Enhancing Skeletal Muscle Rehabilitation: The Effects of Diclofenac Phonophoresis and Shock Wave Therapy on Serum Creatine Kinase in Athletes With Delayed-Onset Muscle Soreness.

Background Delayed-onset muscle soreness (DOMS) is a common condition in athletes characterized by muscle pain and stiffness after intense or unfamiliar exercise. It significantly impairs an athlete's performance by reducing muscle strength, flexibility, and overall physical capacity, often leading to suboptimal training or competition outcomes. Managing and mitigating DOMS is crucial for athletes to maintain peak performance and prevent potential injuries. The evaluation of effective treatment techniques is essential for expediting DOMS recovery by identifying biomarkers of skeletal muscle damage. This approach not only aids in optimizing recovery strategies but also contributes to the rehabilitation process, enabling athletes to return to peak performance quickly and safely. This study aims to evaluate the effects of shock wave therapy and diclofenac phonophoresis on serum creatine kinase levels in novice athletes suffering from DOMS in comparison to a control group. This research aims to assess the potential benefits of these therapeutic interventions in reducing skeletal muscle damage and enhancing recovery for individuals new to athletic training. Methodology A total of 48 novice athletes were recruited using simple random sampling and the block randomization approach to participate in this single-blind, multi-group, repeated-measures design. Male novice athletes in the age group of 18-25 years were included, and athletes with elevated serum creatine kinase variables at baseline measurements were excluded from the study. Before obtaining a written informed consent form, athletes were made aware of the procedure and associated risks. Group A received focused shock wave therapy, Group B received diclofenac phonophoresis, while Group C received no treatment. The Epley formula was used to compute the one-repetition maximum for each subject. Blood samples were taken at the baseline, 24, 48, 72, and 96 hours. Blood samples were taken before initiation of the study, as well as 24 hours, 48 hours, 72 hours, and 96 hours after DOMS was induced. Creatine kinase skeletal muscle biomarker was used as a dependent variable. Results In the evaluation of serum creatine kinase levels using analysis of variance (ANOVA), no statistically significant differences were observed between the three groups at baseline and 24-hour measurements (p > 0.05). However, statistically significant differences were found between the three groups at 48 hours, 72 hours, and 96 hours (p < 0.05). The repeated-measures ANOVA revealed significant overall changes in creatine kinase levels within the three groups, indicating time-dependent effects (p < 0.05). Specifically, during the 48 to 96-hour interval, the shock wave therapy group showed a lower mean value compared to the diclofenac phonophoresis group, followed by the control group. Conclusions The study demonstrates that a single administration of focused shock wave therapy effectively mitigated the elevation of creatine kinase levels in novice athletes with DOMS, surpassing the outcomes of diclofenac phonophoresis and the control group. These findings suggest the potential benefits of shock wave therapy in accelerating recovery from DOMS in the athletic population.

Vascular Anatomy of Segment IV of the Liver in Live Liver Donors.

BACKGROUND:  Studies on the anatomy of the liver have helped surgeries such as liver resection. Liver resection is of significance in liver transplantation. In liver resection, the anatomy of segment IV is very important as it is more prone to ischemia. AIM: The primary objective is to study the anatomical variations of the hepatic artery and hepatic vein of segment IV from MDCT images of the hepatic vasculature in living liver donors. This study aims to document the anatomy of the hepatic artery supplying segment IV and its venous drainage in 300 living liver donors. MATERIALS AND METHODS: In this retrospective study, 600 MDCT images of hepatic vasculature were observed, and the interpretations were recorded. The origin of the artery to segment IV was documented. The observations of the hepatic vein were tabulated as classified in Nakamura's study. RESULTS:  Segment IV artery originates from the left hepatic artery (LHA) in 72% of the cases and the right hepatic artery (RHA) in 23%. Hepatic venous drainage of segment IV comprises type I, type II, and type III in 14.33%, 53.67%, and 30% of cases, respectively. Type I anatomy of the hepatic vein is preferred in both right and left lobe liver transplantation as the drainage from segment IV is safe. CONCLUSION: Vascularity to segment IV is key in living liver donors, as donor safety is of utmost importance in the case of living donor liver transplantation.

Effects of Endocrine Disrupting Chemicals (EDCs) on Skeletal System Development: A Review.

INTRODUCTION: Endocrine-disrupting chemicals (EDCs) are exogenous substances that alter endocrine function and cause adverse effects on an organism. EDC interference with the endocrine system leads to chronic autoimmune disorders, abnormal osteogenesis, infertility, and reproductive, neurological, cardiovascular, and metabolic disorders. Among the adverse effects of EDCs are their impact on developing fetuses and neonates. EDCs like bisphenol A (BPA), pesticides, and lead interfere with or alter sex steroid hormone synthesis and metabolism, leading to developmental delay, infertility, and urogenital carcinoma in both sexes. OBJECTIVE: This review article examines the most harmful EDC, BPA, which affects the skeletal system during the embryonic period. The literature investigates the effects of BPA on various systems in our body, but the mechanism behind skeletal system development during the embryonic period is still unknown. MATERIALS AND METHODS: In the present review, 25 articles were reviewed through multiple windows like PubMed, Scopus, and Web of Science. Many articles mention the effects of BPA on the skeletal system after birth and also examine reproductive system abnormalities, hereditary characteristics, excretory system malfunctions, and physical and mental illness in various mechanisms. DISCUSSION: The impact of BPA on the skeletal system causes morphological and physiological changes in developing embryos. The general ideology regarding skeletal system development and its mechanism is as follows: the formation of bone (osteocytes) is reduced by the apoptosis of precursor bone cells (osteoblasts) by the effect of BPA. CONCLUSION: EDC exposure induces the apoptosis of bone cells and inhibits the formation of osteoblasts, and long-term exposure to these chemicals will also impact immune system development.