An investigation to establish how the evolution of rugby influences the risk of spinal injury during scrummaging

The rugby scrum results in a large number of injuries to the players of the front row, particularly the hooker. Front row players have been known to suffer from acute and chronic injuries of the cervical spine as well as low back pain. The principal goal of this research was to develop a method to measure spinal biomechanics of the hooker’s role during rugby scrummaging and use this method to address the question of whether recent changes in rugby affect the risk on hooker spinal injury. In recent years, a number of changes have occurred in rugby which may have an effect in injury risk, however, little is currently known about the effect of these changes. This was accomplished through three experimental stages. Firstly, a review of kinematic measurement techniques was undertaken in order to determine the most feasible measurement technique. Inertial sensors were chosen and validated for orientation output against high precision digital encoders with high levels of concordance for each axis of each sensor (>0.95). In addition to this, a method of using electromyography to predict muscle force production was investigated. Determined force and recorded force were found to be insignificantly different (p>0.05) across the 12 participants investigated. Having proved this to be a feasible method, it was put into practise in-field. Inertial sensor technology was combined with a laboratory tested force-EMG correlation to assess spinal biomechanics during live, contested, training scrums for an initial sample of 9 rugby union hookers. No significant differences (p>0.05) were observed for peak kinematic variables or EMG data. The second study assessed whether a change in playing surface affects hooker spinal kinematics by evaluating key variables such as peak range of motion and angular velocity as there has been a recent shift towards the use of artificial surfaces. Twenty-two participants took part in this study with 11 participants in each group. The groups were not significantly different (p>0.05) in terms of anthropometric and background information. The results of this study indicated that key kinematic variables did not differ significantly (p>0.05) between playing surfaces. There was, however, a large effect (d>0.8) for certain peak angular velocity measurements of the thoracic region. THESIS SUMMARY iii The final study investigated how different engagement techniques affected hooker spinal biomechanics since a recent law change was introduced governing the scrum. These techniques included machine scrummaging and live scrummaging of two different engagement sequences. Twenty-nine participants took part in the live-vs-live comparison with 14 of those taking part in all three experimental conditions. The results of this final study indicate significant biomechanical differences (p<0.05) between machine and live scrummaging indicating that machine scrummaging is a much more constrained environment. Live scrummaging of the two different sequences did not yield any significant differences (p>0.05) for both kinematic and muscle activity/determined force data indicating that the sequences do not affect hooker spinal biomechanics. These results suggest that the recent changes in rugby do not significantly affect the risk of spinal injury of the rugby union hooker

IN VITRO RELEASE KINETICS OF SIMVASTATIN FROM METHYL CELLULOSE GEL

Objective: a) To estimate the ideal percentage of polymer (methyl cellulose) and the drug (simvastatin) for controlled release gel. b) To evaluate the release kinetics and physical property.Methods: Drug polymer interaction was studied using Differential Scanning Calorimeter (DCS) and Fourier Transform Infrared Spectroscopy (FTIR). Simvastatin powder was hydrolysed to active simvastatin hydroxyl acid. Nine gel formulations using three different concentrations of simvastatin (SMV) (1.2%, 1.7% and 2.2%) and three concentration of methyl cellulose (MC) (4%, 5% and 6%) were prepared. Drug release kinetics of 9 formulations was assessed using open end tube method with the dialysis membrane. The physical property was studied using rheometer.Results: DSC and FITR results showed no drug polymer interaction. The release kinetics of all nine formulations was in a controlled manner. 4% MC 2.2% SMV, 5% MC 2.2% SMV, 6% MC 2.2% SMV showed controlled drug release compared to other six formulations. The pH of all the nine formulations ranged between 6.21–6.25. The drug content of each formulation was above 97.9%.Conclusion: This study showed that increase in polymer concentration in the gel increased the controlled release of the drug and addition of the drug to the gel decreased the viscosity of the gel.Â

The effects of changes in glutathione levels through exogenous agents on intracellular cysteine content and protein adduct formation in chronic alcohol-treated VL17A cells

Alcohol-mediated liver injury is associated with changes in the level of the major cellular antioxidant glutathione (GSH). It is interesting to investigate if the changes in intracellular GSH level through exogenous agents affect the intracellular cysteine content and the protein adduct formation indicative of oxidative insult in chronic alcohol treated liver cells. In VL-17A cells treated with 2mM N-acetyl cysteine (NAC) or 0.1mM ursodeoxycholic acid (UDCA) plus 100mM ethanol, an increase in cysteine concentration which was accompanied by decreases in hydroxynonenal (HNE) and glutathionylated protein adducts were observed. Pretreatment of 100mM ethanol treated VL-17A cells with 0.4mM buthionine sulfoximine (BSO) or 1mM diethyl maleate (DEM) had opposite effects. Thus, altered GSH level through exogenous agents may either potentiate or ameliorate chronic alcohol-mediated protein adduct formation and change the cysteine level in chronic alcohol treated VL-17A cells. The gene expression of non-treated and ethanol-treated hepatocytes in 2 microarray datasets was also compared to locate differentially expressed genes involved in cysteine metabolism. The study demonstrates that increased protein adducts formation and changes in cysteine concentration occur under chronic alcohol condition in liver cells which may increase alcohol-mediated oxidative injury

Ectopic pregnancy in a tertiary care center: a retrospective study

Background: Ectopic pregnancy is an obstetric emergency which if not diagnosed in time can cost the life of the patient. This emphasizes the importance of diagnosing this perilous condition and hence this study was undertaken to study symptoms with which the patients with ectopic pregnancy present.Methods: Retrospective study of 5 years was done in the department of Obstetrics and Gynecology, M. S. Ramaiah medical college and teaching hospital, Bangalore, India between January 2011 to January 2016. Detailed analysis of patients with ectopic pregnancy inclusive of the age and clinical features were studied.Results: A total of 90 patients with ectopic pregnancy were studied. 95.5% of the patients (n=86) presented with abdominal pain, 81.1% (n=73) of the patients presented with amenorrhea, 24.4% (n=22) patients presented with bleeding per vagina, 30% (n=27) patients with nausea, vomiting and 48.8% (n=44) presented with fainting and giddiness.Conclusions: It is very essential to study the symptoms of ectopic pregnancy as this may help in early detection of ectopic pregnancy and hence can reduce the mortality in this catastrophic condition

Impact of HIV Infection on Radiographic Features in Patients with Pulmonary Tuberculosis

Background. There is insufficient data on the radiographic presentation of tuberculosis in human immunodeficiency virus (HIV) infected patients from India. Methods. We examined the chest radiographs of 181 patients including 82 HIV positives with newly diagnosed sputum culture positive pulmonary tuberculosis before and after the completion of anti-tuberculosis treatment (ATT). Patients with smear/culture positive pulmonary tuberculosis were treated with Revised National Tuberculosis Control Programme (RNTCP) Cat-I regimen (2EHRZ3/4HR3). An independent assessor blinded to HIV and clinical status of patients read the radiographs. Results. At presentation, HIV seropositive patients were significantly more likely to have normal chest radiographs (14.2% vs 0), miliary tuberculosis (10.7% vs 1%) and pleural effusion (16.6% vs 3%), and less likely to have cavitation (17.8% vs 39.4%) as compared to HIV negative patients. At the end of treatment, HIV positive patients were more likely to have normal radiographs (42.8% vs 1.2%), and less likely to have fibrosis (17.8% vs 42.5%). Conclusions. The radiographic presentation of pulmonary tuberculosis in HIV-infected patients is atypical with less cavitation, and more dissemination. On completion of ATT, patients with HIV have less radiographic sequelae in the form of fibrosis. These features may be due to the reduced inflammatory response that patients with HIV infection may be able to mount

Study and Analysis of an Intelligent Microgrid Energy Management Solution with Distributed Energy Sources

In this paper, a robust energy management solution which will facilitate the optimum and economic control of energy flows throughout a microgrid network is proposed. The increased penetration of renewable energy sources is highly intermittent in nature; the proposed solution demonstrates highly efficient energy management. This study enables precise management of power flows by forecasting of renewable energy generation, estimating the availability of energy at storage batteries, and invoking the appropriate mode of operation, based on the load demand to achieve efficient and economic operation. The predefined mode of operation is derived out of an expert rule set and schedules the load and distributed energy sources along with utility grid.Study and Analysis of an Intelligent Microgrid Energy Management Solution with Distributed Energy SourcespublishedVersio

Lack of association between plasma levels of non-nucleoside reverse transcriptase inhibitors & virological outcomes during rifampicin co-administration in HIV-infected TB patients.

BACKGROUND & OBJECTIVES Among patients with HIV-associated tuberculosis (TB), reduced plasma non-nucleoside reverse transcriptase inhibitors (NNRTI) concentrations during rifampicin (RMP) co-administration could lead to HIV treatment failure. This study was undertaken to examine the association between plasma nevirapine (NVP) and efavirenz (EFV) concentrations and virological outcomes in patients infected with HIV-1 and TB. METHODS This was a nested study undertaken in a clinical trial of patients with HIV-1 and TB, randomized to two different once-daily antiretroviral treatment (ART) regimens along with anti-TB treatment (ATT). Trough concentrations of plasma NVP and EFV were estimated at months 1 (during ATT and ART) and 6 months (ART only) by HPLC. Plasma HIV-1 RNA level >400 copies/ml or death within 6 months of ART were considered as unfavourable outcomes. Genotyping of CYP2B6 516G>T polymorphism was performed. RESULTS Twenty nine per cent of patients in NVP arm had an unfavourable outcome at 6 months compared to 9 per cent in EFV arm (PT polymorphism significantly associated with virologic outcome in patients receiving EFV-based regimen. INTERPRETATION & CONCLUSIONS Trough plasma concentrations of NVP and EFV did not show any association with response to ART in patients on ATT and once-daily ART. CYP2B6 516G>T polymorphism was associated with virologic outcome among patients on EFV