Effectiveness of novel facial stretching with structured exercise versus conventional exercise for Bell's palsy: a single-blinded randomized clinical trial.

The purpose of the study was to assess the effects of a novel technique involving facial stretching of the unaffected side along with a structured exercise for the affected side on facial symmetry and facial functions as compared to conventional exercise. A hospital-based parallel-group randomized trial was completed among patients with acute Bell's palsy in Mangalore, India. Participants were randomized to receive facial stretching and a structured exercise program (experimental group) or the conventional exercise regimen (conventional group). Primary outcomes were facial symmetry and voluntary movement; assessed by the Sunnybrook Facial Grading System (SFGS). Both regimens were given for 3 weeks, with baseline, 10th day, and 20th day assessments. Out of 31 participants screened, 24 were eligible and 12 participants each were assigned to experimental and conventional groups. Change scores revealed greater improvement in the SFGS score (p = 0.002) for the experimental group participants. Facial stretching and structured exercise program exhibited promising results in enhancing facial symmetry and function in acute Bell's palsy when compared to conventional exercise regimen.

Is functional mobility associated with quality of sitting in cerebral palsy? A cross-sectional study.

Objectives: A group of neuromuscular system anomalies associated with non-progressive issues in the developing fetal or newborn brain are known as cerebral palsy (CP). These abnormalities are typified by poor posture and motor development, which limits the execution of functional activities. Consequently, to achieve the same goals as peers who are typically developing, children with CP employ a variety of compensatory postures and techniques. Given that both sitting and mobility are essential for functioning, assessing each skill alone and in relation to the other is necessary. This study aims to determine if a child's functional mobility affects their sitting ability. Materials and Methods: Twenty CP (Gross Motor Function Classification System [GMFCS] levels I and II) children, aged 6-12, were enrolled in the research. The level of sitting scale (LSS) and the modified timed up and go (mTUG) test were utilized to evaluate sitting and functional mobility, respectively. Results: The quality of sitting was shown to have a substantial effect on functional mobility, as a significant difference in mTUG durations was established between LSS levels (P < 0.001) and persisted when analyzed within the same GMFCS level (P = 0.007). Conclusion: The importance of trunk control in functional mobility can be inferred from the link between sitting quality and mobility. To improve children with CP's functional mobility, this evidence may be utilized to design a well-informed and specific intervention program incorporating trunk control.

Comparing distributed versus massed practice on functional recovery and Brain-Derived Neurotrophic Factor (BDNF) in acute stroke subjects.

Objectives: Globally, stroke is known to be one of the major health problems, resulting in disability among an aging population. Rehabilitation is a process of re-learning of skills, lost due to brain injury. Many factors influence motor learning post neurological insult and practice is one of the key factors which influence relearning or reacquisition of lost motor skills. Practice can be varied concerning order (blocked or random), scheduling (massed or distributed), or whole and part practice. The study observed the effect of variations in practice schedules on motor and functional recovery. Materials and Methods: Thirty-two acute stroke subjects were recruited and equally divided into two groups (16 in massed and 16 in distributed). Both groups received an accelerated skill acquisition program (ASAP) for six sessions a week for 2 weeks. Pre- and post-outcome measures included stroke rehabilitation assessment of movement (STREAM) for motor recovery, modified Barthel index (MBI) for functional recovery, and brain-derived neurotrophic factor (BDNF) for neuroplasticity. Results: The median scores of participants in the massed practice group before the intervention, of STREAM total, MBI, and BDNF were 23.5, 19, and 0.65, respectively, whereas post values of STREAM total, MBI, and BDNF were 40.5, 60.5, and 0.75, respectively. The median scores of the distributed practice group of the pre-STREAM total, MBI, and BDNF were 23.5, 6.5, and 0.70, respectively, whereas the post-STREAM total, MBI, and BDNF were 41, 45.5, and 0.80, respectively. P-value was reported to be <0.05 while comparing pre- and post-values of STREAM, MBI, and BDNF within both intervention groups. The median change scores of STREAM, MBI, and BDNF reported P ≥ 0.05 when compared between the groups. Conclusion: Both the groups had significant recovery post-intervention designed based on ASAP, about impairment mitigation, pursuing skilled movement leading to significant functional gains. Appropriate timing along with optimal dosage became an active ingredient in functional recovery in acute stroke subjects. The distributed practice might have added effect of spacing, resulting in easier learning and accuracy of skills. The study reveals that distributed practice can be part of regular clinical practice to enhance functional recovery in acute stroke rehabilitation.

Oblique, forward, and lateral directions reach test distances in young adults, and concurrent validity of these tests with the center of pressure excursion in assessing the limits of stability.

Limits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company. METHODS: The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests. RESULTS: The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p < 0.001) and 0.50 (p < 0.001) respectively. A Significant standardized beta value of 0.49 (p < 0.05) for the oblique direction reach test with total stability limits. CONCLUSIONS: The oblique and lateral direction reach tests are correlated with their respective center of pressure excursion. However, the oblique direction reach test moderately correlated with the total limits of stability scores. Forward reach distances were more in number followed by oblique and lateral reach distances among young Saudi adults.

Oblique direction reach test: evaluating psychometric properties in stroke population.

Background: Post-stroke individuals are observed to have reduced limits of stability (LOS) in all directions. Functional activities are rarely performed in pure cardinal planes; instead, they are most likely to be performed in an oblique direction. Existing tools are either expensive or sophisticated to assess the LOS in an oblique direction. Therefore, this study's primary objective is to evaluate the intra-rater, inter-rater reliability, and validity of the oblique direction reach test (ODRT) among stroke subjects. Materials & Methods: A total of 96 first-time stroke patients with age, gender, height, and weight-matched healthy controls aged 18-80 years were recruited for the study. Oblique, forward, and lateral reach distances were assessed using the standard procedure of ODRT, Functional Reach Test (FRT), and Lateral Reach Test (LRT), respectively. Validity was tested by correlating the ODRT distance with the Berg Balance Scale (BBS) Score using Spearman's rank correlation coefficient. Intraclass correlation coefficients (ICCs) and Bland Altman analysis were used to establish inter-rater reliability. ICCs were used to find intra-rater reliability. The Mann-Whitney U test was used to establish the mean difference of the FRT, LRT, and ODRT. Spearman's rank correlation coefficient and linear regression were used to correlate the distance of FRT and LRT with ODRT. Results: A high concurrent validity was found between BBS and ODRT with an r-value of 0.905 (p < 0.001). Inter-rater reliability was high with an ICC of 0.997 (95% CI [0.996-0.998]), and intra-rater reliability was highly significant with an ICC of 0.996 (95% CI [0.994-0.998]). The stroke subjects reached a significantly shorter distance than healthy individuals in FRT, ODRT, and LRT. ODRT was highly correlated with FRT (r = 0.985) and LRT (r = 0.978) (p < 0.001) and had an R2 = 0.987. Conclusion: ODRT is a highly valid and reliable tool that can be used to evaluate balance in stroke patients. Individuals who reached less in the forward and lateral directions showed reduced reach distance in the oblique direction.

Exploring the Solubility and Bioavailability of Sodium Salt and Its Free Acid Solid Dispersions of Dolutegravir.

Amorphous salt solid dispersion (ASSD) of Dolutegravir amorphous salt (DSSD) was generated using quench cooling and compared to its Dolutegravir free acid solid dispersion (DFSD) to improve the solubility and bioavailability. Soluplus (SLP) was used as a polymeric carrier in both solid dispersions. The prepared DSSD and DFSD, physical mixtures, and individual compounds were characterized by employing DSC, XRPD, and FTIR to assess the formation of the single homogenous amorphous phase and the existence of intermolecular interactions. Partial crystallinity was observed for DSSD, unlike DFSD, which is completely amorphous. No intermolecular interactions were observed between the Dolutegravir sodium (DS)/Dolutegravir free acid (DF) and SLP from the FTIR spectra of DSSD and DFSD. Both DSSD and DFSD improved the solubility of Dolutegravir (DTG) to 5.7 and 4.54 folds compared to the pure forms. Similarly, drug release from DSSD and DFSD was 2 and 1.5 folds higher than that in the pure form, owing to the rapid dissolution of the drug from the formulations. The permeability of DSSD and DFSD was estimated using the dialysis membrane, which enhanced the DTG permeability. The improvement in in vitro studies was translated into in vivo pharmacokinetic profiles of DSSD and DFSD, where 4.0 and 5.6 folds, respectively, improved the Cmax of DTG.

Effect of Trunk Targeted Interventions on Functional Outcomes in Children with Cerebral Palsy- A Systematic Review.

Objective of this review was to collate information on the effectiveness of trunk targeted intervention on children with cerebral palsy (CP) on three functional outcomes that are gross motor function, trunk control and balance. A comprehensive search was conducted on online databases from inception to August 2021, using relevant keywords. A total of 15 randomized controlled trials which enrolled children with cerebral palsy under 18 years met the inclusion criteria. A significant improvement was seen in the trunk targeted training groups on applying trunk targeted interventions. Trunk targeted interventions improve gross motor function, trunk control as well as balance, hence should be incorporated in the conventional physical therapy program delivered to children with CP and would help in greater functional recovery.

Augmented rescue of macroglobulins by supplementation of anti-snake venom with methanolic extract of Andrographis paniculata in Naja naja envenomation.

Proteins of the macroglobulin family are prime targets of venom enzymes in snake bite. A massive reduction in the active concentration of these multifunctional proteins in snake bite, makes the living system vulnerable to dysregulation. This study investigates the ability of Indian polyvalent anti-snake venom (ASV), methanolic extract of Andrographis paniculata (MAP) and their combination in rescuing human alpha 2-macroglobulin (A2MG) and its homologues in rat plasma, from inactivation by Naja naja (N.N) venom enzymes. In-vitro experiments were conducted with heparinized human plasma and in-vivo experiments with female Wistar rats. Along with appropriate controls, there were 3 test groups in in-vitro and 8 test groups in in-vivo experiments. The in-vitro test groups were exposed to N.N venom for zero, 30 or 90 min prior to incubation with ASV or MAP or reduced ASV supplemented with MAP and incubated for 16 h at 37 °C. Chymotrypsin-bound esterase (CTBE) activity of A2MG was estimated. Rats were administered the venom intramuscularly and treated with ASV/MAP/ASV + MAP. CTBE activity of macroglobulin homologues was measured on day 1, 7 and 14. Survival of animals was noted. In human plasma, addition of ASV or MAP or ASV + MAP prevented loss of A2MG activity maximally to the extent of 88-100% (p = 0.001). In rats, reduced concentration of ASV supplemented with MAP showed complete rescue of macroglobulin homologues and 90% survival. The compulsive evidence from this study, underscores the merits of using this multipronged strategy in rescuing the macroglobulins and improving survival in envenomation due to N.N.

Relationship between trunk muscle strength, reaching ability and balance in children with Down syndrome - A cross-sectional study.

BACKGROUND: Children with Down Syndrome (DS) present with neuromuscular disturbances leading to delayed developmental milestones, poor quality of movement and poor balance. The aim of this study is to discuss the role of trunk muscle strength in the functional performance of children with DS. METHODOLOGY: 28 children were recruited in the study, 14 with DS and 14 age and gender-matched controls. Trunk muscle strength, reaching ability and balance were assessed using a Handheld Dynamometer, Modified Functional Reach test and Pediatric Balance Scale, respectively. RESULTS: Children with DS present with poorer trunk muscle strength, reaching ability and balance as compared to typically developing (TD) children. There was a positive correlation between trunk muscle strength and lateral reaching in children with DS. A strong to moderate correlation was observed between the trunk muscle strength and balance in children with DS. DISCUSSION: Children with DS demonstrated a significantly weak trunk muscle groups. Lateral reaching distance is reduced due to the poor proximal control and they present with near-normal forward reach distance attributed to compensation using the lower trunk muscles. They exhibit poor balance in the components that require a small base of support. CONCLUSION: Children with DS exhibit weak trunk muscles along with lesser reaching distance and poor balance. Also, trunk muscle strength influences lateral reaching ability. Trunk muscle strength, mainly trunk extensors impacted functional balance in sitting, standing and while performing transfers.

Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review.

BACKGROUND: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. PURPOSE: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. METHODS: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. RESULTS: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. CONCLUSION: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

Relationship between Trunk Position Sense and Trunk Control in Children with Spastic Cerebral Palsy: A Cross-Sectional Study.

METHODS: In this study, 24 children with spastic CP aged between 8 and 15 years were recruited. They were classified based on their functional performance using Gross Motor Function Classification System (GMFCS). Trunk control and trunk position sense were assessed using the trunk control measurement scale (TCMS) and digital goniometer, respectively. The correlation between these variables was tested using Spearman's correlation coefficient. RESULTS: Significant negative correlation was found between trunk position sense and TCMS score. Similarly, a significant moderate correlation was found between trunk position sense and GMFCS. A strong negative correlation was also found between GMFCS and TCMS. CONCLUSION: Children with spastic CP with better trunk position sense had better trunk control. Similarly, children with higher functional performance had better trunk control and lesser error in trunk position sense. The current findings imply the relevance of proprioceptive training of the trunk for enhancing trunk motor control in children with spastic CP.

The FAANG Data Portal: Global, Open-Access, "FAIR", and Richly Validated Genotype to Phenotype Data for High-Quality Functional Annotation of Animal Genomes.

The Functional Annotation of ANimal Genomes (FAANG) project is a worldwide coordinated action creating high-quality functional annotation of farmed and companion animal genomes. The generation of a rich genome-to-phenome resource and supporting informatic infrastructure advances the scope of comparative genomics and furthers the understanding of functional elements. The project also provides terrestrial and aquatic animal agriculture community powerful resources for supporting improvements to farmed animal production, disease resistance, and genetic diversity. The FAANG Data Portal (https://data.faang.org) ensures Findable, Accessible, Interoperable and Reusable (FAIR) open access to the wealth of sample, sequencing, and analysis data produced by an ever-growing number of FAANG consortia. It is developed and maintained by the FAANG Data Coordination Centre (DCC) at the European Molecular Biology Laboratory's European Bioinformatics Institute (EMBL-EBI). FAANG projects produce a standardised set of multi-omic assays with resulting data placed into a range of specialised open data archives. To ensure this data is easily findable and accessible by the community, the portal automatically identifies and collates all submitted FAANG data into a single easily searchable resource. The Data Portal supports direct download from the multiple underlying archives to enable seamless access to all FAANG data from within the portal itself. The portal provides a range of predefined filters, powerful predictive search, and a catalogue of sampling and analysis protocols and automatically identifies publications associated with any dataset. To ensure all FAANG data submissions are high-quality, the portal includes powerful contextual metadata validation and data submissions brokering to the underlying EMBL-EBI archives. The portal will incorporate extensive new technical infrastructure to effectively deliver and standardise FAANG's shift to single-cellomics, cell atlases, pangenomes, and novel phenotypic prediction models. The Data Portal plays a key role for FAANG by supporting high-quality functional annotation of animal genomes, through open FAIR sharing of data, complete with standardised rich metadata. Future Data Portal features developed by the DCC will support new technological developments for continued improvement for FAANG projects.

Evaluation of the merit of the methanolic extract of Andrographis paniculata to supplement anti-snake venom in reversing secondary hemostatic abnormalities induced by Naja naja venom.

Increasing evidence suggests a sizable involvement of hemotoxins in the morbidity associated with envenomation by the Indian spectacled cobra, Naja naja (N.N). This study investigates the ability of Indian polyvalent anti-snake venom (ASV), methanolic extract of Andrographis paniculata (MAP) and their combination in reversing the hemostatic abnormalities, viz. activated partial thromboplastin time(aPTT), prothrombin time(PT) and thrombin time(TT) in citrated plasma. These parameters were assessed in 2 groups of experiments. Group 1: Without the prior incubation of plasma with venom and Group 2: With prior incubation of plasma with venom for 90 min at 37°C. Venom caused significant (p < 0.001) prolongation in aPTT (175%), PT (49%) and TT (34%) in Group 1 and ASV could completely bring them back to normal. MAP showed a concentration-dependent reversal in aPTT, normalization of PT and prolongation of TT. When low concentration of ASV was supplemented with MAP, their combined effect in normalizing aPTT and PT improved by 37% and 26% respectively when compared to ASV alone. In Group 2, venom caused significant (p < 0.001) prolongation in aPTT (231%), PT (312%) and TT (245%). ASV had limited effect in reversing aPTT (52%), TT (31%) but completely normalized PT. MAP was marginally effective in reversing the prolonged aPTT and PT but caused further prolongation of TT. Combination of ASV and MAP was more effective than ASV alone in reversing venom-induced increase in aPTT (52%) and PT (29%). The study proved that, a drastic reduction of ASV by 70%, could be effectively supplemented by MAP in combating hemostatic abnormalities induced by NN venom.

Effect of Compelled Body Weight Shift (CBWS) Therapy in Comparison to ProprioceptiveTraining on Functional Balance, Gait, andMuscle Strength Among Acute Stroke Subjects.

Background: The majority of poststroke individuals tend to exhibit reduced loading over the paretic lower extremity, leading to increased postural sway, and gait asymmetry predisposing to a higher number of falls. Compelled body weight shift (CBWS) therapy is an innovative method aimed to force body weight shift toward the paretic extremity. Proprioceptive training (PT) is another method that improves balance ability contributing to the increase in muscle activity. Both the CBWS and PT have been shown to improve the quality of life in stroke subjects. Purpose: The aim of this study is to compare the effects of CBWS therapy and PT in improving balance, kinematic gait parameters, and muscle strength among acute stroke patients. Methods: Thirty subjects were nonrandomly divided into two groups where both groups received routine physiotherapy for two weeks in addition to which the CBWS group incorporated a 15 mm platform placed under the unaffected extremity while the PT group included incorporated proprioceptive exercises on the ground and foam mat. Functional balance, functional mobility, videographic analysis of degrees of hip flexion, knee hyperextension, and ankle dorsiflexion along with gait speed and satiotemporal gait parameters were obtained. Results: The pre-post analysis within both groups revealed statistically significant improvement in all parameters except for the kinematic parameters of gait. However, no statistically significant difference was observed between the CBWS and PT groups. Conclusion: CBWS can be used as an alternative to PT in the rehabilitation of stroke patients concerning balance and gait. CBWS provided during active treatment sessions results as effective as those seen as a result of all-day therapy.

Anti-snake venom and methanolic extract of Andrographis paniculata: a multipronged strategy to neutralize Naja naja venom acetylcholinesterase and hyaluronidase.

The study investigates the ability of methanolic extract of Andrographis paniculata (MAP) to supplement polyvalent anti-snake venom (ASV) in inhibiting neurotoxic enzyme acetylcholinesterase (AChE) and 'spreading factor' hyaluronidase from Naja naja (N.N) venom. AChE and hyaluronidase activity were measured in 100 or 200 µg of crude venom, respectively, and designated as 'control'. In Test Group I, enzyme assays were performed immediately after the addition of ASV/MAP/ASV + MAP to the venom. Inhibition of AChE by ASV (100-367 µg) was 12-17%, and of hyaluronidase (22-660 µg) was 33-41%. Under the same conditions, MAP (100-400 µg) inhibited AChE and hyaluronidase to the extent of 17-33% and 17-52%, respectively. When ASV (220 µg) and MAP (100-200 µg) were added together, AChE and hyaluronidase were inhibited to a greater extent from 39-63 to 36-44%, than when either of them was used alone. In Test Group 2, the venom was incubated with ASV/MAP/ASV + MAP for 10-30 min at 37 °C prior to the assay which enhanced AChE inhibition by 6%, 82% and 18% respectively, when compared to Test Group I. Though there was no change in inhibition of hyaluronidase in the presence of ASV, MAP could further increase the extent of inhibition by 27% and ASV + MAP upto 4%. In Test Group III, venom and substrate were incubated for 90 min and hyaluronidase activity was measured after the addition of inhibitors. Here, ASV + MAP caused increased inhibition by 69% compared to ASV alone. The study confirms the ability of phytochemicals in MAP to contribute to a multipronged strategy by supplementing, thereby augmenting the efficacy of ASV.

Can the methanolic extract of Andrographis paniculata be used as a supplement to anti-snake venom to normalize hemostatic parameters: A thromboelastographic study.

ETHNOPHARMACOLOGICAL RELEVANCE OF ANDROGRAPHIS PANICULATA: The whole plant (including leaves and roots) is used in traditional Ayurveda and Siddha medicine to treat various clinical conditions such as fever, respiratory tract infections, colic pain, liver disorders, diabetes, hypertension, and inflammation. It is also used as an antidote for snake-bite, poisonous bites of insects and recommended as a dietary supplement to boost immunity. AIM OF THE STUDY: In-vitro thromboelastographic evaluation of the efficacy of methanolic extract of Andrographis paniculata (MAP) and polyvalent anti-snake venom (ASV) in neutralizing the Naja naja (N.N) venom-induced changes in hemostatic parameters. MATERIALS AND METHODS: Thromboelastographic evaluation of hemostatic parameters was initiated by adding 3µg N.N venom to citrated whole blood from healthy volunteers. The effect of different concentrations of ASV and MAP in neutralizing the toxicity of N.N venom were studied in two groups. In group 1 experiments, citrated whole blood (340µl) was mixed with N.N venom (3µg), immediately followed by successive addition of ASV (5µl, 8µl and 15µl) or MAP (15µg, 30µg, 60µg and 120 µg) or combination of ASV and MAP (3µl ASV+30µg MAP and 3µl ASV+60µg MAP). In group 2 experiments, N.N venom was incubated with whole blood for 90 minutes at 37°C, followed by successive addition of ASV (5µl, 10µl, and 15µl) or MAP (30µg and 60µg) or combination of ASV and MAP (5µl ASV+30µg MAP and 5µl ASV+60µg MAP). RESULT: In Group 1 experiments, N.N venom caused significant (p<0.05) increase in R-time, K-time, LY30% and a decrease in angle and MA. Optimum effect on hemostatic parameters was observed at a concentration of 8µl ASV, where all the deleterious effects of the venom were completely reversed. Similarly, the addition of MAP to the assay system could reproduce results as ASV, in reversing the deleterious effects of the venom. This occurred in a concentration-dependent manner, from 15µg-60µg, with the optimum results at 60µg. When ASV concentration was reduced to 3µl and supplemented with MAP (30µg or 60µg), the positive supplementary effect of MAP was demonstrated. In Group 2 experiments, N.N venom caused significant (p<0.05) changes in all TEG parameters, with most deleterious changes observed in MA and LY30% compared to Group 1 experiments. ASV when added in increasing concentrations (5-15µl), had beneficial effects only on K-time, angle, and MA. When added together with ASV, MAP (30µg or 60µg) could significantly (p<0.05) supplement the effect of ASV (5µl) in improving R-time, K-time, and angle. CONCLUSION: This in-vitro study demonstrates the effectiveness of MAP as a supplement to ASV in combating the deleterious effects of N.N venom on hemostasis. However, further in-vivo experiments in animal models are required to substantiate these effects.

Anti-aging and Sunscreens: Paradigm Shift in Cosmetics.

Skin, being one of the vital organs and a protective barrier needs to be pampered and taken care of from early childhood. It is the most visible and the widest exposed organ and by far reflects the general health condition and the aging process in humans. Both intrinsic and extrinsic factors contribute to this complex biological process of skin aging. In recent times, skin health and its beauty is perceived as an indicator of one's health which has resulted in an increasing demand for anti-aging products. Exposure to UV radiation is considered to be one of the factors responsible for aging termed as photoaging. In this review, we have discussed the various factors which may accelerate the process of skin aging. Various approaches and strategies to delay the process of skin aging have been emphasized upon. The patents filed in the area of anti-aging and sunscreen products have also been reviewed to gain an insight into the new formulations which have been developed as an anti-aging product. There has been a tremendous rise in the cosmetic and cosmeceuticals market with products having a dual activity of anti-aging and sun protection. Research is constantly on the rise to ensure the safety of these products. Alternatives to the current topical application of sunscreen are being considered to overcome the drawback of reapplication of the sunscreen often which can be a boon to the cosmeceutical market.

Effect of Taping of Thoracic and Abdominal Muscles on Pelvic Alignment and Forward Reach Distance Among Stroke Subjects: A Randomized Controlled Trial.

INTRODUCTION: The objective of this study was to find the immediate as well as short-term effect on pelvic alignment and forward arm reach distance in sitting among stroke patients following thoracic spine and abdominal muscles taping along with conventional therapy. METHODS: Thirty subjects with stroke attending the physiotherapy programme at Department of Physiotherapy at a tertiary care hospital underwent this randomized controlled experimental study. Subjects in the experimental group received taping, along with conventional physiotherapy treatment, for restricting thoracic kyphosis and facilitating abdominal muscles. Subjects in the control group received only conventional physiotherapy treatment. To assess the change in pelvic alignment and forward arm reach distance while sitting, Palpation MeterTM (PALMTM) and sit and reach test were used, respectively. RESULTS: In the experimental group, pelvic obliquity was corrected (4.1 ± 0.94) and anterior pelvic tilt revealed improvement (4.9 ± 2.1, p value < 0.001). In the control group, no improvement in pelvic alignment was recorded. Improvement in forward arm reach distance was similar in both groups (p value = 0.804). CONCLUSION: Taping as an adjunctive treatment method to physiotherapy can cause immediate as well as short-term improvement of pelvic alignment in sitting, following stroke. It also, immediately improves the sit and reach distance in the same population.

Effectiveness of prowling with proprioceptive training on knee hyperextension among stroke subjects using videographic observation- a randomised controlled trial.

INTRODUCTION: Knee hyperextension is seen in 40-68% of ambulating hemiparetics. If left untreated it may lead to laxity of posterior structures of knee resulting in early degeneration of knee leading to pain, reduced independence in activities of daily living (ADL), deformities and instability. In this study we hypothesize walking with bent knee attitude (prowling) along with proprioceptive training may help to reduce knee hyperextension during the stance phase of gait cycle. OBJECTIVE: To test the efficacy of prowling along with proprioceptive training on knee hyperextension range, dorsiflexion range and spatio temporal parameters of gait using Wisconsin gait scale (WGS) as compared to routine physiotherapy. METHOD: 32 subjects were randomized into 2 groups- experimental and control groups. Both the groups were given routine physiotherapy. Experimental group received an additional treatment consisting of prowling along with proprioceptive training. Knee hyperextension and ankle dorsiflexion ranges were videotaped and analysed using Kinovea software, and for spatio-temporal gait parameters WGS was used. RESULTS: In our study, the experimental group showed significant improvement over the control group with regards to knee hyperextension, dorsiflexion range and WGS score. Pre post intervention analysis, within the group, for time taken to cover the distance revealed significant improvement, however between group analysis did not reveal any significant difference. CONCLUSION: Prowling along with proprioceptive training is effective in reducing knee hyperextension, increasing dorsiflexion range and improving spatio-temporal gait parameters.

Isolated third nerve palsy: a rare neurological presentation of Burkitt's lymphoma.

Lymphoma patient presenting with isolated third nerve palsy is relatively rare, and diagnosis of underlying disease may be challenging. Until this date, less than 20 cases have been described in the literature. This is the case of a 3-year-old boy who presented to neurologist with ptosis of left eye for 8 days. On examination, abdominal mass was detected, and the child was referred to paediatric surgery department. Laparotomy and excision of the mass was done. Histopathology and immunohistochemistry of the mass confirmed it to be a case of Burkitt's lymphoma. At this point, the patient was referred to haematology department. Contrast-enhanced CT brain showed infiltration around left cavernous sinus. Patient was treated with two cycles of R-CODOX-M/R-IVAC. Ptosis improved completely within few days of starting chemotherapy. Follow-up positron emission tomography CT scan done after the second cycle of chemotherapy revealed no metabolically active disease.