An Ocular Prosthesis for a Geriatric Patient: A Case Report.

An ocular prosthesis for a geriatric patient: a case report.

J Clin Diagn Res. 2013 Jun; 7(6): 1236-8
Kamble VB, Kumar M, Panigrahi D

When geriatric patients with maxillofacial defects are handled, the clinician must be confident of addressing and managing the psychology of these patients. It is also required that the clinician must understand and be sensitive to the medical and financial states of geriatric patients. The loss of an eye has a far-reaching impact on an individual’s psychology and an immediate replacement is necessary to promote the physical and psychological healing of the patient and to improve his/her social acceptance. Special approaches and treatment goals are considered while treating geriatric patients with ocular defects and special consideration is given to the appointment length, the number of appointments and their medical and financial statuses. This article presents the prosthetic rehabilitation of a geriatric patient with an ocular defect, with a customized stock ocular prosthesis, by using a minimal intervention geriatric approach. HubMed – rehab

Primary Nailing in the Open Fractures of the Tibia-Is it worth?

J Clin Diagn Res. 2013 Jun; 7(6): 1125-30
Agrawal A, Chauhan VD, Maheshwari RK, Juyal AK

Context (Background): The tibial shaft is one of the most common sites of open fractures. The specific methods of skeletal stabilization and soft tissue treatment of open fractures continue to be topics of debate in the orthopaedic traumatology. Aims: To evaluate the results of the intramedullary nailing in the open fractures of the tibia, especially in the Indian scenario. Settings and Design: An observational, descriptive study which was done at a tertiary care hospital from 2006 to 2010. Material and Methods: A prospective study was done on thirty cases which had sustained open fractures of t/hable Gustilo and Anderson grades I, II and III, who were operated for primary intramedullary interlocking nail fixation after thorough debridement and closure of their wounds with suturing, lateral skin release, split thickness skin grafting and muscle pedicle flap, where ever necessary. All the patients were followed up for a minimum of two years. Statistical Analysis: Descriptive statistics and Fisher’s Exact test were used. Results: Of the total thirty cases, ten were of grade I, seven were of grade II, three were of grade IIIA, seven were of grade IIIB and three were of grade IIIC. Dynamization was done in nine cases. The average time to union was 16.0 weeks in the grade I cases, it was 18.3 weeks in the grade II cases, it was 23.6 weeks in the grade III A cases, it was 28.4 weeks in the grade III B cases and it was 32 weeks in the grade III C cases. The mean time to union was 20.7 weeks. Infection occurred in 3 cases. Delayed unions were observed in 4 cases. A non union occurred in 1 case of type IIIC. A mal union was observed in 1 case of type IIIB. 1 case of grade IIIC had the compartmental syndrome. No case had any implant failure (nail / screw breakage), or deep vein thrombosis. Conclusion: We conclude that the unreamed intramedullary nailing in cases of open fractures of the tibia, with an early soft tissue coverage, results in a faster soft tissue and bony healing, an easier soft tissue coverage, a better biomechanical stability and early rehabilitation and infection rates as comparable to those which are seen with other methods. HubMed – rehab

Exercise training in aging and diseases.

Transl Med UniSa. 2012 May; 3: 74-80
Conti V, Russomanno G, Corbi G, Filippelli A

Sedentary lifestyle along with high blood pressure, abnormal values for blood lipids, smoking, and obesity are recognized risk factors for cardiovascular diseases and for many other chronic diseases, such as diabetes, osteoporosis, breast and colon cancer. Several studies conducted on large cohort of individuals have documented the protective effects of physical activity for both vascular and nonvascular syndromes. Exercise training is an integral part of cardiac rehabilitation, a complex therapeutic approach, effective both in young and elderly patients. Despite the number of evidences underling the benefits associated with physical fitness, the cardiac rehabilitation is still an underused medical resource. The molecular mechanism behind physical activity protective effect is presently unresolved, and further studies are also needed to establish the best protocol in terms of specificity, volume and duration of the training. HubMed – rehab

Safety profile of bone marrow mononuclear stem cells in the rehabilitation of patients with posttraumatic facial nerve paralysis-a novel modality (phase one trial).

J Neurol Surg B Skull Base. 2012 Aug; 73(4): 245-52
Aggarwal SK, Gupta AK, Modi M, Gupta R, Marwaha N

Objectives?The objectives of this study were to study the safety profile and role of mononuclear stem cells in the rehabilitation of posttraumatic facial nerve paralysis not improving with conventional treatment. Study Design?This is a prospective nonrandomized controlled trial. Study Setting?This study is conducted at Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh between July, 2007 and December, 2008. Patients?We included eight patients of either sex aged between 18 and 60 years of posttraumatic facial nerve paralysis not improving with conventional treatment presented to PGIMER, Chandigarh between July 2007 and December 2008. Methods?All patients underwent preoperative electroneuronography (ENoG), clinical photography, and high-resolution computed tomography (HRCT) temporal bone. All patients then underwent facial nerve decompression and stem cell implantation. Stem cells processing was done in well-equipped bone marrow laboratory. Postoperatively, all patients underwent repeat ENoG and clinical photography at 3 and 6 months to assess for objective and clinical improvement. Clinical improvement was graded according to modified House-Brackmann grading system. Intervention Done?All patients of posttraumatic facial nerve paralysis who were not improving with conventional surgical treatment were subjected to facial nerve decompression and stem cell implantation. Main Outcome Measures?All patients who were subjected to stem cell implantation were followed up for 6 months to assess for any adverse effects of stem cell therapy on human beings; no adverse effects were seen in any of our patients after more than 6 months of follow-up. Results?Majority of the patients were male, with motor vehicle accidents as the most common cause of injury in our series. Majority had longitudinal fractures on HRCT temporal bone. The significant improvement in ENoG amplitude was seen between preoperative and postoperative amplitudes on involved side which was statistically significant (0.041). Clinical improvement seen was statistically significant both for eye closure (p?HubMed – rehab

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