Neurocognitive Rehabilitation in COVID-19 Patients: A Clinical Review.

Abstract: COVID-19 has affected many people all around the world for more than two years now have suffered many long-term consequences which is commonly referred to as long-haulers. Despite multiorgan complaints in long haulers, symptoms related to cognitive functions commonly referred as brain fog are seen in the high risk covid patients with age more than 50, women more than men, obesity, asthma and those who experienced more than five symptoms during the first week of covid illness. Long term isolation has certainly contributed to high level of anxiety and stress calling for an empathetic response to this group of covid patients as there is no specific test to detect long haulers and no specific cognitive rehabilitation techniques available as of today.

An unusual presentation of hemiparesis: Rapidly progressing Streptococcal pneumoniae meningitis secondary to acute mastoiditis.

A sixty-three year-old male who arrived to our emergency department with signs and symptoms of an acute left middle cerebral artery cerebrovascular accident. Initial neurovascular imaging failed to demonstrate any abnormalities that explained his symptoms. His neurologic status rapidly deteriorated in conjunction with the development of severe sepsis. The patient required endotracheal intubation and was transferred to our intensive care unit. After an extensive diagnostic work-up, the etiology of his condition was determined to be due to bacterial meningitis originating from acute mastoiditis. Cultures of cerebrospinal fluid and peripheral blood grew Streptococcus pneumoniae. The patient improved with intravenous antimicrobials, intravenous dexamethasone and a left sided myringotomy with tympanostomy tube. The patient made a complete neurological recovery following this treatment.

A novel method to assess rate of force relaxation: reliability and comparisons with rate of force development across various muscles.

PURPOSE: The ability to generate quick submaximal muscle forces followed by quick relaxations is essential for various athletic and daily tasks. While force generation has been studied extensively, the studies of force relaxation are scarce. Therefore, we aimed to develop the rate of force relaxation scaling factor (RFR-SF) as a kinetic variable to assess the ability to relax submaximal muscle forces quickly. METHODS: Thirteen young adults performed rapid isometric force pulses to various submaximal levels in two different sessions. We compared RFR-SF with rate of development scaling factor (RFD-SF) in grip force muscles (GF), elbow (EE), and knee extensors (KE) and tested its reliability. Both RFD-SF and RFR-SF were calculated as the slopes of the linear relationship between peak forces and the corresponding peak rates of force development and relaxation, respectively. RESULTS: RFR-SFs were mainly different among the tested muscle groups (GF 8.22 ± 0.76 1/s; EE 7.64 ± 0.92 1/s; KE 6.01 ± 1.75 1/s) and there was no correlation among them (all p > 0.05). Within each tested muscle group, RFR-SF was lower than RFD-SF (GF 9.29 ± 1.05 1/s; EE 10.75 ± 0.87 1/s; KE 9.66 ± 0.89 1/s; all p < 0.001). The reliability of RFR-SF was moderate to good across the tested muscles (ICCs between 0.54 and 0.76 and all CVs < 15%). CONCLUSION: The RFR-SF is a clinically relevant kinetic variable that can reliably quantify the ability to relax a muscle force quickly. Future studies should assess both RFD-SF and RFR-SF as they represent different properties of the neuromuscular system.

Design of affordable and ruggedized biomedical devices using virtual instrumentation.

Abstract This paper presents the designs of four low-cost and ruggedized biomedical devices, including a blood pressure monitor, thermometer, weighing scale and spirometer, designed for the East African context. The design constraints included a mass-production price point of $10, accuracy and precision comparable to commercial devices and ruggedness to function effectively in the harsh environment of East Africa. The blood pressure device, thermometer and weighing scale were field-tested in Kenya and each recorded data within 6% error of the measurements from commercial devices and withstood the adverse climate and rough handling. The spirometer functioned according to specifications, but a re-design is needed to improve operability and usability by patients. This article demonstrates the feasibility of designing and commercializing virtual instrumentation-based biomedical devices in resource-constrained environments through context-driven design. The next steps for the devices include designing them such that they can be more easily manufactured, use standardized materials, are easily calibrated in the field and have more user-friendly software programs that can be updated remotely.