Myofascial release versus other soft tissue release techniques along superficial back line structures for improving flexibility in asymptomatic adults: A systematic review with meta-analysis.

OBJECTIVE: Our review is aimed to find out the efficacy of Myofascial Release Technique (MFRT) based on the Randomised Controlled Trials, on flexibility when given along superficial back line (SBL) structures and to compare it with other soft tissue release techniques. DATA SOURCES: A systematic literature search on MEDLINE (Pubmed), Google Scholar, Science direct, Cochrane Library, Physiotherapy Evidence Database (PEDro) and Clinical Trial Database in English; up to April 2020 was undertaken. STUDY SELECTION: PRISMA (The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols) was used for screening the relevant citations and reviewing the relevant studies. The literature searched total of 6,938 articles, however, only 68 were screened for eligibility. In the further screening, 16 studies fulfilled the inclusion criteria for our systematic review. DATA EXTRACTION: Data were extracted into a table containing sample size, mean age of subjects, types of intervention, area to be treated, outcome measures used, and results of the accepted studies. DATA SYNTHESIS: 16 randomized controlled trials and cross-over trials were found to be eligible for our review. Quality assessment of the RCTs was done with the PEDro scoring method. Randomised clinical trials that studied the comparative effect of Myofascial Release (MFRT) technique with different MFRT techniques, control/sham, and other soft tissue release techniques like stretching, were included. Results of this analysis showed little evidence proving the additional effectiveness of MFRT treatment compared to other soft tissue release techniques for improving flexibility so as to consider it as the preferred treatment. Methodological aspects of selected studies for further research are suggested. Study was registered in the PROSPERO database (CRD42020179118). CONCLUSION: MFRT appears to be a good technique for improving flexibility. However, in comparison with other soft tissue release techniques, this therapy becomes less successful. More research is needed regarding its effectiveness.

Convalescent Plasma Therapy in the management of COVID-19 patients-The newer dimensions.

BACKGROUND: COVID 19 infection caused by novel coronavirus with no specific established treatment. Convalescent Plasma Therapy has been authorized as an off-label therapeutic procedure. We assessed the outcome of convalescent plasma (CP) units versus standard treatment on the complete recovery, improvement and 28 days' mortality of COVID 19 patients. MATERIALS AND METHODS: The present was multi-centric case controlled observational prospective study. The study was conducted for a period of four and half months from July 15 2020 to 30 November 2020 after taking approval from the Expert Committee, Health & Family Welfare Department, Government of Odisha. Plasma therapy was applied on two groups of 1189 serious COVID patients (959 number of pre- critical and 230 number of critical patients) not responding to oxygen therapy. It was compared with non- transfused control group of 1243 patients (996 number of pre-critical and 247 number of critical patients). RESULTS: Discharge was better in (55.5%) transfused than (43%)in non-transfused pre-critical patients and the mortality was lower (44.3%) in transfused, (48.9%) than non-transfused critical patients respectively. Complete recovery was highest in those who were transfused with CP with neutralizing titer more than 1:160 (52.5%), 18-30 years' age group (64%), females (53%), 'O' Rh D positive blood group (51.5%). There was no adverse reaction due to CP transfusion. CONCLUSIONS: CP is effective in improving the recovery rate with earlier discharge and decrease in the 28 days' mortality than in the control non-transfused group. CP with neutralizing antibody titer more than 1:160 has the best outcome with complete recovery and decrease in the mortality. It is more effective in treating pre-critical patients when transfused early, in female patients, in younger age group and in blood group 'O' Rh D positive.

Livedoid Vasculopathy with Hyperhomocysteinemia Responding to Hyperbaric Oxygen Therapy.

A 30-year-old male presented to the dermatology department with complaints of multiple ulcers over both legs of 6 years duration. The ulcers had a waxing and waning course with present exacerbation of lesions since 1 month. Dermatological examination revealed multiple ulcers distributed in a reticular pattern over medial and lateral aspects of both lower legs, extensor aspect of both ankles and dorsum of both feet. Multiple interspersed atrophic porcelain white scars were also present. Investigations revealed raised serum homocysteine levels. A skin biopsy from the ulcers showed features of livedoid vasculopathy. Following recurrence of lesions after oral corticosteroid therapy, the patient was given a course of hyperbaric oxygen therapy for the ulcers to which he responded very well. This case is being presented for the novel option of hyperbaric oxygen therapy in livedoid vasculopathy, which by itself is rarely reported in this part of the world.

Free radicals and antioxidant status in protein energy malnutrition.

Background/Objectives. The aim of this study was to evaluate oxidant and antioxidant status in children with different grades of Protein Energy Malnutrition (PEM). Subjects/Methods. A total of two hundred fifty (250) children (age range: 6 months to 5 years) living in eastern UP, India, were recruited. One hundred and ninety-three (193) of these children had different grades of PEM (sixty-five (65) children belong to mild, sixty (60) to moderate, and sixty-eight (68) to severe group). Grading in group was done after standardization in weight and height measurements. Fifty-seven (57) children who are age and and sex matched, healthy, and well-nourished were recruited from the local community and used as controls after checking their protein status (clinical nutritional status) with height and weight standardization. Redox homeostasis was assessed using spectrophotometric/colorimetric methods. Results. In our study, erythrocyte glutathione (GSH), plasma Cu, Zn-superoxide dismutase (Cu,Zn-SOD,EC 1.15.1.1), ceruloplasmin (Cp), and ascorbic acid were significantly (P < 0.001) more decreased in children with malnutrition than controls. Plasma malondialdehyde (MDA), and protein carbonyl (PC) were significantly (P < 0.001) raised in cases as compared to controls. Conclusion. Stress is created as a result of PEM which is responsible for the overproduction of reactive oxygen species (ROSs). These ROSs will lead to membrane oxidation and thus an increase in lipid peroxidation byproducts such as MDA and protein oxidation byproducts such as PC mainly. Decrease in level of antioxidants suggests an increased defense against oxidant damage. Changes in oxidant and antioxidant levels may be responsible for grading in PEM.

Oxidative stress in children with severe malaria.

Fifty cases of severe malaria were studied for their oxidant and antioxidant status. Severe anemia (54%) was the most common presentation followed by hyperpyrexia, cerebral malaria and jaundice. Plasma malondialdehyde, protein carbonyl, nitrite, ascorbic acid and copper levels were significantly raised in cases as compared with controls (p < 0.001). Plasma ceruloplasmin, glutathione and superoxide dismutase levels were significantly decreased in children with severe malaria (p < 0.001). Plasma zinc was increased in cases but difference is not statistically significant. Significantly decreased level of nitrites and increased value of glutathione was found in patients with hemoglobinuria and jaundice, respectively. The significantly elevated malondialdehyde and protein carbonyl levels reflect the increased oxidative stress, whereas decreased levels of glutathione and superoxide dismutase point toward utilization of the antioxidants in severe malaria. Thus, changes in oxidants and antioxidants observed suggest the production of reactive oxygen species and their possible role in pathogenesis of severe malaria.

Modeling the operation of a three-stage fluidized bed reactor for removing CO2 from flue gases.

A bubbling counter-current multistage fluidized bed reactor for the sorption of carbon dioxide (CO(2)) by hydrated lime particles was simulated employing a two-phase model, with the bubble phase assumed to be in plug flow, and the emulsion phase in plug flow and perfectly mixed flow conditions. To meet prescribed permissible limit to emit carbon dioxide from industrial flue gases, dry scrubbing of CO(2) was realized. For the evaluation, a pilot plant was built, on which also the removal efficiency of CO(2) was verified at different solids flow rates. The model results were compared with experimental data in terms of percentage removal efficiency of carbon dioxide. The comparison showed that the EGPF model agreed well with the experimental data satisfactorily. The removal efficiency was observed to be mainly influenced by flow rates of adsorbent and CO(2) concentration.

Parenteral immunization of fish, Labeo rohita with Poly D, L-lactide-co-glycolic acid (PLGA) encapsulated antigen microparticles promotes innate and adaptive immune responses.

Immunogenicity of different antigen preparations of outer membrane proteins (OMP) of Aeromonas hydrophila such as Poly d, l-lactide-co-glycolic acid (PLGA) microparticles, oil emulsion, neat OMP and bacterial whole cells were compared through intra-peritoneal injection in fish, Labeo rohita. Among these preparations, PLGA encapsulated antigen stimulated both innate and adaptive immune parameters and the immunogenicity exhibited by PLGA microparticles was significantly higher (p < 0.05) at both 21 and 42 days post-immunization suggesting that the above delivery system would be a novel antigen carrier for parenteral immunization in fish, Labeo rohita.

Cysticercal encephalitis with cortical blindness.

The authors report a 6-year-old boy, who had presented with low-grade fever, altered sensorium, headache and seizure for 5 days. On examination, he had features of raised intracranial pressure with left VI cranial-nerve palsy and bilateral extensor plantar response. CT scan showed multiple calcifications in cerebral cortex. MRI cranium showed multiple cysts involving whole of the brain. He was diagnosed as having cysticercal encephalitis, based on immunological and imaging study. He was managed with 20% mannitol, phenytoin and albendazole, and regained consciousness 7 days later, but had residual neurological deficit as left-lower-limb monoparesis and visual acuity of just projection of rays (PR+) and perception of light (PL+).

Removal of hazardous gaseous pollutants from industrial flue gases by a novel multi-stage fluidized bed desulfurizer.

Sulfur dioxide and other sulfur compounds are generated as primary pollutants from the major industries such as sulfuric acid plants, cupper smelters, catalytic cracking units, etc. and cause acid rain. To remove the SO(2) from waste flue gas a three-stage counter-current multi-stage fluidized bed adsorber was developed as desulfurization equipment and operated in continuous bubbling fluidization regime for the two-phase system. This paper represents the desulfurization of gas mixtures by chemical sorption of sulfur dioxide on porous granular calcium oxide particles in the reactor at ambient temperature. The advantages of the multi-stage fluidized bed reactor are of high mass transfer and high gas-solid residence time that can enhance the removal of acid gas at low temperature by dry method. Experiments were carried out in the bubbling fluidization regime supported by visual observation. The effects of the operating parameters such as sorbent (lime) flow rate, superficial gas velocity, and the weir height on SO(2) removal efficiency in the multistage fluidized bed are reported. The results have indicated that the removal efficiency of the sulfur dioxide was found to be 65% at high solid flow rate (2.0 kg/h) corresponding to lower gas velocity (0.265 m/s), wier height of 70 mm and SO(2) concentration of 500 ppm at room temperature.

Column performance of granular activated carbon packed bed for Pb(II) removal.

The excessive release of lead from lead acid batteries, smelting plant into the environment is a major concern worldwide. Adsorption process is among the most effective techniques for lead removal from wastewater and activated carbon has been widely used as an adsorbent. In this paper an attempt has been made to investigate the adsorption behaviour of Pb(II) from aqueous systems onto granular activated carbon using the batch mode and continuous mode in a packed bed column with more successive service and regeneration. The experiments were performed at constant temperature and dimensions of column and packed bed of granular activated carbon with variation of flows through the bed and concentrations of lead solutions. Breakthrough points were found out for the adsorption of lead on the adsorbent using continuous-flow column operation by varying different operating parameters like hydraulic loading rate from 4 to 16 m(3)/h m(2) and feed concentrates from 20 to 60 mg/l. Granular activated carbon column regeneration using 0.5 M concentration of HNO(3) has been investigated. Results indicate encouraging performance towards removal of Pb(II).

Studies on the removal of Pb(II) from wastewater by activated carbon developed from Tamarind wood activated with sulphuric acid.

The low-cost activated carbon were prepared from Tamarind wood material by chemical activation with sulphuric acid for the adsorption of Pb(II) from dilute aqueous solution. The activated carbon developed shows substantial capacity to adsorb Pb(II) from dilute aqueous solutions. The parameters studied include physical and chemical properties of adsorbent, pH, adsorbent dose, contact time and initial concentrations. The kinetic data were best fitted to the Lagergren pseudo-first-order and pseudo-second order models. The isotherm equilibrium data were well fitted by the Langmuir and Freundlich models. The maximum removal of lead(II) was obtained 97.95% (experimental) and 134.22 mg/g (from Langmuir isotherm model) at initial concentration 40 mg/l, adsorbent dose 3g/l and pH 6.5. This high uptake showed Tamarind wood activated carbon as among the best adsorbents for Pb(II).

Maternal anthropometry as predictors of low birth weight.

The usefulness of maternal anthropometric parameters i.e. maternal weight (MWt), maternal height (MHt), maternal mid-arm circumference (MMAC) and maternal body mass index (MBMI) as predictors of low birth weight (LBW) was studied in 395 singleton pregnancies. The maternal anthropometric parameters were measured in the first trimester of pregnancy and were plotted against the birth weight of the newborns. Significant positive correlations were observed among MWt and birth weight (r=0.38), MHt and birth weight (r=0.25), MMAC and birth weight (r=0.30) and MBMI and birth weight (r=0.30). The most sensitive being MWt (t=7.796), followed by MMAC (t=5.759), MHt (t=4.706) and MBMI (t=5.89). For prediction of LBW, the critical limits of MWt, MHt, MMAC and MBMI were 45 kg, 152 cm, 22.5 cm, 20 kg/m2 respectively. From these observations, the use of colour-coded weighing machines, height rods and tapes may be devised for use by peripheral health workers and traditional birth attendants for detection of mothers at risk of delivering low birth weight babies (Table 5). Mothers who have anthropometric parameters in the 'red zone' are at risk of delivery LBW infants.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India.

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible "threats" into "opportunities" and changing the "weaknesses" into "strengths" regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow.

Effect of amniotic sac puncture on parturition in rat.

Pregnant Charles Foster rats were subjected to amniotic sac puncture on day 15 of gestation and the effect was observed on parturition. All the control rats as expected delivered on day 22 of gestation. In the group where all the sacs were punctured, only 12.5% rats delivered on day 22 while rest either failed to deliver (62.5%) or died (25%). In the group with unpunctured sacs at vaginal ends, 75% rats delivered on day 21 while 25% on day 22. In the group with unpunctured sacs at ovarian ends, 75% rats delivered on day 23 and rest 25% failed to deliver. The resorption rates ranged between 61 to 94% in different groups. Malformations were observed only in one pup. The results suggest that amniotic sac puncture interferes with parturition in the form of either failure or delayed parturition. Nonpatency of the birth canal due to puncture induced fetal deaths and tissue adhesions were presumed to be the contributing factors.

Acardiac anomaly spectrum.

BACKGROUND: Acardiac anomaly spectrum is a rare congenital malformation found in monozygotic twin pregnancy. Besides the absence of heart, the condition is associated with variable grades of developmental disruption. Thus, no two cases are similar. METHODS: This case report is based on physical examination and autopsy findings. RESULTS: The twin had acardia and partial development of head and face. There was complete absence of upper extremities. CONCLUSIONS: The twin reversed arterial perfusion (TRAP) theory is the most accepted etiology of the disorder. Normally, the cephalic pole is the most severely affected, being most distal to the retrograde perfusion. In acardia, partial development of head, face, and brain is usually associated with the development of the upper extremities. However, in the present case, there was extensive cephalic development in the absence of upper extremity development.

Parturient abdominal circumference as a predictor of low birthweight.

The usefulness of parturient abdominal circumference as a predictor of low birthweight (LBW) was studied in 151 singleton pregnancies. The abdominal circumference was measured in early labour and was plotted against the birthweight of the newborns. A significant positive correlation was observed between the two parameters (r = +0.507). For the prediction of LBW, the critical limit of the abdominal circumference was 86 cm, which means that an abdominal circumference of more than 86 cm is reasonably safe while lesser values predict a higher chance of a LBW infant. From these observations, the use of a colour-coded tape by peripheral health workers and traditional birth attendants is suggested: red for abdominal circumference <82 cm, yellow for abdominal circumference 82-86 cm, and green for abdominal circumference >86 cm. Mothers who have an abdominal circumference in the 'red zone' are at risk of delivering LBW infants.

Effect of intraamniotic vitamin A on palatal closure of fetal rats.

On day 15 of gestation, intraamniotic vitamin A in a dose of 150 IU was administered to the fetal rats to examine its effect on palatal closure. Fetuses subjected to only amniocentesis acted as control for the study. The fetuses were recovered on day 19, 20 and 21, respectively. Vitamin A resulted in poor development of palatine shelves. There was no clear demarcation of the base and the free margins of the shelves were either rounded or blunted with poor attempt towards closure. In the vitamin A group, the incidence of cleft palate were similar in all three days while there was a gradual decline with increasing gestational age in the amniocentesis group. The results suggest that unlike amniocentesis, in vitamin A treated fetuses, there was no attempt towards a delayed closure of the palate.