Diagnostic Comparability of Ratio of Tissue Dielectric Constant (TDC) Between Patients with Lipedema and Those with Lower Limb Lymphedema (LLL): A Prospective Observational Study.

Lipedema is usually thought of as a dis-ease of women. Potentially diagnostic comparative data is needed between patients with lip-edema and those with lower limb lymphedema (LLL). Since there is no gold standard to diagnose lipedema, some promising modalities such as Tissue Dielectric Constant (TDC) need to be investigated among patients with lipedema and lymphedema. This study was completed with a total of 26 patients (14 lipedema, 12 LLL). Local tissue water was assessed with Moisture MeterD compact (DelfinTech, Kuopio, Finland) according to the TDC method at 300 MHz within a 2.5 mm tissue penetration depth via the following reference points: Thigh, calf (20 cm upper and lower point of knee level, respectively), and malleoli (5 cm upper point of medial malleolus). Patients with LLL showed significantly higher TDC values and interlimb TDC ratios in all affected points and unaffected malleolus points compared to patients with lipedema. No significant difference was achieved between genders with LLL in all reference points. The area under the curve (AUC) for thigh, calf, and malleolus reference points were found as 0.851 (95%CI .678-1.00), 0.801 (95% CI 0.612-0.989) and 0.786 (95%CI 0.596-0.976), respectively. Patients with LLL showed significantly higher TDC values compared to patients with lipedema, these differences should be carefully interpreted in patients with bilateral LLL and those with lipo-lymphedema.

A new era of seeking knowledge for #lymphedema on social media: A detailed Instagram hashtag analysis.

Instagram® is one of the most active social media platforms with over a billion users worldwide. Since the importance of education on lymphedema has been established due to the chronic nature of the disease, seeking knowledge attracts much attention not only clinically but also on social platforms such as Instagram ®. Our aim was to examine content by analyzing posts tagged with hashtags on Instagram ® related to lymphedema. Nine predefined hashtags related to lymphedema were used to search posts uploaded to Instagram® via the Apify tool. Retrieved public posts were classified and analyzed by four researchers for their content and post-type. We found that the vast majority of sharing on Instagram® in the context of lymphedema and its related aspects have relatively low scores for both relevancy and accuracy with a 77% irrelevancy rate. The best posts were those determined to be educational, which were found 57% relevant and correct. Medical professionals should consider that disseminating true guidance and therapy carries importance for patients with lymphedema and treatment success. The ability for patients to reach knowledge via social media might also be an important aspect in reliving suffering due to lymphedema. However, our results demonstrate that Instagram® might not be a good platform for patients to discover reliable information about lymphedema.

Intra-observer and inter-observer reliability of leg circumference measurement among six observers: a single blinded randomized trial.

Hypothesis: Circumference measurement of extremities that was reported to be a reliable method as long as being standardized is commonly used both in clinical and home settings by clinicians or caregivers due to its cheapness and easy use. Objectives: The aims of this study were to determine the inter-observer and intra-observer reliability of manual circumference measurement among different observers and various measurement points. Methods and Results: A total of 58 lower limbs were included in the study. Both lower limbs of each subject were assessed by 6 observers randomly using circumference measurement method from 9 reference points specified with a Leg-O-Meter. All observers performed the measurements and they were blind to each other's measurements. Results: Measurement results from reference points were statistically significant between good to perfect (ICC 0.65-0.99, p<0.001). Interrater reliability of all observers' first and second measurements showed perfect reliability for both measurements (ICC: 0.92-0.99, p<0.001). Conclusions: This study demonstrated that the lower extremity manual circumference measurement is a reliable method for clinical practice. Abbreviations: BMI = Body Mass Index, ICC = Intraclass Correlation Coefficient, Metatarsal heads (cA), Ankle-heel (cY), Ankle (cB), Distal beginning point of gastrocnemius (cB1), The widest point for gastrocnemius (cC), Head of fibula (cD), Midline of knee (cE), Midline of thigh (cF), Groin level (cG).

The comparison of EMG-biofeedback and extracorporeal magnetic innervation treatments in women with urinary incontinence.

PURPOSE: This study aimed to compare the effectiveness of EMG-biofeedback (EMG-BF), extracorporeal magnetic innervation (ExMI), and pelvic floor muscle training (PFMT) treatments on women with stress urinary incontinence (SUI). Materials and Meth- ods: The study included 67 women with SUI. Pelvic floor muscles (PFMs) were evaluated with electromyography and the quality of life (QoL) with Incontinence Quality of Life (I-QoL) questionnaire; afterwards, the subjects were divided into three groups; EMG-BF group (n=23), ExMI group (n=20), and PFMT group (n=24). EMG-BF group and ExMI group were given training in urogynecologi- cal physiotherapy clinic. PFMT group were given eight-week home exercises. Each group was assessed before training and after eight weeks. RESULTS: All three groups showed a significant improvement in EMG activity values and average QoL scores. The greatest im- provement was observed in the EMG-BF training group for QoL scores. CONCLUSIONS: This study demonstrated that all of the three methods performed with the purpose of increasing PFM strength were effective. The increase in PFM strength reduces incontinence associated symptoms and thus improves Qol.

Morphometric and meristic variation in two congeneric archer fishes Toxotes chatareus (Hamilton 1822) and Toxotes jaculatrix (Pallas 1767) inhabiting Malaysian coastal waters.

A simple yet useful criterion based on external markings and/or number of dorsal spines is currently used to differentiate two congeneric archer fish species Toxotes chatareus and Toxotes jaculatrix. Here we investigate other morphometric and meristic characters that can also be used to differentiate these two species. Principal component and/or discriminant functions revealed that meristic characters were highly correlated with pectoral fin ray count, number of lateral line scales, as well as number of anal fin rays. The results indicate that T. chatareus can be distinguished from T. jaculatrix by having a greater number of lateral line scales, a lower number of pectoral fin rays, and a higher number of anal fin rays. In contrast, morphometric discriminant analyses gave relatively low distinction: 76.1% of fish were ascribed to the correct species cluster. The observed morphometric differences came from the dorsal and anal spines lengths, with T. chatareus having shorter dorsal and longer anal spines than T. jaculatrix. Overall, meristic traits were more useful than morphometrics in differentiating the two species; nevertheless, meristics and morphometrics together provide information about the morphological differentiation between these two closely related archer fishes.

Effects of mechanical massage, manual lymphatic drainage and connective tissue manipulation techniques on fat mass in women with cellulite.

OBJECTIVE: To evaluate and compare the effectiveness of three different noninvasive treatment techniques on fat mass and regional fat thickness of the patients with cellulites. METHODS: Sixty subjects were randomized into three groups. Group 1 (n = 20) treated with mechanical massage (MM), group 2 (n = 20) treated with manual lymphatic drainage (MLD) and group 3 (n = 20) treated with connective tissue manipulation (CTM) techniques. Subjects were evaluated by using standardized photographs, body composition analyzer (TBF 300) (body weight (BW), body mass index (BMI), fat %, fat mass (FM), fat free mass (FFM), total body water (TBW)), circumference measurement from thigh, waist-hip ratio (WHR), fat thickness measurements from abdomen, suprailium and thigh regions with skin fold caliper. RESULTS: All groups had an improvement in thinning of the subcutaneous fat after the treatment (P < 0.05). Thigh circumference decreased by an average of 0.5 cm in all groups and thigh fat thickness decreased 1.66 mm in Group 1, 2.21 mm in Group 2 and 3.03 mm in Group 3. Abdomen and suprailium fat thicknesses decreased 2.4 and 2.58 mm in Group 1, 1.78 and 2 mm in Group 2 and 1.23 and 0.64 mm in Group 3, respectively. The mean difference in waist-hip ratio was 0.1 cm in all groups. CONCLUSION: All the treatment techniques are effective in decreasing the regional fat values of the patients with cellulites.

Population growth, trophic level, and reproductive biology of two congeneric archer fishes (Toxotes chatareus, Hamilton 1822 and Toxotes jaculatrix, Pallas 1767) inhabiting Malaysian coastal waters.

Population growth, trophic level, and some aspects of reproductive biology of two congeneric archer fish species, Toxotes chatareus and Toxotes jaculatrix, collected from Johor coastal waters, Malaysia, were studied. Growth pattern by length-weight relationship (W=aL(b)) for the sexes differed, and exhibited positive allometric growth (male, female and combined sexes of T. chatareus; female and combined sexes of T. jaculatrix) and isometric growth (male samples of T. jaculatrix only). Trophic levels of both species were analyzed based on 128 specimens. The results show that, in both species, crustaceans and insects were the most abundant prey items, and among crustaceans the red clawed crab Sesarma bidens and Formicidae family insects were the most represented taxa. The estimated mean trophic levels for T. chatareus and T. jaculatrix were 3.422+/-0.009 and 3.420+/-0.020, respectively, indicating that they are largely carnivores. Fecundity of T. chatareus ranged from 38 354 to 147 185 eggs for females with total length ranging from 14.5 to 22.5 cm and total body weight from 48.7 to 270.2 g, and T. jaculatrix 25 251 to 150 456 eggs for females with total length ranging from 12.2 to 23.0 cm and total body weight from 25.7 to 275.0 g. Differences in values of gonadosomatic and hepatosomatic indexes calculated for both species in this study may have resulted from uneven sample size ranges.

Isolation of dinucleotide microsatellite markers in commercially threatened Malaysian Mahseer, Tor tambroides.

Seven single locus dinucleotide microsatellite markers were developed to characterize an economically important sport fish and food fish in Malaysia and in Southeast Asia. They were obtained by using a rapid method namely the 5' anchored PCR enrichment protocol. The specific primers were designed to flank the repeat sequences and these were subsequently used to characterize 120 unrelated fish from Malaysia and 30 fishes from Indonesia. The number of alleles per locus ranged from 2 (SYKVJ1-11) to 6 (SYKVJ1-4) while the levels of heterozygosity ranged from 0.0472 (SYKVJ1-11) to 0.7745 (SYKVJ1-2).