Clinical Trial – The Effects of Meditation and Hyperbaric Oxygen Therapy on Chronic Wounds

In Ontario, wound care support has steadily increased over the years. With the growth of the
aging population, the financial and psychological burden related to wound care will continue
to rise. Studies have shown that structured meditation programs can improve on the recovery
process for both physical and psychological disease. Therapeutic treatments like Hyperbaric
Oxygen Therapy (HBOT) for chronic wounds have shown to promote angiogenesis, cerebral blood
and neuroplasticity in patients with stroke, traumatic brain injury and chronic pain. By
combining meditation and HBOT, this have been independently shown to improve healing and
reducing costs associated with chronic wounds.

Clinical Trial – Adjunctive Hyperbaric Oxygen Therapy (HBOT) for Lower Extermity Diabetic Ulcer:

Diabetic foot ulcers are associated with high risk of amputation. About 50% of patients
undergoing non-traumatic lower limb amputations are diabetics5. The 5-year amputation rate is
estimated to be 19% with a mean time to amputation 58 months since the onset of an diabetic
foot ulcer6.Because infection and tissue hypoxia are the major contributing factors for
non-healing diabetic foot ulcers, hyperbaric oxygen therapy (HBO) carries a potential benefit
for treating these problematic wounds that do not respond to standard therapy.

The role of oxygen in the wound healing cascade and subsequent combatting action against
bacterial invasion, especially anaerobes, is well documented.14 Delayed or arrested healing
and the development of infection is a direct result from decreased perfusion and poor
oxygenation of tissue.15 The presence of wound hypoxia is an major etiological pathway in the
development of chronic non-healing diabetic foot ulcers

Clinical Trial – Influence of Injection Rate of Intrathecal Mixture of Local Anesthesia on Hypotension in Cesarean Section

Hypotension is the most common complication of neuraxial anesthesia in obstetric patients and
its prevalence in cesarean section is about 50-90%. Maternal hypotension causes unpleasant
symptoms such as nausea, vomiting, loss of consciousness, respiratory depression, and cardiac
arrest. Hypotension may reduce placental perfusion and result in fetal acidosis and
neurological injury. Several techniques have been proposed to prevent hypotension.

The recommended spinal block height to ensure patient comfort for Cesarean delivery is T4-6.
Clinically, it is desirable that the spread of local anesthetic through the cerebrospinal
fluid (CSF) achieves a sensory level no higher than the T4 dermatome to avoid extensive
sympathetic block. It is also important that the spinal block level be no lower than T6 to
avoid patient discomfort during peritoneal manipulation and uterine exteriorization. The
effect of injection speed on spread of spinal anesthesia is controversial. Several studies
have demonstrated more extensive spread with faster injection while others report either
greater spread with slower injection, or no difference. Slow injection of hyperbaric
bupivacaine 10 mg over 60 and 120 sec has been shown to reduce the incidence and severity of
hypotension during Cesarean delivery under spinal anesthesia.