A Comparitive study between Myofascial Trigger Point Release and Self Stretching with Intermittent Icing in Improving the Foot and Ankle Function of Hockey Players with Plantar Heel Pain

NEED FOR THE STUDY: Plantar heel pain not only cause pain and discomfort but also affects the physical foot and ankle functions of the hockey players and their results in deconditioning. Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain. Few studies are available to analyse the effect of soft tissue therapy for plantar heel pain in athletic population. So this study was conducted in order to compare either Myofascial trigger point release or self-stretching with intermittent icing as a useful intervention in the management to improve foot and ankle function for plantar heel pain in hockey players. OBJECTIVES: 1. To determine the efficacy of physiotherapeutic techniques in improving foot and ankle function of hockey players with plantar heel pain. 2. To systematically compare the efficacy of myofascial trigger point and self stretching with intermittent icing in improving foot and ankle functions of hockey players with plantar heel pain. 3. To systematically assess the literature and present the best available evidence for improving the foot and ankle function in hockey players with plantar heel pain. METHODOLOGY: STUDY DESIGN: Pre test-post test study comparative in nature. STUDY SETTING: Study was conducted at Nehru stadium - Hockey team Coimbatore, Tamilnadu, under the guidance of Shasti Sports Institute. STUDY DURATION: Total duration was six months. Individuals received the treatment for duration of one week. SUBJECTS: 30 hockey players with clinical diagnosis of plantar heel pain, who fulfill the predetermined inclusive and exclusive criteria were selected and divided into 2 groups by simple random sampling method. Each group consists of 15 patients. Groups are named as group A, and B. CRITERIA FOR SELECTION: INCLUSIVE CRITERIA: Male hockey players, Age group between 18 and 25 years, Minimum one years of continuous performance, Clinical diagnosis of unilateral plantar heel pain, Specific controls for subjects included the time of testing, activities of daily living, nutritional factors, and psychological status can be controlled during the study. EXCLUSIVE CRITERIA: Subjects with Neurological problems, Any recent injuries to lower limbs, Any recent surgery in lower limbs, Psychologically unstable players. Red flags to manual therapies; Tumour in lower limb, Fractures in lower limb, Rheumatoid arthritis, Osteoporosis, Severe vascular disease, Calcanial spur, TA calcification. Previous manual therapy interventions for the foot region. RESULTS: In the table I & IV the pre test and post value of Visual Analogue Scale and Foot and Ankle Ability Measures were assessed for the stretching group. The results show that there was significant decrease in reduction of pain and increase in the physical performance for plantar heel pain hockey players. In the table II & V the pre test and post value of Visual Analogue Scale and Foot and Ankle Ability Measures were assessed for the myofascial trigger point release and self-stretching with intermittent icing group. The results showed that there was significant decrease in reduction of pain and increase in the physical performance for plantar heel pain hockey players. In the table III & VI the post test value of both Visual Analogue Scale and Foot and Ankle Ability Measures show that there is significant difference in between self-stretching with intermittent icing and myofascial trigger point release The analysis of the post test values shows that there is decrease in reduction of pain and increase in the foot and ankle function between the groups for plantar heel pain in hockey players. Post test values of Group A and Group B is analysed by Unpaired ‘t’ test. In table III and Figure III he calculated ‘t’ value is 3.0880 which is greater than table ‘t’ value 1.7011 at 5% level of significance. SUMMARY AND CONCLUSION: The aim of the study is to compare myofascial trigger point release and selfstretching with intermittent icing for plantar heel pain in hockey players. 30 hockey players with a minimum of five year experience in playing hockey were selected in the age group between 18 and 25 years and the subjects were allotted into two groups, according to inclusion criteria. Group A received self-stretching & intermittent icing ; Group B received Myofascial trigger point release. The pre-test and post-test were taken before and at the end of the treatment. Statistical analysis was done by using paired and unpaired ‘t’ test. Paired ‘t’ test was used to find out the improvement within the group. Unpaired ‘t’ test was used to find out the difference between two groups. The results of the study showed that there is a reduction of pain and increasing foot and ankle function in hockey players with plantar heel pain in both the Group A and Group B When comparing both Group A and Group B it was concluded that myofacial trigger point release showed better improvement in hockey players with plantar heel pain. CONCLUSION: It as concluded that myofascial trigger point treatment programme showed better improvement in the reduction of pain in hockey players with plantar heel pain than Group A. It is concluded that the myofascial trigger point treatment programme showed better improvement in foot and ankle function among hockey players with plantar heel pain than Group A

Transitions to Nematic states in homogeneous suspensions of high aspect ratio magnetic rods

Isotropic-Nematic and Nematic-Nematic transitions from a homogeneous base state of a suspension of high aspect ratio, rod-like magnetic particles are studied for both Maier-Saupe and the Onsager excluded volume potentials. A combination of classical linear stability and asymptotic analyses provides insight into possible nematic states emanating from both the isotropic and nematic non-polarized equilibrium states. Local analytical results close to critical points in conjunction with global numerical results (Bhandar, 2002) yields a unified picture of the bifurcation diagram and provides a convenient base state to study effects of external orienting fields.Comment: 3 Figure

A Study on Body Fat Distribution and Cardiovascular Risk Factors

CONCLUSIONS: 1. The mean BMI of the south Indian males was 21.82 and that of south Indian females was 21.97. 2. BMI does not properly define obesity and the risk of cardiovascular events. BMI can be normal in a patient with cardiovascular disease. 3. Abdominal obesity is an independent risk factor for coronary heart disease. Waist hip ratio and waist circumference are better indicators of the cardiovascular risk in a given individual than BMI. 4. Waist hip ratio is a significant factor in males but not in females. 5. The central skin fold thickness was significant in males but not in females. 6. For the same BMI, females had more uniform distribution of fat than males who had predominantly more distribution of fat in abdominal region. 7. Central obesity leads to atherogenic lipid profile in both the sexes and places the individual at high risk of cardiovascular events

An open model cross sectional observational study of hyponatremic patients in a tertiary care hospital

Background: Hyponatremia is the most common electrolyte disturbance encountered in clinical practice. Hyponatremia frequently develops in hospitalized patients, especially in metabolic encephalopathy patients, their causes are multiple. Symptomatology depends more on the rate of development of the electrolyte abnormality than on its severity. We undertook this study to determine etiological, clinico-lab profile and differential diagnosis in a group of hyponatremic patients.Methods: We included retrospectively 50 patients of hyponatremia admitted in medical intensive care unit between June 2013 and May 2014. We excluded all patients who presented with chronic hyponatremia, chronic use of diuretics and recent cases undergoing surgery and chronic cases of malnutrition and those with age below 18 years. Data were analyzed by univariate methods, followed by multivariate analysis.Results:  Among the 50 patients with hyponatremia, 42% of encephalopathy patients had metabolic encephalopathy. Majority who developed hyponatremia had age between 61 to 80 years. Clinical profile of patients with hyponatremia was revealed that most of the patients with hyponatremia were observed having confusion followed by nausea/vomiting, delirium, seizure. The most common etiology of metabolic encephalopathy with hyponatremia is diuretic induced, followed by diabetic ketoacidosis, chronic liver disease, chronic kidney disease, SIADH and hypothyroidism. The common co-morbid conditions for hyponatremia were hypertension 55.93%, diabetes mellitus 43.85%, and chronic renal failure 35.29%. In the patients with hyponatremia high urine sodium level suggests that most of the patients had hyponatremia due to renal loss of sodium other than extra renal cause.Conclusions: In the present study, hypertension was found a major risk factor for hyponatremia. Common causes of hyponatremia found are intake of diuretics and excessive renal loss. Most of the hypertensive patients in the present study group were on thiazide or potassium sparing diuretics. Diabetes mellitus and dyslipidemia were important co-morbidities of hyponatremia.

A Comparative Study on Orthostatic Hypotension in Elderly Hypertensives and Non Hypertensives.

Orthostatic hypotension is a common and important clinical disorder in the elderly population. The pathogenesis is multi factorial but is probably often due to changes in the autonomic nervous system, as well as to age-related changes in the cardiovascular and endocrine systems. Orthostatic hypotension can be seen as a prototypical clinical disorder of the elderly (1, 6). In addition, the presence of multiple diseases and medications, especially antihypertensives (2, 5) are common contributing factors. Standardized measurement of postural blood pressure and recording of heart rate and assessment of associated symptoms are essential for the clinical diagnosis. Usually elimination of offending medications and treatment of contributing medical disorders are adequate. It reflects impaired homeostasis; its etiology is multi factorial and due to the effects of both age and disease; it is clinically protean. It can result in falls, injury, and progressive decline if not recognized and treated early. Many studies have proved that Orthostatic hypotension is more prevalent among the elderly population, and more so among the elderly hypertensives. Symptoms, as mentioned above can lead to drug non- compliance as well as a reduced quality of life. High blood pressure, once believed to represent a normal and progressive component of the aging process, is now recognized as a manifestation of structural and physiologic abnormalities of aortic function. Elevated systolic blood pressure and increased pulse pressure unquestionably increase the risk of both fatal and nonfatal cardiovascular events, including stroke, myocardial infarction, and heart failure. Isolated systolic hypertension, defined as a systolic blood pressure > 140 mm Hg with a diastolic blood pressure < 90 mm Hg, affects most individuals aged 60 years and older. Several clinical trials have clearly demonstrated that treatment of hypertension significantly reduces the cardiovascular event rate. However, controversy continues as to the choice of antihypertensive agents and combinations of agents. It is both appropriate and necessary to treat elderly hypertensives aggressively to the same target blood pressures identified for younger patients. It is also appropriate to initiate treatment with lower doses of antihypertensive agents and to bring the pressure down more slowly, monitoring for orthostatic hypotension, impaired cognition, and electrolyte abnormalities. 1) Orthostatic hypotension is a common clinical disorder in the elderly. There is no sex difference in the prevalence of orthostatic hypotension. 2) The prevalence of Orthostatic hypotension is more among hypertensives than non – hypertensives. 3) There is no significant relation between orthostatic hypotension and the symptoms of orthostatic hypotension. 4) Orthostatic hypotension is not related to either the type or number of drugs used in this study. 5) Development of Orthostatic hypotension has no relation to control of hypertension

A study to evaluate the efficacy of cranberry extract supplements in prevention of recurrent urinary tract infections in female patients

Background: Recurrence of urinary tract infections (UTI) are either due to re infection or relapse. Overall likelihood of developing UTI is approximately 30 times higher in women than men due to their anatomical peculiarities. The objective was to evaluate efficacy of cranberry extract supplementations in prevention of recurrent UTI in female patients, assess the quality of life of patients, medication adherence of patients and effect of patient counselling.Methods: A prospective observational study was carried out for a period of 6 months and samples were taken from the Urology Department of Cosmopolitan Hospital, Trivandrum, Kerala. The selected patients were administered with cranberry extract supplements after their regular Antibiotic therapy and were observed for recurrence for a period of six months. Three follow ups were taken and the betterment was assessed using the score from prepared proforma.Results: 84 patients were analysed and among them we observed and concluded that 86.9% of patients were free of recurrent infection. Study shows that E. coli was the commonest infectious organism causing UTI. In this study the most commonly observed symptom of UTI was lower abdominal pain and the most common co morbidity was DM.Conclusions: Through this study it was concluded that the cranberry extract supplements significantly reduced the recurrence of UTI in women. Since the antibiotic prophylaxis is having the risk of developing resistance and side effects, the cranberry extract supplements can be suggested as a best alternative to antibiotics in recurrent UTI prophylaxis

Strengthening of Load Bearing Masonry Wall Panels with Externally Bonded Precast Textile Reinforced Concrete Laminate

241-245Textile Reinforced Concrete (TRC) has gained worldwide popularity as a strengthening material for masonry structures in the recent years. As of today, the application of TRC for masonry strengthening is either by cast-in-place methodology or by spraying method. The present work is a first-of-its kind study, which explores the feasibility of using externally bonded precast TRC laminate for strengthening of load bearing brick masonry wall panels. The binder used in TRC itself is used as adhesive for adhering the TRC laminate to masonry wall panels. Experimental investigations were carried out on unstrengthened and strengthened brick masonry wall panels under axial compression and combined axial compression and shear loading. The influence of TRC strengthening system is assessed by examining the performance indicators such as strength, stiffness and deformation. Based on the investigations, the use of externally bonded precast TRC laminate is found to be a feasible solution to strengthen brick masonry walls to have the required structural adequacy

Assessment of Radon in groundwater and associated human risk from Sankarabarani River Sub Basin, Southern India

Radon (222Rn) and associated human risk assessment in groundwater from quaternary shallow aquifers of Sankarabarani River sub basin, Southern India has been attempted by considering 41 groundwater samples and analysed for 222Rn using scintillation Radon monitoring system. The Radon ranges between 0.140±0.01 Bq l-1 to 7.869±0.33 Bq l-1 with an average of 1.797±0.12Bq l-1 and found to be within the maximum contamination level of Environmental Protection Agency (11.1 Bq l-1). The doses of ingestion and inhalation calculated for radon varies between 0.709 µSv y-1 to 39.933µSv y-1 with an average of 9.121µSv y-1which is within the prescribed dose limit of 100µSv y-1 by World Health Organisation. Uranium speciation attempted suggests saturated Haiweeite and Soddyite as sources for uranium/radon into the aquifer systems. The Eh-pH diagram suggests uraninite solubility within the pH ranges 6 to 8 within the groundwater environment