A Review on the Effect of Nutrition on Exercise-Induced Muscle Damage (EIMD)

A muscle strain develops when a muscle lengthens or is torn. This would be frequently caused by muscle exhaustion, abuse, or misuse. Exercise-Induced Muscle Damage (EIMD) is defined based on indicators appearing soon after initiating an exercise session and continues for up to 14 days after the end of the session. Muscle damage from trauma, inherited genetic illnesses, pathology or complete circumstances are highly common and cause significant socio-economic consequences. Athletes care about EIMD-related loss of muscle strength and discomfort since they can affect their performance significantly. This current review is intended to highlight the updated findings and its present preventive and management strategies. The review also discussed the pathophysiology behind EIMD in detail to highlight the understanding points regarding EIMD. The frequency of EIMD following exercise must are linked with strength training, and muscle strain as measured by an increased level of serum kinase (CK). the percentage of tissue micro-injuries. EIMD is quite frequent among athletes and also among the general population. This review has discussed the available diet and nutrition to prevent such EIMD and tackle, it if EIMD sets in. Finally, this current review has covered EIMD from all the phases and recommendations have been made for further study, especially in clinical trials.

Compliance to radiotherapy: A tertiary care center experience

CONTEXT: The most commonly prescribed conventional fractionation radiotherapy uses 1.8–2.2 Gy per fraction for five fractions in a week. Many times, unwanted interruptions are encountered, which ultimately affect the local control and overall survival. AIMS: The present retrospective study was carried out to study the compliance to radiotherapy at our institute and to determine various factors related to it. PATIENTS AND METHODS: The present retrospective study was carried out at the department of Radiotherapy, SMS Medical College and attached group of hospitals, Jaipur; in patients who were treated with curative intent with conventional fractionation radiotherapy over telecobalt machine from January 2017 to April 2017. Noncompliance was studied for association with various factors such as age, sex, site of primary disease, stage of tumor, distance patients had to travel to receive treatment, administration of concurrent chemotherapy, and financial burden of the treatment. RESULTS: Of 203 patients, 138 were of head-and-neck cancer, 42 of cervical cancer, and 23 of breast cancer. The cumulative incidence of noncompliance was 12.8% (15.9% for head-and-neck cancer, 7.2% for cervical cancer, and 4.4% for breast cancer). Statistically significant association was found between noncompliance and higher age of the patients (P = 0.07), male gender (P = 0.002), advanced stage (P = 0.004), administration of concurrent chemoradiotherapy (CCRT) (P < 0.001), and greater distance patients had to travel for radiotherapy (P = 0.03). CONCLUSIONS: The factors ith which noncompliance is significantly associated in the present study are higher age, male gender, advanced stage of tumor, administration of CCRT, and greater distance patients had to travel to avail radiotherapy.

Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

PURPOSE: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening. MATERIALS AND METHODS: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L’Insalata’s method. Functional outcome was measured at 2-year follow-up. RESULTS: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups. CONCLUSIONS: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices. LEVEL OF EVIDENCE: Level 3, Retrospective Cohort

Intrathecal levobupivacaine versus bupivacaine for inguinal hernia surgery: a randomized controlled trial / 대한마취과학회지

BACKGROUND: Levobupivacaine is an attractive alternative to racemic bupivacaine for spinal anesthesia due to the lower potential for cardio-toxicity and faster recovery profile. This study was designed to compare isobaric levobupivacaine with hyperbaric racemic bupivacaine with respect to intraoperative quality of anesthesia and the postoperative recovery profile in patients undergoing inguinal hernia surgery. METHODS: A total of 100 American Society of Anesthesiologists 1 and 2 patients, aged 18–60 years, undergoing elective daycare unilateral inguinal hernia surgery, were randomized into two groups. Group L received spinal anesthesia with 3 ml of 0.5% plain levobupivacaine. Group B received 3 ml of 0.5% hyperbaric racemic bupivacaine. Quality of anesthesia, sensory and motor block characteristics, duration of effective analgesia, time to mobilization, and incidence of side effects were compared. RESULTS: The quality of anesthesia was comparable between the two groups. No difference was observed in the block onset time or maximum block height. The duration of anesthesia was significantly shorter in group L compared with that in group B (206.2 ± 18.9 min vs. 224.1 ± 15.6 min, P < 0.001), as was duration of motor block (185.9 ± 20.3 min vs. 196.4 ± 21.2 min, P = 0.016) and time to walk unaided (321.9 ± 19.2 min vs. 356.7 ± 26.6 min, P < 0.001). The incidence of hypotension was less in group L (12%) compared to group B (32%) (P = 0.028). CONCLUSIONS: Levobupivacaine is an effective alternative to bupivacaine for patients undergoing unilateral inguinal hernia surgery. It has a shorter duration of sensory and motor block, allowing earlier mobilization in daycare surgeries, and a lower incidence of intraoperative hypotension.

Comparison of apical sealing and periapical extrusion of the ThermaFil obturation technique with and without MTA as an apical barrier: An in vitro study.

Aim: The aim of the study was to compare the conventional ThermaFil obturation technique and ThermaFil obturation with mineral trioxide aggregate (MTA) as an apical barrier, with regard to apical sealing and extrusion. Materials and Methods: Twenty extracted human canines were instrumented using a crown-down technique and divided into two groups. The experimental group was obturated using ThermaFil obturation with MTA as an apical barrier and the control group was obturated using the conventional ThermaFil obturation technique. AH Plus sealer was used in both the groups. Apical extrusion was recorded. Teeth of both the groups were coated with nail polish, except for the apical 3 mm. After 24 h, they were suspended in black India ink for 48 h. Canines were decalcified, rendered transparent, and linear dye penetration was measured under ×40 stereomicroscope. Results: There was a significant extrusion noticed in conventional ThermaFil obturation technique. Frequency of extrusion of sealer and/or gutta-percha was supposed to be evaluated using χ² test, but since the values of the samples of ThermaFil plus MTA group were zero, statistical analysis could not be conducted, whereas linear dye leakage was calculated with Mann-Whitney U test because the distribution was abnormal. Conclusion: Although ThermaFil plus MTA group showed microleakage, extrusion of sealer and the core material was prevented in comparison with conventional ThermaFil obturation technique. It is advantageous to use MTA as an apical plug as there is no fear of apical extrusion and the root canal system can then be packed three dimensionally against this barrier using any thermoplasticized gutta-percha obturation technique.

HIV prevalence in suspects attending Sir Sunder Lal Hospital

<p><b>OBJECTIVE</b>To assess the sero-positivity rate of HIV infection among clinically suspected subjects of reproductive age group (15-49 years), biological and behavioral characteristics of the subjects gender specific variation of sero-positivity rate, and the differentials of the sero-positivity rate for the history of blood transfusion or blood products or other organs, history of needle exposure and symptoms of morbidity.</p><p><b>METHODS</b>Study is based on the retrospective data of the calendar year 2005 obtained from Voluntary Counseling and Testing Centre (VCTC) (now renamed as ICTC), Department of Microbiology, I.M.S., B.H.U., Varanasi. These cases were either referred by the consultants of different OPD'S of Sir Sunderlal Hospital or came voluntarily for knowing their HIV status. About 2-3 mL of blood samples were collected in a plain vial and tested for HIV status by strategy II/III as per WHO/NACO guidelines.</p><p><b>RESULTS</b>Overall sero-positivity of HIV was 15.3% (18.1% in males and 12.2% in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes. Sero-positivity rate in male migrants was 43.1%, while in female migrants it was 18.7%. The history of multiple sexual contacts was about 3 times higher in males as compared to females; predominantly it was very high in male migrants (67.7%) as compared to male non-migrants (15.8%). History of multiple sexual contacts was not uncommon in females and it was 25.0% in female migrants and 9.7% in non-migrant females. The sero-positivity rate with the history of multiple sexual contacts was 45.4% in males and 60.3% in females, while without history of multiple sexual contacts these were only 2.8% and 5.3% respectively. Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives. It is to be noted that sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms; vice versa, in males presenting with some symptoms HIV infection was 7 times higher than those without symptoms.</p><p><b>CONCLUSIONS</b>The findings indicate a high sero-positivity among both the genders. Multiple heterosexual contacts, especially, in migrants are the main root of transmission of HIV. These are causing spread of HIV to their spouses. The multiple sexual contacts in the society, especially, among non migrant females of this region are indicating the distortion of traditions and cultures which are a serious concern and may lead to HIV infection on the rise. Awareness program to the susceptible group is the need to reduce further spread of HIV.</p>

HIV prevalence in suspects attending Sir Sunder Lal Hospital

Objective: To assess the sero-positivity rate of HIV infection among clinically suspected subjects of reproductive age group (15-49 years), biological and behavioral characteristics of the subjects gender specific variation of sero-positivity rate, and the differentials of the sero-positivity rate for the history of blood transfusion or blood products or other organs, history of needle exposure and symptoms of morbidity. Methods: Study is based on the retrospective data of the calendar year 2005 obtained from Voluntary Counseling and Testing Centre (VCTC) (now renamed as ICTC), Department of Microbiology, I.M.S., B.H.U., Varanasi. These cases were either referred by the consultants of different OPD'S of Sir Sunderlal Hospital or came voluntarily for knowing their HIV status. About 2-3 mL of blood samples were collected in a plain vial and tested for HIV status by strategy II/III as per WHO/NACO guidelines. Results: Overall sero-positivity of HIV was 15.3% (18.1% in males and 12.2% in females) which increased 6-7 folds in the age group 35-49 years as compared to 15-24 years in both the sexes. Sero-positivity rate in male migrants was 43.1%, while in female migrants it was 18.7%. The history of multiple sexual contacts was about 3 times higher in males as compared to females; predominantly it was very high in male migrants (67.7%) as compared to male non-migrants (15.8%). History of multiple sexual contacts was not uncommon in females and it was 25.0% in female migrants and 9.7% in non-migrant females. The sero-positivity rate with the history of multiple sexual contacts was 45.4% in males and 60.3% in females, while without history of multiple sexual contacts these were only 2.8% and 5.3% respectively. Sero-positive cases had on an average 3.6±1.7 various morbidity symptoms as compared to 0.7±1.1 in sero-negatives. It is to be noted that sero-positivity rate was more in those females who seemed apparently healthy compared to those presenting with some of the symptoms; vice versa, in males presenting with some symptoms HIV infection was 7 times higher than those without symptoms. Conclusions: The findings indicate a high sero-positivity among both the genders. Multiple heterosexual contacts, especially, in migrants are the main root of transmission of HIV. These are causing spread of HIV to their spouses. The multiple sexual contacts in the society, especially, among non migrant females of this region are indicating the distortion of traditions and cultures which are a serious concern and may lead to HIV infection on the rise. Awareness program to the susceptible group is the need to reduce further spread of HIV.

Effect of the plants Thevetia peruviana and Alstonia scholaris [family: apocynaceae] on acetylcholinesterase activity of lymnaea acuminata snails

The aquatic snail Lymnaea acuminata is a vector of the liver flukes Fasciola hepatica and Fasciola gigantica, which cause endemic fascioliasis in cattle and livestock of Eastern India. Very low concentration of the aqueous and partially purified extracts of lattices of Thevetia peruviana and Alstonia scholaris [Family-Apocynaceae] can kill these snails. The latices of both plants had strong in vivo and in vitro inhibitory effects on the acetylcholinesterase [AChE] of Lymnaea acuminata. These plants could potentially use in snail control. Their reversible action and low toxicity to fishes would be an added advantage in their use. It is possible that at this level of molluscicidal activity, the tested extracts from the plants Thevetia peruviana and Alstonia scholaris will have a future use in control of fascioliasis