Reliability of Shear Wave Elastography for the Assessment of Gastrocnemius Fascia Elasticity in Healthy Individual

The mechanical properties of deep fascia (i.e. an index of stiffness) strongly affect the development of muscle pathologies, and muscular actions, such as compartment syndromes. Actually, a clear understanding of the mechanical characterization of muscle deep fascia still lacks. The present study focuses on examining the reliability of ultrasonic shear wave elastography device (USWE) in quantifying the shear modulus of gastrocnemius fascia in healthy individual and the device’s abilities to examine the shear modulus of gastrocnemius deep fascia during ankle dorsiflexion. Twenty-one healthy males participated in the study (age: 21.48±1.17 years). The shear modulus of the medial gastrocnemius fascia (MGF) and lateral gastrocnemius fascia (LGF) were quantified at different angles using USWE during passive lengthening. The operators took turns to measure each subject’s MGF and LGF over 1-hour period and by operator B with a 2-hour interval. In the intra-operator test, the same subjects participated at the same time 5 days later. The intra-rater [ Intra-class correlation coefficient (ICC) = 0.846-0.965)] and inter-rater (ICC = 0.877-0.961) reliabilities for measuring the shear modulus of the MGF and LGF were rated as both excellent, and the standard error in measurement (SEM) was 3.49 kPa, the minimal detectable change (MDC) was 9.68 kPa. Regardless of the ankle angle, the shear modulus of the LGF were significant greater than that of the MGF (p < 0.001). The significant increase in the shear modulus both of the MGF and LGF were observed at neutral position compared to the relaxed position. This results indicate that the USWE is a technique to assess the shear modulus of gastrocnemius fascia and detect its dynamic changes during ankle dorsiflexion. USWE can be used for biomechanical study and intervention experiments of deep fascia.

Evaluation of recovery of oxygen saturation and rate of perceived exertion in different body positions after submaximal exercise test in normal healthy individual

Background: Oxygen saturation is the fraction of oxygen saturated hemoglobin relative to total hemoglobin in blood. Normal oxygen saturation level in humans are 95-100 percent. Breathlessness is an unpleasant sensation of rapid or difficult breathing. The reason behind the subject experiencing breathlessness is that the body demands more oxygen than it supplies. Thus this study is conducted to Evaluate Recovery of Oxygen saturation and Rate of perceived exertion in different body positions after submaximal exercise testing in normal healthy individuals. Methodology: It was Pre and Post Study Design with 6 months duration including 40 healthy students recruited by purposive sampling method. The outcome measure was Recovery of Oxygen saturation and rate of perceived exertion. Result – Using the Paired t test, this shows that fastest recovery of oxygen saturation occurs in prone position that is within 1 min (99±0.96) than supine within 3 min (99±0) than upright sitting within 3 min (99±0) and fastest recovery of rate of perceived exertion occurs in prone position that is within 1 min (0.825±0.99) than supine within 3 min (0±0) than upright sitting within 3 min (0±0). Conclusion - From the present study we evaluate the Recovery of oxygen saturation and RPE in supine, prone, upright sitting position and we found that the fastest recovery of oxygen saturation and Rate of perceived exertion occurs in prone position than supine and upright sitting position after submaximal exercise testing in normal healthy individual.

Predicting Forefoot-Orthosis Interactions in Rheumatoid Arthritis Using Computational Modelling

Foot orthoses are prescribed to reduce forefoot plantar pressures and pain in people with rheumatoid arthritis. Computational modelling can assess how the orthoses affect internal tissue stresses, but previous studies have focused on a single healthy individual. This study aimed to ascertain whether simplified forefoot models would produce differing biomechanical predictions at the orthotic interface between people with rheumatoid arthritis of varying severity, and in comparison to a healthy control. The forefoot models were developed from magnetic resonance data of 13 participants with rheumatoid arthritis and one healthy individual. Measurements of bony morphology and soft tissue thickness were taken to assess deformity. These were compared to model predictions (99th% shear strain and plantar pressure, max. pressure gradient, volume of soft tissue over 10% shear strain), alongside clinical data including body mass index and Leeds Foot Impact Scale–Impairment/Footwear score (LFIS-IF). The predicted pressure and shear strain for the healthy participant fell at the lower end of the rheumatoid models’ range. Medial first metatarsal head curvature moderately correlated to all model predicted outcomes (0.529 &lt; r &lt; 0.574, 0.040 &lt; p &lt; 0.063). BMI strongly correlated to all model predictions except pressure gradients (0.600 &lt; r &lt; 0.652, p &lt; 0.05). There were no apparent relationships between model predictions and instances of bursae, erosion and synovial hypertrophy or LFIS-IF score. The forefoot models produced differing biomechanical predictions between a healthy individual and participants with rheumatoid arthritis, and between individuals with rheumatoid arthritis. Models capable of predicting subject specific biomechanical orthotic interactions could be used in the future to inform more personalised devices to protect skin and soft tissue health. While the model results did not clearly correlate with all clinical measures, there was a wide range in model predictions and morphological measures across the participants. Thus, the need for assessment of foot orthoses across a population, rather than for one individual, is clear.

ROLE OF RASA DHATU IN THE MAINTENANCE OF BODY

Ayurveda emphasizes on maintenance of health in a healthy individual and treating the diseased ones. The human body comprises Tridosha, Saptadhatu, Trimala (structural and functional entities of the body). Sharira (body) is a mula for health as well as disease. Srotas (body channels) are those channels that transport and transform the sub- stances to respective tissues, cells of the human body required for life sustenance. As the Dhatu’s are classified as Sthayi and Asthayi dhatu, based on the Aahara (food) consumed the respective Dosha Utpatti (biotransformation) takes place leading to Saara Kitta Vibhajana (formation of metabolic nutrients and waste). Rasa dhatu is an Asthayi Dhatu which is predominant of Jala Mahabhuta. From the Aahara Rasa, Rasa Dhatu is formed which is the prime Dhatu resulting in the development of subsequent dhatus of the sharira. Rasa Saara Purusha is en- dowed with Aayushmanta (longer life span) and Aarogya (health). As Rasadhatu Dusti Janya Vikaras are abun- dant in our clinics, understanding of Rasavaha Srotodusti Nidana (causative factor) and Lakshana (signs and symptoms) in a patient with a relevant examination by means of Trividha Pariksha and prescribing appropriate Chikitsa (treatment) by understanding Guna -Karma principle is the need of the hour. Keywords: Rasavaha Srotas (lymph channels), Pariksha (examination), Chikitsa (treatment)

IMPORTANCE AND PROCEDURE FOR ANALYSIS OF MEDA DHATU

Ayurveda, the most ancient science means knowledge of life which serves mankind by providing a comprehen- sive, natural and holistic cure for diseases related to mind and body. The aim of Ayurveda is not only to treat the disease but also to protect the health of the healthy individual as said in the classics i.e., “swasthasya swasthya rakshanam aturasya vikara prashmanam ch”. Health in Ayurveda is defined as an accurate amount of Dosha, Dhatu and Mala. Any type of variations in quantity as well as quality leads to diseases. One of the dhatus i.e., Meda Dhatu is correlated with fat and lipid in modern science. This paper is about the method by which Meda Dhatu can be assessed according to Ayurveda. Keywords: meda, dhatu, swasthasya, assessment

Double-Effect Donation Disputed

In “Double Effect Donation,” Camosy and Vukov argue that “there are circumstances in which it is morally permissible for a healthy individual to donate their organs even though their death is a foreseeable outcome”. They propose that a living donor could ethically donate an entire, singular, vital organ while knowing that this act would result in death. In reply, I argue that it is not ethical for a living person to donate an entire, singular, vital organ. Moreover, mutatis mutandis, it is not ethical for surgeons and others to perform such a deadly operation. For to do so is “intentionally to cause the death of the donor in disposing of his organs”. Such an act violates the dead donor rule which holds that an entire, singular, vital organ may be taken only from a corpse. Contrary to Camosy and Vukov’s claims, double-effect reasoning does not endorse such organ donation.

STUDY OF BRAIN-NATRIURETIC PEPTIDE, LACTATE LEVELS AND BLOOD PRESSURE IN PATIENTS WITH CONGESTIVE HEART FAILURE

INTRODUCTION: Congestive Heart Failure is a complex physiological syndrome caused from structural or functional alterations to the myocardium. Lactate is produced by anaerobic metabolism and is secreted by the Brain-Natriuretic peptide heart ventricles in response to left ventricular stretching or wall tension. AIM: The aim of the study was to evaluate Brain-Natriuretic Peptide, Lactate levels and Blood pressure in Congestive Heart Failure patients and compared them with healthy individual. MATERIALS AND METHODS: Total 80 participants who fullled the inclusion and exclusion criteria were enrolled in the study. They were divided into two group i.e., case and control group. Case group included 40 patients of Congestive Heart Failure, age between 18-65 years and control group comprised of 40 healthy individuals with similar age range. Blood sample were drawn and analyzed for the evaluation of Serum lactate and Brain-Natriuretic Peptide. Blood Pressure was also measured in both the groups. RESULT: The present study has demonstrated that the level of Brain-Natriuretic Peptide and lactate were signicantly high in Congestive heart failure patients when compared with control group. Systolic and Diastolic blood pressure were also higher among patients group. CONCLUSION: The results of the study suggested that the levels of Lactate and Brain-Natriuretic Peptide were high in Congestive heart failure patients when compared with healthy individual. Systolic and Diastolic blood pressure were also higher among patients group. Elevated lactate and Brain-Natriuretic Peptide level can be recommended as useful indicator of poor prognosis and hence can be helpful in early identication of patients at risk.