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Abstract:Introduction: Background. Upper abdominal surgery alters postoperative pulmonary function, as observed by impairment of lung volumes such as total lung capacity, vital capacity. Impaired clearance of sputum results in a vicious cycle of colonization and infection of bronchi with pathogenic organisms, dilation of bronchi and further production of sputum. The aim was to investigate the effect of combination of Acapella device and breathing exercises on treatment of post operative pulmonary complications after upper abdominal surgeries. Subjects and methods: Sixty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure pulmonary function: Forced vital capacity (FVC) and Forced expiratory volume in one second (FEV1) using electronic spirometer. Results: Post treatment results showed that there was a significant improvement difference in FVC and FEV1 in both groups in favor of the study group. Percentage of improvement of FVC in the study group was 42.28%, while it was 16.31%in the control group. Percentage of improvement of FEV1 in the study group was 49.05%, while it was 20.79%in the control group. Conclusion: Combination of Acapella device and breathing exercises were considered to be an effective modality for treatment of postoperative pulmonary complications and removal of secretions after upper abdominal surgeries.

Protein catabolism is a common complication after burn injury leading to loss of muscle mass and a decrease in muscle strength. The present study aims to evaluate the efficacy of combining exercise training with protein supplementation on lean body mass and muscle strength in patients with severe burn. Sixty participants with severe burn > 30% of total body surface area were randomly distributed into 4 equal groups of 15 participants per group. Group A (Exercise & Protein) received oral protein supplementation (Inkospor X-TREME; 1.5-2.0 g/kg/day), exercise program and traditional burn care, group B (Protein) received oral protein supplementation and traditional burn care, group C (Exercise) received exercise program and traditional burn care, group D (Control) received traditional burn care. Lean body mass was measured using Dual-energy x-ray absorptiometry whereas muscle strength was measured using Biodex 3 Dynamometer System before treatment and 12 weeks after treatment. A significant increase in lean body mass was found in group A compared with that of group B, group C and group D post-treatment (p < 0.001). Also, a significant increase was recorded in peak torque of group A compared with that of group B, group C and group D post-treatment (p < 0.001). Exercise training can significantly increase lean body mass and peak torque. Protein supplementation can significantly increase lean body mass but cannot significantly increase muscle strength whereas, protein +exercise group has a great impact on lean body mass and muscle power than exercise group and protein group in burn patients.

Introduction. Cellulite is associated with variations in the skin appearance with cottage cheese, mattress-like, or orange peel. The most common areas for these lesions are the posterior or upper thighs and buttocks and mainly affect females after puberty. The objective of the study was to determine whether extracorporeal shock wave therapy (ESWT) or manual lymphatic drainage (MLD) is more effective for the reduction of the grade of cellulite after liposuction. Methods. This study is a single-blinded randomized controlled clinical trial. Thirty females with grade 3 cellulite were randomly distributed into two groups equal in number (n = 15), group A was equipped to ESWT and group B was equipped to MLD. The cellulite grading scale was used to assess cellulite grade, and the skinfold caliper was used to assess the thickness of subcutaneous fat. The assessment was carried out before and four weeks after starting the treatment. Both groups received topical retinol twice daily for four weeks; in addition, group A received ESWT, while group B received MLD, two times/week for 4 weeks. Results. The mean values of the skinfold caliper in group A decreased by 24.4% and in group B by 15.38% with a significant difference between the two groups p < 0.001 . Also, the mean values of the cellulite grading scale decreased significantly after treatment in group A compared with the mean values of group B p < 0.001 . Conclusions. There was more reduction in the grade of cellulite and thickness of subcutaneous fat in the ESWT group than the MLD group after liposuction.