Background There is a need for innovation to improve compliance and accessibility of rehabilitation programs for individuals with acquired brain injuries. A computer game‐assisted tele‐rehabilitation platform (GTP) has been developed to address this need. With the novel application of a miniature inertial computer mouse and taking advantage of the wide variety of computer games, the GTP can provide engaging exercises for rehabilitation of upper extremity motor skills. Objective To determine the feasibility and acceptability of the game‐assisted home exercise program for upper extremity rehabilitation for people with stroke. The treatment effect was also measured after 16 weeks of intervention. Design A feasibility study. Setting College of Rehabilitation Science, University of Manitoba. Participants Ten stroke clients. Intervention Participants received three to four initial clinically supervised therapy sessions for training with the game assisted therapy program. Once trained, participants continued the program at the home for 16 weeks, four times per week. Main Outcome Measures Feasibility was evaluated based on retention rate and compliance. Semistructured interviews after the completion of the program were done to assess acceptability of the program. Quantitative analysis included (1) the Wolf Motor Function Test A and B and (2) a computerized performance‐based assessment of specific object manipulation tasks that required a combination of finger, wrist, elbow and shoulder motion. Results Findings demonstrated the feasibility and acceptability of the home tele‐rehab program. Eight of the 10 participants fully complied with the 16‐week exercise program. Two participants had difficulty with computer operations and did not complete the program. For the eight participants who completed the program, there was a substantial improvement from pre‐ to postintervention. Conclusion Although some difficulties with the technology were reported, the findings demonstrate feasible trial procedures, acceptable game‐assisted task‐oriented home training with a high compliance rate and positive outcomes. These findings and the theoretical evidence direct the next phase of a full‐scale randomized controlled trial.
Many performance-based assessment tools are available to measure upper extremity function. Most define hand function by the time taken to complete a task. A new computer gamebased hand-arm function evaluation (GHA) tool has been developed to quantify fine and gross object manipulations skills. Objective of this study was to evaluate the test-retest reliability and convergent validity of the GHA assessment tool. Thirty stroke clients with the mean age of 68.41 years were recruited. Test-retest reliability was assessed by Intraclass correlation coefficient iii Acknowledgements
Introduction: Identification whether of living person or of dead bodies have always been an uphill task for forensic experts. Traditional ways of identification are used commonly due to limited resources and lack of trained personals in the relevant field. Identification becomes very important when victim or assailant is unknown. To establish identification, methods commonly used are finger prints, foot prints, DNA technology. Lip prints a relatively neglected field of identification can be used to establish identification and sex determination producing almost same results as other methods of identification. Objectives: To determine whether lip prints can be used from their configuration to determine the gender identification. Material and Method: 75 medical college students with equal gender distribution, 35 male and 35 females were included in the study. Students were aged between 18 to 25 years. Inclusion criteria: Students with no lip abnormality were included in the study. Exclusion criteria: Students with any abnormality of lips or who have some lip surgery were excluded from the study. Results: The uniqueness of the lips was established by the facts that no two lips matched with each other. Females revealed type I, I’ most abundant, whereas type IV was abundantly observed among males. From the current study, with inexperienced observers it was revealed that from sample of 20 lip patterns from each gender, 18 females and 17 males were easily identified. Conclusion: Identification of a person whether living or dead is a challenging task for forensic experts around the globe. Lip prints are among the cheapest and easily available methods of identification producing almost same results as finger prints. It is a rather neglected area which needs to be focused more as it is cheap and can be equally effective in producing almost same results as other related methods used for identification and sex determination in particular unknown cases. Keywords: Sex determination, Lip prints, Medicolegal importance.
Introduction: Consent is a legal requirement for all medical procedures whether surgical or non-surgical. Different types of consents are discussed in books, all fulfill legal requirements which totally depends upon the nature and type of case under process. Objective: Main objective of the study is to determine the awareness of public about consent and its legal value. Material and Method: It is a cross sectional observational study conducted at orthopedic department of Services Hospital Lahore, from 1st January 2019 to 29th December, 2019. A total of 125 patients were selected for this study. Study design: It is a cross sectional observational study. Setting: Study was conducted in the orthopedic department of Services Hospital Lahore. Duration: Study was conducted from 1st January 2019 to 29th December 2019. Data Collection: Data was collected through a questionnaire which was modified after pilot study. Results: Majority 60% of the patients believe that consent is a formality for any medical procedure. 76% of the patients have a feeling that consent is a medical document and has no legal value. 40% of the patients believe that by signing consent they forgive their right for any compensation. 48% of patient’s view consent as protection of their rights whereas 36% of them are unaware about this fact. Conclusion: This study concludes the ignorance of the people about the legal value of consent. A vast gap exists between the informed consent and the knowledge of the people signing this document. In the current situation inform consent need to be modified so that public should be aware about its importance. Keywords: Consent
Background: Covid-19 outbreak is found to be associated with increased levels mental health issues among the general population. The high prevalence of fatigue, anxiety and depression was also reported in patients on hemodialysis during Covid-19 pandemic as compared to pre-pandemic studies. Aims: This article determines the level of fatigue, anxiety and depression due to the challenges faced by patients undergoing hemodialysis and their caregivers during the Covid-19 pandemic. Methods: This descriptive cross-sectional study was carried out in hemodialysis unit of a tertiary care hospital over the period of 3 months from August to October 2021, using validated questionnaire consisted of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Hospital Anxiety and Depression Scale (HADS). Results: Among 115 patients (age; mean 53.45 ± 13.9 S.D), fatigue was seen in 80%, anxiety in 67%, depression in 82.6%. While in their caregivers, the prevalence of fatigue was 73.6%, anxiety was 52.7%, depression was 59.1%. Logistic regression analysis showed that gender and challenges e.g. feeling additional burden while visiting the hospital and fear of getting infection and feeling of isolation/loneliness were the main risk predictors of fatigue, anxiety and depression in patients and their caregivers. Conclusions: In Pakistan the prevalence of fatigue, anxiety and depression due to the challenges of Covid-19 pandemic was significantly high among patients undergoing hemodialysis and their caregivers as compared to pre-covid era. This study gives firm grounds for future researches, which should ascertain the suitable interventions to lessen the fatigue, anxiety, and depression due to the challenges of any future pandemic or epidemic among patients undergoing hemodialysis and their family members.
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