End-stage renal disease is emerging as a major public health problem in the developing countries. It must be treated with renal replacement therapy and hemodialysis (HD) is the most widely used therapy and the only maintenance treatment if kidney transplant is not feasible. This study aimed to determine the effectiveness of intradialytic exercise on dialysis efficacy, physiological parameters, biochemical markers, and quality of life among patients on HD. Experimental research design was adopted to conduct the study with 20 patients in our HD unit who met the inclusion criteria and patients were randomly allocated into experimental group and control group. The experimental group received intradialytic exercise during the first 2 h of HD besides receiving routine care compared to the control group. Data were tabulated and analyzed using the SPSS package. The finding of the present pilot study reveals that the prescribed intradialytic exercise intervention resulted in significant improvement in Kt/V, serum creatinine, blood urea, serum potassium, phosphorous, and quality of life. Based on the findings of the present study, it can be concluded that intradialytic exercise program is a safe complementary intervention and does not need an extra time of the patient and showed improvement in patients' outcome.

Graves’ disease is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies. Graves’ disease was originally known as “exophthalmic goiter” but is now named after Sir Robert Graves, an Irish doctor who first described the condition in 1835. A number of conditions can cause hyperthyroidism, but Graves’ disease is the most common, affecting around 1 in 200 people. It most often affects women under the age of 40, but it is also found in men. It affects an estimated 2–3 percent of the world’s population. Thyroid-stimulating immunoglobulin (TSIs) binds to and activates thyrotropin receptors, causing the thyroid gland to grow and the thyroid follicles to increase synthesis of thyroid hormone. The overproduction of thyroid hormones can have a variety of effects on the body causes exophthalmic goiter, graves ophthalmopathy, graves dermopathy etc.,. Thyroid profile including antithyroid antibodies, radioactive iodine uptake study, and thyroid scan are the main diagnostic investigations to rule out Graves’ disease. The major aim of the treatment is to inhibit the overproduction of thyroid hormones by targeting the thyroid gland, to reduce the symptoms, and prevention of complication is also major challenges.

Hypoglycemia is the acute complication of diabetes mellitus and the commonest diabetic emergency and is associated with considerable morbidity and mortality. It can be caused by too much insulin intake or oral hypoglycemic agents, too little food, or excessive physical activity. The level of glucose that produces symptoms of hypoglycemia varies from person to person and varies for the same person under different circumstances. It characterized by sweating, tremor, tachycardia, palpitation, nervousness, hunger, confusion, slurred speech, emotional changes, double vision, drowsiness, sleeplessness, and often self-diagnosed which may leads to serious symptoms of seizure, cognitive impairment, coma and death. The immediate treatment of hypoglycemia should be known by all the diabetic patients, so that need for hospitalization could be avoided. Hypoglycemia and its severity can be prevented by early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens, appropriate educational programs for healthcare professionals. The major challenges of the treatment of hypoglycemia are good glycemic control, minimize the risk of hypoglycemia and thereby minimize long-term complications. Hence there is an urgent need to understand the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this life-threatening complication.

Background: Most stroke survivors continue to live with disabilities and may require physical rehabilitation to control the trunk and balance during the post-stroke period. The cause of lack of trunk control and balance among stroke patients is the weakened trunk muscle strength. Purpose: To study the effect of proprioceptive neuromuscular facilitation (PNF) neck pattern and trunk-specific exercise on trunk control and balance among stroke patients. Setting: The study was conducted at the medical wards of Saveetha Medical Col-lege and Hospital, Chennai, India. Participants: Sixty patients with stroke who met the inclusion criteria participated in the study. Research Design: This is a quasi-experimental study. Intervention: PNF trunk-specific exerise was administered to the experimental group for 45 min of 28 sessions, which contained 15 min of stretching exercise and 30 min trunk-specific exercise. The control group received routine hospital care services. Main Outcome Measures: The study’s primary outcome was balance and trunk control, measured by the Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS) before the intervention and at the end of the intervention of 28 days. Results: Within-group analysis, paired t test showed a significant improvement comparing the trunk control and balance score before (13.40±1.04 & 25.40±1.81) and after (15.03±0.96 & 27.07± 1.48) the intervention in the experimental group (p < .001). Between-group analysis, both the experimental and control group post-test mean score of TIS (15.03±0.96 &13.70±1.15) and BBS (27.07±1.48 & 25.30±1.73) showed significant difference (p < .001). Conclusion: PNF neck pattern and trunk-specific exercise used in this study effectively improved balance and trunk control among patients with stroke.