Diaphragmatic strengthening exercises for patients with post COVID-19 condition after mild-to-moderate acute COVID-19 infection: a randomized controlled study.

OBJECTIVE: To assess the clinical effects of incentive spirometry (IS) and diaphragmatic breathing (DB) in patients with post COVID-19 condition and diaphragmatic dysfunction as compared with the standard care alone. METHODS: The present longitudinal randomized study included 60 patients with post COVID-19 condition and diaphragmatic dysfunction. Patients were equally randomized to receive standard care plus IS (G1), standard care plus DB (G2) or standard care alone (G3) for 8 weeks. The primary outcome is clinical improvement as evaluated by the modified Medical Research Council (mMRC) dyspnoea scale. RESULTS: Comparison between the studied groups revealed significant improvement in G1 and G2 in all parameters at the end of follow-up. However, no significant improvement was found in G3. At the end of follow-up, 15 patients (75.0%) in G1, 11 patients (55.0%) in G2, and 3 patients (15.0%) in G3 showed improvement on the mMRC dyspnoea scale. Multivariate logistic regression analysis identified mild acute COVID-19 infection (p = 0.009), use of IS (p < 0.001), and use of DB (p = 0.023) as significant predictors of improvement on the mMRC dyspnoea scale. CONCLUSIONS: IS or DB training in addition to the standard care in post COVID-19 condition was associated with better clinical improvement as compared with the standard care alone.

Effect of home-based pulmonary rehabilitation on exercise capacity in post COVID-19 patients: a randomized controlled trail.

BACKGROUND: Coronavirus 2019 (COVID-19) is an epidemic condition that compromises various consequences. The goal of this study was to investigate the effect of home-based pulmonary rehabilitation on exercise capacity in patients with post COVID-19 syndrome. METHODS: The study was designed as a randomized control trial. A total of sixty-eight patients with post COVID-19 syndrome complaining of fatigue, dyspnea, and exercise intolerance participated in this study. Their ages ranged from 40 to 70 years old. The patients were randomly classified into two equal groups. The control group received usual medical care only, whereas the rehabilitation group received a selected home-based pulmonary rehabilitation exercise program plus the same usual medical care. The Physical Fitness Index (PFI), Chalder fatigue index, SF-36 questionnaire, dyspnea scale, and six-minute walk test (6 MWT) were measured before and after 12 weeks of intervention. RESULTS: The rehabilitation group showed a significant lower mean of Chalder fatigue (11.1 ± 0.94) and a higher mean of 6MWT (439.7 ± 25.3) and PFI (52.3 ± 10.2), in addition to a higher mean of the SF-36 Questionnaire (66.4 ± 3.7) and a significant improvement of dyspnea in the mMRC score (26.7%), grade 2, (63.3%), grade 1 (10%), and grade 0 with a p-value < 0.001 when compared to the control group. CONCLUSION: Home-based pulmonary rehabilitation (HBPR) for patients with post COVID-19 syndrome is effective and has a potential direct influence on exercise capacity, fatigue, dyspnea, and quality of life. HBPR could be considered an adjunctive, applicable, and low-cost therapy for patients with post COVID-19 syndrome. TRIAL REGISTRATION: The study was registered in Pan African Clinical Trial Registry as a clinical trial ID (PACTR202111640499636), November 2021.

Effect of different types of aerobic training on peak VO2 and ejection fraction for diastolic heart failure patients; a comparative randomized control trial.

BACKGROUND: Heart failure is described by a lack of confirmed efficient therapies and exercise intolerance. Engagement in physical activity decreases the possibility of adverse cardiovascular consequences involving heart failure. THE PURPOSE OF THE STUDY: Determine the effect of different types of aerobic training on peak VO2 and ejection fraction in diastolic heart failure patients. SUBJECT AND METHODS: The study was designed as a randomized control trail. Forty-eight eligible male patients with diastolic heart failure, aged between 50 and 65 years old, enrolled in this study. They were picked up from Police hospital outpatient clinic and were assigned to 2 equal groups in numbers. The first group (A) received aerobic exercise for the upper limb in the form of arm ergometer exercises, while the second group (B) received aerobic exercise for the lower limb in the form of cycling. Training duration for both groups was 3 sessions/week for 12 weeks. Peak VO2, and ejection fraction of both groups were measured and compared pre- and post-treatment. RESULTS: There was no significant difference (p > 0.05) in the ejection fraction between groups post-treatment. However, a significant increase (p < 0.001) was observed in the peak VO2 of group B when compared to group A post-treatment. CONCLUSION: There is no effect of different types of aerobic training on ejection fraction in diastolic heart failure patients, but lower limb exercise is more effective than upper limb exercise in improving peak VO2 in diastolic heart failure patients. Therefore, the current study recommended the use of lower limb exercise over upper limb exercise in training diastolic heart failure patients. CLINICAL TRIAL REGISTRATION: The study was registered in ClinicalTrial.gov as a clinical trial ID (NCT05637125).

Effect of high-intensity laser therapy versus shockwave therapy on selected outcome measures in osteoporotic long-term hemiparetic patients: a randomized control trial.

BACKGROUND: This study aimed to compare the effects of high-intensity laser therapy (HILT) and extracorporeal shock wave therapy (ESWT) in treating consequences of osteoporosis in hemiparetic patients. METHODS: A randomized controlled trial was conducted on hemiplegic patients with osteoporosis. They were randomly classified into three equal groups (n = 40 in each group). The control group received medication and traditional physiotherapy programs for stroke patients. The high-intensity laser (HIL) group received the same intervention as the control group in addition to high-intensity laser therapy. The shock wave (SW) group received the same intervention as the control group in addition to shock wave therapy. The three groups received an intervention that lasted 3 sessions/week for 12 weeks). All groups were assessed before and after therapy for the degree of pain, fall risk, and quality of life. RESULTS: A statistically significant difference (p < 0.05) was found concerning VAS, which had a significant difference in favor of HILT and ESWT groups compared to the control group; however, no significant difference was determined between HIL and SW groups. Regarding the overall stability index, SFBBS, and QUALEFFO-41, there was a significant difference in favor of HIL and SW groups compared to the control group, and a significant difference was found in HIL when compared to SW. CONCLUSION: The current study indicates that the combined traditional physical therapy and HILT and ESWT have clinical significance in improving osteoporotic long-term hemiparetic patients with more favor to HILT. TRIAL REGISTRATION: The study was registered as a clinical trial at ClinicalTrial.gov ID (NCT05616611).

Effect of electromagnetic therapy versus low-level laser therapy on diabetic patients with trigeminal neuralgia: a randomized control trial.

BACKGROUND: Trigeminal neuralgia (TN) is defined as intense, abrupt, often unilateral, stabbing, short, repeated episodes of pain in one or more distributional branches of the trigeminal nerve. AIM: To see how electromagnetic therapy (EMT) compared to low-level laser therapy (LLLT) affect TN in diabetes patients. DESIGN: This is a randomized controlled trial. SETTING: Physical therapy and Neurology Outpatients Clinics at Faculty of Physical Therapy. POPULATION: One hundred and forty diabetic patients with TN were evaluated for eligibility. As a result, 126 diabetic patients with TN were included in this trial. They were randomly divided into three equal-sized groups using random allocation software. Due to travel to another country, two patients did not complete the treatment protocol, and four opted out of the post-therapy evaluation. So, 120 volunteer diabetic patients with TN of both sexes were diagnosed for the participation in this study by a neurologist (N.=40 in each group). METHODS: For two months, participants in the control group A received the medication only (oral hypoglycemic drugs, Analgesics, vitamin B12), participants in the study group B received the medications as in group A in addition to LLLT, and participants in the study group C received medication as in group A in addition to electromagnetic therapy (EMT). The primary outcome was the amplitude of compound muscle action potentials of temporalis and masseter muscles by using NEXUS 10 (Mind media). The secondary outcome was pain intensity by using the Visual Analog Scale (VAS). RESULTS: According to the results of this study, there is a statistically significant difference in visual analog scale scores and the amplitude of compound muscle action potentials of the temporalis and masseter muscles among groups in favor of group B. CONCLUSIONS: After treatment, all groups improved significantly, with the laser group outperforming the electromagnetic group by a large margin. For irradiation, LLLT was more effective than EMT in reducing diabetic patients' trigeminal pain, and increasing masseter and temporalis muscles compound action potential amplitude in diabetic patients with TN. CLINICAL REHABILITATION IMPACT: LLLT was more effective than EMT at reducing diabetic patient's trigeminal pain, and increasing masseter and temporalis muscles compound action potential amplitude in diabetic patients with TN patients after two months of interventions.

Genetic variation among pumpkin landraces based on seed qualities and molecular markers.

BACKGROUND: Germplasm identification is an essential connection linking the conservation and exploitation of crop genetic resources in several plant breeding programs. This study highlights the biochemical and molecular variations in a collection of pumpkin genotypes representing four climate zones. The information could help improve germplasm management and sustainable exploitation of the neglected genotypes. METHODS AND RESULTS: Chemical characterization and genetic diversity among nine Egyptian landraces of pumpkin (Cucurbita moschata Duchesne) were estimated using Diode Array (DDA) Near Infra-Red (NIR) technology and the Inter simple Sequence Repeat markers (ISSR). Pumpkin seeds were collected from various geographical parts of Egypt. The spectroscopic properties of pumpkin seeds were used to quantify the fat, moisture, protein, ash, fiber, and total carbohydrate contents. The ten ISSR primers generated a total number of 46 genotype-specific bands, and the total polymorphism produced in the tested landraces was 63.58%. Based on the ISSR data, the polymorphism analysis divided the nine pumpkin landraces into two main groups, two subgroups, and four sub subgroups. The most diverse pumpkin landraces were Alexandria and Sohag, with a similarity percentage of 49.6%. However, the highest calculated similarity value was 88.3% between Matruh and Gharbia. The resultant genotype-specific bands can be used as markers for future genotypic characterization of pumpkins. CONCLUSIONS: The study results could be helpful in the chemical phenotypic characterization and the parental selection and planning for future breeding programs for pumpkin improvement.

Inhibition of ACE Retards Tau Hyperphosphorylation and Signs of Neuronal Degeneration in Aged Rats Subjected to Chronic Mild Stress.

With increasing life expectancy, Alzheimer's disease (AD) and other types of age-associated dementia are on the rise worldwide. Treatment approaches for dementia are insufficient and novel therapies are not readily available. In this context repurposing of established drugs appears attractive. A well-established class of cardiovascular drugs, which targets the angiotensin II system, is such a candidate, which currently undergoes a paradigm shift with regard to the potential benefit for treatment of neurodegenerative symptoms. In search for additional evidence, we subjected aged rats to chronic unpredictable mild stress, which is known to enhance the development of AD-related neuropathological features. We report here that four weeks of chronic mild stress induced a strong upregulation of the hippocampal angiotensin-converting enzyme (Ace) at gene expression and protein level. Concomitantly, tau protein hyperphosphorylation developed. Signs of neurodegeneration were detected by the significant downregulation of neuronal structure proteins such as microtubule-associated protein 2 (Map2) and synuclein-gamma (Sncg). Ace was involved in neurodegenerative symptoms because treatment with the brain-penetrating ACE inhibitor, captopril, retarded tau hyperphosphorylation and signs of neurodegeneration. Moreover, ACE inhibitor treatment could counteract glutamate neurotoxicity by preventing the downregulation of glutamate decarboxylase 2 (Gad2). Taken together, ACE inhibition targets neurodegeneration triggered by environmental stress.

Thyroid and Hepatic Haemodynamic Alterations among Egyptian Children with Liver Cirrhosis.

Background. Alterations in thyroid hormones regulation and metabolism are frequently observed in patients with cirrhosis. Aims. To assess alterations in thyroid volume (TV), haemodynamics, and hormones in patients with cirrhosis and their relation to hepatic arterial haemodynamics, and disease severity. Methods. Forty cirrhotic patients were compared to 30 healthy subjects regarding TV, free triiodiothyronine (fT(3)), free tetraiodothyronine (fT(4)), thyroid stimulating hormone (TSH), and pulsatility and resistance indices in the inferior thyroid and hepatic arteries. Results. TV (P = 0.042), thyroid volume standard deviation score (TVSDS, P = 0.001), Inferior Thyroid Artery Pulsatility Index (ITAPI, P = 0.001), Inferior Thyroid Artery Resistance Index (ITARI, P = 0.041), Hepatic Artery Pulsatility Index (HAPI, P = 0.029) and Hepatic Artery Resistance Index (HARI, P = 0.035) were higher among cases being highest in Child-C patients. FT(3) was lower in patients than controls (P = 0.001) and correlated negatively with ITAPI (r = -0.71, P = 0.021) and ITARI (r = -0.79, P = 0.011). ITAPI and ITARI correlated directly with HAPI and HARI (r = 0.62, P = 0.03, and r = 0.42, P = 0.04, resp.). Conclusions. Thyroid is involved in the haemodynamic alterations of cirrhosis. Routine study of thyroid by Doppler and assessment of thyroid functions should be performed in patients with cirrhosis to offer proper treatment if needed.