Idiopathic Parkinson's disease requires pharmacological therapies alongside a surgical approach combined with physiotherapy, occupational therapy and speech and language therapy. The following are particularly useful: dancing, swimming, playing drums, yoga, tai chi, and qi gong. This review provides an overview of the potential for pharmacological therapies based on the guidelines of the Oesterreichische Parkinson Gesellschatt.

Idiopathic Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms leading to decreased mobility, independence and social isolation. Traditionally the management of PD is based on symptomatic treatment including drugs and surgical approaches. However, some of the symptoms do not respond sufficiently to medication and surgery. This article reviews therapeutic strategies of rehabilitation in PD, considered as an adjuvant to pharmacological and surgical treatments, with the aim of minimizing functional disabilities and improving quality of life. Growing evidence has been seen for the effectiveness of various types of rehabilitation interventions, particularly the effectiveness of aerobic training, gait training and balance training combined with cognitive training.

Deep brain stimulation (DBS), also called cerebral neuromodulation, is a well-established treatment in Parkinson's disease. Especially in patients with severe tremor or with complications after medical therapy, such as fluctuations and/or dyskinesias, DBS can bring a tremendous improvement in quality of life. Improvements in imaging and the surgical technique have made the implantation procedure easier and safer. Moreover, the patient no longer needs to be awake during surgery. DBS can be performed safely under general anaesthesia. Finally, the technical features of the implantable material have dramatically improved in recent years. Devices are smaller and rechargeable, and they have constant current sources, which allow the electrical field to be better shaped to match the patient's specific anatomy.

The objective of this research was to determine the acid neutralization capacity (ANC) at 37°C ± 2°C (as per United States Pharmacopeia 30 and the National Formulary 25) of antacid preparations sold in various retail pharmacies in the United Arab Emirates. Another important objective was to quantify the sodium and calorific content of antacids, as well as overall monthly consumption, and cost of therapy of different antacids from different manufacturers. The tablet and liquid antacids fall into four statistically different ANC groups. Three of the tablet antacids have an ANC similar to that of liquid antacid medications described as being in the high-ANC class. Of the five liquid antacids tested, only two were found to have a high ANC between four production lots at 5% level of significance. The ANC of the most effective liquid antacid was twice that of the lowest. However, this variation in capacity for neutralization is not observed in the product description of antacid brands. A standard dose is one to two teaspoons: one teaspoon will neutralize 20.2–35.92 mEq and two teaspoons will neutralize 40.44–71.84 mEq depending on the antacid selected. It is apparent from the results of quantification that maximum ANC combined with a minimum dosage volume–weight ratio is achieved by antacids from the high- or intermediate/high-ANC group. Consumption of these categories of antacids is beneficial as they contain less sodium and fewer calories and they are less expensive for pharmacists and/or the public. The monthly cost of daily high-dose therapy is much lower for high-ANC tablet antacids than for low-ANC tablet antacids. In conclusion, if antacids are to be used optimally, it is imperative that the ANC is specified on the product label.

Social media discussion forums, blogs, wikis and three-dimensional virtual worlds are the current new techniques for learning. External social media sites, including Facebook (Facebook, Inc., Menlo Park, CA, USA), YouTube (YouTube, LLC, San Bruno, CA, USA), Wikipedia (Wikimedia Foundation, Inc., San Francisco, CA, USA), Flickr (Yahoo Inc., Sunnyvale, CA, USA), Twitter (Twitter, Inc., San Francisco, CA, USA), LinkedIn (LinkedIn, Mountain View, CA, USA) and Second Life (Linden Lab, San Francisco, CA, USA), have been considered as very useful learning and teaching tools in recent years. This provides a chance for student-centred and social constructivist pedagogies in an online environment, and enables students to easily contribute and collaborate to e-learning environments. The influences of social media have reached Arab culture and are quickly spreading. This study highlights the use of these media for self-directed learning (SDL) purposes among medical students. This is a cross-sectional study and the questionnaire was constructed using the Delphi technique at Google (Google Inc., Mountain View, CA, USA) documents and was uploaded to different social media sites. The questionnaire comprised 28 questions, which included information relating to demographic features and utilization of social media during SDL time. The data were entered into Statistical Product and Service Solutions (SPSS) version 21 (IBM Corporation, Armonk, NY, USA) and Pearson chi-squared tests were applied for comparison. We received a total of 103 responses in 1 week, 52 of which (50.5%) were from men. The greatest proportion of responses came from students in their fifth year (35%), followed by those in their fourth year and first year (18.4%). Most students (63%) scored a grade-point average of 4–5 points. Out of the total, only eight students (7.8%) responded that they do not use social network sites at all. Almost one-third of responders (33%) utilized social networks for SDL for 2–3 hours daily, and 84 responders (81%) declared that these social media sites are helpful during preparation for their examinations. Age, sex and academic year have a significant association (P < 0.05) with the use of social media. In conclusion, it is reported that the culture of using of social media is increasing in Arab society; however, we need to provide the guidance for its proper utilization for SDL purposes.

This article reports the case of a 50-year-old man who suffered bilateral femur neck fractures after falling as a result of excessive alcohol consumption. We record the presentation and subsequent treatment of this rare condition, which occurred in an individual with no previous or predisposing bone or systemic pathology.

Primary lymphoma of the testis is rare. The commonest type of lymphoma of the testis is diffuse large B-cell lymphoma, but other types of primary and metastatic lymphoma of the testis also occur. Diffuse large B-cell lymphoma usually manifests as a painless unilateral mass in older men. Children can also develop lymphoma of the testis. Constitutional symptoms may be experienced. Specimens for histological confirmation of this type of lymphoma are obtained through orchiectomy. Chemotherapy and radiotherapy are used to avoid or reduce recurrences. Intrathecal chemotherapy is also used to reduce recurrence in the central nervous system, but despite this central nervous system recurrences do occur. There is no consensus on the best chemotherapy regimen. It is important that a correct diagnosis is made based upon the microscopic and immunohistochemical characteristics of the tumour, because differentiation of diffuse large B-cell lymphoma from other types of lymphoma is helpful in selecting the correct chemotherapeutic regimen, and the appropriate regimen differs depending upon the specific type of lymphoma. There is a need for a global multicentre trial to identify the best treatment option for improving the long-term survival of patients and reducing central nervous system, extranodal and contralateral testis recurrences.

Increased understanding of the mechanical and physical properties of the lungs and gas flow has allowed considerable advances in the field of mechanical ventilation and lung protection. Maintaining laminar flow, ‘the physiological flow’, and preventing turbulent flow during mechanical ventilation prevent atelectasis and help keep the lung open. This protects the lung from ventilator-induced lung injury (VILI). Analysis of the pressure–volume (P/V) curve of the respiratory system is the basis for maintaining lung protection. Lung volumes affect the dynamics of the lung and usually have a significant effect on the flow, airway resistance, lung compliance, ventilation–perfusion ratio and recruitment. Functional residual capacity (FRC) has a significant role in maintaining the structure and function of the lung, and the relationship between the FRC and closing volume (CV) is more important than considering the FRC and CV alone. Positive end-expiratory pressure (PEEP), by preventing and/or recruiting atelectatic lung regions, can maintain the lung structure and protects against VILI. The optimal PEEP, still controversial, can be determined using the following methods: (1) a decremental PEEP trial after recruitment manoeuvres with PaO₂ and lung compliance guidance; (2) (quasi) static approaches or dynamic approaches based on the P/V curve; (3) based on the FiO₂/PEEP table with oxygenation guidance; (4) PEEP guided by oesophageal pressure; (5) based on a computerized tomography scan or chest radiograph; and (6) using electrical impedance tomography. Recruitment manoeuvres can help to recruit atelectatic lung regions and can be accomplished by raising the transpulmonary pressure periodically and briefly to a higher level than that achieved during tidal ventilation. Clinical and experimental studies has been conducted to identify the durability of the beneficial effects of recruitment manoeuvres, when and how to perform them, early or late in the course of acute respiratory distress syndrome and with high or low PEEP, and which categories of patients will benefit from them.