Endovenous Iliocaval Revascularization for Transplant Kidney Salvage

Purpose: We report the case of a venous iliocaval recanalization to preserve a transplant kidney. Case Report: A young patient with a nephrotic syndrome caused by focal segmental glomerulosclerosis (FSGS) underwent a robot-assisted living-donor kidney transplant. The postoperative course was uneventful; serum creatinine at discharge was 1.51 mg/dL (normal range = 0.72–1.17 mg/dL). In the course of the following months, the patient was readmitted repeatedly due to acute kidney failure not related to rejection, recurrent FSGS, or anastomotic stenosis. All episodes started after prolonged standing and renal function improved after bed rest. Several hospital admissions and investigations later, phlebography revealed an occlusion of the inferior vena cava (IVC) and both common iliac veins with large collateral vessels through the azygos system. An endovenous recanalization of the iliocaval tract was performed, with subsequent normalization of transplant kidney function. Conclusion: Vascular complications after renal transplantation are an important cause of graft loss. We present an endovenous treatment option for a chronic occlusion of the IVC and common iliac vein with intermittent venous congestion as a cause of transplant failure.

A Systemic Review of Pathological Findings in COVID-19 and Its Mechanism of Disease

The Severe Acute Respiratory Syndrome (SARS) coronavirus 2 (SARS-CoV2) has spread worldwide at a rapidly alarming pace and has resulted in the coronavirus disease 2019 (COVID-19) pandemic. The virus has more intensive and prolonged standing effects in the host body post-infection than the other related groups of viruses. The disease has caused an unforeseen need for the availability of intensive support because of the resulting critical respiratory distress and consequent multi-organ failure. What starts as an elegant fever with cough and headache, with body pain, runny nose, sore throat, quickly develops into loss of perception of taste and smell, with nausea, diarrhea, troubled breathing, chills; and finally results into grievous damage to the vital organs of the body, such as heart, lungs, liver, kidneys, blood vessels, and even brain, necessitating the need of urgent and competent availability of critical care infrastructure. It is now the disease with the highest number of affected individuals recorded in the modern era. And, not only does the infection of Covid inflict highly significant morbidity and mortality rates amongst the population, but there have also been multiple and significant strains to the overburdened health care system and also, massively on the economy. Here in this article, our focus will primarily be upon the systemic pathology in the various organ systems and how the coronavirus has been affected. We shall discuss the Respiratory System, the Cardio-Vascular System, the Renal System, Central Nervous System, and the pathophysiology involved herewith after covid infection.

Prolonged standing behaviour in people with joint hypermobility syndrome

Background Joint Hypermobility Syndrome (JHS) is a rare Heritable Disorder of Connective tissue characterised by generalised joint laxity and chronic widespread pain. Joint Hypermobility Syndrome has a large impact on patients’ day to day activities, and many complain of symptoms when standing for prolonged periods. This study investigates whether people with JHS exhibit the same behaviours to deal with the effects of prolonged standing as people with equal hypermobility and no pain, and people with normal flexibility and no pain. Methods Twenty three people with JHS, 22 people with Generalised Joint Hypermobility (GJH), and 22 people with normal flexibility (NF) were asked to stand for a maximum of 15 min across two force-plates. Fidgets were counted and quantified using a cumulative sum algorithm and sway parameters of the quiet standing periods between fidgets were calculated. Results Average standing time for participants with JHS was 7.35 min and none stood for the full 15 min. All participants with GJH and NF completed 15 min of standing. There were no differences in fidgeting behaviour between any groups. There was a difference in anteroposterior sway (p = .029) during the quiet standing periods. Conclusion There is no evidence to suggest people with JHS exhibit different fidgeting behaviour. Increased anteroposterior-sway may suggest a muscle weakness and strengthening muscles around the ankle may reduce postural sway and potentially improve the ability to stand for prolonged periods.

Efficacy of Self Myofascial Release Technique to Reduce Frequency and Severity of Noctural Leg Cramp in Older Adults

Background: Nocturnal leg cramps (NLC) are involuntary muscle contractions of the calf muscles, hamstrings, or foot muscles that occur unexpectedly, episodically, and are unpleasant. Night time cramping affects about one-third of adults. Leg cramps can strike anyone at any age, although they are more widespread and often more severe as grow older. The majority of cramps are idiopathic, and the physiological cause behind them is unknown. Muscle cramps appear to be triggered by neuromuscular structures in muscle, tendons, and nerve fibres, according to some writers. Musculoskeletal issues linked to a sedentary lifestyle, as well as job postures, prolonged standing, and the western habit of sitting rather than squatting, have been implicated of generating cramps, particularly NLC. Patients with cramps have a higher risk of peripheral vascular disease than individuals without cramps. Stretching before bedtime can help older persons lessen the frequency and severity of nocturnal leg cramps. Stretching treatments, like as Myofacial Release, can help relieve NLC. Self-Myofacial release (SMFR) is a sort of Myofacial release (MFR) that is accomplished by the person rather than a therapist, and it is usually done with the help of a tool. Self-MFR is a low-cost, easily accessible approach for people to relieve muscle and fascia pain while also maintaining flexibility. Foam rollers and roller massage are two of the most used devices for self-MFR. MFR is used to treat a wide range of musculoskeletal disorders; it is used to treat a wide range of problems, and many types of treatment, such as trigger-point therapy and proprioceptive neuromuscular facilitation, fall under the myofascial umbrella. Aim and Objectives: To study the main impact of Self Myofascial Release (SMFR) to decreasing the duration of pain and improving Quality of Life in patients with NLC. Methodology: In this study total 30 patient with nocturnal leg cramps will receive Self Myofascial Release technique (SMFR), it will be including exercise which will be performed for 4 weeks twice a day and each for 5-10 mins. Discussion: This study is done to find out the effectiveness of Self Myofacial release in individual with nocturnal leg cramps (NLC). Conclusion: Conclusion of the study can be made based on the effect of Self Myofascial Release technique on patient with nocturnal leg cramps.

A Comparative Study of Footprints of Security Guards with Age and Gender Matched Individuals

Aim: To compare footprints of security personnel with age and gender matched individuals. Background: The human foot and ankle are the last segments, the last within the complex kinetic chain of the lower limb as a whole. The foot is one of the most important interaction parts of the body with the ground, especially in the upright posture. During growth, the foot changes not only its dimensions but also its shape. The lower back, leg, ankle and foot are the most commonly affected region causing pain in security personnel during prolonged standing and sitting. This may also lead to change in the arch of the foot and predispose it to the injury. In this study, we aim to analyze footprints with reference to Staheli Index and Chippaux-Smirak Index of security guards and age and gender matched individuals. Methodology: 25 security personnel and 25 age and gender matched individuals were selected as per inclusion criteria. Demographic data like age, gender, height, weight, BMI and any injury in last 6 months were recorded for all study participants. For obtaining foot prints, ink was applied to the feet of the subjects. The subjects were tasked to step on graph paper in standing position, leaving a clear impression of foot’s plantar surface on the paper. The various distances in centimeters were taken using a transparent ruler. The Staheli Index and Chippaux-Smirak Index were also calculated. Result: Statistical analysis showed significant difference in Staheli Index, Chippaux-Smirak Index, Distance E and G between security personnel and age and gender matched individuals. The other values (A, B, C, D, F) were not found to be statistically different. Conclusion: The distance E and distance G is more in age and gender matched individuals as compared to security personnel. Also the Staheli Index and Chippaux-Smirak Index is less in security guards which indicates higher arch as compared to age and gender matched individuals. Key words: footprint, arch of foot, security personnel, Staheli Index, Chippaux-Smirak Index.

Physical work conditions and perceived health problems among informal automobile artisans

BACKGROUND: Automobile car repair requires intensive activities. Several studies have described different work characteristics of automobile artisans’ work. However, the effects of physical work conditions (PWC) on worker health outcomes are largely unknown. OBJECTIVE: This study aimed to explore which of the PWC have high negative impact on worker’s health outcomes, and whether the same conditions affected both illnesses and injuries. METHODS: A cross-sectional design and a multistage method were used to randomly select 632 workers. A structured self-reported questionnaire was used to obtain information on dependent variables (illness/injuries) and independent variables (PWC). The results were analysed using the chi-square test and logistic regression analysis, while controlling for occupation. RESULTS: Workers who manually lifted heavy items or orally sucked petrol regularly reported illnesses and injuries. Long work experience and long working hours were significantly associated with illness, whereas prolonged standing was significantly related to injuries. Contrary to our initial expectation, workers who regularly worked at 2 m or higher above the ground level tended to report less illness and injury. CONCLUSIONS: PWCs were more significantly related to work-related illnesses than injuries. Therefore, interventional programs for automobile artisans should focus on the PWC that increase worker vulnerability to work-related illnesses.