A comprehensive study of mobile-health based assistive technology for the healthcare of dementia and Alzheimer's disease (AD).

Assistive technology (AT) involvement in therapeutic treatment has provided simple and efficient healthcare solutions to people. Within a short span of time, mobile health (mHealth) has grown rapidly for assisting people living with a chronic disorder. This research paper presents the comprehensive study to identify and review existing mHealth dementia applications (apps), and also synthesize the evidence of using these applications in assisting people with dementia including Alzheimer's disease (AD) and their caregivers. Six electronic databases searched with the purpose of finding literature-based evidence. The search yielded 2818 research articles, with 29 meeting quantified inclusion and exclusion criteria. Six groups and their associated sub-groups emerged from the literature. The main groups are (1) activities of daily living (ADL) based cognitive training, (2) monitoring, (3) dementia screening, (4) reminiscence and socialization, (5) tracking, and (6) caregiver support. Moreover, two commercial mobile application stores i.e., Apple App Store (iOS) and Google Play Store (Android) explored with the intention of identifying the advantages and disadvantages of existing commercially available dementia and AD healthcare apps. From 678 apps, a total of 38 mobile apps qualified as per defined exclusion and inclusion criteria. The shortlisted commercial apps generally targeted different aspects of dementia as identified in research articles. This comprehensive study determined the feasibility of using mobile Health based applications for dementia including AD individuals and their caregivers regardless of limited available research, and these apps have capability to incorporate a variety of strategies and resources to dementia community care.

Mobile-Health Applications for the Efficient Delivery of Health Care Facility to People with Dementia (PwD) and Support to Their Carers: A Survey.

Dementia directly influences the quality of life of a person suffering from this chronic illness. The caregivers or carers of dementia people provide critical support to them but are subject to negative health outcomes because of burden and stress. The intervention of mobile health (mHealth) has become a fast-growing assistive technology (AT) in therapeutic treatment of individuals with chronic illness. The purpose of this comprehensive study is to identify, appraise, and synthesize the existing evidence on the use of mHealth applications (apps) as a healthcare resource for people with dementia and their caregivers. A review of both peer-reviewed and full-text literature was undertaken across five (05) electronic databases for checking the articles published during the last five years (between 2014 and 2018). Out of 6195 searches yielded articles, 17 were quantified according to inclusion and exclusion criteria. The included studies distinguish between five categories, viz., (1) cognitive training and daily living, (2) screening, (3) health and safety monitoring, (4) leisure and socialization, and (5) navigation. Furthermore, two most popular commercial app stores, i.e., Google Play Store and Apple App Store, were searched for finding mHealth based dementia apps for PwD and their caregivers. Initial search generated 356 apps with thirty-five (35) meeting the defined inclusion and exclusion criteria. After shortlisting of mobile applications, it is observed that these existing apps generally addressed different dementia specific aspects overlying with the identified categories in research articles. The comprehensive study concluded that mobile health apps appear as feasible AT intervention for PwD and their carers irrespective of limited available research, but these apps have potential to provide different resources and strategies to help this community.

Congenital alveolar synechiae with cleft palate.

Congential maxillomandibular fusion or jaw adhesions is a rare entity. It is often associated with other congenital anomalies like cleft palate and is characterized by restricted mouth opening. This unusual presentation of congenital alveolar synechiae is highlighted in a 15 days old baby boy. Under inhalational anaesthesia his fibrocartilagenous adhesions were excised and endotracheal tube was then placed. Good recovery without any residual scars or adhesions and a 25 mm mouth opening was achieved.

Management of intramuscular venous malformations of the masseter muscle.

Less than 1% of vasoformative tumours throughout the body occur in skeletal muscle and 15% of them arise in head and neck musculature. The masseter muscle is the most frequent site and accounts for approximately 5% of all intramuscular vascular malformations in the head and neck region. Masseteric venous malformations have a typical clinical presentation and imaging characteristics that should allow clinicians to distinguish them from other abnormalities presenting in this area. We present seven cases of these unusual intramasseteric venous malformations and the diagnosis and management of these lesions is discussed. The diagnosis was made on clinical grounds and was confirmed on MRI. All underwent surgical excision through a facelift approach and were successfully removed from within the substance of the masseter muscle with preservation of the facial nerve. Venous malformations within the masseter are rare but are easy to diagnose and can be reliably surgically excised without complications.

Hypospadias repair: a single centre experience.

Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital's database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428 patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF). The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086). The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications.

Schwannoma of the brachial plexus; report of two cases involving the C7 root.

Brachial plexus schwannomas are rare tumors. They are benign nerve sheath tumors and only about 5% of Schwannoma arise from the brachial plexus. They pose a great challenge to surgeons due to their rare occurrence and complex anatomical location. We present two cases who presented with a supraclavicular swelling, that were proven to be schwannoma on histopathology.