Multiple carpo-metacarpal joint dislocations without fracture

Although carpometacrpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. Therefore, any pure multiple dislocation of the CMC joint without associated fracture is worth to be reported. Untreated the dislocations disrupt both the longitudinal and transverse arches of the hand resulting in an impaired grip and loss of normal axial length. We would like to report an uncommon case of carpometacarpal dislocation without associated fractures in a 28-year old man following a fall from a vehicle at speed. To the best of our knowledge, this is first case being reported in Sudan literature on such injury

Lactic acid- the innocent culprit of muscle fatigue

What causes muscle fatigue? Is lactic acid considered to be a major culprit in the underlying mechanisms of muscle fatigue? These are very important questions and the answers are difficult and sophisticated. For decades, lactic acid was the major culprit of muscle fatigue. This review reveals that muscle fatigue would occur more badly if lactic acid was not produced in anaerobic cellular conditions to regenerate NAD[+] required for continuation of glycolysis, the major pathway for generation of energy needed for muscle performance