ROLE OF PHYSIOTHERAPY IN ADAPTIVE SPORTS IN PEOPLE WITH SPINAL CORD INJURY

Introduction: According to the statistics, from a modest 400 athletes representing 23 countries at first Paralympic games in Rome (1960), the modern Paralympic games now boats 4,000 athletes from 150 nations and ever increasing global television audience. There are currently 10 Paralympic sports (summer & winter) that involve competition in the form of wheelchair. This review article provides an overview of the evidence that links exercise and sports participation to physical and psychological well-being among people with spinal cord injury. Aim of the Study: To encourage exercise and sports participation to promote health and well-being among people living with spinal cord injury. Method: A literature study was conducted using PUBMED search. Out of 65,178 papers identified relating to spinal cord injury out of which 999 papers were related to Wheelchair sports and 404 articles on Paralympic sports. Conclusion: In discovering the potential of individuals with SCI for getting involved in Physical exercises showed improvement in health parameters including- HDL Cholesterol, Physical Functioning & Independence, overcoming shoulder pain, Respiratory function and Psychological well-being. Hence, sport group should be an inherit part of the rehabilitation process. Also, individual not having access to Physical exercise should be given opportunity to participate in wheelchair mobility training. This may improve the adherence to Physical exercises of individuals with SCI in post-clinical settings.  Article visualizations

Lithium as an Alternative Option in Graves Thyrotoxicosis

A 67-year-old woman was admitted with signs and symptoms of Graves thyrotoxicosis. Biochemistry results were as follows: TSH was undetectable; FT4 was \u3e6.99 ng/dL (0.7–1.8); FT3 was 18 pg/mL (3–5); TSI was 658% (0–139). Thyroid uptake and scan showed diffusely increased tracer uptake in the thyroid gland. The patient was started on methimazole 40 mg BID, but her LFTs elevated precipitously with features of fulminant hepatitis. Methimazole was determined to be the cause and was stopped. After weighing pros and cons, lithium was initiated to treat her persistent thyrotoxicosis. Lithium 300 mg was given daily with a goal to maintain between 0.4 and 0.6. High dose Hydrocortisone and propranolol were also administered concomitantly. Free thyroid hormone levels decreased and the patient reached a biochemical and clinical euthyroid state in about 8 days. Though definitive RAI was planned, the patient has been maintained on lithium for more than a month to control her hyperthyroidism. Trial removal of lithium results in reemergence of thyrotoxicosis within 24 hours. Patient was maintained on low dose lithium treatment with lithium level just below therapeutic range which was sufficient to maintain euthyroid state for more than a month. There were no signs of lithium toxicity within this time period. Conclusion. Lithium has a unique physiologic profile and can be used to treat thyrotoxicosis when thionamides cannot be used while awaiting elective radioablation. Lithium levels need to be monitored; however, levels even at subtherapeutic range may be sufficient to treat thyrotoxicosis

The Differentiation and Quantification of Bacterial Colonies Cultured on Plant Based Yogurt and Animal Based Yogurt

The variety of dairy products available on the market have now changed with the advent of alternative plant derived milks. Many believe that these plant based milks may be a healthier and a more sustainable option in contrast to dairy products. The production of both respective types of yogurts requires fermentation which is a process that is carried out by bacteria, hence the presence of live cultures. Fermentation of dairy products is a result of lactose sugars being metabolized by bacteria, probiotics, of which the final metabolic product is lactic acid. Due to the popularity of alternative yogurt, it is essential to explore the differences in probiotic contents of yogurt products. This study’s purpose was to find the differences in probiotic content between cow milk yogurt and oat milk yogurt. Using the serial dilution technique to count the bacterial contents of the products, the experiment consisted of calculating the colony forming units (CFU) in the original yogurt samples. After three experiment trials each, the data showed that average CFU/mL values for cow milk was substantially higher, 94,000,000, than that of the average ο at milk values, 13,333 CFU/ mL. The results supported the hypothesis for this experiment, that cow milk yogurt contained a higher CFU compared to oat milk yogurt. Future work could delve deeper into the different morphologies and species of bacteria present in animal and plant derived yogurts

Sex-selective abortions and infant mortality in India: the role of parents’ stated son preference

In India, millions of female foetuses have been aborted since the 1980s alongside an abnormally high infant girl mortality rate; this has generated a vast literature exploring the root causes of son preference. The literature is sparse, however, on how the decisions to abort or neglect girls are made. This paper examines mothers’ and fathers’ respective roles behind those decisions. Using NFHS-3 data, we show that sex- selective abortions are most commonly used if both spouses or if only the fathers prefer sons, while sex-selective neglect is used if only the mothers prefer sons

A PROSPECTIVE STUDY: KNOWLEDGE ASSESSMENT AND PATIENT CARE OF DIABETIC FOOT ULCER PATIENTS IN TERTIARY CARE HOSPITAL

Objective: To assess the knowledge with a diabetic foot ulcer, to evaluate the severity and grade of diabetic foot ulcer, to study the self-care behaviour and medication adherence in a patient with diabetic foot ulcer and to counsel the patients.Methods: The KAP, self-care foot behaviour and MMAS-8 questionnaire were given during interview; severity using Wagner's scale was assessed. Knowledge, attitude, self-care foot practice and adherence was measured based on various parameters such as demographic factors, clinical characteristics, and medication taking characteristics. It was measured before and after the patient counselling to see improvement in the quality of life.Results: In the study period of 6 mo 111 cases were gathered. There were 74 (66%) patients who were illiterate; the patients with low economic status were 63 (56%). Patients who are illiterate have poor knowledge and poor self-care behaviour, in our study 74 (66%) are illiterate which improved after counselling and 59 patients with high knowledge. Medication adherence is also associated with the education of the patient. After counselling and providing knowledge most of the patients are having high KAP scores. Wagner's scale for the study of the severity shows that most of the patients 30 out of 111 are having Grade 4 of the score which shows the need of counselling and education towards foot care. Improvement in the self-care practice and on safety and prevention was seen after counselling.Conclusion: Knowledge, attitude, self-care practice and adherence of the patient can be improved by establishing a good patient-provider relationship and giving proper patient counselling to the patient or their relatives

Mechanisms of Phosphine Toxicity

Fumigation with phosphine gas is by far the most widely used treatment for the protection of stored grain against insect pests. The development of high-level resistance in insects now threatens its continued use. As there is no suitable chemical to replace phosphine, it is essential to understand the mechanisms of phosphine toxicity to increase the effectiveness of resistance management. Because phosphine is such a simple molecule (PH3), the chemistry of phosphorus is central to its toxicity. The elements above and below phosphorus in the periodic table are nitrogen (N) and arsenic (As), which also produce toxic hydrides, namely, NH3 and AsH3. The three hydrides cause related symptoms and similar changes to cellular and organismal physiology, including disruption of the sympathetic nervous system, suppressed energy metabolism and toxic changes to the redox state of the cell. We propose that these three effects are interdependent contributors to phosphine toxicity

Evaluation of the first year of the Oxpal Medlink: A web-based partnership designed to address specific challenges facing medical education in the occupied Palestinian territories

Objectives: To (1) evaluate educational needs of clinical students at Al-Quds University Medical School in the West Bank; (2) address these needs where possible using synchronous distance learning, with clinicians in Oxford providing case-based tutorials to undergraduates in the West Bank via an online platform (WizIQ) and (3) assess the impact of this education. Design: Review of online OxPal Medlink database for tutorials held between March 2012 and April 2013. Needs assessment and evaluation of student and tutor experiences through online questionnaires, focus groups and semi-structured interviews. Setting: Oxford University Hospitals, Oxford, UK, and Al-Quds University Medical School, Abu Dies, Palestine. Participants: Doctors at Oxford University Hospitals and fourth-, fifth- and sixth-year medical students and faculty members at Al-Quds Medical School. Main outcome measures Number of tutorials, student participation, student-rated satisfaction and qualitative feedback from tutors and students. Results: Students demonstrated strong theoretical knowledge but struggled to apply this in presentation-based scenarios. Between March 2012 and April 2013, 90 tutorials were delivered to 60 students. Feedback: >95% respondents rated tutorials as ‘Excellent’ or ‘Good’ and ‘Very’ or ‘Fairly’ relevant to their future practice in Palestine. Students reported the programme had modified their approach to patients but requested better synchronization with concurrent attachments and clarification of learning outcomes. Conclusions: OxPal Medlink is a novel, web-based distance-learning partnership designed to overcome some of the challenges to local medical education in the occupied Palestinian territories. Evaluation of the first year indicates teaching is relevant to local practice and of high quality. This approach may have the potential to strengthen local capacity for medical education

Age Drives Distortion of Brain Metabolic, Vascular and Cognitive Functions, and the Gut Microbiome

Advancing age is the top risk factor for the development of neurodegenerative disorders, including Alzheimer’s disease (AD). However, the contribution of aging processes to AD etiology remains unclear. Emerging evidence shows that reduced brain metabolic and vascular functions occur decades before the onset of cognitive impairments, and these reductions are highly associated with low-grade, chronic inflammation developed in the brain over time. Interestingly, recent findings suggest that the gut microbiota may also play a critical role in modulating immune responses in the brain via the brain-gut axis. In this study, our goal was to identify associations between deleterious changes in brain metabolism, cerebral blood flow (CBF), gut microbiome and cognition in aging, and potential implications for AD development. We conducted our study with a group of young mice (5–6 months of age) and compared those to old mice (18–20 months of age) by utilizing metabolic profiling, neuroimaging, gut microbiome analysis, behavioral assessments and biochemical assays. We found that compared to young mice, old mice had significantly increased levels of numerous amino acids and fatty acids that are highly associated with inflammation and AD biomarkers. In the gut microbiome analyses, we found that old mice had increased Firmicutes/Bacteroidetes ratio and alpha diversity. We also found impaired blood-brain barrier (BBB) function and reduced CBF as well as compromised learning and memory and increased anxiety, clinical symptoms often seen in AD patients, in old mice. Our study suggests that the aging process involves deleterious changes in brain metabolic, vascular and cognitive functions, and gut microbiome structure and diversity, all which may lead to inflammation and thus increase the risk for AD. Future studies conducting comprehensive and integrative characterization of brain aging, including crosstalk with peripheral systems and factors, will be necessary to define the mechanisms underlying the shift from normal aging to pathological processes in the etiology of AD

Neuroimaging Biomarkers of mTOR Inhibition on Vascular and Metabolic Functions in Aging Brain and Alzheimer’s Disease

The mechanistic target of rapamycin (mTOR) is a nutrient sensor of eukaryotic cells. Inhibition of mechanistic mTOR signaling can increase life and health span in various species via interventions that include rapamycin and caloric restriction (CR). In the central nervous system, mTOR inhibition demonstrates neuroprotective patterns in aging and Alzheimer’s disease (AD) by preserving mitochondrial function and reducing amyloid beta retention. However, the effects of mTOR inhibition for in vivo brain physiology remain largely unknown. Here, we review recent findings of in vivo metabolic and vascular measures using non-invasive, multimodal neuroimaging methods in rodent models for brain aging and AD. Specifically, we focus on pharmacological treatment (e.g., rapamycin) for restoring brain functions in animals modeling human AD; nutritional interventions (e.g., CR and ketogenic diet) for enhancing brain vascular and metabolic functions in rodents at young age (5–6 months of age) and preserving those functions in aging (18–20 months of age). Various magnetic resonance (MR) methods [i.e., imaging (MRI), angiography (MRA), and spectroscopy (MRS)], confocal microscopic imaging, and positron emission tomography (PET) provided in vivo metabolic and vascular measures. We also discuss the translational potential of mTOR interventions. Since PET and various MR neuroimaging methods, as well as the different interventions (e.g., rapamycin, CR, and ketogenic diet) are also available for humans, these findings may have tremendous implications in future clinical trials of neurological disorders in aging populations