SCIENTIFIC STUDY OF VITAP MARMA

Marma is a vital point of the body where trauma or injury may cause a various range of signs and symptoms from Ruja (pain) to even death. Ayurvedic Acharya’s has explained 107 Marma” that are present in the anterior and posterior aspect of the human body. Depending upon the effect of injury on Marma is five types like Sadhyo pranhara, Kalantara pranhara, Vishlyaghna, Vaikalykara & Rujakara Marma. Out of them, Vaikalykar Marma are the points where an injury causes structural or functional deformity. Another type of classification of Marma has also been made as Mamsa (muscle) marma, Sira (artery/vein) marma, Snayu (ligament) marma, Asthi (bone) marma and Sandhi (joint) marma. The Vitap Marma is placed under the Snayu Marma by Acharya Sushrut and Sira Marma by Acharya Vaghbhata. Vitap Marma is situated between Vankshan (Groin) and Vrishna (Testes) and the Viddha lakshan (symptoms of trauma) is Shandata (impotency) and Alpashukrata (oligospermia). The struc- ture present at this point is the inguinal canal. The clinical importance of the inguinal canal is related to the inguinal hernia. Direct or indirect Injury at this particular point affects the physiology of the reproductive system and may cause sterility, which is similar to Viddha lakshan of Vitap marma as described by Sushrut. Keywords: Vitap marma, Vaikalyakar marma, Inguinal canal, Spermatic cord, round ligament

A rare case of Panophthalmitis due to cobra bite

Purpose Ocular manifestations of snake bite are rare, ranging from direct injury to the eye from snake venom or indirect injury due to antivenom. We report a rare case of cobra bite causing panophthalmitis due to indirect injury as a result of snake venom toxin related tissue necrosis and susceptibility to secondary infections. Methods Observational case report. External photographs, slit lamp photos, ultrasonography of the eye and histopathology of the eviscerated eye were used to characterize and describe the clinical findings. Thirty-nine-years-old male farmer presented with history of cobra snake bite on his right index finger and developed right eye sudden onset pain and redness 3 days later. On examination, features were suggestive of panophthalmitis and the eye had to be eviscerated with scleral excision. Conclusion It is important for ophthalmologist to be aware of such grave consequences of snake bite to be prepared for the emergency management of such cases.

Indirect traumatic musculocutaneous nerve injury confused with static line injury: A case report

The musculocutaneous nerve is rarely injured because it is short and is located deep in the shoulder and arm. Damage is usually caused by direct injuries, including stabbing, explosion, and surgery in a war setting. Although indirect injury of the musculocutaneous nerve is extremely rare, it occurs in various situations. In military parachuting-related activities, musculoskeletal injury occurs most commonly, and static line injury is known as rupture of the biceps brachii tendon. However, musculocutaneous neuropathy can also result from secondary injury by the static line. The musculocutaneous nerve goes together with the biceps brachii muscle, and the musculocutaneous nerve could overstretch and compress within the coracobrachialis muscle where the nerve is relatively fixed due to the overloading of the upper arm with shoulder extension. This report focuses on the indirect musculocutaneous nerve injury with axonotmesis following an overloading event by the static line during military parachuting. In this case, some physicians may confuse nerve injury with static line injury, leading to delays in the diagnosis of neuropathy. If the biceps brachii muscle is damaged due to trauma, checking for the accompanying musculocutaneous nerve injury is necessary.

Acute Groin Pain Syndrome Due to Internal Obturator Muscle Injury in a Professional Football Player

Traumatic groin pain syndrome is the result of an acute trauma, usually an indirect muscle injury (i.e., an overstretching of the muscle fibers). The most affected muscles in traumatic groin pain syndrome are rectus abdominis, adductors, and iliopsoas. The internal obturator muscle lesion is very rare. The internal obturator muscle externally rotates the thigh and contributes to the stabilization of the hip joint and its indirect injury may cause the onset of traumatic groin pain syndrome. This case report describes a rare indirect injury of internal obturator in a 29-year-old professional male soccer player.

Midline and Mediolateral Episiotomy: Risk Assessment Based on Clinical Anatomy

Episiotomy is the surgical incision of the vaginal orifice and perineum to ease the passage of an infant’s head while crowning during vaginal delivery. Although episiotomy remains one of the most frequently performed surgeries around the world, short- and long-term complications from the procedure are not uncommon. We performed midline and mediolateral episiotomies with the aim of correlating commonly diagnosed postepisiotomy complications with risk of injury to perineal neuromuscular and erectile structures. We performed 61 incisions on 47 female cadavers and dissected around the incision site. Dissections revealed that midline incisions did not bisect any major neuromuscular structures, although they did increase the risk of direct and indirect injury to the subcutaneous portion of the external anal sphincter. Mediolateral incisions posed greater risk of iatrogenic injury to ipsilateral nerve, muscle, erectile, and gland tissues. Clinician discretion is advised when weighing the potential risks to maternal perineal anatomy during vaginal delivery when episiotomy is indicated. If episiotomy is warranted, an understanding of perineal anatomy may benefit diagnosis of postsurgical complications.

Ossified proximal patellar tendon rupture

Extensor mechanism injuries are not uncommon in young active individuals. Patellar tendon is a part of extensor mechanism of the knee which is commonly ruptured due to forced eccentric contraction against flexed knee. There have been reports of pathological changes in the patellar tendon which eventually lead to the rupture. The common pathologies include hypoxic tendinopathy, mucoid degeneration, calcific tendinopathy and tendolipomatosis. We report a rare case of ossified proximal patellar tendon rupture in a fit and active skittle player, who sustained indirect injury to knee while playing soccer. The rupture was confirmed on examination and radiographs. We discovered intraoperatively that the ruptured proximal patellar tendon was ossified which was sequentially repaired with two Krackow sutures, JuggerKnot suture anchor and finally augmented with Leeds Keio tape. Postoperatively, a knee brace was used to immobilise in knee extension with progressive increase in range of motion. This report supports the pool of evidence suggestive of patellar tendon pathology in causing ruptures.

MicroRNA: Potential biomarker and target of therapy in acute lung injury

MicroRNAs (miRNAs) are small noncoding RNAs stretching over 18–22 nucleotides and considered to be modifiers of many respiratory diseases. They are highly evolutionary conserved and have been implicated in several biological processes, including cell proliferation, apoptosis, differentiation, among others. Acute lung injury (ALI) is a fatal disease commonly caused by direct or indirect injury factors and has a high mortality rate in intensive care unit. Changes in expression of several types of miRNAs have been reported in patients with ALI. Some miRNAs suppress cellular injury and accelerate the recovery of ALI by targeting specific molecules and decreasing excessive immune response. For this reason, miRNAs are proposed as potential biomarkers for ALI and as therapeutic targets for this disease. This review summarizes current evidence supporting the role of miRNAs in ALI.

The Rough and Tumble

Whether a child’s death or injury associated with playing football could in fact be attributed to football was a crucial question in evaluating the sport’s risks. On a technical level, doctors debated such issues as whether heat strokes that athletes suffered while playing in hot weather constituted a direct or indirect injury. More broadly, doctors, coaches, parents, and sports supervisors debated whether certain risks were unique to the particular nature and techniques of football, or simply inherent to the “rough and tumble” of an active childhood. Putting football’s risks in context often involved comparisons to other activities, from driving to boxing to playing baseball. As doctors sought to identify ways to minimize the dangers, their beliefs in the sport’s social benefits shaped their interpretation of those dangers. The conceptualization of football injuries as a medical issue was deeply tied up with ideological, moralistic, religious, and nationalistic beliefs about the role of youth sports.

Komitmen Terhadap Keselamatan Aktiviti Luar Dan Berisiko dalam Pendidikan

Safety is an important element in carrying out all outdoor and risky activities. Certainly this activity is vulnerable to security issues whether before, during or after an activity is implemented. Various important aspects need to be taken into account when conducting outdoor and risky activities to ensure an accident that can be avoided and safe from incidents which may cause direct or indirect injury. The objective of this study is to look at the safety commitment among administrators and implementers in terms of level of knowledge, competence and safety practices of outdoor and risk activities. This study uses questionnaires and open-ended questions to administrators comprising management and implementing groups randomly. The findings show that the percentage of knowledge is very high, 93.8% is directed to not accepting specific safety-related training is 53.1% and uncertain to receive 37.5% specific safety-related training. The existence of the function of the Occupational Safety and Health Management system also noted that 71.0% of the respondents did not and were unsure, but only 6.1% of the respondents recorded uncertain how to deal with the risks during the activity. Respondent's competence to qualified and qualified assignments is a high percentage. Based on commitment and safety practices, the high percentages of respondents provide positive feedback on safety commitments and the need for safe situations during their activities in accordance with Safety Theory Dan Petersen (1982). This scenario demonstrates an effort towards strengthening the existing standard operating procedures (SOP) of outsourced and risky activities plus a risk management element is essential.