Relationships Between Training Load Indicators and Training Outcomes in Professional Soccer

Abstract

Background

In professional senior soccer, training load monitoring is used to ensure an optimal workload to maximize physical fitness and prevent injury or illness. However, to date, different training load indicators are used without a clear link to training outcomes.

Objective

The aim of this systematic review was to identify the state of knowledge with respect to the relationship between training load indicators and training outcomes in terms of physical fitness, injury, and illness.

Methods

A systematic search was conducted in four electronic databases (CINAHL, PubMed, SPORTDiscus, and Web of Science). Training load was defined as the amount of stress over a minimum of two training sessions or matches, quantified in either external (e.g., duration, distance covered) or internal load (e.g., heart rate [HR]), to obtain a training outcome over time.

Results

A total of 6492 records were retrieved, of which 3304 were duplicates. After screening the titles, abstracts and full texts, we identified 12 full-text articles that matched our inclusion criteria. One of these articles was identified through additional sources. All of these articles used correlations to examine the relationship between load indicators and training outcomes. For pre-season, training time spent at high intensity (i.e., >90 % of maximal HR) was linked to positive changes in aerobic fitness. Exposure time in terms of accumulated training, match or combined training, and match time showed both positive and negative relationships with changes in fitness over a season. Muscular perceived exertion may indicate negative changes in physical fitness. Additionally, it appeared that training at high intensity may involve a higher injury risk. Detailed external load indicators, using electronic performance and tracking systems, are relatively unexamined. In addition, most research focused on the relationship between training load indicators and changes in physical fitness, but less on injury and illness.

Conclusion

HR indicators showed relationships with positive changes in physical fitness during pre-season. In addition, exposure time appeared to be related to positive and negative changes in physical fitness. Despite the availability of more detailed training load indicators nowadays, the evidence about the usefulness in relation to training outcomes is rare. Future research should implement continuous monitoring of training load, combined with the individual characteristics, to further examine their relationship with physical fitness, injury, and illness.

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Van Wyk Grumbach syndrome - a rare association of a common prepubertal condition

2016-07-26T10-26-59Z
Source: International Journal of Research in Medical Sciences
Mukta Waghmare, Hemanshi Shah, Vikrant Kumbhar, Shalika Jayaswal.
Van Wyk Grumbach syndrome is a sequel of long standing untreated primary hypothyroidism. It occurs in both sexes. In boys, it is associated with testicular enlargement. Girls present with features of early onset menarche, enlarged bilateral multicystic ovaries and delayed skeletal growth. Prompt replacement therapy with Thyroxine corrects the menstrual abnormality and the ovaries also return to normal over a period of time. We describe an unusual case of irregular vaginal bleeding, giant bilateral ovarian cysts and delayed bone age in a young girl due to severe hypothyroidism who promptly responded to levo-thyroxine.


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Using the Evidence Available to Inform Practice and Direct Future Research

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Study of impairment in collaboration between ceruloplasmin and transferrin in development of complications in type 2 diabetes mellitus

2016-07-26T10-26-59Z
Source: International Journal of Research in Medical Sciences
Reenu Sharma, Sunil S. Patani, Maulik S. Nayak.
Background: Hyperglycemia in diabetic patients can increase the levels of free radicals through various metabolic alterations. One of the most reactive pro-oxidants in peroxidation reactions is free, redox-active iron and generates highly reactive hydroxyl radicals that initiate lipid peroxidation. The purpose of the study was to elucidate the role of CP and TRF in type 2 DM and analyse the effect of disturbance in collaboration between these parameters in pathogenesis of type 2 diabetic complications. Methods: We included 100 Type 2 DM subjects (with and without complications) and 100 healthy controls. The duration of type 2 DM in study subjects ranged from 5 to 16 years. Blood samples in fasting condition were collected for analysis of serum malondialdehyde (MDA), CP and TRF. Results: In the study serum CP levels were higher in Type 2 diabetic subjects with complications compared to diabetic subjects without complications (P=0.01). However, significantly low transferrin values were obtained in diabetic subjects with complications compared to diabetic subjects without complications (P=0.007). Significantly high MDA levels were observed (P=0.002) in type 2 diabetic subjects with complications compared to type 2 diabetic subjects without complications. Conclusions: The results of the present study indicate oxidative stress plays a role in precipitating complications in Type 2 DM reflecting in disturbance of CP and TRF collaboration.


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Impact of Aging on Endurance and Neuromuscular Physical Performance: The Role of Vascular Senescence

Abstract

The portion of society aged ≥60 years is the fastest growing population in the Western hemisphere. Aging is associated with numerous changes to systemic physiology that affect physical function and performance. We present a narrative review of the literature aimed at discussing the age-related changes in various metrics of physical performance (exercise economy, anaerobic threshold, peak oxygen uptake, muscle strength, and power). It also explores aging exercise physiology as it relates to global physical performance. Finally, this review examines the vascular contributions to aging exercise physiology. Numerous studies have shown that older adults exhibit substantial reductions in physical performance. The process of decline in endurance capacity is particularly insidious over the age of 60 years and varies considerably as a function of sex, task specificity, and individual training status. Starting at the age of 50 years, aging also implicates an impressive deterioration of neuromuscular function, affecting muscle strength and power. Muscle atrophy, together with minor deficits in the structure and function of the nervous system and/or impairments in intrinsic muscle quality, plays an important role in the development of neuromotor senescence. Large artery stiffness increases as a function of age, thus triggering subsequent changes in pulsatile hemodynamics and systemic endothelial dysfunction. For this reason, we propose that vascular senescence has a negative impact on cerebral, cardiac, and neuromuscular structure and function, detrimentally affecting physical performance.

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Clonidine versus fentanyl as adjuvant to 0.75% ropivacaine for epidural anesthesia for lower limb surgeries: a comparative evaluation

2016-07-26T10-26-59Z
Source: International Journal of Research in Medical Sciences
Salony Agarwal, Kumkum Gupta, Prashant K. Gupta, Manoranjan Bansal, Raaghav Sharma, Aqsa Buchh.
Background: Epidural adjuvants to local anaesthetic are used to enhance the quality and duration of surgical anaesthesia. The present study was aimed to compare the clinical efficacy of clonidine with fentanyl as adjuvant to epidural ropivacaine for block characteristics and hemodynamic changes during lower limb surgeries. Methods: Sixty adult consenting patients of both gender of ASA physical status I and II scheduled for lower limb surgeries under epidural anaesthesia, were randomized into two groups of 30 patients each to receive either 15 ml of 0.75% ropivacaine with 1 ml of clonidine, 50 µg (Group RC) or with 1 ml of fentanyl 50 µg (Group RF). All patients were assessed for onset and duration of sensory and motor blockade and time to first rescue analgesia as primary end points. The hemodynamic variations, sedation, pruritus, respiratory depression or any other adverse events were recorded as secondary end points. Results: Onset of sensory block to T10 was comparable between the groups. Time to achieve maximum sensory level at T6-7 and maximum motor block was faster when fentanyl was used as compared to clonidine with statistically significant difference between the group (p


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Simple method for estimating soil mass loading onto plant surface using magnetic material content as a soil indicator – Influence of soil adhesion to vegetation on radioactive cesium concentration in forage

Publication date: November 2016
Source:Journal of Environmental Radioactivity, Volume 164
Author(s): Yoshihito Sunaga, Hisatomi Harada
A simple technique for estimating soil mass loading on vegetation was developed using magnetic material content as an indicator of soil adhesion. Magnetic material contents in plant and soil samples were determined by a magnetic analyzer. High recovery rates of 85–97% were achieved in a recovery test in which additional soil was added to powdered plant materials [stem of forage corn (Zea mays L.), aboveground part of Italian ryegrass (Lolium multiflorum Lam.)] at addition rates of 12.3–200 g dry soil kg⁻¹ dry plant material including soil. Samples of different Japanese cultivated soils were tested and showed a range of magnetic contents of 1.27–16.1 g kg⁻¹ on a dry weight basis. These levels are considered adequate for determining soil contamination in plant materials. Then, we applied this method for confirming the effect of soil adhesion on radioactive cesium concentrations in plant samples obtained at the area affected by the 2011 nuclear accident in Japan. The mean soil mass loading (±standard deviation) on forage rye (Secale cereale L.) showing mild lodging was 0.8 ± 0.6 g kg⁻¹, but was 7.4 ± 5.0 g kg⁻¹ for plants with serious lodging. No soil loading was detected on rye plants that showed no lodging. Radioactive cesium concentrations in the rye samples increased linearly with the increase in soil mass loading caused by plant lodging, and consequently mean radioactive cesium concentration for rye plants with serious lodging was about 2.7 times higher than that with no lodging. Cesium radioactivity in forage was affected by variations in soil mass loading onto forage plants caused by changes in plant growth and differences between plant species.



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A study of variations in the branching pattern of popliteal artery and its clinical perspective

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Anisha Bettaiah, Sangeetha Venkat, Saraswathi G..
Background: Popliteal artery is the continuation of femoral artery which is the main and prime arterial supply to the knee, leg and foot. Variations of popliteal artery have been the subject of repeated study as exposure of this artery is required in both emergency and elective vascular procedures. Knowledge of the anatomical variations in the branching of popliteal artery is important, because damage to artery and its branches can lead to limb disability or life threatening haemorrhage. Methods: A total of 40 popliteal arteries were studied by dissection method. Specimens were collected from the cadavers which were available in the department of anatomy, JSS medical college, Mysore, India. Results: The origin, course and termination of the popliteal artery in all the 40 specimens were normal. Regarding the branching pattern of genicular arteries, there was a common stem of origin for superior medial genicular artery (SMGA), middle genicular artery (MGA), superior lateral genicular artery (SLGA) in 2 specimens (5%). Conclusions: Popliteal artery is the commonly approached site for above and below knee bypass grafts. It is also frequently injured during penetrating and blunt trauma involving lower extremity. Although prevalence of the variations was less in our study, the awareness of possible variations will be beneficial to angiographers and to vascular surgeons and orthopaedic surgeons.


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Role of triple phase computed tomography findings for evaluation of hepatic lesions

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Chandra Prakash Ahirwar, Abhijit Patil, Neelam Soni.
Background: Liver is prone to various diseases including benign and malignant because of its major function of digestion, detoxification and rich blood supply by hepatic artery and portal vein. Objectives of the study were to study the characteristic features of various hepatic lesions using triple phase CT as diagnostic modality, differentiating benign hepatic lesions from malignant and correlating findings of triple phase CT with clinical, histopathology or post-operative findings for calculation of its efficacy. Methods: A total of 100 patients were enrolled in this cross-sectional study done in Department of Radiodiagnosis, Gandhi Medical College, Bhopal, Madhya Pradesh, India. All patients underwent triple phase CECT examination and its accuracy, sensitivity and specificity was calculated. Results: Triple phase CT be excellent diagnostic modality for characterisation and better evaluation of hepatic masses with sensitivity of 91.3% , specificity 97.8% , PPV 91.3% and NPV 97.8% (p value


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Metacognitive awareness- evaluation and implications in medical students

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Pallavi Panchu, Biju Bahuleyan, Seethalakshmi K, Tom Thomas.
Background: Medical education is at cross roads today with a mismatch between students expectations of their performance and the reality. This led us to explore the reason for the academic decline. During our search, we found that metacognitive awareness plays a key role in moulding the learning skills of adult learners. Hence this study was conducted to evaluate the metacognitive awareness of medical students studying in the first year of MBBS. Methods: 100 first year medical students were included in the study and metacognitive awareness inventory questionnaire, a validated tool was administered to the students. This measures metacognitive knowledge and regulation. The results were obtained, tabulated and analysed. Results: Metacognitive awareness among medical students was average. Metacognitive knowledge was found to be significantly better than regulation. On comparing the genders, we note that females have better metacognitive regulation while males score higher in metacognitive knowledge which was statistically significant. Conclusions: The findings of the present study points towards the need of introduction of metacognitive strategies in the medical curriculum with more emphasis on problem based learning in order to make our learners become independent thinkers and efficient care givers.


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Exploring nutritional status, physical activity and body mass index of Pakistani teens

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Kiran Khan, Nazia Jameel, Rehana Khalil, Saadia Gul.
Background: Obesity is becoming an increasingly prevalent problem in Pakistan, as it has in other developing countries. Childhood obesity poses high cost to the well-being and negatively affects childrens health, causes chronic disease as children grow older. The aim of this study was to explore nutritional status, physical activity and body mass index (BMI) of school and college going students of mid and late adolescence age (14 to 19 years) studying in multi-ethnic city of Karachi, Pakistan. Methods: A descriptive cross-sectional study was carried out among school and college going students of public and private educational institutes of Karachi, Pakistan. The study sample of 171 students was conveniently selected from these institutes. The data was collected through a semi-structured questionnaire. In order to calculate BMI, the height and weight of each student were measured after completion of the questionnaire. The data were entered and analysed using IBM SPSS version for Windows 20.0 software. Results: The average age of the respondents was 16.2 years with 68% students belonged to school and 32% to College, and 57.3% were males and 42.7% were females. More than half sample (59.6%) participants belonged to privileged and 40.4% to underprivileged class. The sample was eating a wide variety of junk food in daily routine including chips, packed fruit juices, packed flavoured milk, ice creams/ frozen yogurts both at home and at school/college. The physical activity of the school students was found to be better than the college students. No participant had regular activity or strenuous physical games for more than one hour per day. Around one third (38%) respondents used to watch TV or play computer games for more than two hours a day. Almost half of the students BMI was within the normal ranges, but remaining half of the sample was either overweight or underweight. Conclusions: This study indicates that a large proportion of school and college students had physical inactivity, unhealthy dietary habits and they were overweight. All these interrelated factors were independent of their household socioeconomic condition and ethnicity. There is a need to educate and create awareness about healthy lifestyle among the adolescents and the community at large.


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Eating disorders and anxiety among high school students in Western area of Turkey

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Egemen Unal, Resat Aydin, Mehmet Enes Gokler, Alaettin Unsal.
Background Eating disorders (ED) are the one of the most common chronic illness among adolescents. The aim of the present study was to investigate eating disorders and it's associations between anxiety among high school students in Sivrihisar in Eskisehir, Turkey. Methods: This cross-sectional study was carried out in the high school students of center of Sivrihisar between 01 January 2014 and 28 February 2014. The questionnaire prepared according to literature, consisting of 3 parts (socio-demographic characteristics, eating attitude test (EAT-40) and beck anxiety inventory (BAI)). The students completed questionnaire in the presence of a member of the research team. The data collected were self-reported by the students. Results: Of the study group 64.4% (n=625) were females and 35.6% (n=345) were males. The prevalence of eating disorder was 13.0% (n=126). The mean and standard deviation of students' total score of EAT-40 were 18.80±9.88 (ranged 3 to 95). The mean and standard deviation of students' total score of BAI were 20.32±12.32 (ranged 0 to 63). The positive weak correlation was found between the total scores of EAT-40 and BAI (r=0.178; p=0.001). Conclusions: ED is an important health problem for adolescents. On the studies upon epidemiology of ED towards high school students, socio-economic factors should be assessed in more detailed and more comprehensive perspective.


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Difficult patients from the perspective of healthcare workers: a study at a public hospital

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Selahattin Akyüz, Erhan Biyik, Pınar Yalçin-Balçik.
Background: The purpose of the study is to identify the frequency of encounters with difficult patients, the level of patient difficulty and the demographic characteristics of difficult patients from the perception of healthcare workers. Methods: The data have been obtained from the health workers who are employed at a public hospital in the city of Ankara and are in interaction with patients. The data have been obtained with the difficult patient and healthcare personnel interaction survey. Results: It has been determined that approximately 2 out of every 10 patients (=2.11) which the healthcare workers encounter during the day are difficult patients and the level of difficulty of these patients is low (=3.62). It has been found that there is a medium level, positive and significant relationship between patient difficulty and seductive behavior and that seductive behavior has a significant effect on patient difficulty. It has been found that there is a medium level, positive and significant relationship between the discomfort experienced by the personnel and seductive behavior and that seductive behavior has a significant effect on the discomfort experienced by the personnel. Conclusions: As a result, it can be seen that nearly a fifth of all patients are perceived as difficult by healthcare workers. It is believed that healthcare workers should be informed about the characteristics of difficult patients and the aspects which should be taken into consideration while interacting with these patients and thereby more effective form of communication will be established at medical institutions.


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Outcome of albendazole therapy in the management of hepatic hydatid disease

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Shams Ul Bari, Mohd Mubarik Naqash, Ajaz A. Malik.
Background: The treatment modalities for managing patients with hepatic hydatidosis include surgical treatment and non-surgical treatments. The non-surgical methods include albendazole therapy and percutaneous management. Use of albendazole as an adjuvant therapy to surgery has been found to significantly reduce the viability of daughter cyst and recurrence of hydatid disease. The aim of the study was to understand the effect of albendazole therapy on the viability of protoscoleces and recurrence rate of hydatid disease of liver. Methods: The study was conducted at Sher-i-Kashmir Institute of Medical Sciences and Medical College, Srinagar, Kashmir India, from March 2010 to February 2012 with further follow up of 3-4 years and the total of 64 patients were studied. ; Patients were divided into two groups, Group A and Group B, each comprising of 32 patients. In group A, patients were given albendazole for 12 weeks preoperatively followed by further postoperative course for 12 weeks. In group B, patients were first taken for surgery followed by postoperative course of albendazole for 12 weeks. The two main outcome measures studied and compared during present study were the viability of the hydatid cysts and the recurrence rate in two groups. Results: Out of those, patients who received preoperative albendazole, 9.37% had viable cysts at the time of surgery as compared to 96.87% of patients who did not receive any preoperative albendazole. In those patients who received only postoperative albendazole therapy, recurrence rate was 18.75% while as there was no recurrence was in patients who received both preoperative and postoperative albendazole therapy. Conclusions: Study concludes that albendazole is safe and effective adjuvant therapy in the treatment of hydatid liver disease.


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Etiological study of generalized lymphadenopathy in a tertiary care hospital

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Subrata Halder, Bikram Kr. Saha, Debasis Sarkar, Srabani Ghosh.
Background: This study was done to know about the clinical biochemical as well as radiological profile of patients presented as generalized lymphadenopathy in a tertiary care centre and to know the different causes of generalized lymphadenopathy. Methods: 116 patients of generalized lymphadenopathy were included this study based on the inclusion and exclusion criteria. Detailed history, physical examination and relevant systemic examination including detailed examination of lympho-reticular system were done as per a structured proforma and necessary lab investigations were done for confirming diagnosis. Results: Among 116 patients of generalized lymphadenopathy 59.5% were non-malignant causes where 40.5% diagnosed as malignant causes. Among them tuberculosis consist of 39 (33.6%), NHL 18 (15.5%), reactive lymphadenopathy 16 (13.8%), CLL and HD 8 (6.9%) each, ALL 7 (6%), SLE 5(4.3%), Kikuchis disease 4 (3.4%), AML and RA 3 (2.6%) each and castlemans disease, phenytoin lymphadenopathy, metastatic lung and breast carcinoma 1 (0.9%) each. Cervical groups of lymph nodes were most commonly involved 86 patients (74.1%) followed by axillary groups 73 patients (62.9%). Lymph nodes size 1.5cm were due to malignant and non-malignant granulomatous cases. FNAC give definite diagnosis 80.9% malignant cases where 76.8% in non-malignant cases. HPE shown definite diagnosis in 100% cases both malignant and non-malignant diseases. Conclusions: Tuberculosis is most common cause of generalized lymphadenopathy followed by lymphoma. And reactive lymphadenitis is also an important consideration.


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Knowledge, attitude and practices towards consumption of caffeine containing drinks among the student population of Ras al-Khaimah medical and health sciences university, UAE

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Vijayalakshmi S. Bhojaraja, Harshitha Janardhan, Najila Abdul Hameed, Fahmidha Gulsoom A. R., Maryam Zulfiqar Ali.
Background: Caffeine, worlds most widely consumed and legally accepted psychoactive substance which is commonly found ingredient in many drinks like coffee, tea, carbonated drinks and energy drinks. The objective was to explore how much dependent are the teenagers and young adults on caffeine containing drinks, reasons and circumstances for the consumption and to know the knowledge and attitude of the consumers about the health effects of the caffeine containing drinks. Methods: A validated questionnaire was administered randomly to about 298 students from MBBS, BDS, B Pharma and Nursing programmes of RAK Medical and Health Sciences University (RAKMHSU). Results: Out of 298 students in the study, 97% (n=290) of them drink caffeinated beverages in the form of coffee (53%), tea (43%), energy drinks (17%), carbonated drinks (18%) and all of the above (11%). The major reasons for consuming varied, where more than half of them gave the reason as to keep them awake for study purpose (53%), to get refreshed (51%), taste and flavour (49%). About 56% were of an opinion that they do experience different symptoms if they dont consume their daily caffeine intake. 54% students admitted their caffeine consumption has been increased after joining the university. When knowledge and attitude were questioned, 63% of them think caffeine addiction is a health issue and majority of them were aware of the ingredients of these drinks but not the safest amount. Conclusions: Drinking caffeine containing drinks by the students are variable from different sources, so monitoring is necessary for the daily intake and there is need for educational programmes about the health effects related to high consumption of caffeine.


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Cognitive function and its association with level of education and work status in adults in Saudi Arabia: a cross-sectional study

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Mohammed Alarabi, Abdullah Al-Turki, Mohammed Mahasin, Abdulrahman Al-Sehly, Faisal Al-Dawood, Saleh Al-Kurini, Shahid Bashir.
Background: Cognitive decline is not inevitable with age; studies have shown that it can be affected by a number of education and work related factors. We explored this association by carrying out a cross-sectional study in King Khalid University Hospital and King Abdulaziz University Hospital in Riyadh, Saudi Arabia. Methods: We enrolled 202 adults, whose ages ranged between 40 and 85 years. Data was collected using a validated Arabic translation of a standardized test assessing cognitive function, known as the Mini Mental State Examination (MMSE). Subjects were also inquired about their level of education and work status. Results: The results showed that in our subjects of adults above the age of 40, the mean MMSE score was 23.45 (SD=4.203). Females (n=94) had lower scores than their male counterparts (n=108) (mean difference: 3.11, 95% CI 2 to 4.22; p


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Prevalence of oral mucosal lesions and associated habits in Kashmir, India

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Tasneem S. Ain, Owais Gowhar, Saima Sultan, Pradeep Tangade.
Background: A large number of factors may influence the conditions of oral-mucosa and regulate its thresholds against reactions to external irritations and insults. External damage to the tissues may be caused by infections and or other chemical, thermal and mechanical means or there may be some genetic factors involved. The aim of the study was to determine the prevalence of different oral habits and habit related oral lesions among the study population in Kashmir, India. Methods: The final study sample comprised of 7000 patients visiting 2 Government Hospitals in Srinagar and Pulwama district, Kashmir, India. All the selected subjects were examined for any oral mucosal lesions. The diagnosis of the lesion was made based on history, clinical features, according to standard guidelines and color atlas. Results: Prevalence of oral mucosal lesions was found to be 8%. Smokers palate was the most frequently found oral lesion comprising of 33.89% followed by oral lichen planus and leukoplakia (13.55% each). Other lesions included chemical burns, erythroplakia, OSMF and lichenoid reactions. Subjects were indulged into various habits; the most prevalent being the cigarette smoking (56.46%), followed by hukka and bidi smoking and smokeless tobacco. Conclusions: The prevalence of oral mucosal lesions was 8% among the study sample. Subjects were associated with various deleterious habits which were found more in males than females. This study helps in public awareness about the ill effects of oral habits and may motivate them in overcoming their indulgence.


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Retrospective study on predictive scoring system for amputation in open fracture of tibia type III

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Made Bramantya Karna.
Background: Mangled leg remains a challenge in the surgical treatment. Mangled extremity severity score (MESS) is often used as a predictive scoring system. However MESS considered less sensitive because there are still many patients facing amputation legs should be maintained in the end. For that reason, it is necessary to evaluate the counting system has been used. Methods: The study design was a retrospective study using medical records of patients with open fractures of the tibia grade III in emergency room of Dr. Soetomo hospital. From the data on patient medical records, MESI, PSI, HFS, LSI, MESS and NISSSA was calculated. Then the results are assessed by sensitivity, specificity, PPV and NPV. Results: Patients who undergo amputation were 12 people and who successfully maintained limb were 46 people. The sensitivity ranged from 50% (MESI) until 75% (HFS), a specificity ranging from 61% (HFS) until 85% (NISSA). Positive predictive value ranged between 23% (PSI) and 53% (NISSA) and negative predictive value ranged from 81% (PSI) until 91% (NISSA). Conclusions: This study failed to demonstrate the usefulness of the six counting system because it only shows the sensitivity and specificity in distinguishing limb amputation injuries that require immediate and that allows it to be maintained. Some have incorrectly predicted the counting system, where some patients were successfully maintained limb had been predicted for amputees and vice versa.


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Cardiometabolic Syndrome in People with Spinal Cord Injury/Disease: Guideline-derived and Non-Guideline Risk Components in a Pooled Sample

Publication date: Available online 25 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Mark S. Nash, Rochelle E. Tractenberg, Armando J. Mendez, Maya David, Inger H. Ljungberg, Emily A. Tinsley, Patricia A. Burns, Luisa F. Betancourt, Suzanne L. Groah
ObjectiveAssess cardiometabolic syndrome (CMS) risk definitions in spinal cord injury/disease (SCI/D).DesignCross-sectional analysis of a pooled sample.SettingTwo SCI/D academic medical and rehabilitation centers.ParticipantsBaseline data from subjects in seven clinical studies were pooled; not all variables were collected in all studies so that participant numbers varied from 119-389. The pooled sample included males (79%) and females (21%) with SCI/D >1 year at spinal cord levels spanning C3-T2 (AIS A-D).InterventionsNot applicable.Main Outcome MeasuresWe computed the prevalence of CMS using the American Heart Association (AHA)/National Heart Lung Blood Institute (NHLBI) guideline (CMS diagnosis as sum-of-risks (SUM-OF-RISKS) ≥ 3) for the following risk components: overweight/obesity, insulin resistance, hypertension, and dyslipidemia. We compared this prevalence with the risk calculated from two routinely used non-guideline CMS risk assessments: 1) key cut-scores identifying insulin resistance derived from the Homeostatic Model 2 (HOMA2) method or Quantitative Insulin Sensitivity Check Index (QUICKI), and, 2) a cardioendocrine risk ratio based upon an inflammation (C-Reactive Protein [CRP]) - adjusted Total Cholesterol (TC): High-density Lipoprotein Cholesterol (HDL-C) ratio.ResultsAfter adjustment for multiple comparisons, injury level and AIS were unrelated to CMS or risk factors. 13% and 32.1% of participants had CMS when using the sum-of-risks or HOMA2/QUICKI model, respectively. Overweight-obesity and (pre)hypertension were highly prevalent (83% and 62.1%, respectively), with risk for overweight-obesity being significantly associated with CMS diagnosis (sum-of-risks χ²=10.105, adjusted p=0.008). Insulin resistance was significantly associated with CMS when using the HOMA2/QUICKI model (χ² (2) =21.23, adjusted p<0.001). 76.4% of subjects were at moderate/high risk from elevated CRP, which was significantly associated with CMS determination (both methods; sum-of-risks [χ² (2) =10.198, adjusted p=0.048] and HOMA2/QUICKI [χ² (2) =10.532, adjusted p=0.04]).ConclusionsAs expected, guideline-derived CMS risk factors were prevalent in individuals with SCI/D. Overweight/obesity, hypertension, and elevated CRP were common in SCI/D and, because they may compound risks associated with CMS, should be considered population-specific risk determinants. Heightened surveillance for risk, and adoption of healthy living recommendations specifically directed toward weight reduction, hypertension management, and inflammation control should be incorporated as a priority for disease prevention and management.



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Pediatric urolithiasis: What role does metabolic evaluation has to play?

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Sonia Bhatt, Nalini Bhaskaranand, Dilip Kumar Mishra.
Background Pediatric urolithiasis is a perplexing problem faced by pediatricians as well as urologists across the globe. By early diagnosis and treatment of these risk factors, future stone formation may be prevented. Aim: To evaluate the clinical, biochemical and metabolic characteristics of the patients and the interventions required to prevent recurrence. Methods: In this retrospective study, cohort of pediatric patients presenting with urolithiasis at Kasturba Medical College, Manipal formed the study population. Patients records served as study tools. Medical records department was approached and data was collected. Metabolic evaluation was done in all children. Urine tests included urinalysis, urine culture, 24 hours urinary pH, volume, calcium, oxalate, citrate, uric acid, and creatinine. Finally a total of 58 pediatric urolithiasis cases were included in this study. Results: Mean age of study subjects was 6.85±1.27 years. Top three presentations of pediatric urolithiasis were symptoms of Urinary tract infection (UTI), abdominal pain and flank pain in 29.3%, 24.1% and 17.2% children respectively. Gross hematuria was observed in 15.5% of cases. 82.6% of stones were renal stones. Calcium oxalate stone was most common (50%) variety found. Hyperoxaluria was the most common (79.3%) metabolic abnormality detected. 31% had stone recurrence during follow up and 8 of these had >1 metabolic abnormality. Only 6/28 (21.4%) patients managed conservatively had stone recurrence whereas 12/30 (40%) managed with a procedure had stone recurrence. Conclusions: Metabolic evaluation for urolithiasis helps us to identify children those at increased risk for recurrent stone disease. Thus metabolic evaluation is a must in all pediatric patients as it helps in segregating patients needing medical therapy.


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Editorial Board

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8





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Importance of yoga in diabetes and dyslipidemia

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Riyaz Mohammed, Asiya Banu, Imran S., Rajiv Kumar Jaiswal.
Background: The present study was aimed at studying the effect of practicing yoga in patients with type 2 DM for 4 months. The practice of yoga in these patients resulted in a decrease in body weight, total cholesterol, triglycerides and LDL cholesterol and an increase in HDL. Yoga based programs are a low-cost intervention strategy to improve physical and psychological well-being. Rhythmic extension and bending in yoga provides stimulation to organs and glands without straining the muscles. Yoga could be also useful in patient suffering from insulin resistance syndrome. Methods: 50 patients with known type 2 diabetes mellitus and dyslipidemia were selected for the study. Known diabetic patients on treatment with sulphonylurea were also included in this study. 50 patients with type 2 DM attending the diabetic clinic were randomized into control group and study group of 25 patients each. The study group was on oral hypoglycemic drugs, lifestyle modification and yoga for a period of 4 months. The control group was prescribed oral hypoglycemic drugs only and did not perform yogic exercises during this period. Results: 4 months of study has shown that patient enrolled in study group had mild decrease in BMI, and body weight which was not statistically significant but there was a significant reduction in total cholesterol, triglycerides and LDL cholesterol, apart from it, there was a non-significant elevation in HDL. Control group showed a significant increase in body weight. It was also noted that there was non-significant increase in total cholesterol, triglycerides and a decrease in HDL. The bodyweight increase could be attributed to drugs like Sulphonylurea also. Conclusions: Yoga has been tried for its benefit not only in India bur also in developed countries. In view of the benefits of yoga therapy in short-term studies and long-term studies, more awareness and emphasis should be given for it. Patient should be explained clearly about the beneficial effects of yoga. Yoga can help in improved lipid profiles, lower BMI, and lowers glycemic levels which can have a long term beneficial effect on Micro and macro-vascular complications in diabetes.


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Table of Contents

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8





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An analysis of ear discharge and antimicrobial sensitivity to the bacteria used in its treatment

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Mukund M. Vaghela, Hiren Doshi, Sneha Rajput.
Background: Children are unique population with distinct development and physiological differences from adults, clinical trials in children are essential to develop age-specific, empirically verified therapies and interventions to determine and improve the best medical treatment available. The aim of this study was to find out the appropriateness and accuracy of the dose of drugs prescribed and compares it with standard dose. Methods: Total 400 prescriptions were collected from the OPD of the paediatrics of Shree Krishna Hospital, Karamsad. Calculation of standard total daily dose for each drug was done by using Clarks formula and was compared with that of prescribed dose of that particular drug. Results: Total 1042 drugs were prescribed. Among antibiotics (22%) statistically significant difference in the prescribed and standard total daily dose was observed with cefexime [t-value 28.6>1.96 for 95% confidence interval] and metronidazole [t-value2.03>1.96 for 95% confidence interval], NSAIDs (31%), Paracetamol [t-value11.14>1.96 for 95% confidence interval] and antihistaminics (22%), phenylephrine [t-value7.1>1.96 for 95% confidence interval], cetrizine [t-value2.4>2.00 for 95% confidence interval]. Conclusions: Results show that prescribed doses of commonly used drugs were higher than the standard dose. This is directly related to the occurrence and severity of adverse drug reactions.


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Brain Gaming: A User's Product Guide for the Clinician

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8
Author(s): Sandra L. Kletzel, Michael P. Cary, Carrie Ciro, David Berbrayer, Deirdre Dawson, Lilian Hoffecker, Joseph Machtinger, Patrick Pham, Michelle Thai, Patricia C. Heyn




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A study on relationship of facebook and game addictive behaviour with personality traits among medical students

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Vijay Kumar Saini, Girish Chandra Baniya, K. K. Verma, Aditya Soni, Santosh Kumar Kesharwani.
Background: Use of social networking sites and playing internet games are more common web activities among adolescents. Students are more prone to internet abuse for several reasons- natural affinity towards internet, free and unlimited access, flexible schedules, and freedom from parental interference and psychological immaturity. The aim was to study on relationship of facebook and game addictive behaviour with personality characteristics among medical students. Methods: This was a cross sectional observational study, carried out on 140 medical students. All the students were taken randomly. Assessment of sociodemographic details was done with the help of semi-structured performa, bergen facebook addiction scale, game addiction scale and big five inventory were used to see facebook and game addictive behavior and personality traits. Statistical analysis used for comparison of dichotomous variables chi-square test. Correlation and Linear regression was applied to see association. Data analysis was done with the help of statistical software SPSS 23. 0. Results: Mean score of facebook addiction scale among medical students was 39.94 (S.D. 13.133) and mean score of Game addiction scale was 11.19 (S.D. 04.966). It was found that agreeableness (β= -0.275, p=0.000) and extraversion (β = -0.368, p = 0.000) displayed significant associations with FB Total. While neuroticism (β=0.277, p=0.001) and agreeableness (β= -0.177, p=0.029) displayed significant associations with game addictive behavior. Conclusions: In our study we conclude that students with high agreeableness, high neuroticism and low extraversion were more related with Facebook and game addictive behavior. Extraversion was the most powerful predictor of Facebook addiction and neuroticism for gaming addiction.


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Editors' Selections From This Issue: Volume 97 / Number 8 / August 2016

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8





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Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Vinamra Mittal, Manoj Biswas, Shobha Lal.
Background: Percutaneous Nephrostomy or Ureteric Stenting is indicated in patients with Acute Renal Failure following urinary tract obstruction. The purpose of this study was to evaluate the better treatment modality in terms of S. Creatinine level. Methods: Total 50 patients with Creatinine level of >2 mg/dl and hydronephrosis due to upper urinary tract obstruction were grouped into either percutaneous nephrostomy or stent insertion groups. These patients were then evaluated by overall trend of S. creatinine and urine output levels postoperatively. Results: Two comparable groups of PCN and DJS were formed with a mean age of 45.5 years and 47.9 years. Male to female ratio was 1.5:1 and 1.2:1 respectively. Pain with oliguria or anuria was the major presentation. The urine output levels showed a sudden increase postoperatively with a subsequent trend towards normal value in both the groups. Creatinine however showed a normalizing trend from a mean 6.46 mg/dl preoperatively to 1.01mg/dl postoperatively in PCN group whereas in DJS group 5.38mg/dl preoperatively to 2.75mg/dl with a rising trend from POD 15 requiring conversion to PCN in 20% of patients with subsequent normalization of creatinine levels to 0.95 mg/dl. Statistically we found no difference in the outcome when both the groups were compared in view of serum creatinine and urine output levels whereas there is a significant difference in the pre and post operative outcome of both the groups. Conclusions: Our results thus support that though there is no significant difference among both the procedures, ureteral stents are associated with intolerable lower urinary tract symptoms owing to conversion to secondary percutaneous Nephrostomy. Hence percutaneous nephrostomy is superior to ureteral stents for diversion of urine in patients with ARF due to obstructive uropathy.


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To study the existing system of surgical safety for cataract surgery at tertiary care ophthalmic centre to implement WHO surgical safety checklist

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Ruchi Garg, Neeraj Garg, Shakti Kumar Gupta, J. S. Titiyal, R. Mahesh.
Background: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, named after the first President of India, was established on the 10th of March, 1967 as a National centre for ophthalmic science, to provide state of the art patient care, expand human resources for medical education and undertake research to find solutions to eye health problems of national importance. Average numbers of cataract surgeries performed per month are 700 to 1000. Methods: Anticipating implementation in 50% cases hundred cases of cataract surgery were observed to study the existing system of surgical safety followed at Dr. R.P. Center and gap analysis done, against the WHO surgical safety checklist for cataract surgery. Modified WHO surgical safety checklist for cataract surgery was developed and implemented in the centre. Barriers in implementation of surgical safety checklist were also identified, and remedial measures suggested. Results: Significant improvement was noticed in all the parameters after introduction of modified checklist. The additional points which were added in modified surgical safety checklist were implemented in almost all the cases by the nursing staff. Overall mean compliance percentage before implementation of modified surgical safety check list at Dr. R.P.C was 37%±10.1 (P=0.001). While after introduction of modified surgical safety check list the mean compliance has improved to 62.7%±10.3, Wilcoxon rank sum test/Independent test is applied for each domain. Conclusions: Cataract procedure is the most common surgical procedure performed in the population in India. High volume and high turnover increase the potential for errors. Compliance to surgical safety check list before intervention was 32%. After intervention in form of a focus group discussion and introduction of modified surgical safety check list has resulted in increase in the compliance rate to 67%. This study revealed that changes or additional work is not happily accepted by the staff. After six months of intervention of modified surgical safety checklist compliance rate was still high, this suggests that constant supervision and monitoring by senior staff can sustain the compliance rate.


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A cadaveric study for structural variations of the stomach

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
K. Yesupadam, K. V. N. Geetha Devi, V. V. V. Lakshmi.
Background: The morphology of the stomach taken for the study for its clinical interventions like gastro-oesophagial reflux disorders (GERD) which are very common nowadays because of unusual timing of eating food, stress related jobs, eating of junk foods etc. The obesity now considered to be the 2nd leading cause of death, which can be prevented by gastric reconstructive procedures i.e., the bariatric surgeries. Methods: The study includes 70 adult cadavers, 28 obtained from the formalin fixed specimens kept for anatomy dissection for 1st year MBBS students from 2009 batch to 2015 batch. The remaining 42 specimens obtained from the postpartum bodies in the Forensic department of Guntur Medical College, Guntur. The abdominal cavity opened according to the incisions in the Cunninghams manual of anatomy. Stomach identified by reflecting anterior abdominal wall. Location noted, shape observed, Length taken, relations blood supply noted, results tabulated. Results: 71.4% specimens are J shaped, 14.2% are reverse L shaped, 7.2% are cresentic shaped, 7.2% are cylindrical shaped observed. The length is more in J shaped specimens. The lower extent of greater curvature at L3 in 71.4% specimens, at L2 in 21.4% specimens, at L4 in 7.2% specimens. Conclusions: The present study discussed about the shape of the stomach and the majority of specimens shown J shape. Remaining are reverse L shape; cresentic and cylindrical shaped.


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Association of psycho-wellness with various blood types in young medical students

2016-07-26T04-37-20Z
Source: International Journal of Research in Medical Sciences
Anuradha Yadav, Manisha Sankhla, Kusum Lata Gaur, I. D. Gupta.
Background: There are many stressors that affect students mental health. Many evidences indicate that individuals of different blood group have different response to same stressor, suggesting that the genetics of blood type also appear to alter susceptibility to develop neuropsychiatric disease. This study aimed to find out association of blood group with depression so early detection of depression and stress by blood types helps to reduce the overall burden of illness of young students thus improve their academic performance and social life. Methods: A cross-sectional study was carried out on 226 medical students. They are interrogated as per MMS scale to assess the psycho-wellbeing of students. ABO and Rh blood groups were determined by Anti sera A, Anti sera B and Anti sera D. Data were analysed with Primer version 6 and Chi-square. Results: In the present study it was observed that majority of students belong to blood group B (39.38%), followed by blood group 'O' (27.88%), 'A' (27.66%) and 'AB' (7.08%) respectively. Blood type A was more in red zone and more prone to PTSD (post traumatic syndrome disorders). Whereas blood type B was more prone to suicidal tendency. Proportion of psychomorbidity was found more in Rh+ than Rh (28.16% verse 15%). But these variations were statistically insignificant. Conclusions: Blood type 'A' and 'Rh+' were more prone to psycho morbidity and B for suicidal tendency, while 'O' had least suicidal tendency but this variation was not found significant. So it can be concluded that there is no association between blood type and psycho wellness of individual.


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MUNIX: Reproducibility and clinical correlations in Amyotrophic Lateral Sclerosis

Publication date: September 2016
Source:Clinical Neurophysiology, Volume 127, Issue 9
Author(s): Marcio Luiz Escorcio-Bezerra, Agessandro Abrahao, Isac de Castro, Marco Antonio Troccoli Chieia, Lyamara Apostolico de Azevedo, Denise Spinola Pinheiro, Nadia Iandoli de Oliveira Braga, Acary Souza Bulle de Oliveira, Gilberto Mastrocola Manzano
ObjectiveTo study the reproducibility, diagnostic yield to detect denervation, and clinical correlations of the Motor Unit Number Index (MUNIX) in subjects with Amyotrophic Lateral Sclerosis (ALS).MethodsMUNIX evaluation was performed in three muscles twice on the same day to assess reproducibility. Cut-off values for the MUNIX were based on data from 51 healthy subjects (controls) to evaluate the sensitivity of the technique to detect denervation in 30 subjects with ALS.ResultsThe method had good reproducibility. The variability was greater in the ALS group. In 23 ALS subjects (77%), low MUNIX values were detected. Most of the muscles with low MUNIX had also low compound muscle action potential (CMAP) and strength, but these parameters were normal in 9% of muscles. According to ROC curve analysis, MUNIX was generally accurate (AUC=0.9504) for discriminating between healthy individuals and subjects with at least one denervated muscle.ConclusionsMUNIX variability was higher in the ALS group. The method showed good diagnostic performance for the detection of denervation in a sample of patients with ALS.SignificanceThis study demonstrated that in addition to being a quantitative tool MUNIX can detect denervation in subjects with ALS.



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The role of sub-hippocampal versus hippocampal regions in bitemporal lobe epilepsies

Publication date: September 2016
Source:Clinical Neurophysiology, Volume 127, Issue 9
Author(s): Sandrine Aubert, Francesca Bonini, Jonathan Curot, Luc Valton, William Szurhaj, Philippe Derambure, Sylvain Rheims, Philippe Ryvlin, Fabrice Wendling, Aileen McGonigal, Agnes Trébuchon, Fabrice Bartolomei
ObjectiveWe aimed at better delineating the functional anatomical organization of bitemporal lobe epilepsy.MethodsWe studied the epileptogenic zone (EZ) by quantifying the epileptogenicity of brain structures explored by depth electrodes in patients investigated by stereoelectroencephalography (SEEG). We compared 15 patients with bilateral mesial temporal lobe epilepsy (BTLE) and 15 patients with unilateral mesial temporal lobe epilepsy (UTLE). This quantification was performed using the 'Epileptogenicity Index' (EI).ResultsAge at epilepsy onset, and epilepsy duration, were not statistically different in both groups. UTLE patients more frequently displayed maximal epileptogenicity in hippocampal structures, whereas BTLE patients had maximal values in subhippocampal areas (entorhinal cortex, temporal pole, parahippocampal cortex).ConclusionsOur results suggest different organization of the EZ in the two groups.SignificanceBTLE was associated with more involvement of subhippocampal regions, a result in agreement with known anatomical connections between the two temporal lobes.



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Cochrane Physical and Rehabilitation Medicine: A New Field to Bridge Between Best Evidence and the Specific Needs of Our Field

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8
Author(s): Stefano Negrini, Carlotte Kiekens, William Levack, Frane Grubisic, Francesca Gimigliano, Elena Ilieva, Meyer Thorsten




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Masthead

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8





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Intra-rater and Inter-rater Reliability of the Hierarchical Balance Short Forms in Patients With Stroke

Publication date: Available online 25 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Wan-Hui Yu, Kuan-Lin Chen, Sheau-Ling Huang, Wen-Shian Lu, Shu-Chun Lee, Ching-Lin Hsieh
ObjectiveTo examine the intra-rater and inter-rater reliability of a quick balance measure, the Hierarchical Balance Short Forms (HBSF), in outpatients with stroke receiving rehabilitation.DesignA repeated-assessments design (one week apart) was used to examine the intra-rater and inter-rater reliability of the HBSF. The HBSF was administered by a single rater in the intra-rater reliability study and by two raters in the inter-rater reliability study. The raters had sufficient working experience in stroke rehabilitation.SettingSeven teaching hospitals.ParticipantsTwo independent groups of outpatients (each with 53) with stroke in chronic stages and in stable medical condition were recruited.InterventionsNot applicable.Main Outcome MeasuresHBSFResultsFor the intra-rater reliability study, the values of the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and percentage of MDC (MDC%) were 0.95, 1.02, and 16.3%, respectively, for the HBSF. The 95% limits of agreement (LOA) of the HBSF ranged from -0.69 to 1.19. For the inter-rater reliability study, the values of the ICC, MDC, and MDC% were 0.91, 1.22, and 18.3%, respectively, for the HBSF. The 95% LOA of the HBSF ranged from -1.01 to 1.35.ConclusionsOur results suggest that the HBSF has satisfactory intra-rater and inter-rater reliability for assessing balance function in outpatients with stroke. The MDC values of the HBSF are useful for both researchers and clinicians to determine whether the change in balance function of an individual patient is real when administered by an individual rater or by different raters.



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Request for Proposals

Publication date: August 2016
Source:Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 8





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The Exercise is Medicine® Initiative: Physical Activity as a Vital Sign and Prescription in Adult Rehabilitation Practice

Publication date: Available online 25 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Rachel E. Cowan
To support Rehabilitation Healthcare Professionals efforts to increase Physical Activity Levels among their outpatient rehabilitation and post-discharge patients, we review the Exercise is Medicine® Initiative (EIM). EIM was launched in 2007 jointly by the American College of Sports Medicine and American Medical Association. Three principles underlie EIM. First, that physical activity should be monitored as a vital sign and second, that physical activity is an effective medical modality and should be prescribed. The target weekly physical activity level is 150 minutes of moderate to vigorous physical activity, as established by the Centers for Disease Control and World Health Organization. Persons falling below the weekly target physical activity level should be prescribed physical activity and/or referred to an Exercise Professional for implementation support. Selection of an Exercise Professional for referral is based on the patient's risk stratification and need to participate in clinically supervised physical activity.



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A comparative study between the still births and full term normal deliveries based on the clinical history of mother

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Preksha Sharma, Sangita Chauhan, Shreya Sharma, Parul Pahal.
Background: To study the impact of duration of pregnancy, obstetrical history of mother and age of the mother on foetal outcome in still birth and full term normal deliveries. Methods: After taking due permission from the ethical committee the study was conducted in the S.M.S. Medical College and attached group of hospitals. Results: Following parameters were recorded: (1) duration of pregnancy (in weeks): it was found that females reporting with still births have significantly lowered weeks of gestation; (2) obstetrical history: it was found that both groups were well comparable without any significant difference neither in gravidity nor in parity; (3): age of the mother: there was no significant (p>0.05) difference found in mean age of females of both the groups. Conclusions: Knowledge about the various factors leading to still birth is important so that that maximum attention could be paid on these causative factors so as to improve the outcome.


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Assessment of oxidative stress in serum of pulmonary tuberculosis patients

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Vishal Wagh, Shreewardhan Rajopadhye, Sandeepan Mukherjee, Anant Urhekar, Deepak Modi.
Background: Tuberculosis (TB) remains a human health issue and often deadly infectious disease in low-middle income nations. In TB, oxidative stress is a result of tissue inflammation, poor dietary intake of micronutrients due to illness, free radical burst from activated macrophages. This study was conducted prospectively to evaluate the oxidative stress in TB. Methods: The study included 30 newly diagnosed TB positive patients and 30 healthy individuals. Pro-oxidant markers like the thiobarbituric acid reactive species (TBARS) and nitric oxide were studied from serum. Antioxidant parameter like serum total-SH was also assessed. Results: Levels of pro-oxidants were significantly increased whereas antioxidant defense markers were significantly impaired in the TB group. Nitric oxide and TBARS were increased (p


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Locomotor deficits in recently concussed athletes and matched controls during single and dual-task turning gait: preliminary results

There is growing evidence that mild traumatic brain injury (concussion) can affect locomotor characteristics for prolonged periods of time even when physical signs and symptoms are absent. While most locomotor...

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Study of serum electrolytes in acute exacerbation of chronic obstructive pulmonary disease patients

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Gnaneshwar Goli, Rajender Mukka, Sunil Sairi.
Background: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, mortality and decreased quality of life. Due to lack of awareness of precipitating factors and predictors of prognosis in acute exacerbation of COPD in developing countries by most treating physicians, often leads to fatal outcomes. Aim of the study was to study of serum electrolytes in acute exacerbation of COPD Patients. Methods: In our study, we assessed the levels of serum sodium and potassium in subjects with acute exacerbation of COPD and their healthy controls. Results: We found a significantly low level of serum sodium (132±5.65Meq/lit) and potassium (3.29±0.96 Meq/lit)) in subjects with acute exacerbation of COPD than their healthy controls (Na+ =140±2.28 Meq/lit and K+ = 4.51±0.02 Meq/lit (p


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Knowledge and practices among male medical students regarding smoking and its hazards

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Asif Mehmood, Usman Sarwar, Waqar Ahmed, Hassan Tahir.
Background: Tobacco use is the leading preventable cause of death worldwide, and according to the latest estimates, by year 2030, 10 million annual tobacco-attributable deaths worldwide, 70% of which will be in low-middle-income countries. The purpose of study was too assess the knowledge and practices regarding cigarette smoking among male medical students in Allama Iqbal Medical College, Lahore, Pakistan and to assess the awareness of students regarding smoking related health hazards. Methods: A Cross-Sectional Study was conducted From May 2009 - September 2009 in Allama Iqbal Medical College, Lahore, Pakistan. The male students enrolled in Allama Iqbal Medical College Lahore, were selected by non-probability convenient sampling. Results: In present study 47.3% respondents were smokers, 94.1% were knowledgeable about hazards of smoking, 85.9% were aware about passive smoking, and 19.1% started consuming tobacco below 17 years of age. Only 19.1% tried to quit smoking but none of them succeeded. 25% have no family association of smoking. There were 18.2% whos mostly close friends were smokers only 13.2% smokes more than 15 cigarettes daily. 43.6% said they would smoke cigarette if one of their close friends offer them. 30.5% believe cigarette smoking help to relax and 25% want to quit smoking among them 10% want to quit due to its hazards while 5.9% due to family pressure. Conclusions: Present study concluded that high proportion male medical students smoke cigarette. Most of them were unaware about tobacco consumption hazards, and passive smoking.


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Preterm premature rupture of membranes: correlates and pregnancy outcome in a tertiary care setting

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Reeti Rajan, Vrinda Menon.
Background: Prelabour membrane rupture before 37 weeks of gestation is referred to as preterm premature rupture of membranes (PPROM). Incidence of PPROM is about 2% of all pregnancies. This prospective study aims to determine fetal and early neonatal outcome of pregnancies with PPROM. Methods: The study was conducted in 190 antenatal women with PPROM between 24 weeks to 36weeks of gestation over a period of 18 months. Their babies were followed up till discharge from Pediatric new born unit. Results: Prevalence of PPROM was 0.8%, accounting for 19% of preterm deliveries. 61% of women with PPROM showed evidence of lower genito-urinary tract infection, 28% had anemia, 48% gave history of coitus during pregnancy. Mean gestational age of membrane rupture was 32 weeks, the mean latency between membrane rupture and delivery was 4.4 days. Chorioamnionitis developed in 13% of women with PPROM, cord prolapse in 4% and abruption in 3%. The gestational age wise survival was 40% in babies weighing less than 1.5kg, 88% in babies weighing 1.5 to 2.5kg and 93% in those more than 2.5kg. The predominant causes of neonatal mortality were hyaline membrane disease (HMD) in babies born before 28 weeks, HMD and sepsis between 29 to 33 weeks and sepsis in babies born after 34 weeks. Conclusions: Screening and treatment of risk factors may contribute to prevention of PPROM. Neonatal survival depends on gestational age and availability of advanced NICU facilities. Patients and family members should be counseled regarding the outcome of pregnancies with PPROM. A team effort by the obstetrician and neonatologist in a tertiary care setting can ensure a healthy and fruitful life for mother and baby.


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Prevalence of rhesus negativity among pregnant women

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Ezhil Arasi Nagamuthu, Padmavathy Mudavath, Pasupuleti Prathima, Srilatha Bollipogu.
Background: Hemolytic disease of the newborn (HDN), secondary to Rhesus D (Rh D) iso - immunization, contributes significantly to perinatal morbidity and mortality. The objective of the study was to determine the frequency of Rh factor in this region, which would not only help in blood transfusion services but also eliminate the risk of Erythroblastosis fetalis in the neonates. Methods: A two year retrospective study of rhesus negative pregnant women was carried out at Tertiary care center, Modern Government Maternity Hospital, Petlaburz, Hyderabad, from January 2014 to December 2015. Results: The prevalence rate of Rh D negative women for antenatal care, were 895 (4.29%). Out of that 304 (33.96%) of the Rh D negative women were of blood group B followed by blood group O of 292(32.62%), blood group A of 218 (24.35%) and blood group AB of 81 (9.05%), respectively. Conclusions: The prevalence of Rh D negative women is low when compared to Rh D positive women.There is a need for adequate counselling of pregnant women on the importance of Rh D negative factor during the antenatal period in order to prevent hemolytic disease of the newborn.


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Assessment of patients knowledge, attitude and practice regarding hypertension

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Manasa Bollampally, Preethika Chandershekhar, Kodishala Pradeep Kumar, Aruna Surakasula, Sharadha Srikanth, T. Rama Mohan Reddy.
Background: Hypertension is not a disease but it is an important risk factor for cardiovascular complications. Approximately 77.9 million American adults (1 in 3 people) and one billion people worldwide have high blood pressure. Hypertension can be described as the sleeping snake which bites when it wakes up. There is need to investigate KAP among the general population which helps in the future development programmes for effective health education The main aim of this study was to assess the patients Knowledge, Attitude and Practice regarding hypertension. Methods: This is a prospective observational study conducted in the In-patient Departments of Gandhi hospital, Secunderabad for a period of 6 months (August 2015 - January 2016) which was approved by institutional ethics committee. A total of 160 hypertensive patients with or without comorbid condition were included. . Adults of age less than 30 years, paediatrics, Pregnant and lactating women were excluded. Patients were selected by simple random sampling method. A suitably designed and validated KAP questionnaire was administered to hypertensive patients. This questionnaire was filled in at face to face interview along with inform consent Statistical analysis was performed using Graph pad prism software version 5. Data was analysed using unpaired t-test. Results: We observed a good score towards knowledge, attitude and poor score towards practice. Conclusions: Our study signifies that patients require support and guidance for practicing better disease management. Clinical activities such as patient counselling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management.


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How harmless bacteria can cause fatal infections

Technische Universität München News

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High origin of radial artery: a comparative, anatomical and embryological consideration

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Shilpi Agarwal, Rekha Lalwani, C. S. Ramesh Babu.
Background: Radial artery is one of the terminal branches of the brachial artery arising in the cubital fossa about 1 cm below the bend of the elbow. Diversions of the radial artery from its normal anatomical pattern as regards to its origin or its course constitute the largest group of vascular variations of the upper extremity. Unusual origin of the radial artery may cause failure of transradial approach for percutaneous coronary angiography and difficulty in the reconstructive surgery of the upper limb. Methods: The present study was conducted in the Department of Anatomy at LLRM Medical College on 16 formalin fixed cadavers (12 male and 4 female) of adult age group i.e. 32 upper limbs. Axilla and arm was carefully dissected. Axillary artery and brachial artery were dissected and its branching pattern was observed to note the origin of radial artery. The course of radial artery was noted in each case. Results: Radial artery took origin from the third part of the axillary artery in 3.12%. It arose 2 cm above the lower border of teres major, coursed superficial to median nerve in the arm and continued in the forearm as such. The brachial artery after giving its branches continued as ulnar artery in the forearm. In 96.88%, radial artery arose normally in cubital fossa. Conclusions: High origin and superficial course of the radial artery may be hazardous and vulnerable to injury during venepuncture and surgical procedures. This type of anomaly is due to failure of formation of the communicating branch between superficial brachial artery and axial artery at level of elbow. Awareness about details and topographic anatomy of such variations may help to prevent diagnostic errors, influence surgical tactics and interventional procedures.


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Comparative evaluation of bioactive glass bone graft material with platelet rich fibrin and bioactive glass bone graft material alone for the treatment of periodontal intrabony defects: a clinical and radiographic study

2016-07-26T02-39-06Z
Source: International Journal of Research in Medical Sciences
Prashant John Ashawan, R. M. Zade.
Background: The primary goal of periodontal therapy is to arrest the progression of periodontal disease and maintain the natural dentition in health and comfortable function. Growth factors that seem to play an important role in periodontal and bone wound healing are PDGF, IGF combined with PDGF and TGF-ß. Platelet-rich fibrin (PRF) seems to be an appropriate and economical method to obtain these growth factors. The cell type-specific actions of PRF may be beneficial for periodontal regeneration. The purpose of this study is to compare the clinical and radiographic outcomes obtained by a combination of bioactive glass with PRF and bioactive glass alone in treatment of periodontal intrabony defects. Methods: The present study was carried out in Rajnandgaon city (C.G.) India, during study period May 2013 to October 2014. After initial examination, the following recording was made using Plaque index and Gingival index. Preparation of PRF was done by Choukroun criteria. Surgical procedure was performed. Post-surgical findings were noted. Student t test (Paired and unpaired) were applied with value of


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