Shwe Parami Stroke Rehabilitation Clinic

29/10/2025

Acute stroke management

"Every Minute Counts" that is an urgent massage of World Stroke Day 2025,
emphasizing how timely action can save lives and improve recovery.

Acute stroke management is critical because it aims to save brain cells, minimize long-term disability, and improve the chance of recovery.

A stroke is the rapidly developing loss of brain functions because of disturbance in the blood supply to brain. It can be due to ischemia caused by thrombosis or embolism or due to hemorrhage. 85% will have sustained a cerebral infarction due to inadequate blood flow to part of the brain. The remainder will have had an intracerebral hemorrhage. Sometimes stroke symptoms are resolved completely within 24 hours because of the reversibility of tissue damage from ischemic attack that is called transient ischemic attack (TIA). If affected area of the brain that is large, neurological deficient of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours.
An ischaemic stroke is occasionally treated with thrombolysis, but usually with supported care (physiotherapy, speech and language therapy and occupational therapy) in a ”stroke unit” and secondary prevention with antiplatelet drugs (aspirin and often dipyridamole), blood pressure control, statins and selected patient with carotid endarterectomy and anticoagulation.

Various systems have been proposed to increase recognition of stroke. Sudden onset face weakness, arm drift (i.e. if a person, when asked to raise both arms, involuntarily lets one arm drift downward), and abnormal speech are the findings most likely to lead to the correct identification of a case of stroke increasing the likelihood by 5.5 when at least one of these is present). All of these are absent, the likelihood of stroke is significantly decreased (likelihood ratio of 0.39).
Propose systems include FAST (face, arm, speech, and time) as advocated by the Department of Health (UK) and the Stroke Association, the American Stroke Association, the National Stroke Association (US), Los Angeles Prehospital Stroke Screen (LAPSS) and Cincinnati Prehospital Stroke Scale (CPSS). Use of these scales is recommended by professional guidelines.
For the people referred to emergency room, early recognition of stroke, a scoring system is called ROSIER (recognition of stroke in the emergency room), it is based on features from the medical history and physical examination.

Acute stroke management requires immediate stabilization, including airway support, blood pressure control, and IV access, while addressing the stroke type (ischemic or hemorrhagic) with interventions like thrombolytics or mechanical thrombectomy if applicable. Simultaneously, damage-induced pulmonary edema (neurogenic pulmonary edema) necessitates supportive care like oxygen or mechanical ventilation, but avoids aggressive diuresis to prevent compromising cerebral perfusion.
Monitor ICP and manage it if it becomes elevated using osmotherapy (e.g., hypertonic saline) or other methods.

Stroke and management can be seen at following link.

Stroke A stroke is the rapidly developing loss of brain functions because of disturbance in the blood supply to brain. It can be due to ischemia caused by thrombosis or embolism or due to hemorrhage. 85% will have sustained a cerebral infarction due to inadequate blood flow to part of the brain....

28/10/2025

Tomorrow, August 29 is World Stroke Day,
the annual event was started in 2006 by the World Stroke Organization (WSO) and the WSO declared stroke a public health emergency in 2010.

World Stroke Day 2025 brings an urgent message through its theme
“Every Minute Counts,”
emphasizing how timely action can save lives and improve recovery.
The campaign also promotes the F.A.S.T. acronym (Face drooping, Arm weakness, Speech difficulty, Time to call for help) and calls for increased advocacy, awareness, and timely action from individuals, communities, and healthcare systems.

I have sent many posts about stroke rehabitation by using multiple injections of vitamin B12 on facebook and LinkedIn.
It can be used as another choice for stroke rehabitation, if a stroke patient does not progress by current rehabitation treatments.
Multiple injections of vitamin B12 technique has been used for stroke rehabilitation before staring the annual event of World Stroke Day.

This technique is nerve stimulation by using vitamin B12 injections near the nerve on limbs and body sites on affected sdie.
It is how to use the abnormal reflex responses after stroke to aid in rehabilitation, as stimulating the withdrawal reflex can be a tool to improve muscle power and reduce spasticity.

After a stroke, the central nervous system's ability to control spinal reflexes is disrupted, which can lead to abnormal muscle activation and movement difficulties.
However, withdraw reflex that was stimulated by using multiple injections of vitamin B12 method, has shown in improving power, balance, and other motor functions. These multiple injections cause synergies of muscle and adjust
abnormal muscle synergies lead to involuntary and stereotypical movements, such as the flexor synergy (elbow, wrist, and finger flexion) or the extensor synergy (hip extension, knee extension, and plantar flexion of the foot) and reduce spasticity.

While voluntary muscle movement originates from the brain, every movement can be learned or replicated through the direct stimulation of the motor nerves that control the muscles. This is the principle behind multiple injections of vitamin B12 method that causes muscle contractions, mimicking the body's natural process.

In addition pain stimulation triggers neuroplasticity, the brain's ability to change, which can either be beneficial (in acute pain) or maladaptive (in chronic pain).
In the short term, pain stimulation can enhance the connections between neurons, helping the body adapt.

Post stroke rehabitation by using multiple injections of vitamin B12 technique can be seen at the following link.

Abstract This is a technique of post stroke rehabilitation by using multiple injection of B12. Most of stroke patients recovered in certain duration after taking of the treatment by multiple B12 injections. Those are injected near a relevant nerve on the limbs and body sites of stroke patient on ...

26/10/2025

Microtubules of Nervous System,
Pain Stimulation, and Why Multiple Injections of Vitamin B12 Causes Induction of Neuroplasticity

Microtubules play a crucial role in neuroplasticity by providing structural support, acting as tracks for transport, and responding dynamically to neural activity.
They help maintain neuronal shape, regulate synaptic function, and transport essential components to synapses, allowing for changes in neural connections that are fundamental to learning and memory.

Microtubules are dynamic structures that can undergo polymerization (growth) and depolymerization (shrinkage).
Microtubule dynamics can be altered by pain stimulation, leading to changes in synaptic vesicle release, neurotransmitter receptor expression, and the overall excitability of the neuron.

Mechanisms of action
Synaptic transmission: Microtubules are essential for the transport and recycling of synaptic vesicles, which are the storage sacs for neurotransmitters. During pain stimulation, proper microtubule function is needed for the release of neurotransmitters that transmit the pain signal from one neuron to the next.

Synaptic plasticity:
Microtubule dynamics are essential for synaptic plasticity. Pain stimulation can trigger activity-dependent changes in microtubules, affecting synaptic plasticity and the overall network response to pain.

Dendritic spines:
Pain stimulation can lead to the dynamic entry of microtubules into dendritic spines, which is a key process for postsynaptic plasticity and the strengthening or weakening of synaptic connections.

Axonal regeneration:
In response to injury, changes in microtubule stability can promote axon regeneration and sprouting, which is a form of neuroplasticity that can contribute to pain relief.

Neuronal excitability:
Microtubules contribute to the organization of the axon initial segment, which is critical for the initiation of action potentials. Changes in microtubule dynamics can affect neuronal excitability by altering firing activity.

Pathological conditions:
In chronic pain states, microtubules can become less dynamic and stable than in healthy individuals, which can lead to inefficient synaptic transmission, aberrant firing activity, and a loss of postsynaptic plasticity.

Regulation of neurotransmitter release: Microtubule dynamics are tightly regulated to control the release of neurotransmitters. For example, they can restrict spontaneous neurotransmitter release and replenish the readily releasable pool of synaptic vesicles, a process that can be impacted by pain.

Neuromodulation and pain relief:
By modulating microtubule dynamics, neuromodulation techniques, can enhance microtubule stability and promote a beneficial plasticity that can lead to pain relief.

Therefore stimulation by using multiple injections of vitamin B12 near the nerve on limbs and body sites on affected side, a neuromodulation technique that causes induction of neuroplasticity and relives pain.

Photo credit

26/10/2025

Immune Tolerance Therapy and Tolerogenic Dendritic Cells (tolDCs)

This post is related with current Nobel Prize in Physiology or Medicine.
The 2025 Nobel Prize in Physiology or Medicine was awarded to Mary E. Brunkow, Fred Ramsdell, and Shimon Sakaguchi for their discoveries concerning peripheral immune tolerance.
They identified regulatory T cells (T-regs), which are immune system cells that prevent the body from attacking itself and causing autoimmune diseases. This breakthrough is considered fundamental to understanding how the immune system is regulated and has opened up new avenues for treating autoimmune diseases, cancer, and other immune-related conditions.

Immune tolerance therapy is a medical approach that aims to reprogram the immune system to stop it from attacking the body's own tissues or foreign antigens, leaving its ability to fight off harmful pathogens intact. This can be applied to treat autoimmune diseases or conditions where the immune system has developed an adverse reaction, such as the formation of inhibitor antibodies in hemophilia or organ transplant rejection.

Therapies can work by promoting the activity of regulatory T-cells, inducing anergy (unresponsiveness) in effector T-cells, or leading to the apoptosis (programmed cell death) of antigen-specific B-memory cells.

T cells have a dual role in autoimmune diseases. Regulatory T calls they are crucial for maintaining self-tolerance, but when this system fails, autoreactive T cells cause tissue damage and inflammation. They can directly harm tissue or help B cells produce autoantibodies, and their dysfunction can lead to the chronic inflammation characteristic of autoimmune disorders.
Dendritic Cells (DCs) are critical for maintaining immune tolerance, but dysregulation in their function can lead to the breakdown of this network and promote T cells that attack self-antigens.

Immune tolerance therapy uses dendritic cells (DCs) to reprogram the immune system to prevent autoimmune responses. DCs can be manipulated to become "tolerogenic" (tolDCs) to stop the immune system from attacking itself, while still allowing it to fight off pathogens.

These tolDCs are generated in a lab by modifying a patient's dendritic cells to be less inflammatory and more suppressive.

Tolerogenic dendritic cells (tDCs) are induced through various methods, including the use of specific cytokines like IL-10, or by stimulating them with certain molecules such as vitamin D receptor (VDR) agonists, retinoic acid, and activating the aryl hydrocarbon receptor (AhR).

These tolDCs then train the immune system to be tolerant by:
Preventing the activation of self-reactive T cells.
Promoting the development of regulatory T cells (Tregs), which suppress the immune response.
Limiting the differentiation of other harmful effector T cells.

This therapy holds promise for treating conditions like autoimmune diseases and preventing organ transplant rejection.

Current challenges and future directions
Standardization: Identifying the best subsets of DCs for different applications and standardizing their generation for clinical use is an ongoing area of research.

Clinical trials: While early clinical trials have shown promise for the safety and efficacy of tolDC-based therapies, more studies are needed to fully evaluate their effectiveness in patients.

Photo credit

24/10/2025

Chimeric Antigen Receptor (CAR) T-cell Therapy

Stem cell-based immunotherapy uses stem cells to fight diseases, particularly cancer, by training the immune system, replacing damaged cells, or delivering targeted therapies. This approach leverages stem cells' abilities to differentiate into specialized cells and to modulate immune responses.
A key advancement is engineering stem cells, such as pluripotent stem cells (PSCs) or induced pluripotent stem cells (iPSCs), to create enhanced immune cells like Chimeric Antigen Receptor (CAR)-T cells.

Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy where a patient's own T-cells are genetically engineered to recognize and attack cancer cells. This is a personalized process that involves collecting a patient's T-cells, modifying them in a lab to express a CAR that targets cancer-specific antigens, growing large numbers of the modified cells, and then infusing them back into the patient to fight the disease. It is used to treat certain blood cancers like leukemia and lymphoma, especially when other treatments have failed, and is being studied for solid tumors.

A summary of stem cell-based immunotherapy for cancer treatment.
(1) Blood collection: blood is drawn from the patient.
(2) Stem cell isolation: cells, including T cells, are isolated from the collected blood. (3) CAR gene insertion:
The T-cells are sent to a laboratory where they are genetically modified to produce chimeric antigen receptors (CARs) on their surface.
T cells are genetically engineered to express a Chimeric Antigen Receptor (CAR) targeting specific tumor antigens. The CAR typically consists of an antigen-recognition domain (e.g., scFv) and one or more signaling domains for T cell activation.
(4) Activation: The CAR T cells are expanded ex vivo to obtain sufficient numbers for therapeutic use.
The modified T-cells are grown in large numbers.
(5) Injection into patient: Activated CAR T cells are infused back into the patient.
(6) Tumor targeting: CAR T cells recognize and bind to tumor cells, leading to their elimination. The effector mechanism involves the release of cytotoxic molecules such as perforin (PFN) and granzyme B (GzmB), and pro-inflammatory cytokines like interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α), ultimately inducing cancer cell death.

The lower panel illustrates various cancer immune suppressing cells involved in TME: Myeloid-Derived Suppressor Cells (MDSC), M2 macrophages (M2), Regulatory T cells (Treg), T helper 2 cells (TH2), NKT2 cells (NKT2), N2 neutrophils (N2), Group 2 innate lymphoid cells (ILC2), and Natural Killer cells (NK2). These cells secrete various cytokines and chemokines, including interleukin (IL)−6, IL-10, IL-13, IL-5, transforming growth factor beta (TGF-β), and CCL2, which contribute to immune suppression. Growth suppressors are also depicted, indicating their role in inhibiting cell proliferation (Created with BioRender). See at the folloeing picture.

CAR -T cells therapy is effective in treating certain types of leukemia, lymphoma, and multiple myeloma, particularly when the cancer is refractory (doesn't respond to other treatments).

Solid tumors: Currently being studied for its potential to treat solid tumors, such as colorectal cancer.

Potential risks and side effects
Cytokine release syndrome (CRS): A systemic inflammatory response that can cause fever, headache, and changes in blood pressure.
Neurologic complications: Can range from headaches to confusion, delirium, and seizures.
Other potential side effects: Include fever, chills, fatigue, and low blood pressure.
Long-term effects: In rare cases, long-term symptoms or organ damage may occur.

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18/10/2025

The char on barbecued food and risk of cancer

Cooking or eating raw is not inherently superior; both have benefits and drawbacks, and the best approach is often a mix of both.
Cooking can improve digestibility and make certain nutrients like lycopene and beta-carotene more available, while also increasing food safety by killing harmful bacteria.
On the other hand, raw foods are a great source of certain nutrients, like vitamin C in raw spinach, and raw vegetables contain fiber that is beneficial for digestion.

Smoked foods can increase the risk of cancer, particularly stomach and intestinal cancers, because the smoking and high-heat cooking processes create harmful chemicals like Polycyclic Aromatic Hydrocarbons (PAHs) and Heterocyclic Amines (HCAs).

PAHs: These form when fat and juices from meat drip onto a hot grill, causing smoke. This smoke coats the food with PAHs.
HCAs: These form in meat when high temperatures react with amino acids and creatine. The longer the cooking time at high heat, the more HCAs are produced.

The PAHs and HCAs in smoky, charred foods can cause DNA damage, which is linked to an increased risk of cancer.
These compounds are mutagenic, meaning they can cause changes in your DNA, which increases your risk of developing cancer.
High consumption has been linked to an increased risk of intestinal cancers like stomach and colon cancer, and potentially breast and prostate cancer.

In the early modern period, chimney sweeps' carcinoma is a squamous cell carcinoma of the sc***um, historically linked to chimney sweeps due to occupational exposure to soot. First described by Percivall Pott in 1775, it was the first cancer to be identified as occupational in origin. Prolonged skin contact with soot, especially in the scrotal area, would lead to warts ("soot warts") that could develop into cancer.

Soot contains carcinogenic substances, most notably polycyclic aromatic hydrocarbons (PAHs), such as benzo[a]pyrene.
These PAHs are genotoxic, meaning they can damage DNA. Benzo[a]pyrene, for example, forms adducts with DNA.

The char on barbecued food is largely made of carbon atoms that have been left behind after the non-carbon atoms in the food break down due to prolonged heat. These particles, along with soot, are a major component of smoke and can be harmful when inhaled or ingested.

The PAHs and HCAs in smoky, charred foods can cause DNA damage, which is linked to an increased risk of cancer.
Inhaling smoke and carbon particles, especially from traditional cooking methods that use biomass, can cause respiratory issues.
Soot and carbon particles have been linked to cardiovascular problems and damage to other organs.

How to minimize risks
Limit charring and smoking: Avoid heavily charred or burnt parts of food and opt for less smoky methods when possible.
Ventilate properly: Use exhaust fans when cooking, and if barbecuing, do so outdoors to reduce indoor air pollution.
Be mindful of meat: Choose leaner cuts of meat, and consider eating less red meat, which can produce more carcinogens than white meat when smoked or charred.
Don't overcook: Watch your food closely to prevent overcooking and burning, which releases more harmful compounds.
Keep surfaces clean: Clean cooking surfaces to prevent debris from burning and creating extra smoke.

Photo credit

15/10/2025

White matter functions in children's brain and Excessive screen time can affect on white matter integrity

White matter connects different parts of the brain, allowing regions that send and receive signals to work together efficiently.
It is crucial for developing higher-level functions such as focus, problem-solving, and learning. Early white matter development is linked to later cognitive abilities.

White matter tracts are fundamental for language-related activities, including conversational turns and the development of phonological awareness and vocabulary.

White matter helps coordinate sensory and motor skills, contributing to functions like balance when walking.

Maturation of white matter is associated with increased brain efficiency, which in turn affects various cognitive and behavioral outcomes.

Throughout childhood, experiences and coordinated brain activity drive the maturation of these connecting pathways, supporting the emergence of complex cognitive functions.

Preschoolers may seem more "like screens" than adults due to the continuous, dopamine-driven stimulation screens provide, which can be difficult for young, developing brains to ignore.

Excessive screen time in young children is associated with lower white matter integrity, which could affect the development of language, literacy, and cognitive skills.

For very young children, passive screen time can hinder the development of language and problem-solving skills because it reduces opportunities for active, hands-on exploration and interaction.

Inaddition excessive screen time can lead to physical issues like eye strain, obesity, and poor posture, while also contributing to mental and emotional problems such as anxiety, depression, and aggression.

Too much time in front of a screen can harm a child's mental and physical well-being. Therefore it is very important to limit the amount of time that children use their devices.
Screen time can displace crucial activities like free play, social interaction, and physical exercise, which are essential for a child's healthy development.

In this study of 47 preschool-aged children, increased use of screen-based media in the context of the AAP guidelines was associated with lower microstructural integrity of brain white matter tracts that support language, executive functions, and emergent literacy skills, controlling for child age and household income. Screen use was also associated with lower scores on corresponding behavioral measures, controlling for age.

This cross-sectional study examines the results of diffusion tensor imaging, cognitive testing, and a screen time survey to identify the implications of screen-based media use for the development of language and literacy skills in early childhood.

10/10/2025

My patient with left hemiplega without CT changes

A 52 years old female patient with left hemiplega comes to take rehabilitation treatment on today.
The patient has gotten stroke attack and left hemiplega since 20 days ago.
She has atreial fibrillation (AF) with severe mitral stenosis (MS) of heart in accordance with Echo cardiogram result and ECG findings.
However there is no hypodense or hyperdense areas in both sides of brain in the CT scan of head.

In the emergency setting, a standard CT (NCCT) has limited sensitivity for early ischemic stroke, with sensitivity often around 50-75% and typically only detecting changes after 12-18 hours.
Standard CT (Non-Contrast CT or NCCT) is not very sensitive for early ischemic stroke because the physical changes of ischemia, such as gray-white matter differentiation, take time to become visible on the scan.
But it is crucial for ruling out hemorrhagic stroke (bleeding), which is a critical distinction for treatment decisions.

However, CT Perfusion (CTP) significantly improves sensitivity to about 82%, while CT Angiography (CTA) has a high sensitivity of 93-98% for detecting vascular blockages like stenoses and occlusions. Therefore, a combination of CTA and CTP is the most effective CT-based approach to quickly assess acute ischemic stroke in the emergency department.

Factors influencing CT sensitivity:
1. Time from onset: CT sensitivity is very low in the first few hours after a stroke begins, but increases over time as the affected area of the brain shows more changes.
2. Stroke size and location: Small, deep, or brainstem strokes may not be detectable on early CT scans.
3. CT technology:
3a. NCCT (Non-Contrast CT): Detects changes in brain tissue density and is excellent for ruling out a hemorrhagic stroke, but it is less sensitive for identifying acute ischemic changes.
3b. CT Perfusion (CTP): By using a contrast agent to measure cerebral blood flow and volume, CTP can detect ischemic changes and identify areas of infarct core and penumbra with much higher sensitivity than NCCT.
3c. CT Angiography (CTA): This technique uses contrast to visualize blood vessels and is more sensitive than NCCT for detecting the cause of the stroke.

When CT is insufficient:
1. Early stroke: In the critical first few hours after symptoms start, an MRI, particularly with Diffusion-Weighted Imaging (DWI), is more sensitive than CT for detecting ischemic damage.
2. Small or deep strokes: Tiny infarcts or those located deep within the brain may be missed on a standard CT scan, even after several hours.
3. Complex cases: In some situations, a combination of imaging techniques, including MRI and CTA, may be necessary for an accurate diagnosis and treatment decision.

03/10/2025

Stem cell transplantation can reverse stroke damage, researchers at the University of Zurich report. Its beneficial effects include regeneration of neurons and restoration of motor functions, marking a milestone in the treatment of brain disorders.

https://scitechdaily.com/stroke-damage-reversed-as-stem-cells-regrow-the-brain/

01/10/2025

အာရုံကြောနှင့်အနီးကပ် ဗီတာမင်ဘီတွဲ ထိုးခြင်းနည်းပညာနှင့် အာရုံကြောအသစ်ဖြစ်ပေါ်ခြင်းနှင့် ပြန်လည်ကောင်းမွန်ခြင်း
Perineural injection of vitamin B12 technique and peripheral nerve regeneration and repair

ဗီတာမင်ဘီတွဲသည် ဒီအင်န်အေဖွဲ့စည်းတည်ဆောက်ခြင်း သွေးနီဥဖြစ်ခြင်း နှင့် အာရုံကြောများထိန်းသိမ်းခြင်းနှင့် ဦးနှောက်ကျန်းမာရေးအတွက်မရှိအဖြစ်လိုအပ်သည်။
အစာအဟာရ များကိုစွမ်းအင်အဖြစ်ပြောင်းလဲပေးခြင်း၊ ဗဟိုအာရုံကြောစနစ်ဖွံဖြိုးဖြင်းနှင့် သွေးအားနည်းရောဂါ (megaloblastic anaemia) မဖြစ်အောင်ကာကွယ်ခြင်းတို့အတွက် အရေးကြီးသည်။
Vitamin B12 is essential for DNA synthesis, forming healthy red blood cells, and maintaining nerve and brain health. It is crucial for converting food into energy, the development of the central nervous system, and preventing megaloblastic anemia.
အာရုံကြောနှင့်အနီးကပ် ထိုးပေးခြင်းသည် သီးခြား နည်းပညာအသစ်တစ်ခုဖြစ်သည်
အာရုံကြေားအနီးကပ် ဘီတြဲ ထိုးပေးခြင်သည် အာရုံကြောများ အသစ်ဖြစ်ပေါ်ခြင်းနှင့် ပြန်လည်ကောင်းမွန်လာခြင်းကို အထောက်အကူပြုတို့းမြင့်စေ၍ အာရုံကြောဆိုင်ရာလိုသလိုပြောင်းလဲဖြစ်ပေါ်ခြင်း (neuroplasticity) ကိုတွန်းအားပေခြင်းဖြစ်သည်ဟုကောက်ချက်ချနိုင်သည်
Perineural injection is a relatively new technique.
Perineural injections of vitamin B12 promote nerve regeneration and repair, which can be interpreted as inducing neuroplasticity.

အာရုံကြောအနီးကပ် ဗီတာမင်ဘီတွဲထိုးပေးခြင်းများတွင်ပါဝင်သည်မှာ ဘီတြဲ၊ မီသိုင်းကိုဘာလမင်း (methylcobalamin) ကို အာရုံကြောအနီးထိုးပေးခြင်းဖြင့် ပြင်ပအာရုံကြောစနစ် အာရုံကြော ပျက်စီးခြင်းဖြစ်သော လက်မောင်းအရုံကြောအစုအဖွဲ (brachial plexus) ပျက်စီးခြင်း အာရုံကြောများထုံကျင်ခြင်းတို့တွင် အာရုံကြောအသစ်ဖြစ်ပေါ်စေခြင်း၊ အာရုံကြောအမြှေးပါး မိုင်ရီလင် (myelin) ဖြစ်ပေါ်ခြင်းနှင် အာရုံ ကြောအလယ်ဝင်ရိုး (axon) ဖွံ့ဖြိုးခြင်းကိုအထောက်အကူပြု တို့းမြှင့်စေသည်
Perineural vitamin B12 injections involve directly injecting methylcobalamin (a form of B12) around a nerve to promote nerve regeneration, myelin formation, and axonal maturation in cases of peripheral nerve damage, such as brachial plexus injuries or neuropathy.
ဤ အသစ်ထွက်ပေါ်လာသောနည်းပညာသည် ထိခိုက်သောအာရုံကြောသို့တိတိကျကျရောက်စေရန် ပို၍မြင်မားမြင်သာသောအောထရာဆောင်းလမ်းညွန်(high resolution ultasound guide) နှင့်ထိုးပေးခြင်းဖြစ်သည်၊ ထိုသို့ပြုလုပ်ပေးခြင်းဖြင့် သီးခြားအကြောင်းအရာ၌ အာရုံဆိုင်ရာလှုပ်ရှားမှုနှင့်ခံစားမှုများပိုမိုတိုးတက်ကောင်းမွန်လာသည့်အလားအလာရှိသည့် ရလာဒ်ကိုပြဆိုသည်
This emerging technique uses high-resolution ultrasound to guide the injection, allowing for precise delivery to the affected nerve, and has shown promising results in improving motor and
sensory function in specific cases, though further research is needed to validate its widespread efficacy.

သုတေသနပြုမှုက ပြဆိုသည်မှာ ဗီတာမင်ဘီတွဲသည် အာရုံကြောအလယ်ဝင်ရိုး (axon) ကြီးထွားမှုကိုလှုံဆော်နိုင်သည်၊ အာရုံကြောထိခိုက်ဒဏ်ရာရပြီးခြင်းမျိုးဖြစ်သော လက်မောင်းဆိုင်ရာအာရုံကြောအစုအဖွဲ (brachial plexus) လုပ်ဆောင်မှုဆိုင်ရာပြန်လည်ကောင်းမွန်တိုးတက်လာသည်၊ အာရုံကြောဆိုင်ရာတည်ဆောက်ပုံနှင့် လုပ်ဆောင်မှုအတွက်အရေးပါသော မိုက်ခရိုပြွန်ငယ်များ (microtubules) တည်ငြိမ်ရန်အကူအညီဖြစ်သည်
Research indicates vitamin B12 can stimulate axon growth, improve functional recovery after nerve injuries like brachial plexus injury (BPI), and may help stabilize microtubules, a crucial component of neuronal structure and function.
တိကျသောလုပ်ဆောင်ခြင်းများသည် စုံစမ်းလေ့လာဆဲပင်ဖြစ်သောလည်း ဘီတွဲသည် အာရုံကြောထိခိုက်ခြင်းမှကာကွယ်နိုင်သည်၊ အာရုံကြောများပြန်လည်ကောင်းမွန်လာစေရန် အဓိကအချက်အဖြစ် ပတ်ဝန်းကျင်တစ်ခုဖန်တီးပေးခြင်းဖြင့် အာရုံကြောဆိုင်ရာလိုအပ်လိုပြောင်းလဲခြင်း (neuroplasticity) အခနျးကဏ်ဏ္႑တဈခု အဖြစ်ရှိနေသည်
While the exact mechanisms are still under investigation, vitamin B12's role in protecting neurons from damage and creating an environment for nerve recovery points to a role in neuroplasticity.

စူးစမ်းလေ့လာမှုများကပြငည်မှာ အာထရာဆောင်း လမ်းညွှန့်အာရုံကြောအနီးကပ် ဘီတွဲထိုးပေးခြင်းသည်အကျိုးသက်ရောက်မှုရှိသည်အပြင် လက်မောင်းအာရုံကြောအစုအထွဲ (brachial plexus) အပါအဝင် ပြင်ပအာရုံထိခိုက်ပျက်စီးခြင်း (peripheral nerve damage) ကို ပြန်ကောင်စေနိုင်သောအကျိုးရရှိသည်။
Studies have shown ultrasound-guided perineural vitamin B12 injections to be effective and beneficial for recovery from peripheral nerve damage, including brachial plexus injury. .

အဓိကစဉ်းစားရမည့်အကြောင်းများ
Important Considerations
နည်းပညာပေါ်ထွက်လာခြင်း၊
အာရုံကြော အနီးကပ်ထိုးပေးခြင်းသည် သီးခြားနည်းပညာအသစ်ဖြစ်သည်၊ နည်းပညာ၏ထိရောက်မှုသည် တရားဝင်အတည်ဖြစ်ရန် သုတေသနပြုလုပ်ဆဲဖြစ်သည်
Emerging Technique: Perineural injection is a relatively new technique, and its efficacy is still being validated through ongoing research.
လုပ်ဆောင်မှုအကျိုးအာနိသင်၊
ဘီတွဲသည် အာရုံကြောကျန်းမာရေးအတွက် မရှိမဖြစ်ဖြစ်သည်ကိုသိပြီးဖြစ်သော်လည်း အာရုံကြောအနီးကပ်၍ဘီတွဲထိုးခြင်း (perineural injections)သည် အာရုံကြောဆိုင်ရာလိုသလိုပြောင်းလဲဖြစ်ပေါ်ခြင်းကိုတွန်းအားပေးခြင်း (induce neuroplasticity) ဖြစ်သည့် တိကျသောမော်လီကျူးဆိုင်ရာလုပ်ဆောင်ခြင်းများ (precise molecular machanisms) ကိုအချို့သောလေ့လာချက်များအရ ရှာဖွေဖေါ်ထုတ်ဆဲဖြစ်သည်
Mechanism of Action: While B12 is known to be essential for nerve health, the precise molecular mechanisms by which perineural injections induce neuroplasticity are still being explored, according to some studies.

Zawgyi
အာ႐ုံေၾကာႏွင့္အနီးကပ္ ဗီတာမင္ဘီတြဲ ထိုးျခင္းနည္းပညာႏွင့္ အာ႐ုံေၾကာအသစ္ျဖစ္ေပၚျခင္းႏွင့္ ျပန္လည္ေကာင္းမြန္ျခင္း
Perineural injection of vitamin B12 technique and peripheral nerve regeneration and repair

ဗီတာမင္ဘီတြဲသည္ ဒီအင္န္ေအဖြဲ႕စည္းတည္ေဆာက္ျခင္း ေသြးနီဥျဖစ္ျခင္း ႏွင့္ အာ႐ုံေၾကာမ်ားထိန္းသိမ္းျခင္းႏွင့္ ဦးႏွောက္က်န္းမာေရးအတြက္မရွိအျဖစ္လိုအပ္သည္။
အစာအဟာရ မ်ားကိုစြမ္းအင္အျဖစ္ေျပာင္းလဲေပးျခင္း၊ ဗဟိုအာ႐ုံေၾကာစနစ္ဖြံၿဖိဳးျဖင္းႏွင့္ ေသြးအားနည္းေရာဂါ (megaloblastic anaemia) မျဖစ္ေအာင္ကာကြယ္ျခင္းတို႔အတြက္ အေရးႀကီးသည္။
Vitamin B12 is essential for DNA synthesis, forming healthy red blood cells, and maintaining nerve and brain health. It is crucial for converting food into energy, the development of the central nervous system, and preventing megaloblastic anemia.
အာ႐ုံေၾကာႏွင့္အနီးကပ္ ထိုးေပးျခင္းသည္ သီးျခား နည္းပညာအသစ္တစ္ခုျဖစ္သည္
အာ႐ုံေၾကားအနီးကပ္ ဘီႀတဲ ထိုးေပးျခင္သည္ အာ႐ုံေၾကာမ်ား အသစ္ျဖစ္ေပၚျခင္းႏွင့္ ျပန္လည္ေကာင္းမြန္လာျခင္းကို အေထာက္အကူျပဳတို႔းျမင့္ေစ၍ အာ႐ုံေၾကာဆိုင္ရာလိုသလိုေျပာင္းလဲျဖစ္ေပၚျခင္း (neuroplasticity) ကိုတြန္းအားေပျခင္းျဖစ္သည္ဟုေကာက္ခ်က္ခ်နိဳင္သည္
Perineural injection is a relatively new technique.
Perineural injections of vitamin B12 promote nerve regeneration and repair, which can be interpreted as inducing neuroplasticity.

အာ႐ုံေၾကာအနီးကပ္ ဗီတာမင္ဘီတြဲထိုးေပးျခင္းမ်ားတြင္ပါဝင္သည္မွာ ဘီႀတဲ၊ မီသိုင္းကိုဘာလမင္း (methylcobalamin) ကို အာ႐ုံေၾကာအနီးထိုးေပးျခင္းျဖင့္ ျပင္ပအာ႐ုံေၾကာစနစ္ အာ႐ုံေၾကာ ပ်က္စီးျခင္းျဖစ္ေသာ လက္ေမာင္းအ႐ုံေၾကာအစုအဖြဲ (brachial plexus) ပ်က္စီးျခင္း အာ႐ုံေၾကာမ်ားထုံက်င္ျခင္းတို႔တြင္ အာ႐ုံေၾကာအသစ္ျဖစ္ေပၚေစျခင္း၊ အာ႐ုံေၾကာအျမႇေးပါး မိုင္ရီလင္ (myelin) ျဖစ္ေပၚျခင္းႏွင္ အာ႐ုံ ေၾကာအလယ္ဝင္ရိုး (axon) ဖြံ႕ၿဖိဳးျခင္းကိုအေထာက္အကူျပဳ တို႔းျမႇင့္ေစသည္
Perineural vitamin B12 injections involve directly injecting methylcobalamin (a form of B12) around a nerve to promote nerve regeneration, myelin formation, and axonal maturation in cases of peripheral nerve damage, such as brachial plexus injuries or neuropathy.
ဤ အသစ္ထြက္ေပၚလာေသာနည္းပညာသည္ ထိခိုက္ေသာအာ႐ုံေၾကာသို႔တိတိက်က်ေရာက္ေစရန္ ပို၍ျမင္မားျမင္သာေသာေအာထရာေဆာင္းလမ္းၫြန္(high resolution ultasound guide) ႏွင့္ထိုးေပးျခင္းျဖစ္သည္၊ ထိုသို႔ျပဳလုပ္ေပးျခင္းျဖင့္ သီးျခားအေၾကာင္းအရာ၌ အာ႐ုံဆိုင္ရာလႈပ္ရွားမႈႏွင့္ခံစားမႈမ်ားပိုမိုတိုးတက္ေကာင္းမြန္လာသည့္အလားအလာရွိသည့္ ရလာဒ္ကိုျပဆိုသည္
This emerging technique uses high-resolution ultrasound to guide the injection, allowing for precise delivery to the affected nerve, and has shown promising results in improving motor and
sensory function in specific cases, though further research is needed to validate its widespread efficacy.

သုေတသနျပဳမႈက ျပဆိုသည္မွာ ဗီတာမင္ဘီတြဲသည္ အာ႐ုံေၾကာအလယ္ဝင္ရိုး (axon) ႀကီးထြားမႈကိုလႈံေဆာ္နိုင္သည္၊ အာ႐ုံေၾကာထိခိုက္ဒဏ္ရာရၿပီးျခင္းမ်ိဳးျဖစ္ေသာ လက္ေမာင္းဆိုင္ရာအာ႐ုံေၾကာအစုအဖြဲ (brachial plexus) လုပ္ေဆာင္မႈဆိုင္ရာျပန္လည္ေကာင္းမြန္တိုးတက္လာသည္၊ အာ႐ုံေၾကာဆိုင္ရာတည္ေဆာက္ပုံႏွင့္ လုပ္ေဆာင္မႈအတြက္အေရးပါေသာ မိုက္ခရိုႁပြန္ငယ္မ်ား (microtubules) တည္ၿငိမ္ရန္အကူအညီျဖစ္သည္
Research indicates vitamin B12 can stimulate axon growth, improve functional recovery after nerve injuries like brachial plexus injury (BPI), and may help stabilize microtubules, a crucial component of neuronal structure and function.
တိက်ေသာလုပ္ေဆာင္ျခင္းမ်ားသည္ စုံစမ္းေလ့လာဆဲပင္ျဖစ္ေသာလည္း ဘီတြဲသည္ အာ႐ုံေၾကာထိခိုက္ျခင္းမွကာကြယ္နိုင္သည္၊ အာ႐ုံေၾကာမ်ားျပန္လည္ေကာင္းမြန္လာေစရန္ အဓိကအခ်က္အျဖစ္ ပတ္ဝန္းက်င္တစ္ခုဖန္တီးေပးျခင္းျဖင့္ အာ႐ုံေၾကာဆိုင္ရာလိုအပ္လိုေျပာင္းလဲျခင္း (neuroplasticity) အခနျးကဏ်ဏ္႑တဈခု အျဖစ္ရွိေနသည္
While the exact mechanisms are still under investigation, vitamin B12's role in protecting neurons from damage and creating an environment for nerve recovery points to a role in neuroplasticity.

စူးစမ္းေလ့လာမႈမ်ားကျပငည္မွာ အာထရာေဆာင္း လမ္းၫႊန႔္အာ႐ုံေၾကာအနီးကပ္ ဘီတြဲထိုးေပးျခင္းသည္အက်ိဳးသက္ေရာက္မႈရွိသည္အျပင္ လက္ေမာင္းအာ႐ုံေၾကာအစုအထြဲ (brachial plexus) အပါအဝင္ ျပင္ပအာ႐ုံထိခိုက္ပ်က္စီးျခင္း (peripheral nerve damage) ကို ျပန္ေကာင္ေစနိုင္ေသာအက်ိဳးရရွိသည္။
Studies have shown ultrasound-guided perineural vitamin B12 injections to be effective and beneficial for recovery from peripheral nerve damage, including brachial plexus injury. .

အဓိကစဥ္းစားရမည့္အေၾကာင္းမ်ား
Important Considerations
နည္းပညာေပၚထြက္လာျခင္း၊
အာ႐ုံေၾကာ အနီးကပ္ထိုးေပးျခင္းသည္ သီးျခားနည္းပညာအသစ္ျဖစ္သည္၊ နည္းပညာ၏ထိေရာက္မႈသည္ တရားဝင္အတည္ျဖစ္ရန္ သုေတသနျပဳလုပ္ဆဲျဖစ္သည္
Emerging Technique: Perineural injection is a relatively new technique, and its efficacy is still being validated through ongoing research.
လုပ္ေဆာင္မႈအက်ိဳးအာနိသင္၊
ဘီတြဲသည္ အာ႐ုံေၾကာက်န္းမာေရးအတြက္ မရွိမျဖစ္ျဖစ္သည္ကိုသိၿပီးျဖစ္ေသာ္လည္း အာ႐ုံေၾကာအနီးကပ္၍ဘီတြဲထိုးျခင္း (perineural injections)သည္ အာ႐ုံေၾကာဆိုင္ရာလိုသလိုေျပာင္းလဲျဖစ္ေပၚျခင္းကိုတြန္းအားေပးျခင္း (induce neuroplasticity) ျဖစ္သည့္ တိက်ေသာေမာ္လီက်ဴးဆိုင္ရာလုပ္ေဆာင္ျခင္းမ်ား (precise molecular machanisms) ကိုအခ်ိဳ႕ေသာေလ့လာခ်က္မ်ားအရ ရွာေဖြေဖၚထုတ္ဆဲျဖစ္သည္
Mechanism of Action: While B12 is known to be essential for nerve health, the precise molecular mechanisms by which perineural injections induce neuroplasticity are still being explored, according to some studies.

Sources: Google AI
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