Influences of high vs. low-intensity exercises on muscle strength, function, and quality of life in post-COVID-19 patients with sarcopenia: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of high vs. low-intensity exercise training on muscle strength, physical function, and quality of life in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease (CKD). PATIENTS AND METHODS: 82 subjects were randomized into 2 groups: high intensity (HIG, n=42), which received high-intensity resistance training, and low intensity (LIG, n=40), which conducted low-intensity aerobic activities. Exercises were performed for 30 min, 3 times per week for 6 weeks. A handheld dynamometer, pinch press, and 1 min sit-to-stand (STS) test were used to assess muscle strength. Modified physical performance test and sarcopenia Quality of Life questionnaire (SAR-QoL) were used to assess function and quality of life, respectively. Measures were collected before and at the end of the treatment program. RESULTS: Participants were similar at baseline. The within-group comparisons demonstrated statistically significant improvement in both HIG and LIG groups in all outcome measures (p<0.001). Between groups, comparisons revealed statistically significant better achievements with high effect size in Modified Physical Performance Test (MMPT) (p<0.001, d=1.28), handgrip (p<0.001, d=3.6), STS (p<0.001, d=2.38), and SAR-QoL (p<0.001, d=3.24) in favor of the HIG. On the other hand, pinch press strength was equally improved in both groups (p=0.09, d=0.36). CONCLUSIONS: High-intensity exercise is better than low-intensity exercises in post-COVID-19 patients with sarcopenia secondary to chronic kidney disease regarding muscle strength, physical function, and quality of life.

Efficacy of neuromuscular electrical stimulation of calf muscles on nocturnal symptoms and quality of life in asthmatic children.

OBJECTIVE: To determine whether neuromuscular electrical stimulation of calf muscles could improve nocturnal symptoms and quality of life in asthmatic children. PATIENTS AND METHODS: Sixty children (8-12 years) with moderate asthma were randomly allocated to three groups (A, B, and C). The three groups completed 12 weeks of supervised breathing exercises for 30 min. In addition, group A completed neuromuscular electrical stimulation of the calf muscles and group B completed aerobic exercise in the same period. The intervention was conducted five days a week for 12 consecutive weeks. Pre-and post-treatment evaluations involved pulmonary function tests, the Children's Asthma Control Questionnaire, calf muscle isometric muscle force, six-minute walk test, and Pediatric Asthma Quality of Life Questionnaire. RESULTS: A significant increase in all measured variables was recorded in all groups in favor of group A (p < 0.001). However, calf muscle isometric muscle strength, and nocturnal symptoms were non-significant in group C (p > 0.05). There was a significant difference between groups A and C in all measured variables (p < 0.001) in favor of group A. Significant differences between groups B and C in all measured variables (p < 0.001) in favor of group B were also noted. No significant differences were seen between groups A and B (p > 0.05). CONCLUSIONS: Neuromuscular electrical stimulation of calf muscles is an excellent adjunct to breathing exercise programs in improving nocturnal symptoms and quality of life in asthmatic children. Moreover, it can serve as a considerable alternative to traditional physical training in periods of disease exacerbation.

Evaluation of outcome of transurethral needle ablation for treating symptomatic benign prostatic hyperplasia: A 10-year experience.

AIM: The aim of this study is to report our 10-year experience with transurethral needle ablation (TUNA) to evaluate its outcome on long-term basis. PATIENTS AND METHODS: A total of 351 patients' records who underwent TUNA procedure for the management of benign prostatic hyperplasia were reviewed. The International Prostate Symptom Score (IPSS) and peak urinary flow rate were evaluated before the procedure, at 3 and 6 months postoperatively, and then yearly for 10 years. For patients complaining of de novo erectile dysfunction, the International Index of Erectile Function-5 was evaluated. Postoperative complications, number of patients who required additional therapeutic modality/other TUNA sessions, or those dropped out during follow-up were all recorded. RESULTS: Three hundred and fifty-one patients who underwent TUNA with fulfillment of our selection criteria were included in the study. The yearly records of included patients showed that patients' baseline IPSS was significantly improved all over the follow-up years. Similarly, the maximum flow rate of the patients was significantly improved during the next 8 years. About 96.4% of patients who underwent TUNA did not require additional therapeutic modality/other TUNA sessions during the 1st-year follow-up. However, by 10 years, 26.4% of patients were offered another TUNA session and shifted to either medical therapy or other minimally invasive therapies. Mild hematuria was the most common complication (85.7%). Urinary retention, urethral stricture, and de novo erectile dysfunction were developed in 15.1%, 1.7%, and 6.8% of patients, respectively. There were no cases of retrograde ejaculation. CONCLUSION: TUNA can be considered as a relatively effective technique with a good safety profile. The current study demonstrated both significant subjective and objective improvements over 10 and 8 years of follow-up, respectively. It can be considered as a preferable option for patients who prefer surgical option with preservation of their sexual function and fertility.

Outcome of female urethral reconstruction: a 12-year experience.

INTRODUCTION AND HYPOTHESIS: To report our experience over 12 years in female urethral reconstruction with either anterior bladder tube (Tanagho) or labia minora pedicled tube. PATIENTS AND METHODS: This retrospective study included 16 patients with posttraumatic urethral loss. The patients were divided into two groups. Group I: included 6 patients managed with combined vaginal and abdominal approach using a proximally based anterior bladder tube (Tanagho) and Group II: included 10 patients underwent repair with labial fat pad flap with concomitant TOT sling. Outcomes included the success or failure of anatomical repair and continence, which was assessed during patient follow up by voiding diary, 24-h pad test and uroflowmetry. RESULTS: A total of 15 patients were followed for a mean of 42 months postoperatively, and only one patient was lost to follow up. Total continence was achieved in 10 patients (66.6 %) [4/6 patients (66.6 %) in group I and 6/9 patients (66.6 %) in group II]. Partial continence (i.e., one or two pad per day) was achieved in 2 patients (13.3 %). Failure occurs in 3 cases (20 %) [one case in group I and two cases in group II]. All our patients had a smooth postoperative course. In the labia pedicled tube, meatal stenosis was encountered in one patient and transient postoperative urine retention in 2 patients. Successful anatomical repair was achieved in all our patients. CONCLUSION: Both Bladder tube and labia minora pedicled tube with sling procedure have high success rate with only minor complications and are equally effective in the management of females with total urethral loss. Due to the small number of patients in this study, we still need to extend our study to verify our results.