BACKGROUND AND OBJECTIVE

Pediatric post-operative congenital diaphragmatic hernia (CDH) patients have been shown to encounter reduced pulmonary function tests (PFT) potentially leading to respiratory symptoms. Strategies involving exercise have been used to improve PFT. This meta-analysis aims to determine the effectiveness of exercise in improving lung function in pediatric post-operative CDH patients.

METHODS

An electronic search was done on May 2023 in MEDLINE via Pubmed, Cochrane Library, Embase, ClinicalKey, Scopus, Google Scholar, and Herdin Plus, using the search terms "exercise" and "congenital diaphragmatic hernia" and "children" or "pediatric" and "pulmonary function" or "lung function". The study included pediatric patients in whom CDH has been surgically corrected, and excluded patients who were unable to perform the test maneuvers, have cardiopulmonary instability, and have serious associated anomalies. Randomized controlled trials (RCT) were identified and independently assessed by two review authors. Each RCT was independently assessed for bias by two review authors using the Cochrane Handbook for Systematic Reviews of Interventions. The RevMan 5.4 software was used for statistical analysis.

RESULTS

A total of 124 participants from three studies were included in the meta-analysis. The pooled mean difference showed a significantly higher mean functional vital capacity (FVC) (MD=6.12, 95%CI=3.91 to 8.33, p-value < 0.00001) and forced expiratory volume in 1 second (FEV1 ) (MD=6.25, 95%CI=3.39 to 9.10, p-value < 0.0001) in the study group compared to the control group.

CONCLUSION

Exercise may be effective in improving lung function in children with pediatric post-operative CDH. However, the study is limited by its small sample size, the lack of assessment of long-term outcomes, and the difference in exercise regimens used in each RCT. Further studies are recommended to determine the most optimal exercise regimen and to measure its effect on the other outcomes for this population.

Human ; Exercise ; Hernias, Diaphragmatic, Congenital ; Child ; Children

OBJECTIVE

This study aimed to determine if selenium supplementation for a period of six months can decrease signs and prevent worsening of mild Graves’ ophthalmopathy among Filipino patients.

METHODS

We conducted an open-label, assessor-masked, randomized controlled trial involving adult patients diagnosed with mild Graves’ ophthalmopathy. Participants were divided into two groups: one group received standard care (eye drops) alone (control group), while the other group received an additional 200 mcg/day oral selenium supplementation alongside standard care. Inclusion criteria encompassed adult patients with Graves’ hyperthyroidism presenting at least one sign of mild ophthalmopathy and a disease duration of less than 18 months. Statistical analyses were performed using independent sample t-test, Mann-Whitney U test and Fisher’s Exact/Chi-square test to compare means, ranks and frequencies between the two intervention groups. Paired sample t-test, Wilcoxon signed rank test and McNemar test were employed to assess changes from baseline to the third and sixth month observations.

RESULTS

A significant difference in clinical activity score (CAS) was observed between the selenium supplementation group and the control group. Initially, 14 eyes (33.33%) in the selenium group exhibited a CAS score of 0, which increased to 27 eyes (64.29%) at the third month of treatment and slightly decreased to 26 eyes (61.9%) at the sixth month. Conversely, the control group had 11 eyes with a CAS score of 0 at baseline, which increased to 16 eyes (38.1%) at three months and decreased to 14 eyes (33.33%) at the sixth month. The improvement in CAS was significantly associated with reductions in caruncle and plica swelling (p = 0.040). Further analysis revealed a statistically significant difference in CAS between the treatment and control groups (p = 0.017) at the sixth month mark.

CONCLUSION

Selenium supplementation provided significant benefit in reducing the signs and preventing deterioration of mild Graves’ ophthalmopathy, as indicated by improved CAS scores. Future research exploring baseline and end of treatment selenium concentrations in the Philippines is recommended to further substantiate these findings.

Human ; Female ; Randomized Controlled Trial ; Tertiary Care Centers

The poor stability of the ligustilide (LIG) makes its quantitation in Angelica sinensis (AS) difficult. This study establishes a chemical conversion method for the determination of ligustilide content in AS and proposes a national pharmacopoeia standard. Mechanical agitation and sonication of a powdered AS extract in a methanol/cyprolamine mixture facilitated the stabilization and transformation of ligustilide. Using an external reference HPLC-DAD method, the cyclopropyl-ligustilide (LIGc) content in the mixture could be determined. The content of ligustilide was greater than 1.0% based on 144 AS specimens including 68 obtained from the originally planted areas of Qinghai and Gansu Province; 55 specimens were obtained from Minxian and Weiyuan County medicine markets, and 21 specimens for which the storage period reached or exceeded 1.5 years. According to the Hong Kong Chinese materis medica standards, the content of ligustilide in AS should not be lower than 0.6%. The developed method could also be applied to the quality control of other Chinese medicinal materials (such as Ligusticum chuanxiong) or Chinese patent medicines in which ligustilide is the main component.