No abstract

Background: Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. Objective: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. Methods: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. Results: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. Conclusion: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

effectivity of the intermittent blocks judged by low pain scores and superb respiratory function. Conclusions Sublatissimus serratus catheter provied efficient pain relieve after thoracic surgery. Superior trunk catheter and low volume LA covers clavicle and scapula while preserving diaphragmatic function.

Q had similar VAS scores compared to GROUP I at 12 hrs. DYNAMIC VAS scores are less in GROUP Q. GROUP I received rescue analgesic after 16 hrs GROUP Q received rescue analgesic after 18hrs.Time taken to perform block was much lower in GROUP I compared to GROUP Q Conclusions We conclude that USguided TRANS MUSCULAR QL block provide superior analgesia compared to IL-IH TAP PLANE block.But time taken to perform block is more and there is difficulty in identifying sono anatomy comparedto IL-IH TAP PLANE.

ejection fraction of 30%Chest X-ray findings: multiple small consolidatory radiodense lesions noted in bilateral lung fields . In view of his compromised cardiopulmonary reserve we chose continuous fractional spinal Anesthesia over general Anesthesia. Patient was preloaded with 200 ml RL over 15 min and Graded continuous fractional spinal anesthesia was performed with 18G Tuohy needle and intentional dural puncture was done at the level of L1-L2 and 20G catheter was introduced and 2cm catheter placed in subarachnoid space.0.5% Hyperbaric bupivacaine was given in graded manner through the catether(0.6+0.6+0.6+0.6+0.6+0.6+0.6+0.6 +1+0.6+0.6+0.5).T4 level of sensory blockade was achieved and intraoperative haemodynamics were stable.Abstract B265 Figure 1 Results Continuous fractional spinal anesthesia offers the advantage of fractionating the doses of local anesthetic in the subarachnoid space and has lesser effect on respiratory and cardiac physiology Conclusions Continuous spinal anesthesia (CSA) is a safer alternative technique to general anesthesia in patients with severe cardio -respiratory disease in whom general anesthesia could result in prolonged ICU stay.

cannula oxygen with 0/10 chestpain at rest. The severe pain around the clavicle and scapula managed effectively with a superior trunk catheter of the brachial plexus instead of interscalene to spare the phrenic nerve. Bolusing with 6 mL of Lidocain 1% provided complete analgesia with intact diaphragmatic movement on ultrasound. Continuous blocks were accomplished by intermittent boluses in every 12 hours instead of infusion in order to facilitate mobilization.Abstract LB7 Figure 2 Results The effectivity of the intermittent blocks judged by low pain scores and superb respiratory function. Conclusions Sublatissimus serratus catheter provied efficient pain relieve after thoracic surgery. Superior trunk catheter and low volume LA covers clavicle and scapula while preserving diaphragmatic function.