Irshad Qureshi

Recurrent radiculopathy after lumbar spine surgery, known as failed back surgery syndrome (FBSS), is a challenging condition, especially in individuals who have experienced prolonged stress induced by the postoperative loading of the back in the workplace. Evidence on structured physiotherapy interventions in these high-risk patients remains limited. A male farm labourer in his late 30s had a 2-year history of recurrent low back pain (LBP) radiating down to the left lower limb and a 3-year history of neck pain with upper limb radiation following two prior L5-S1 surgeries. Symptoms were exacerbated by prolonged standing, bending forward and manual farming. The patient’s clinical examination showed mechanical LBP and neck pain with radicular features, positive neural tension signs and movement-dependent symptom centralisation. MRI showed recurrent L5-S1 disc pathology with central canal stenosis and multilevel cervical degenerative changes. The patient received a 12-week individual physiotherapy programme guided by Mechanical Diagnosis and Therapy (MDT) principles. It included patient education and activity modification; movement-based directional exercises; manual therapy and spinal mobilisation; neural mobilisation; pain modulation through electrotherapy, including acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS); gradual strengthening of the trunk and lower limb musculature and cervical traction and mobilisation. Occupational ergonomics and self-management strategies were employed to mitigate mechanical loads during farming activities. Patient reported lumbar and cervical pain resolved at the end of the treatment period of 12 weeks (Numeric Pain Rating Scale: 0/10). Objective evaluation showed a normalised movement pattern, negative neural tension signs and full muscle strength (Manual Muscle Testing: 5/5). At discharge, the patient reported resumption of full-time manual farming without symptom recurrence. No long-term post-discharge follow-up data were available. These findings suggest that structured, reasoning-driven physiotherapy may support meaningful short-term functional recovery in selected cases of recurrent postoperative radiculopathy in high-risk occupational cohorts. The contribution of this report lies in the novelty of the integrated application of techniques (systematic MDT classification in postsurgical FBSS, concurrent multiregional spinal management and mechanistically informed selection of AL-TENS over conventional TENS). Mechanical assessment appears valuable for identifying reversible dysfunction and guiding conservative management. Long-term follow-up studies are needed to confirm the durability of these outcomes.

Benign paroxysmal positional vertigo (BPPV), particularly involving the posterior semicircular canal (PC-BPPV), is the most common peripheral vestibular di

Background: Both benign and malignant tumors in neonates frequently necessitate invasive diagnostic and therapeutic procedures, exposing infants to significant pain and stress during critical periods of brain development. Procedural stress can disrupt the hypothalamic-pituitary-adrenal axis, affect synaptic pruning, and alter myelination, potentially leading to long-term cognitive and neurodevelopmental impairments. While standard medical care remains the cornerstone of management, there is growing interest in multimodal interventions—including integrative therapies, physiotherapy, and non-pharmacological approaches such as massage, music therapy, kangaroo care, and sensory stimulation—to mitigate discomfort and support neurodevelopmental outcomes. Objective: This study aimed to systematically evaluate how well multimodal therapies reduce stress and suffering while enhancing neurodevelopmental outcomes in infants with both benign and malignant tumors. Methods: The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) standards will be followed in the conduct of this systematic review. Studies that use multimodal therapies (eg, physiotherapy, massage, music therapy, kangaroo care, or other non-pharmacologic techniques) for newborns with proven malignant or benign tumors will be considered. A thorough literature search will be conducted using databases such as the PubMed, Embase, and CINAHL, Cochrane, and CancerLi. Cohort studies, case-control studies, quasi-experimental studies, and randomized controlled trials will all be considered. Measures of pain (such as validated neonatal pain scales), stress (such as cortisol levels and behavioral markers), and neurodevelopment (such as the Bayley Scales of Infant Development) will be the main objectives. Results: The anticipated timeline for completing this systematic review is June 2025 to December 2027. Two independent reviewers will conduct each stage of the review process in a blinded manner to minimize bias. Conclusions: This systematic review aims to provide evidence-based insights into the role of multimodal interventions in enhancing standard care for neonates undergoing tumor-related procedures. Conclusions regarding clinical impact will be conditional on the quality and consistency of the evidence, as assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). The findings are expected to guide future research, inform cautious clinical recommendations, and support the development of integrative strategies to optimize neurodevelopmental outcomes in this vulnerable population.

Background: Abnormal cell growth that can multiply and transfer to other bodily parts is referred to as cancer. Chemotherapy is a standard treatment for cancer patients. During or after treatment, patients may have varying degrees of cognitive impairment caused by the drug, which can negatively impact their quality of life. Cognitive impairment brought on by chemotherapy is one of the most frequent side effects that occur both during and after chemotherapy. Cognitive effects after and during chemotherapy have not been addressed in patients. Objective: To evaluate the effectiveness of cognitive rehabilitation on cognition and quality of life in chemotherapy-induced cognitive impairment. Methods: In this Randomized Control Trial (RCT), 60 subjects with chemotherapy-induced cognitive impairments secondary to any cancer will be randomised into 2 groups by the sequentially numbered opaque sealed envelope approach. The cognitive functions will be measured as the outcome measures, which include all the recall strategies, executive function tasks, information processing speed, and attention. Both groups will receive intervention every day for 4 weeks. Wilcoxon signed the rank test for data analysis, and students paired the “t” test, which will be used to study within-group effects. Mann-Whitney U Test and students Unpaired “t” Test will be used to compare groups at pre-treatment and post-treatment. Results: As of November 2024, we will enrol 60 participants, and the data collection process will start from November 2024- November 2025. The expected results of the effect of cognitive rehabilitation on cognition and quality of life in chemotherapy-induced cognitive impairment in cancer patients will be significant, and the expected results will be published at the end week of November 2025. Conclusions: The study design is a framework to plan and test the feasibility of the intervention. The cognitive therapy will improve the cognition in chemotherapy-induced cognitive impairment patients. Trial Registration: Clinical Trials Registry India CTRI/2024/04/065805; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTAyNTE1&Enc=&userName= International Registered Report Identifier (IRRID): DERR1-10.2196/66011

This systematic review protocol introduces the rationale to investigate how well the Vojta approach works to improve respiratory function and lessen neuromuscular deficits in premature newborns. Innovative approaches like the Vojta technique may offer a possible therapeutic path for preterm newborns, who frequently suffer significant obstacles in their early development. We outline a rigorous methodology for this systematic review. A comprehensive search strategy will be implemented across various databases to identify relevant studies. This systematic review will encompass randomized controlled trials through electronic and manual searches. Electronic searches will be carried out in databases such as PubMed, Medline, Scopus, and Web of Science. The search will span articles published from 2000 to 2025; predefined eligibility criteria involve participants who were premature babies (those born before 37 weeks gestation). Exposure includes participants diagnosed with any other diagnosis that does not include NRDS. Outcome measures focus on oxygen saturation levels (SpO₂), arterial blood gas (ABG) analysis (e.g., PaO₂, PaCO₂, and pH), respiratory rate (breaths per minute), and lung compliance (static or dynamic) will all be used to quantify respiratory function. Two independent reviewers will conduct study selection, data extraction, and risk of bias assessment. The primary outcomes encompassing SpO₂, ABG, Ballard, and APGAR will be systematically analysed. Dissemination and ethics As no primary data will be collected, ethical approval is not required. The findings will be presented at relevant conferences and published in a peer-reviewed journal. Systematic review registration PROSPERO CRD420250643755.

The importance of maternal involvement in the care of a preterm newborn after discharge from Neonatal Respiratory Distress Syndrome is demonstrated by this instance. With a birth weight of 2.99 lb at 34 weeks gestation, the baby needed NICU support, which included mechanical ventilation and surfactant therapy. The mother showed remarkable engagement after a stable discharge by attending follow-up appointments consistently, adhering to physiotherapy and vaccination regimens, and identifying minor ailments early. The infant met age-appropriate growth and developmental milestones over the 6 month follow-up period, and there were no significant problems or readmissions. The case highlights the vital role that maternal involvement in post-discharge care plays by demonstrating the favourable long-term effects that structured caregiver education, emotional support and empowerment may have on high-risk newborns.

Background: Neonatal respiratory distress syndrome (NRDS), a common and serious illness in preterm infants, is characterized by lung immaturity and inadequate surfactant production. Even though improvements in neonatal care have increased survival rates, optimizing supportive therapies such as physiotherapy is still essential to improve respiratory outcomes and overall recovery. Objective: This study aims to evaluate the effectiveness of physiotherapy therapies in enhancing respiratory function and clinical outcomes in neonates with NRDS. Methods: PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines will be followed for conducting a systematic review. Studies assessing the effects of physiotherapy therapies on newborns with NRDS, such as respiratory exercises, manual chest compressions, percussion, vibration, and postural drainage, high-frequency oscillation of the chest wall, cough stimulation, or suctioning will be included. A comprehensive search of electronic databases, including PubMed, Embase, CINAHL, and the Cochrane Library, to find pertinent observational studies, experimental studies, and randomized controlled trials, will be conducted. Important outcomes will be respiratory function metrics, oxygen saturation levels, length of mechanical ventilation, occurrence of problems, and overall newborn outcomes. Results: Exact numbers are not accessible at this time, as the review is hypothetical and has not yet been conducted. In order to inform clinical procedures and future studies, the results will contain data on respiratory improvement, intervention kinds, safety profiles, and the best times and frequencies for physical therapy in neonates with respiratory distress syndrome. Conclusions: This review will provide a comprehensive understanding of the role of physiotherapy in managing NRDS and its impact on clinical outcomes in neonates. The findings may guide clinical practice and inform future research on noninvasive strategies for improving neonatal respiratory care.