The cervical spine is responsible for allowing mobility and stability to the head and neck. Any deviation to the center of gravity of the head results in an increase in cantilever loads, which can be particularly damaging to the upper cervical joints. Excessive neck bending also exaggerates stretching through the cervical spine and all of the spinal structures below. It has been reported that forward head posture (FHP) can cause a multitude of disorders including cervical radiculopathy, cervicogenic headaches and cervicogenic dizziness. Most of these conditions manifest with clusters of painful symptoms and spine dysfunctions. The purpose of this case study is to describe the radiographic imaging considerations and to illustrate the potential impacts in symptomatic adults with FHP. We randomly selected radiographs of three individuals with FHP who had undergone cervical adjustment for cervical pain. The occipito-axial (C0-C2) and atlanto-axial (C1-C2) joints were assessed via the C0-2 distance from the C2 base to the McGregor line (Redlund-Johnell criterion) and the Ranawat C1-2 index, in addition to subjective radiographic parameters. By comparing the radiographs of before-and-after intervention of each patient, a regressive joint spacing was observed from both indices. Such a long-lasting stretching concordant with FHP was assumed to be hazardous to joint stability. A definite conclusion, however, cannot be drawn due to the small sample size and a lack of convincing measurements.
The purpose of this study was to analyze the adaptation response after the eruption of Mount Sinabung in Gurukinayan Village, Karo District. This research is qualitative with an explorative phenomenological approach. Data collection was carried out through observation and in-depth interviews with key informants who were the victims of the Mount Sinabung eruption. The analysis was conducted using content analysis description and life history with 6 participants. The adaptation response results obtained from the community were maladaptive (staying/surviving in the eruption site). The impacts of this eruption are physical/health impacts (cough, shortness, flu and fever), psychological impacts (trauma, anxiety and panic), social/economic impacts (crop failure and job loss), and infrastructure impacts (damaged houses, damaged roads and clean water crisis). Post-eruption adaptation strategies are from the aspects of health (medical treatment, traditional medicine mix), social/economic aspects (carrying out community activities, cultivating land and expecting food and land assistance from donors), infrastructure aspects (building huts, repairing houses, clean water treatment, and expecting operational assistance from the government). It is recommended that in handling post-eruption of Mount Sinabung, the government or village apparatus establish a post-disaster recovery program and decision making (stakeholders) in making policies or decisions related to Eruption Disasters handling.
Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
Cervical muscles have numerous connections with vestibular, visual and higher centres, and their interactions can produce effective proprioceptive input. Dysfunction of the cervical proprioception because of various neck problems can alter orientation in space and cause a sensation of disequilibrium. Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain in patients with cervical pathology. Here, we report a 24-year-old female, who was diagnosed with CGD based on the correlating episodes of neck pain and dizziness. Both symptoms improved with targeted chiropractic adjustment and ultrasound therapy. CGD is a seemingly simple complaint for patients, but tends to be a controversial diagnosis because there are no specific tests to confirm its causality. For CGD to be considered, an appropriate management for the neck pain should not be denied any patient.
Dystonia is a neurological disorder characterized by sustained or intermittent muscle contractions resulting in twisting, repetitive movements or painful postures. Cervical dystonia (CD), an isolated dystonia of the cervical musculature, can predispose the atlantoaxial joint to unstable changes. Symptomatic treatment of dystonia through local injections of botulinum toxin clearly reduces pain in most clinical settings. However, repeated chemodenervation of the involved muscles with neurotoxin is expensive and not available to the complicated cases of CD. In this report a 14-year-old girl with a 1-year history of CD complicated by atlantoaxial subluxation was treated using chiropractic intervention. As a result of this regimen, the girl reported a significant relief from the neck pain and torticollis after the first week. More gains of cervical range of motion were made over the course of 6 months of treatment. Chiropractic might have yielded some biomechanical responses linked to clinical effects. This case demonstrates an unexpected association between CD and atlantoaxial subluxation. In cases of CDs, atlantoaxial subluxation may be ignored but requires specialized treatment. An index of suspicion should be maintained for this rare but potentially debilitating complication.
Atlantoaxial rotatory subluxation (AARS) is the loss of normal alignment and stability of the first (atlas) and second (axis) cervical vertebrae with respect to each other. We describe the clinical challenges of managing a 10-year-old boy who presented with repetitive episodes of torticollis. Open-mouth odontoid radiograph and computed tomographic (CT) scan gave a diagnosis in ARRS, based on its characteristic imaging findings. The child was admitted multiple times for continuous halter traction in the first 6 months after symptom onset. He also experienced a temporary complication from an overcorrection with correcting neck bracing. Seven months after symptom onset, this case was discussed by a multidisciplinary spine team and referred to chiropractic clinic. Despite persistent radiographic evidence of atlantoaxial instability, after 5 months of chiropractic treatment, the child was asymptomatic with nearly full range of neck movement. He also weaned off acetaminophen he had been taking over the past year. Incidentally, bilateral gynecomastia was discovered at the surveillance after treatment. The incidental finding of innocent gynecomastia, even if common in preteen boys, brings up the topic of acetaminophen's effects on the regulation of sex hormones that was previously overlooked.
Based on preliminary studies, it is known that 80% of working mothers fail to make exclusive breastfeeding, on average babies are given formula milk 2-4 months old and stop breastfeeding at 6-18 months of age. Papaya leaves are one of the galactagogues that contain quercetin which can activate the hormone prolactin and help increase breastmilk. The purpose of this study was to determine the effect of giving papaya leaf juice for nursing mothers who work toward increasing levels of the hormone prolactin and infant weight in Tangerang. The research design used was a pre-experimental model with one group pretest-posttest design. Samples taken as many as 10 mothers who have babies aged 0-6 months who have difficulty in breastfeeding because the amount of breastmilk was a little. The study was conducted in several clinics in Tangerang. The intervention was giving papaya leaf juice for 7 consecutive days. The results obtained from this study are as follows: 90% of mothers aged between 20 and 35 years, 70% of mothers have a history of spontaneous labor and have no complications at the time of delivery, 40% of mother's education is junior high school (SMP), and 70% of mothers are primiparas. The average increase in the amount of prolactin after the intervention was 19.59ng/ml, while the average weight gain of the newborn after the intervention was 165g. Wilcoxon test results for increased levels of the hormone prolactin p-value of 0.047<0.05 and for an increase in body weight of newborns p-value of 0.009<0.05. CONCLUSION: There is an effect of giving papaya leaf juice for nursing mothers who work on increasing levels of the hormone prolactin and infant weight in Tangerang. Papaya leaf juice can be a galactagogue for mothers who experience problems with a small amount of breastmilk.
A sustainable method was used to produce aromatic ketones by the solvent-free benzylic oxidation of aromatics over mesoporous Cu(II)-containing propylsalicylaldimine anchored on the surface of Santa Barbara Amorphous type material-15 (CPSA-SBA-15) catalysts. For comparison, mesoporous Cu(II)-containing propylsalicylaldimine anchored with Mobil Composition of Matter-41 (CPSA-MCM-41) was assessed for these reactions under similar reaction conditions. The washed CPSA-SBA-15(0.2) (W-CPSA-SBA-15(0.2)) catalyst was prepared using an easy chemical method for the complete removal of non-framework CuO nanoparticle species on the surface of pristine CPSA-SBA-15(0.2) (p-CPSA-SBA-15(0.2) prepared with 0.2 wt% of Cu, and its catalytic activity was evaluated with different reaction parameters, oxidants and solvents. In order to confirm the catalytic stability, the recyclability was assessed, and the performance of hot-filtration experiments was also evaluated. All the catalysts used for these catalytic reactions were characterized using many instrumental techniques to pinpoint the mesoporous nature and active sites of the catalysts. The proposed reaction mechanism has been well documented on the basis of catalytic results obtained for solvent-free oxidation of aromatics. Based on the catalytic results, we found that W-CPSA-SBA-15(0.2) is a very ecofriendly catalyst with exceptional catalytic activity.
This retrospective chart review was undertaken to investigate the role of chiropractic intervention for patients with adolescent idiopathic scoliosis (AIS). Ten cases of patients with AIS, mean age 13.3 years, undergoing chiropractic adjustment were retrospectively evaluated. Chart review was performed to extract age, medical history and treatment intervention. The magnitude of scoliosis was quantified using the Cobb method on standing radiographs. A comparison of the measurements from pre- and post-treatment radiographs revealed that Cobb angle reduced from average 29.7° down to average 23.4° (average 21.2% correction). Improvements in spinal morphologies were observed in most curves (64%, n=9/14) and curve stabilization in the rest (36%, n=5/14). A better correction was obtained in cases of mild and moderate AIS. In terms of stabilizing progression (≤5o curve progression) or correcting curvatures (≥6° reduction), radiological changes were observed in all patients.
Buongiorno's nanofluid model is followed to study the bioconvection in two stretchable rotating disks with entropy generation. Similarity transformations are used to handle the problem equations for non-dimensionality. For the simulation of the modeled equations, Homotopy Analysis Method is applied. The biothermal system is explored for all the embedded parameters whose effects are shown through different graphs. There exists interesting results due to the effects of different parameters on different profiles. Radial velocity decreases with increasing stretching and magnetic field parameters. Temperature increases with Brownian motion and thermophoresis parameters. Nanoparticles concentration decreases on increasing Lewis number and thermophoresis parameter while motile gyrotactic microorganisms profile increases with increasing Lewis and Peclet numbers. Convergence of the solution is found and good agreement is obtained when the results are compared with published work.
The behavior of an Oldroyd-B nanoliquid film sprayed on a stretching cylinder is investigated. The system also contains gyrotactic microorganisms with heat and mass transfer flow. Similarity transformations are used to make the governing equations non-dimensional ordinary differential equations and subsequently are solved through an efficient and powerful analytic technique namely homotopy analysis method (HAM). The roles of all dimensionless profiles and spray rate have been investigated. Velocity decreases with the magnetic field strength and Oldroyd-B nanofluid parameter. Temperature is increased with increasing the Brownian motion parameter while it is decreased with the increasing values of Prandtl and Reynolds numbers. Nanoparticle's concentration is enhanced with the higher values of Reynolds number and activation energy parameter. Gyrotactic microorganism density increases with bioconvection Rayleigh number while it decreases with Peclet number. The film size naturally increases with the spray rate in a nonlinear way. A close agreement is achieved by comparing the present results with the published results.