ABSTRACT
INTRODUCTION: Quantitative electromyography (QEMG) allows fast analysis of motor unit action potential (MUAP) parameters such as amplitude, duration, size index (SI), phases, turns and firing rate. When automated duration cursor placement is incorrect, the electrodiagnostician will manually edit this function potentially introducing bias to the final results. OBJECTIVE: To identify that (1) size index is the MUAP parameter least affected by manually editing duration cursors and (2) MUAP amplitude will influence the manual cursor correction rate. MATERIALS AND METHODS: Included were twenty-one consecutive patients who had QEMG with monopolar needle electrode for diagnostic evaluation of their myofascial pain symptoms. Evaluated for neck pain included 6 bilateral upper limb and cervical paraspinal muscles and for lower back pain were 5 bilateral lower limb and lower back muscles. Twenty MUAPs were recorded from each muscle and hardcopies of data obtained before and after manual edit. RESULTS: Of a total of 5360 MUAPs analyzed 1764 (33%) required manual editing of duration cursors. Cursor correction rate 120 MUAP s/individual muscle analyzed was also similar at 33+/-17%. Percentage change in duration more so than turns, before and after correction, was significantly larger than that of other parameters. No significant differences in percentage changes noted between SI and phases. CONCLUSIONS: SI and phases are least influenced by the manual correction of duration cursors since there is insubstantial amplitude and area at the tail-end of the MUAP.
Subject(s)
Action Potentials/physiology , Electromyography/methods , Muscle, Skeletal/physiopathology , Adult , Electromyography/statistics & numerical data , Facial Neuralgia/physiopathology , Female , Humans , Male , Middle Aged , Observer Variation , Reproducibility of Results , Time FactorsABSTRACT
INTRODUCTION: Automated and/or electrical twitch-obtaining intramuscular stimulation (ATOIMS & ETOIMS) evoke twitches at/or near motor end plate zones to relieve muscle pain. OBJECTIVES: To demonstrate that pain levels recorded daily by patients enable statistical process control (SPC) analysis of ATOIMS & ETOIMS effects over time. METHODS: Four chronic fibromyalgic patients received ATOIMS & ETOIMS treatments to bilateral C3-C8 and L3-S1 myotomes and recorded daily pain on a visual analogue scale. Mechanical stimulation with ATOIMS involved a custom device to insert, oscillate and retract a monopolar needle (MN) at 2 Hz x2s. ETOIMS involved manual insertion of the MN and stimulating with 5 Volts, 0.5 ms pulse duration at 2 Hz for 2s to multiple sites. Positive outcome measures include two pain scales reduction. RESULTS: Patient 1-4 had 89, 38, 40, 36 treatments during a follow-up time of 625, 1018, 378, 466 days with 5.4 +/- 3.7, 8.0 +/- 4.9, 4.2 +/- 2.4 and 4.6 +/- 2.7 days between treatments (DBT) during the first 6 months and 4.7 +/- 3.0, 21.8 +/- 15.6, 6.2 +/- 4.4 and 4.3 +/- 2.5 DBT respectively in the latter phase of the therapy. The average pain level (APL) in 1st week of treatment for patient 1-4 were 6.4 +/- 1.1, 3.7 +/- 1.1, 6.6 +/- 2.8 and 7.5 +/- 0.4 and in the last week of treatment were 4.5 +/- 0.4, 1.2 +/- 0.1, 4.2 +/- 1.0 and 4.7 +/- 0.7 respectively. APL correlated negatively with time during the first 6 months for patients 2-4 and also after 6 months for patients 4 & 1 who had unchanged and reduced DBT respectively. APL correlated positively with time for patient 2 with no correlation for patient 3 (both had increased DBT) after 6 months. CONCLUSIONS: Patients will chronically record their pain scales daily enabling analysis by SPC. ATOIMS & ETOIMS applied periodically can be helpful in relieving fibromyalgic pain.
Subject(s)
Electric Stimulation Therapy/statistics & numerical data , Fibromyalgia/physiopathology , Fibromyalgia/therapy , Motor Endplate/physiopathology , Muscle, Skeletal/physiopathology , Pain Management , Pain Measurement/statistics & numerical data , Pain/physiopathology , Process Assessment, Health Care/statistics & numerical data , Adult , Chronic Disease , Electromyography/statistics & numerical data , Female , Fibromyalgia/complications , Humans , Male , Middle Aged , Pain/etiology , Time FactorsABSTRACT
A case-control study was carried out on 311 tuberculous children under 5 years of age and 1536 non-tuberculous controls, matched for age, sex and the sector of residence, to evaluate the effectiveness of BCG vaccination of newborns in Rangoon, Burma. BCG vaccination status of both the cases and their matched controls was recorded. BCG vaccination in the newborn conferred 38% protection against the sum total of all forms of tuberculosis. The protective efficacy varied with the different forms of tuberculosis. It was only 20% for primary complex and 52% and 80% for tuberculous meningitis and disseminated tuberculosis, respectively. The protective effect of BCG vaccination was highest during the first 3 years after vaccination and then waned during the subsequent years. Although the protective efficacy seemed to be low, the impact of a BCG vaccination programme on the preventable deaths, neurological sequelae and the health services expenses is considerable.
Subject(s)
BCG Vaccine , Tuberculosis, Pulmonary/prevention & control , Child, Preschool , Humans , Infant, Newborn , Myanmar , VaccinationABSTRACT
BCG test reactions were studied in 1095 non-tuberculous children from 6 months to 5 years of age, who had received BCG vaccination in the newborn period, in order to find out the diagnostic value of the BCG test in previously BCG vaccinated children. Previous BCG vaccination has an effect on the BCG test reaction in the form of an accelerated BCG reaction. Although the degree of reaction decreases with time, 51.4% of children still showed a strongly accelerated BCG reaction 4 1/2-5 years after BCG vaccination. It is concluded that the BCG test cannot be used as a diagnostic test for tuberculosis in children under 5 years of age who have had previous BCG vaccination.
