dangers of using high‐flow nasal oxygen alongside an ignition source. [ABSTRACT FROM AUTHOR]

The use of devices for tissue dissection and hemostasis during surgery is almost unavoidable. Electrically powered devices such as electrocautery, ultrasonic and laser units produce surgical smoke containing more than a thousand different products of combustion. These include large amounts of carcinogenic, mutagenic and potentially teratogenic noxae. The smoke contains particles that range widely in size, even as sms 0.007 µm. Most of the particles (90%) in electrocautery smoke are ≤6.27 µm in size, but surgical masks cannot filter particles smaller than 5 µm. In this situation, 95% of the smoke particles which pass through the mask reach deep into the respiratory tract and frequently cause various symptoms, such as headache, dizziness, nausea, eye and respiratory tract irritation, weakness, and abdominal pain in the acute period. The smoke can transport bacteria and viruses that are mostly between 0.02 µm and 3 µm in size and there is a risk of contamination. Among these viruses, SARS-CoV-2, influenza virus, HIV, HPV, HBV must be considered. The smoke may also carry malignant cells. The long-term effects of the surgical smoke are always ignored, because causality can hardly be clarified in individual cases. The quantity of the smoke changes with the technique of the surgeon, the room ventilation system, the characteristics of the power device used, the energy level at which it is set, and the characteristics of the tissue processed. The surgical team is highly exposed to the the surgeon experiencing the highest exposure. However, the severif exposure differs according to certain factors, e.g., ventilation by laminar or turbulent mixed airflow or smoke evacuation system. In any cae surgical smoke must be removed from the operation area. The most effective method is to collect the smoke from the source through an aspiration system and to evacuate it outside. Awareness and legal regulations in terms of hygiene, toxicology, as well as occupational health and safety should increase.

Abstract Background Lumbar disk herniation (LDH) is a cause of chronic low back pain (CLBP) treated using physical therapy (PT), including exercise and physical modalities such as ultrasound (US) and short wave diathermy (SWD). Despite the use of US and SWD, there is inconclusive evidence on their efficacy. The aim of this study was to investigate the efficacy of US and SWD in the treatment of CLBP in patients with LDH. Methods A prospective randomized control clinical study. Individuals with radicular CLBP and LDH on magnetic resonance imaging, presenting to the Physical and Rehabilitation Medicine Department were randomized into 3 treatment groups. All participants received 10 sessions of hotpack, transcutaneous nerve stimulation (TENS) and therapeutic exercises. In addition, Group 1 received 10 sessions of therapeutic US (1 MHz, 1.5W/cm2, 10 min), Group 2 SWD (27.12 MHz, wavelength 11.06 m, induction technique, 20 min) to the lower back. Group 3 (control group) received hotpack, TENS and therapeutic exercises alone. Visual analogue scale (VAS) for LBP, Modified Oswestry Disability Index (MODI) and Short Form 36 (SF-36) were evaluated pre and post treatment and at one and three months follow up. Results In all groups, VAS for LBP and MODI improved with treatment and at the one and three month follow up (p

Aims: Orthopaedic surgery uses many varied instruments with high-speed, high-impact, thermal energy and sometimes heavy instruments, all of which potentially result in aerosolization of contaminated blood, tissue, and bone, raising concerns for clinicians’ health. This study quantifies the aerosol exposure by measuring the number and size distribution of the particles reaching the lead surgeon during key orthopaedic operations. Methods: The aerosol yield from 17 orthopaedic open surgeries (on the knee, hip, and shoulder) was recorded at the position of the lead surgeon using an Aerodynamic Particle Sizer (APS; 0.5 to 20 μm diameter particles) sampling at 1 s time resolution. Through timestamping, detected aerosol was attributed to specific procedures. Results: Diathermy (electrocautery) and oscillating bone saw use had a high aerosol yield (> 100 particles detected per s) consistent with high exposure to aerosol in the respirable range (< 5 µm) for the lead surgeon. Pulsed lavage, reaming, osteotome use, and jig application/removal were medium aerosol yield (10 to 100 particles s-1). However, pulsed lavage aerosol was largely attributed to the saline jet, osteotome use was always brief, and jig application/removal had a large variability in the associated aerosol yield. Suctioning (with/without saline irrigation) had a low aerosol yield (< 10 particles s-1). Most surprisingly, other high-speed procedures, such as drilling and screwing, had low aerosol yields. Conclusion: This work suggests that additional precautions should be recommended for diathermy and bone sawing, such as enhanced personal protective equipment or the use of suction devices to reduce exposure. Cite this article: Bone Joint Res 2023;12(10):636–643.

Shortwave and microwave diathermy devices are commonly used in physical therapy as heating treatment. The rise in temperature occurs due to the flow of electric current in the treated area. Ions are evenly distributed in a predicted pattern from skin to deeper tissues. We hypothesise that the diathermy physiotherapy devices (DPDs) can be repurposed as a means of neutralisation of the Rabies virus (RABV) by exploiting the generated electric charges. In order to minimise the ohmic heating of the tissue, the pulsed output of the diathermy devices is preferred where the ‘on’ time of active energy emission is considerably shorter than the ‘off’ time. RABV proteins mediating cell invasion, cytoplasmic replication and budding, contain polar components that can be adversely affected by non-thermal electric phenomena. Repurposed DPDs can replace the Rabies immunoglobulin (RIG) by targeting the site of inoculation i.e. the area of the animal bite, provided that the delivered electric charges can reduce pathogenicity by altering key viral proteins. The modality is advantageous compared to conventional RIG since it can theoretically neutralise all Lyssavirus species, is not limited by the compartment syndrome, can intercept RABV even after it gains access to the peripheral neural network where conventional post-exposure prophylaxis is ineffective and is cost-effective in the long term. The principle of physical alteration of vulnerable proteins by electricity delivered by electromagnetic radiation is not limited to RABV, but may be applied to a spectrum of viral pathogens.

(1) Background: The main characteristic of fibromyalgia (FM) is generalized musculoskeletal pain. This may be accompanied by muscle and joint stiffness, sleep and mood disorders, anxiety and depression, cognitive dysfunction, and chronic fatigue. It is endemic in developed countries, with a higher prevalence among women than men, and its etiology is still unknown. Diagnosis is made based on chronic generalized pain and through the presence of tender points. The objective of this study was to analyze the efficacy of diathermy on pain in patients with fibromyalgia. (2) Methods: A single, blind, randomized experimental study was developed with a sample of 31 participants. Measurements were taken and recorded at three different intervals using the following measurement tools: the pressure pain threshold (PPT) at the tender points (TP) of the right and left trochanteric prominence with an algometer, the pain measurement scale, the Fibromyalgia Impact Questionnaire, the sleep quality index (PSQI, Pittsburgh), the Multidimensional Fatigue Inventory (MFI-S), and the scale for anxiety and depression (Hospital Anxiety and Depression Scale). Sociodemographic data were collected through Google Forms (age, height, weight, Body Mass Index). The intervention took place twice weekly across four weeks of sessions. (3) Results: Statistically significant results were obtained in the right and left trochanter PPT, as well as for anxiety and fatigue in the experimental group. The results obtained show that this treatment has managed to improve the quality of sleep, the impact of disease, chronic fatigue, and anxiety in patients with FM. (4) Conclusions: Diathermy is a tool that can help reduce pain. It can also improve the baseline levels of chronic fatigue, anxiety, the impact of the disease, and sleep quality in patients with fibromyalgia.

Abstract Background Our objective was to summarize, synthesize, and integrate the evidence evaluating the effectiveness of biophysical agents compared to other conservative treatments, for the management of carpal tunnel syndrome (CTS). Methods This was an overview of systematic reviews (SRs). We searched several online databases and obtained SRs relating to managing CTS using biophysical agents. Two independent researchers screened and appraised the quality of the SRs using the A MeaSurement Tool to Assess systematic Reviews-2 appraisal tool. We extracted information related to study characteristics as well as the effectiveness of biophysical agents for CTS, the effect sizes, and between-group significances. We categorized the information based on the type of biophysical agent. We also performed a citation mapping and calculated the corrected covered area index. Results We found 17 SRs addressing 12 different biophysical agents. The quality of the SRs was mainly critically low (n = 16) or low (n = 1). The evidence was inconclusive for the effectiveness of Low-level Laser therapy and favorable for the short-term efficacy of non-thermal ultrasound in improving symptom severity, function, pain, global rating of improvement, satisfaction with treatment, and other electrophysiological measures compared to manual therapy or placebo. Evidence was inconclusive for Extracorporeal Shockwave therapy, and favorable for the short-term effectiveness of Shortwave and Microwave Diathermy on pain and hand function. The corrected covered area index was lower than 35% indicating a low overlap of the SRs. Conclusions The findings were based on low-quality primary studies, with an unclear or high risk of bias, small sample sizes, and short follow-ups. Therefore, no recommendations can be made for the long-term effectiveness of any biophysical agents. High-quality evidence is needed to support evidence-based recommendations on the use of biophysical agents in the management of CTS. PROSPERO registration number CRD42022319002, registered on 17/04/2022

ABSTRACT Background: Anorectal functional pain syndrome, also called chronic proctalgia, represents a neglected clinical entity and often confused with other syndromes such as vulvodynia or acute proctalgia. It is a very often disabling disease with a consequent significant negative impact on the patient’s quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. To improve symptoms in functional anorectal pain syndromes, various rehabilitation techniques are used with the aim of promoting relaxation of the pelvic floor; however, to improve defecatory dynamics in patients with levator ani syndrome, only biofeedback has shown efficacy in a randomized study. The aim of this work is to evaluate whether a rehabilitation protocol with manometric biofeedback and radiofrequency diathermy (mt100 Fremslife emotion Tecar) reduces pain and paradoxical contraction of the levator ani and improves the quality of life in patients with anorectal pain syndromes. functional. Methods: This was a prospective study on 30 patients (20 women and 10 men) with anorectal functional pain syndrome and paradoxical contraction of the pelvic floor enrolled at the UOC of General, Minimally Invasive, Oncological and Obesity Surgery of the AOU “Luigi Vanvitelli” of Naples, Italy, from September 2021 to May 2022. All patients were evaluated with a coloproctological specialist visit followed by anorectal manometry and evaluation of altered clinical physiatric parameters (Brusciano Score). The protocol consisted of 10 rehabilitation sessions of the pelvic floor once a week and lasting approximately 45 minutes. During the sessions the patients were subjected to diathermy / radiofrequency treatment (10 minutes) with a static resistive electrode on the diaphragm, during which they were required to breathe diaphragmatically and to become aware of the perineal muscles, under the supervision of a physiotherapist; followed by application of diathermy with static capacitive (5 minutes) and resistive (10 minutes) electrode at the lumbar level. This was followed by the use of manometric biofeedback (15 minutes of tonic / phasic exercises) in order to instruct the patient on the reflex mechanism to obtain a voluntary relaxation of the external anal sphincter. The variables evaluated were Pain (VAS 0-10) and the questionnaire on the impact of colorectal and anal pathologies on the quality of life (CRAIQ-7) at the beginning, after 3 months and at the end of the treatment. Results: After 10 weeks, the rehabilitation treatment combined with diathermy and manometric biofeedback proved effective in the short term with a reduction in the scores of the Vas scale and CRAIQ-7 questionnaire and an increase in the percentage of release of the anal muscles on anorectal manometry. Conclusion: The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient.

Abstract Background Inferior turbinate hypertrophy is a common cause of chronic nasal obstruction with many procedures for management including submucosal diathermy and coblation with a variation in their techniques. The aim of this study was to assess the protective role of submucosal saline injection in the inferior turbinates prior to submucosal diathermy or coblation techniques. A prospective cohort study was conducted on 80 patients diagnosed with bilateral hypertrophied inferior turbinates causing persistent nasal obstruction and not responding to medical treatment. The patients were distributed randomly and equally between 2 groups. Group I included 40 patients operated on with coblation of the inferior turbinates. Group II included 40 patients operated on with submucosal diathermy of the inferior turbinates. The right side of the nose of both groups had a saline injection of the inferior turbinates before the procedure and the left side of the nose did not have such injection. Each side of the nose in every patient was assessed for the degree of nasal crusting at 1 week postoperative, the presence of turbinate gangrene at 3 weeks postoperative, and the visual analog scale (VAS) of four symptoms (nasal discomfort, nasal pain, nasal obstruction, and thick nasal discharge) at 1 week postoperative. Results In the coblation group, there was a significant difference between the right and left sides regarding the degree of crusting at 1 week postoperative, and a non-significant difference between the two sides regarding the presence of gangrene at 3 weeks postoperative. In the diathermy group, there was a significant difference between the right and left sides regarding the same parameters. Comparison between the injection and non-injection sides in each group regarding the nasal symptoms showed a highly significant difference between the two sides in each group favoring the injection side. Conclusion Saline injection prior to inferior turbinate coblation or submucosal diathermy had a protective effect against crusting with both techniques and gangrene formation with submucosal diathermy. This was reflected on better postoperative nasal symptoms.

Introduction Airway fire is a life-threatening complication in the operation table which is preventable. We report an incident of airway fire that occurred during a tracheostomy and discuss what went wrong. Case report A 48-year-old gentleman with carcinoma tongue and multinodular goiter underwent modified radical neck dissection, hemithyroidectomy, tracheostomy, hemi glossectomy, and free radial forearm flap reconstruction. During tracheal hemostasis with cautery, a flame appeared, and airway burns resulted. It was extinguished in a few seconds with wet mops, but the resultant combustion injury of the tracheobronchial tree and later bilateral pneumonia required multiple sittings of bronchoscopic toileting and intensive airway management for recovery. Discussion This report is to make anesthetists and surgeons aware of such a rare but life-threatening complication, its prevention, and early therapeutic steps which can prevent long-term complications and death.

Introduction It is generally accepted that the ideal method of tonsillectomy should have less operative time, blood loss, post-operative haemorrhage and morbidity.1 Objective: To compare post-operative pain, intra-operative blood loss and duration of surgery between cold dissection and bipolar diathermy dissection method of Tonsillectomy. Materials and Methods This study was a prospective and comparative hospital-based study. It was conducted from January 2021 - June 2022 at the Department of ENT of a tertiary referral hospital, Kolkata. 90 patients were included in this study fulfilling the inclusion and exclusion criteria. Results In bipolar diathermy method, the mean total blood loss (in ml) (mean±s.d.) of patients was 15.0778±4.6011 and in cold steel method it was 33.0000±5.8737. Post-operative pain for cold dissection on day 1, day 3 and day 10 was [4.4889±.6613], [2.0222±.7830] and [.3778±.4903] respectively. Post-operative pain for bipolar diathermy on day 1, day 3 and day 10 was [4.9556±.2084], [2.5778±1.0111] and [1.6222±.7474] respectively. Duration (in minutes) for bipolar diathermy dissection was [15.2889±1.9612] and for cold dissection it was [24.0444±2.3351]. Conclusion The blood loss and duration were less in bipolar diathermy method but post-operative pain was more as compared to cold steel method. Keywords Tonsillectomy, cold steel, bipolar diathermy, post-operative pain.

Abstract Background Post-circumcision penile ischemia is a devastating complication. We will present our experience in managing children with various forms of penile ischemia. Materials and methods This cohort prospective observational and interventional study was performed on all male children with post-circumcision penile ischemia between April 2017 and October 2021. A designed and approved protocol includes a combination of early pentoxifylline infusion, hyperbaric oxygen inhalation, early catheterization, and appropriate surgical debridement were applied for patients with deep ischemia 11/23, mainly the necrotic skin and subcutaneous tissues. Data of patient age, anesthesia method, monopolar diathermy usage, early presentation and positive wound culture were collected and analyzed statistically. Results During the study period 3,382 children were circumcised for non-medical reasons; 23 children were diagnosed with penile ischemia (0.7%), among other complications (9%). Most of the penile ischemia is associated with the use of monopolar diathermy (74%). The use of compressive wound dressing to control post-circumcision bleeding and infections is also responsible for ischemia in 52.2% and 43.5% of the cases. Inexperienced physicians were commonly responsible for ischemia (73.9%). Patients managed at first 24 h had better outcomes than those who were presented later (p = 0.001). Conclusion In children with post-circumcision penile ischemia, a combination of hyperbaric oxygen therapy and pentoxifylline is especially effective for patients with skin and facial necrosis, this management reduces penile tissue loss.

Abdulmajeed R Almalty,1,2 Hassan M Abdelnour,2 Mohannad Hawamdeh,1 Shadi A Alkhob2 1Department of Physical and Occupational Therapy, College of Allied Health Sciences, The Hashemite University, Zarqa, Jordan; 2Physical Therapy Department, College of Allied Health Sciences, Jerash University, Jerash, JordanCorrespondence: Abdulmajeed R Almalty, Department of Physical and Occupational Therapy, The Hashemite University, Zarqa, 13133, Jordan, Tel +962-7-97366912, Email abedmalty@hu.edu.joPurpose: It is known that electromagnetic fields and heat generated by shortwave diathermy (SWD) can have adverse effects on living tissue. The purpose of this research is to evaluate Jordanian physiotherapists’ knowledge of pulsed and continuous SWD contraindications. And investigate the potential contraindications about which Jordanian physiotherapists may have limited knowledge.Subjects and Methods: This cross-sectional study investigates Jordanian physiotherapists’ knowledge of SWD contraindications. In 38 private and public hospitals, a self-administered questionnaire survey was carried out. Participants were asked to classify 32 conditions as “always, sometime, or never” contraindicated or “I do not know”. Participants are physiotherapists with two or more years of postgraduate experience. Two forms comprised the survey. The first consisted of assessing their reaction to the contraindications of pulsed shortwave diathermy (PSWD), while the second consisted of continuous shortwave diathermy (CSWD).Results: Approximately 270 physiotherapists were eligible to participate in this investigation. Only 150 questionnaires were distributed to the therapists who agreed to the study. One hundred twenty-eight were returned for an average response rate of 85.3% (128/150). Respondents had good agreement about using SWD for cardiovascular condition, however, 24 respondents (19%) thought PSWD can be used over venous thrombosis. Only 64% of the respondents was aware that pacemakers are contraindicated for PSWD. Approximately 14% to 32% seem unaware that tuberculosis and osteomyelitis are contraindicated for both CSWD and PSWD. About 21% to 28% have been unaware that the use of PSWD is contraindicated for specialized tissues (eg, eyes, gonads, or malignant tissues) and 29% during pregnancy.Conclusion: Jordanian physiotherapists generally agreed on the widely acknowledged contraindications of CSWD for specific conditions. However, there was considerable uncertainty among Jordanian physical therapists about the contraindications of PSWD. This discrepancy highlights the need to improve physiotherapist awareness and for more fact-based research to the contraindication of SWD modality.Keywords: diathermy, electrotherapy, electromagnetic, deep heat

AbstractObjective: To verify that the TiO2 nanofilm dip-coated by sol-gel can reduce titanium alloy implants (TAI)’s heat production after microwave diathermy (MD).Methods: The effect of 40 W and 60 W MD on the titanium alloy substrate coated with TiO2 nanofilm (Experimental Group) and the titanium alloy substrate without film (Control Group) were analyzed in vitro and in vivo. Changes in the skeletal muscle around the implant were evaluated in ex vivo by histology.Results: After 20 min of MD, in vitro the temperature rise of the titanium substrate was less in the Experimental Group than in the Control Group (40 W: 1.4 °C vs. 2.6 °C, p

Background: Lumbar disk herniation (LDH) is a cause of chronic low back pain (CLBP) treated using physical therapy (PT), including exercise and physical modalities such as ultrasound (US) and short wave diathermy (SWD). Despite the use of US and SWD, there is inconclusive evidence on their efficacy. The aim of this study was to investigate the efficacy of US and SWD in the treatment of CLBP in patients with LDH. Methods: A prospective randomized control clinical study. Individuals with radicular CLBP and LDH on magnetic resonance imaging, presenting to the Physical and Rehabilitation Medicine Department were randomized into 3 treatment groups. All participants received 10 sessions of hotpack, transcutaneous nerve stimulation (TENS) and therapeutic exercises. In addition, Group 1 received 10 sessions of therapeutic US (1 MHz, 1.5W/cm2, 10 min), Group 2 SWD (27.12 MHz, wavelength 11.06 m, induction technique, 20 min) to the lower back. Group 3 (control group) received hotpack, TENS and therapeutic exercises alone. Visual analogue scale (VAS) for LBP, Modified Oswestry Disability Index (MODI) and Short Form 36 (SF-36) were evaluated pre and post treatment and at one and three months follow up. Results: In all groups, VAS for LBP and MODI improved with treatment and at the one and three month follow up (p < 0.001). In Groups 1 and 2, MODI scores continued to reduce at 1 and 3 months (p < 0.001 and p = 0.012 respectively). SF-36 physical, social function and pain parameters reduced in all groups (p < 0.05). Role limitation due to physical and emotional problems, emotional well-being, vitality and mental health improved in Groups 1 and 2 (p < 0.05). Conclusions: Deep heating agents can be used as part of the physical therapy for CLBP in those with LDH with positive mid-term effects. Trial registration: NCT03835182, 02/04/2019. [ABSTRACT FROM AUTHOR]