Knowledge and use of Transcutaneous Electrical Stimulation (TENS) among Nigerian physical therapists

AIMS AND OBJECTIVE

The purpose of this study was to evaluate the knowledge and the use of Transcutaneous Electrical Nerve Stimulation (TENS) by Nigerian physical therapists.

METHODS

A cross sectional study design was carried out among Nigerian physical therapists. Eighty-six physical therapists participated in this study and data were collected using a structured and validated questionnaire. Copies of the questionnaires were distributed by hand and by mail (with self addressed envelopes) to various hospitals, clinics, universities that offer physical therapy services/programmes across Nigeria. Data were analyzed using descriptive statistics.

RESULTS

Academic staff constituted 10.5% while 89.5% were clinicians. First degree holders constituted 61.6% while 38.4% had postgraduate degrees. Majority of physical therapists, 90.7% use TENS, 83% of those who use TENS are aware of the different types of TENS; 98.72% use TENS for 30 minutes or less, 48.7% use it for 15 minutes or less. The frequency commonly use is between 1-30 Hz and about 12.8% of those using this frequency believed that TENS relieves pain through the pre-synaptic inhibition, endogenous pain control, and direct inhibition of abnormally excited nerve and restoration of afferent input. Furthermore, 12.8% calibrated their TENS devices. Only 6.4% have published TENS related papers in the last five years while 29.5% have attended TENS related seminar in the past. Majority, 88.5% considered TENS to be cost effective.

CONCLUSION

This study concluded that TENS is widely used among Nigerian physical therapists and tend to have adequate knowledge of TENS and its application in the management of pain.

Evaluation of gemeprost vaginal pessaries in the termination of abnormal intra-uterine pregnancies at twelve teaching hospitals in Indonesia

Vaginal pessaries, up to a maximum of 5, each containing 1 mg of 16,16-dimethyl-trans-delta squared-prostaglandin E1, ester (Gemeprost) were inserted as high as possible into the posterior fornix of the vagina at 3 hourly intervals in 459 women with abnormal intrauterine pregnancies presenting for termination of the pregnancy. There were 145 missed abortions (31.6%), 207 intrauterine fetal deaths (45.1%), 86 molar pregnancies (18.7%), 5 anencephalics (1.1%), and 16 others (3.5%). The study was conducted from July 1981-March 1982. 402 women (87.6%) underwent abortion within the 30 hour observation period, including 139 women (30.3%) who required additional procedures to complete evacuation of the uterus. Expulsion of the uterine contents failed to occur within 30 hours in 57 women (12.4%) and alternative procedures were employed. These failures consisted of 37 missed abortions, 17 intrauterine fetal deaths, 2 molar pregnancies, and 1 pregnancy with an IUD in situ. Side effects caused by the drug were basically tolerable. 234 women (51.0%) had 1 or more side effects, gastrointestinal tract disturbances (nausea, vomiting, and diarrhea) being the most frequently observed, and moderate fever the next most frequent. There was 1 ruptured uterus.

A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever

The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60%) DHF patients with hepatomegaly compared to DF (40%) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12%) DHF and 2 (8%) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) micromol/l] compared to DF [10.9(5-30) micromol/l)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36%) DHF and 6 (24%) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/l in DHF and 90.8(13-352) U/l in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/l in DHF and 93.3(34-258) U/l in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.