Journal of Health and Rehabilitation Sciences

Functional and Anatomical Outcomes Following Intravitreal Bevacizumab in Treatment-Naïve Centre-Involving Diabetic Macular Edema: A 3-Month Prospective Evaluation

2025-10-20T02:55:48+02:00

Introduction: Diabetic macular edema (DME) remains a major cause of vision impairment worldwide. Intravitreal bevacizumab, though used off-label, is an established therapy for centre-involved DME (CI-DME). This study evaluated how effectively microperimetry complements standard measures—best-corrected visual acuity (BCVA) and central macular thickness (CMT)—in assessing treatment outcomes.

Methods: In this prospective observational study, 52 eyes with treatment-naïve CI-DME received three monthly bevacizumab injections. BCVA, CMT (via OCT), and mean retinal sensitivity (by microperimetry) were recorded at baseline, one month, and three months. Statistical analyses included the Wilcoxon signed-rank test for repeated measures and Spearman’s rank correlation for structure–function relationships.

Results: After three months, mean BCVA improved from 0.50 ± 0.095 to 0.67 ± 0.088 (p < 0.001), while CMT decreased from 401.9 ± 87.6 µm to 329.5 ± 23.2 µm (p < 0.001). Mean retinal sensitivity rose from 14.96 ± 1.01 dB to 16.50 ± 1.39 dB (p < 0.001). Improvement in BCVA correlated positively with both CMT reduction (ρ = 0.340, p = 0.014) and sensitivity gain (ρ = 0.412, p = 0.004), while CMT reduction correlated inversely with sensitivity improvement (ρ = –0.367, p = 0.009).

Conclusion: Three consecutive bevacizumab injections resulted in significant anatomical and functional recovery in eyes with CI-DME. The consistent correlations between macular structure and function underscore the value of microperimetry as a sensitive, complementary tool for evaluating therapeutic response beyond standard acuity and OCT metrics.

Development and validation of Thought, Language, and Communication Assessment Scale for Persons with Aphasia

2025-10-08T01:37:45+02:00

Introduction: Aphasia impacts language and thought organization, disrupting effective communication. Thought, Language, and Communication (TLC) are interrelated, and breakdowns in one domain often affect the others. A comprehensive assessment tool is essential to understand and address these interlinks. This study aimed to develop and validate the Thought, Language, and Communication Assessment Scale for Persons with Aphasia (TLCAS-PWA) for Persons with Aphasia (PWA) and Neurotypical Individuals (NTI).

Method: The tool was developed through literature review and expert validation, comprising 14 parameters across communication, language, and thought domains, rated on a 5-point scale. It was administered to 20 PWA and 20 NTI.

Results: Among PWA, PCS showed the highest mean scores, while Self-reference was least frequent. At the domain level, both PWA and NTI had higher scores in Communication Disorder and lower in Language Disorder. Mann-Whitney U tests revealed significant differences between groups across all the domains. Psychometric analysis showed good internal consistency (α = 0.88), excellent inter-rater reliability (ICC = 0.98), and stable test–retest reliability.

Conclusion: TLCAS-PWA is a valid tool that aids clinicians in assessing TLC in aphasia, supporting diagnosis, intervention, and progress monitoring.

Evaluation of horizontal fusional vergence in young children with intermittent exotropia using the synoptophore and prism bar.

2025-10-14T02:09:21+02:00

Purpose: The aim of the study was to compare the synoptophore and prism bar for assessing horizontal fusional vergence (HFV) in young children with intermittent exotropia (IXT).

Methods: The research involved ninety-eight subjects with IXT, aged between six and sixteen years. The examination included vision assessment, a cover test, identification of the dominant eye, and measurement of the angle of deviation using a prism bar. The subjects' HFV (positive and negative fusional vergence) was assessed using a horizontal prism bar and synoptophore at both near and far distances. We assessed IXT's control utilizing the Newcastle score for both near and far distances.

Results: The positive fusional vergence (PFV) break points of the synoptophore above those of the prism bar at both near and distance ranges (P < 0.01). There was a statistically significant difference in PFV recovery points for both near (P < 0.01) and distance (P < 0.01). There were no statistically significant changes in the near-negative fusional vergence (NFV) blur and break points as determined by the prism bar and synoptophore. The distance, NFV blur, and break points were larger on the synoptophore compared to the prism bar (P < 0.01).The difference in NFV recovery points was statistically significant at both near (P = 0.05) and distance (P = 0.03).

Conclusion: It is essential to exercise caution when assessing the PFV and NFV in young children with IXT, as the synoptophore and prism bar are not comparable in these kinds of situations.

Treatment of Borderline Personality Disorder (BPD) Using ReAttach Therapy and an Eclectic Approach: A Case Study of a 27-Year-Old Unmarried Hindu Female Engineering Graduate

2025-10-20T02:55:58+02:00

Background: Borderline Personality Disorder (BPD) is a complex psychiatric condition characterised by persistent emotional dysregulation, a fragmented self-image, impulsive behaviors, and significant difficulties in maintaining interpersonal relationships. Managing BPD poses notable challenges, particularly when accounting for the impact of various cultural contexts on symptom expression and treatment methodologies.

Objectives: This case study aimed to assess the effectiveness of an eclectic treatment approach that integrates ReAttach Therapy with established interventions for the management of BPD. The subject of the study was a 27-year-old unmarried Hindu female engineering graduate diagnosed with BPD.

Methods: The intervention lasted 52 weeks and combined ReAttach Therapy as the primary modality with Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and mindfulness practices. Standardised psychometric tools (BSL-23, DERS, and BDI-II) were administered before and after treatment to evaluate outcomes.

Results: The results indicate significant improvements in emotional regulation, a decrease in fears of abandonment, stabilisation in relationships, and enhanced psychological resilience. These findings suggest that the combination of ReAttach Therapy with eclectic techniques presents a promising and culturally adaptable framework for managing BPD.

Conclusions: The integrative approach resulted in a considerable reduction in BPD symptoms, indicating that ReAttach Therapy, when used in conjunction with eclectic techniques, may offer an effective and culturally responsive strategy for treating BPD.

Family Quality of Life from the Perspective of Parents of Children with Intellectual Disabilities

2025-08-03T21:30:52+02:00

Aim: The quality of life of families with children with intellectual disabilities has been frequently analysed in recent research. There are numerous factors that influence the quality of life of families. The aim of the study was to determine the quality of life of families of children with intellectual disabilities who are cared for by the Sloboština Rehabilitation Centre.

Methods: The study used the Beach Center Family Quality of Life Scale questionnaire, which was completed online by the parents. 51 parents of children and adolescents with intellectual disabilities took part in the study.

Results: The results of the study show that the overall quality of life is satisfactory. However, parents of children with intellectual disabilities are least satisfied with emotional well-being and disability-related support. They are not satisfied with the time they have to pursue their interests or with outside help for all family members. They also consider the support a child with disabilities receives at school to be mediocre. No statistically significant differences in quality of life were found in relation to the age and gender of parents and children, except for the family interaction subscale, where families with girls had a better quality of life.

Conclusion: The results of the study show that although the overall quality of life is satisfactory, families of children with intellectual disabilities need external support that provides them with some free time but also aims to support all family members.