Objective: To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke. Methods: Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated. Results: There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group. Conclusion Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This “double phenotype” as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level.
Architectural Accessibility* ; Asia ; Asian Continental Ancestry Group ; Delivery of Health Care ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Health Expenditures ; Hong Kong* ; Hospitalization ; Humans ; Incidence ; Insulin Resistance ; Mortality ; Obesity, Abdominal ; Patient Participation ; Prevalence ; Public Policy