A double-blind, randomized, multicentric, placebo-controlled clinical trial of antarth, a phytomedicine, in the treatment of osteoarthritis

Objective:

To test Antarth, a polyherbal phytomedicine, for its efficacy and safety in patients with osteoarthritis (OA) and compared with placebo.

Material and Methods:

A total of 90 male or female adult patients who were diagnosed clinically and radiologically with OA were recruited in the study. Antarth or placebo was given 2 capsules b.i.d. for 3 months and the patients were assessed every month for its efficacy. Diclofenac sodium was allowed to be taken as rescue medication.

Results:

After 3 months of treatment, the reduction in severity of pain on Visual Analog Scale (VAS) was more in Antarth group compared to placebo but the difference between the two groups was not significant. However, pain during functioning of disabled joints while walking distance, squatting, sitting cross-legged and climbing steps were significantly reduced in Antarth group compared to placebo (P < 0.05). Reduction in consumption of rescue medication, diclofenac sodium, was more in Antarth than in placebo group.

Conclusions:

In Patients’ Global Assessment, patients treated with Antarth were more satisfied than the ones treated with placebo. Observations were similar in Physicians’ Global Assessment too. There were no adverse events in both the groups.     

Consuming eggs for breakfast influences plasma glucose and ghrelin,while reducing energy intake during the next 24 hours in adult men

We hypothesized that consuming eggs for breakfast would significantly lower postprandial satiety and energy intake throughout the day. Using a crossover design, 21 men, 20 to 70 years old, consumed 2 isoenergetic test breakfasts, in a random order separated by 1 week. The macronutrient composition of the test breakfasts were as follows: (EGG, % CHO/fat/protein = 22:55:23) and (BAGEL, % CHO/fat/protein = 72:12:16). Fasting blood samples were drawn at baseline before the test breakfast and at 30, 60, 120, and 180 minutes after breakfast. After 180 minutes, subjects were given a buffet lunch and asked to eat until satisfied. Subjects filled out Visual Analog Scales (VAS) during each blood draw and recorded food intake the days before and after the test breakfasts. Plasma glucose, insulin, and appetite hormones were analyzed at each time point. Subjects consumed fewer kilocalories after the EGG breakfast compared with the BAGEL breakfast (P< .01). In addition, subjects consumed more kilocalories in the 24-hour period after the BAGEL compared with the EGG breakfast (P < .05). Based on VAS, subjects were hungrier and less satisfied 3 hours after the BAGEL breakfast compared with the EGG breakfast (P < .01). Participants had higher plasma glucose area under the curve (P < .05) as well as an increased ghrelin and insulin area under the curve with BAGEL (P < .05). These findings suggest that consumption of eggs for breakfast results in less variation of plasma glucose and insulin, a suppressed ghrelin response, and reduced energy intake.     

The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women

Objectives: To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women.

Methods: This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n?=?51), or a supine position modified to 45 degree of semi-fowler (n?=?51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups.

Results: The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p?Conclusions: In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.     

三维医学影像分析系统上气道建模在儿童阻塞性睡眠呼吸暂停低通气综合征研究中应用的初探

目的　探讨三维医学影像分析系统（3D medicalimage analysis,3DMIA）软件在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿上气道建模中的应用前景。方法  30例经多导睡眠监测确诊OSAHS患儿,分别于睡眠和清醒时通过螺旋CT采集资料,借助3DMIA软件构建患儿自鼻咽到声门上整个上呼吸道的三维模型,并借助软件算法进行上气道容积、气道最小横截面积的测量。结果　30例患儿睡眠时的上气道容积和气道横截面积均明显小于清醒时,其差异有显著统计学意义（t =9.392、9.256,P 均＜0.01）。结论　借助3DMIA软件建模并进行算法测量较传统放射学方法,能更客观的评价OSAHS患儿的上气道狭窄范围和程度,在OSAHS患儿的上气道形态和功能研究方面具有较好的应用前景。     

眩晕残障量表在良性阵发性位置性眩晕筛查诊断中的价值

目的：探讨眩晕残障量表(Dizziness Handicap Inventory,DHI)在筛查初诊眩晕患者时鉴别诊断良性阵发性 位置性眩晕(benign paroxysmal positional vertigo,BPPV)的价值。方法：收集2016年4月至2017年2月在南方医科大学南方 医院耳鼻咽喉科门诊就诊的以眩晕或头晕为主诉的患者322位,自行填写中文版DHI和视觉模拟量表(Visual Analogue Scale,VAS)。经详细的前庭功能检查,将患者分为BPPV组、前庭检查正常组和前庭检查异常组。结果：BPPV组 的DHI-2项得分为5.52±2.10,明显高于前庭检查正常组(3.94±2.91)(t=3.847,P<0.01)和前庭检查异常组(4.17±2.74) (t=4.149,P<0.01),3组间DHI-2项得分差异有统计学意义(F=9.870,t=4.515,P<0.01)。BPPV组的DHI-条目13得分为 3.09±1.39,明显高于前庭检查正常组(1.97±1.63)(t=4.515,P<0.01)和前庭检查异常组(1.95±1.70)(t=5.305,P<0.01),3组 间DHI-条目13得分差异有统计学意义(F=16.402,P<0.01)。BPPV组、前庭检查正常组、前庭检查异常组之间VAS得分 比较,差异有统计学意义(P<0.05)。但进一步的两组之间的t检验发现：BPPV组和前庭检查异常组之间的差异有统计 学意义(P<0.05),而BPPV组和前庭检查正常组之间差异无统计学意义(P>0.05)。结论：DHI-2项和DHI-条目13在初诊 眩晕患者时,应该加入到病史询问中去,从而可有效、快速地鉴别BPPV。     

针刺加耳穴贴压治疗紧张性头痛的临床研究

目的:观察针刺加耳穴贴压治疗紧张性头痛(TTH)的临床疗效.方法:将90例TTH患者采用随机数字表法分为针刺组、耳穴贴压组和观察组,每组30例.观察组接受针刺及耳穴贴压治疗,针刺组仅接受针刺治疗,耳穴贴压组仅接受耳穴贴压治疗.观察治疗前、治疗后及治疗后3个月随访时的头痛发作频率,以及头痛程度视觉模拟量表(VAS)、焦虑...     

Using crowdsourced analog patients to provide feedback on physician communication skills

ObjectiveEffective physician-patient communication is important, but physicians who are seeking to improve have few opportunities for practice or receive actionable feedback. The Video-based Communication Assessment (VCA) provides both. Using the VCA, physicians respond to communication dilemmas depicted in brief video vignettes; crowdsourced analog patients rate responses and offer comments. We characterized analog patients’ comments and generated actionable recommendations for improving communication.MethodsPhysicians and residents completed the VCA; analog patients rated responses and answered:“What would you want the provider to say in this situation?” We used qualitative analysis to identify themes.ResultsForty-three participants completed the VCA; 556 analog patients provided 1035 comments. We identified overarching themes (e.g., caring, empathy, respect) and generated actionable recommendations, incorporating analog patient quotes.ConclusionWhile analog patients’ comments could be provided directly to users, conducting a thematic analysis and developing recommendations for physician-patient communication reduced the burden on users, and allowed for focused feedback. Research is needed into physicians’ reactions to the recommendations and the impact on communication.Practice implicationsPhysicians seeking to improve communication skills may benefit from practice and feedback. The VCA was designed to provide both, incorporating the patient voice on how best to communicate in clinical situations.     

Concurrent validity of electronic von Frey as an assessment tool for burn associated pain

An important challenge in pain assessment is the inability of an evaluator to corroborate, using objective signs or indicators, the subjective pain report of a patient. In this scenario, the Electronic von Frey (EVF) anaesthesiometer rises as a valuable Quantitative Sensory Testing modality for pain evaluation. Although EVF showed good reproducibility when applied to healthy areas in humans, its use for evaluation of burn-related pain threshold has not yet been validated. The present study demonstrated the concurrent validity of EVF by determining its correlation with the traditionally used Visual Analog Scale (VAS). EVF was compared to VAS through pain measurements obtained from 44 patients with superficial partial thickness burns treated with silver sulfadiazine. A very good and significant positive correlation between both methods was detected. Baseline clinical and demographic parameters did not significantly affect the association between EVF and VAS. Additionally, EVF had significant and moderate positive correlation with the amount of analgesic used and with the Burns Specific Pain Anxiety Scale scores. Regular pain assessment is essential for the establishment of an appropriate treatment plan; thus, it is critical that we continue to refine our pain assessment skills to avoid chronic pain and psychological trauma in burn patients.     

不同模拟滤波参数对中潜伏期反应的影响

文中测试了10例听力正常人中潜伏期反应,研究采用不同高通和低通模拟滤波参数对其影响.结果表明采用滤波频带为25～500Hz或者更窄,同一受体和个体差异的中潜伏期反应波形变异性明显减少.采用滤波频带小于25～500Hz则显著性影响Pa潜伏期,然而,将低通滤波设置从500Hz上升至3000Hz,Pa潜伏期几乎无变化.认为选择滤波频带为25～500Hz既可减少中潜伏期反应波形变异性,又可避免中潜伏期彼形的失真.