Search results for: myocardial ischemia-reperfusion injury

Authors: Jaspal Rana, Varinder Singh

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min, followed by 24 h reperfusion, was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity were also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rose in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury which may be attributed to its antioxidant properties.

Keywords: allium cepa, cerebral ischemia, memory, sensorimotor

Procedia PDF Downloads 88

Authors: J. A. N. Sandamali, R. P. Hewawasam, K. A. P. W. Jayatilaka, L. K. B. Mudduwa

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Introduction: Doxorubicin is widely used in the treatment of solid organ tumors and hematological malignancies, but the dose-dependent cardiotoxicity due to free radical formation compromises its clinical utility. Therapeutic strategies which enhance cellular endogenous defense systems have been identified as promising approaches to combat oxidative stress-associated conditions. Cinnamomum zeylanicum (Ceylon cinnamon) has a number antioxidant compounds, which can effectively scavenge reactive oxygen including superoxide anions, hydroxyl radicals and as well as other free radicals. Therefore, the objective of the study was to elucidate the most effective dose of Cinnamomum bark extract which ameliorates doxorubicin-induced cardiotoxicity. Materials and methods: Wistar rats were divided into seven groups of 10 animals in each. Group 1: normal control (distilled water, orally, for 14 days, 10 mL/kg saline, ip, after 16 hours fast on the 11th day); Group 2: doxorubicin control (distilled water, orally, for 14 days, 18 mg/kg doxorubicin, ip, after 16 hour fast on the 11th day); Groups 3-7: five doses of freeze dried aqueous bark extracts (0.125, 0.25, 0.5, 1.0, 2.0g/kg, orally, daily for 14 days, 18 mg/kg doxorubicin, ip, after 16 hours fast on the 11th day). Animals were sacrificed on the 15th day and blood was collected for the estimation of cardiac troponin I (cTnI), AST and LDH concentrations and myocardial tissues were collected for histopathological assessment of myocardial damage and irreversible changes were graded by developing a score. Results: cTnI concentration of groups 1-7 were 0, 161.9, 128.6, 95.9, 38, 19.41 & 12.36 pg/mL showing significant differences (p<0.05) between group 2 and groups 4-7. In groups 1-7, serum AST concentration were 26.82, 68.1, 37.18, 36.23, 26.8, 26.62 & 22.43U/L and LDH concentrations were 1166.13, 2428.84, 1658.35, 1474.34, 1277.58, 1110.21 & 974.40U/L and a significant difference (p<0.05) was observed between group 2 and groups 3-7. The maximum score for myocardial necrosis was observed in group 2. Parallel to the increase of the dosage of plant extract, a gradual reduction of the score for myocardial necrosis was observed in groups 3-7. Reversible histological changes such as vacuolation, congestion were observed in group 2 and all plant treated groups. Haemorrhages, inflammatory cell infiltrations, and interstitial oedema were observed in group 2, but absent in groups treated with higher doses of the plant extract. Discussion & Conclusion: According to the in vitro antioxidant assays performed, Cinnamomum zeylanicum (Ceylon cinnamon) bark possesses high amounts of polyphenolic substances and high antioxidant activity. The present study showed that Cinnamomum zeylanicum extract at 2.0 g/kg possesses the most significant cardioprotective effect against doxorubicin-induced cardiotoxicity. It can be postulated that pretreatment with Cinnamomum bark extract may replenish the cardiomyocytes with antioxidants that are needed for the defense against oxidative stress induced by doxorubicin.

Keywords: cardioprotection, Cinnamomum zeylanicum, doxorubicin, free radicals

Procedia PDF Downloads 137

Authors: Waziri B. I., Elkhashab M. M.

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Background: One of the most serious consequences of spinal cord injury (SCI) is progressive deterioration of renal function mostly as a result of urine stasis and ascending infection of the paralyzed bladder. This necessitates for investigation of early changes in serum urea and creatinine and associated sex related differences in response to SCI. Methods: A total of 24 adult albino rats weighing above 150g were divided equally into two groups, a control and experimental group (n = 12) each containing an equal number of male and female rats. The experimental group animals were paralyzed by complete transection of spinal cord below T4 level after deep anesthesia with ketamine 75mg/kg. Blood samples were collected from both groups five days post SCI for analysis. Mean values of serum urea (mmol/L) and creatinine (µmol/L) for both groups were compared. P < 0.05 was considered as significant. Results: The results showed significantly higher levels (P < 0.05) of serum urea and creatinine in the male SCI models with mean values of 92.12 ± 0.98 and 2573 ± 70.97 respectively compared with their controls where the mean values for serum urea and creatinine were 6.31 ± 1.48 and 476. 95 ± 4.67 respectively. In the female SCI models, serum urea 13.11 ± 0.81 and creatinine 519.88 ± 31.13 were not significantly different from that of female controls with serum urea and creatinine levels of 11.71 ± 1.43 and 493.69 ± 17.10 respectively (P > 0.05). Conclusion: Spinal cord injury caused a significant increase in serum Urea and Creatinine levels in the male models compared to the females. This indicated that males might have higher risk of renal dysfunction following SCI.

Keywords: albino rats, creatinine, spinal cord injury (SCI), urea

Procedia PDF Downloads 107

Authors: Renato André S. Silva, Nana L. F. Sampaio, Carlos J. G. Cruz, Bruno Vianna, Flávio O. Pires

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multiple stage bicycle races require high physiological loads from professional cyclists. Such demands can lead to immunosuppression and health problems. However, in this type of competition, little is known about its physiological effects on amateur athletes, who generally receive less medical support. Thus, this study analyzes the hematological effects of a multiple stage bicycle race on amateur cyclists. Seven Brazilian national amateur cyclists (34 ± 4.21 years) underwent a laboratory test to evaluate VO2Max (69.89 ± 7.43 ml⋅kg-1⋅min-1). Six days later, these volunteers raced in the Tour of Goiás, participating in five races in four days (435 km) of competition. Arterial blood samples were collected one day before and one day after the competition. The Kolmogorov-Smirnov tests were used to evaluate the data distribution and Wilcoxon to compare the two moments (p <0.05) of data collection. The results show: Red cells ↓ 7.8% (5.1 ± 0.28 vs 4.7 ± 0.37 106 / mm 3, p = 0.01); Hemoglobin ↓ 7.9% (15.1 ± 0.31 vs 13.9 ± 0.27 g / dL, p = 0.01); Leukocytes ↑ 9.5% (4946 ± 553 versus 5416 ± 1075 / mm 3, p = 0.17); Platelets ↓ 7.0% (200.2 ± 51.5 vs 186.1 ± 39.5 / mm 3, p = 0.01); LDH ↑ 11% (164.4 ± 28.5 vs 182.5 ± 20.5 U / L, p = 0.17); CK ↑ 13.5% (290.7 ± 206.1 vs 330.1 ± 90.5 U / L, p = 0.39); CK-MB ↑ 2% (15.7 ± 3.9 vs. 20.1 ± 2.9 U / L, p = 0.06); Cortizol ↓ 13.5% (12.1 ± 2.4 vs 9.9 ± 1.9 μg / dL, p = 0.01); Total testosterone ↓ 7% (453.6 ± 120.1 vs 421.7 ± 74.3 ng / dL, p = 0.12); IGF-1 ↓ 15.1% (213.8 ± 18.8 vs 181.5 ± 34.7 ng / mL, p = 0.04). This means that there was significant reductions in O2 allocation / transport capacities, vascular injury disruption, and a fortuitous reduction of muscle skeletal anabolism along with maintenance and / or slight elevation of immune function, glucose and lipid energy and myocardial damage. Therefore, the results suggest that no abnormal health effect was identified among the athletes after participating in the Tour de Goiás.

Keywords: cycling, health effects, cycling stages races, haematology

Procedia PDF Downloads 177

Authors: Yin Hua Zhang

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Cardiac metabolism is essential in myocardial contraction. In addition to glucose, fatty acids (FA) are essential in producing energy in the myocardium since FA-dependent beta-oxidation accounts for > 70-90% of cellular ATP under resting conditions. However, metabolism shifts from FAs to glucose utilization during disease progression (e.g. hypertrophy and ischemic myocardium), where glucose oxidation and glycolysis become the predominant sources of cellular ATP. At advanced failing stage, both glycolysis and beta-oxidation are dysregulated, result in insufficient supply of intracellular ATP and weakened myocardial contractility. Undeniably, our understandings of myocyte function in healthy and diseased hearts are based on glucose (10 mM)-dependent metabolism because glucose is the “sole” metabolic substrate in most of the physiological experiments. In view of the importance of FAs in cardiovascular health and diseases, we aimed to elucidate the impacts of FA supplementation on myocyte contractility and evaluate cellular mechanisms those mediate the functions in normal heart and with pathological stress. In particular, we have investigated cardiac excitation-contraction (E-C) coupling in the presence and absence of FAs in normal and hypertensive rat left ventricular (LV) myocytes. Our results reveal that FAs increase mitochondrial activity, intracellular [Ca²+]i, and LV myocyte contraction in healthy LV myocytes, whereas FA-dependent cardiac inotropyis attenuated in hypertension. FA-dependent myofilament Ca²+ desensitization could be fundamental in regulating [Ca²+]i. Collectively, FAs supplementation resets cardiac E-C coupling scheme in healthy and diseased hearts.

Keywords: hypertension, fatty acid, heart, calcium

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Authors: Chantell Gouws, Lourens Millard, Anne Naude, Jan-Wessel Meyer, Brandon Stuwart Shaw, Ina Shaw

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Background: Millions of South African youths participate in team sports, with netball and rugby being two of the largest worldwide. This increased participation and professionalism have resulted in an increase in the number of musculoskeletal injuries. Objective: This study examined the extent to which sport coaching knowledge translates to the injuries and prevention of injuries in adolescents participating in netball and rugby. Methods: Thirty-four South African sports coaches participated in the study. Eighteen netball coaches and 16 rugby coaches with varying levels of coaching experience were selected to participate. An adapted version of Nash and Sproule’s questionnaire was used to investigate the coaches’ knowledge with regards to sport-specific common injuries, injury prevention, fitness/conditioning, individual technique development, training programs, mental training, and preparation of players. The analysis of data was carried out using a number of different techniques outlined by Nash and Sproule (2012). These techniques were determined by the type of data. Descriptive data was used to provide statistical analysis. Quantitative data was used to determine the educational framework and knowledge of sports coaches on injury prevention. Numerical data was obtained through questions on sports injuries, as well as coaches’ sports knowledge levels. Participants’ knowledge was measured using a standardized scoring system. Results: For the 0-4 years of netball coaching experience, 76.4% of the coaches had knowledge and experience and 33.3% appropriate first aid knowledge, while for the 9-12 years and 13-16 years, 100% of the coaches had knowledge and experience and first aid knowledge. For the 0-4 years in rugby coaching experience, 59.1% had knowledge and experience and 71% the appropriate first aid knowledge; for the 17-20 years, 100% had knowledge and experience and first aid, while for higher or equal to 25 years, 45.5% had knowledge and experience. In netball, 90% of injuries consisted of ankle injuries, followed by 70% for knee, 50% for shoulder, 20% for lower leg, and 15% for finger injuries. In rugby, 81% of the injuries occurred at the knee, followed by 50% for the shoulder, 40% for the ankle, 31% for the head and neck, and 25% for hamstring injuries. Six hours of training resulted in a 13% chance of injuries in netball and a 32% chance in rugby. For 10 hours of training, the injury prevalence was 10% in netball and 17% in rugby, while 15 hours resulted in an injury incidence of 58% in netball players and a 25% chance in rugby players. Conclusion: This study highlights the need for coaches to improve their knowledge in relation to injuries and injury prevention, along with factors that act as a preventative measure and promotes players’ well-being.

Keywords: musculoskeletal injury, sport coaching, sport trauma

Procedia PDF Downloads 133

Authors: A. J. Al-Graitti, G. A. Khalid, P. Berthelson, A. Mason-Jones, R. Prabhu, M. D. Jones

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Motor vehicle related pedestrian road traffic collisions are a major road safety challenge, since they are a leading cause of death and serious injury worldwide, contributing to a third of the global disease burden. The auto rickshaw, which is a common form of urban transport in many developing countries, plays a major transport role, both as a vehicle for hire and for private use. The most common auto rickshaws are quite unlike ‘typical’ four-wheel motor vehicle, being typically characterised by three wheels, a non-tilting sheet-metal body or open frame construction, a canvas roof and side curtains, a small drivers’ cabin, handlebar controls and a passenger space at the rear. Given the propensity, in developing countries, for auto rickshaws to be used in mixed cityscapes, where pedestrians and vehicles share the roadway, the potential for auto rickshaw impacts with pedestrians is relatively high. Whilst auto rickshaws are used in some Western countries, their limited number and spatial separation from pedestrian walkways, as a result of city planning, has not resulted in significant accident statistics. Thus, auto rickshaws have not been subject to the vehicle impact related pedestrian crash kinematic analyses and/or injury mechanics assessment, typically associated with motor vehicle development in Western Europe, North America and Japan. This study presents a parametric analysis of auto rickshaw related pedestrian impacts by computational simulation, using a Finite Element model of an auto rickshaw and an LS-DYNA 50^th percentile male Hybrid III Anthropometric Test Device (dummy). Parametric variables include auto rickshaw impact velocity, auto rickshaw impact region (front, centre or offset) and relative pedestrian impact position (front, side and rear). The output data of each impact simulation was correlated against reported injury metrics, Head Injury Criterion (front, side and rear), Neck injury Criterion (front, side and rear), Abbreviated Injury Scale and reported risk level and adds greater understanding to the issue of auto rickshaw related pedestrian injury risk. The parametric analyses suggest that pedestrians are subject to a relatively high risk of injury during impacts with an auto rickshaw at velocities of 20 km/h or greater, which during some of the impact simulations may even risk fatalities. The present study provides valuable evidence for informing a series of recommendations and guidelines for making the auto rickshaw safer during collisions with pedestrians. Whilst it is acknowledged that the present research findings are based in the field of safety engineering and may over represent injury risk, compared to “Real World” accidents, many of the simulated interactions produced injury response values significantly greater than current threshold curves and thus, justify their inclusion in the study. To reduce the injury risk level and increase the safety of the auto rickshaw, there should be a reduction in the velocity of the auto rickshaw and, or, consideration of engineering solutions, such as retro fitting injury mitigation technologies to those auto rickshaw contact regions which are the subject of the greatest risk of producing pedestrian injury.

Keywords: auto rickshaw, finite element analysis, injury risk level, LS-DYNA, pedestrian impact

Procedia PDF Downloads 167

Authors: Guilhermina Torrao

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An extensive number of studies have been conducted to determine the factors which influence crash injury risk (CIR); however, uncertainties inherent to selected variables have been neglected. A review of existing literature is required to not only obtain an overview of the variables and measures but also ascertain the implications when comparing studies without a systematic view of variable taxonomy. Therefore, the aim of this literature review is to examine and report on peer-reviewed studies in the field of crash analysis and to understand the implications of broad variations in variable selection in CIR analysis. The objective of this study is to demonstrate the variance in variable selection and classification when modeling injury risk involving occupants of light vehicles by presenting an analytical review of the literature. Based on data collected from 64 journal publications reported over the past 21 years, the analytical review discusses the variables selected by each study across an organized list of predictors for CIR analysis and provides a better understanding of the contribution of accident and vehicle factors to injuries acquired by occupants of light vehicles. A cross-comparison analysis demonstrates that almost half the studies (48%) did not consider vehicle design specifications (e.g., vehicle weight), whereas, for those that did, the vehicle age/model year was the most selected explanatory variable used by 41% of the literature studies. For those studies that included speed risk factor in their analyses, the majority (64%) used the legal speed limit data as a ‘proxy’ of vehicle speed at the moment of a crash, imposing limitations for CIR analysis and modeling. Despite the proven efficiency of airbags in minimizing injury impact following a crash, only 22% of studies included airbag deployment data. A major contribution of this study is to highlight the uncertainty linked to explanatory variable selection and identify opportunities for improvements when performing future studies in the field of road injuries.

Keywords: crash, exploratory, injury, risk, variables, vehicle

Procedia PDF Downloads 96

Authors: Asaf Toker

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Matricelf developed a technology that enables the production of autologous engineered tissue composed of matrix and cells derived from patients Omentum biopsy. The platform showed remarkable pre-clinical results for several medical conditions. The company recently licensed the technology that enabled scientist at Tel Aviv university that 3D printed a human heart from human cells and matrix for the first time in human history. The company plans to conduct its first human clinical trial for Acute Spinal Cord Injury (SCI) early in 2023.

Keywords: tissue engineering, regenerative medicine, spinal Cord Injury, autologous implants, iPSC

Procedia PDF Downloads 92

Authors: Nisha Nandlal Sharma, Julaluk Carmai, Saiprasit Koetniyom, Bernd Markert

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Whiplash Injuries are usually associated with car accidents. The sudden forward or backward jerk to head causes neck strain, which is the result of damage to the muscle or tendons. Neck pain and headaches are the two most common symptoms of whiplash. Symptoms of whiplash are commonly reported in studies but the Injury mechanism is poorly understood. Neck muscles are the most important factor to study the neck Injury. This study focuses on the development of finite element (FE) model of human neck muscle to study the whiplash injury mechanism and effect of active muscle contraction on occupant kinematics. A detailed study of Injury mechanism will promote development and evaluation of new safety systems in cars, hence reducing the occurrence of severe injuries to the occupant. In present study, an active human finite element (FE) model with 3D neck muscle model is developed. Neck muscle was modeled with a combination of solid tetrahedral elements and 1D beam elements. Muscle active properties were represented by beam elements whereas, passive properties by solid tetrahedral elements. To generate muscular force according to inputted activation levels, Hill-type muscle model was applied to beam elements. To simulate non-linear passive properties of muscle, solid elements were modeled with rubber/foam material model. Material properties were assigned from published experimental tests. Some important muscles were then inserted into THUMS (Total Human Model for Safety) 50th percentile male pedestrian model. To reduce the simulation time required, THUMS lower body parts were not included. Posterior to muscle insertion, THUMS was given a boundary conditions similar to experimental tests. The model was exposed to 4g and 7g rear impacts as these load impacts are close to low speed impacts causing whiplash. The effect of muscle activation level on occupant kinematics during whiplash was analyzed.

Keywords: finite element model, muscle activation, neck muscle, whiplash injury prevention

Procedia PDF Downloads 326

Authors: Jaspal Rana, Alkem Laboratories, Baddi, Himachal Pradesh, India Chitkara University, Punjab, India

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min followed by 24 h reperfusion was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity was also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rise in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury, which may be attributed to its antioxidant properties.

Keywords: stroke, neuroprotection, ischemia reperfusion, herbal drugs

Procedia PDF Downloads 80

Authors: Olga Blagova, Yuliya Osipova, Evgeniya Kogan, Alexander Nedostup

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Purpose: to quantify the value of various clinical, laboratory and instrumental signs in the diagnosis of myocarditis in comparison with morphological studies of the myocardium. Methods: in 100 patients (65 men, 44.7±12.5 years) with «idiopathic» arrhythmias (n = 20) and dilated cardiomyopathy (DCM, n = 80) were performed 71 endomyocardial biopsy (EMB), 13 intraoperative biopsy, 5 study of explanted hearts, 11 autopsy with virus investigation (real-time PCR) of the blood and myocardium. Anti-heart antibodies (AHA) were also measured as well as cardiac CT (n = 45), MRI (n = 25), coronary angiography (n = 47). The comparison group included of 50 patients (25 men, 53.7±11.7 years) with non-inflammatory heart diseases who underwent open heart surgery. Results. Active/borderline myocarditis was diagnosed in 76.0% of the study group and in 21.6% of patients of the comparison group (p < 0.001). The myocardial viral genome was observed more frequently in patients of comparison group than in study group (group (65.0% and 40.2%; p < 0.01. Evaluated the diagnostic value of noninvasive markers of myocarditis. The panel of anti-heart antibodies had the greatest importance to identify myocarditis: sensitivity was 81.5%, positive and negative predictive value was 75.0 and 60.5%. It is defined diagnostic value of non-invasive markers of myocarditis and diagnostic algorithm providing an individual assessment of the likelihood of myocarditis is developed. Conclusion. The greatest significance in the diagnosis of latent myocarditis in patients with 'idiopathic' arrhythmias and DCM have AHA. The use of complex of noninvasive criteria allows estimate the probability of myocarditis and determine the indications for EMB.

Keywords: myocarditis, "idiopathic" arrhythmias, dilated cardiomyopathy, endomyocardial biopsy, viral genome, anti-heart antibodies

Procedia PDF Downloads 147

Authors: Mukund Ramchandra Mogarekar, Pankaj Kumar, Shraddha V. More

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Background: Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), Apo B, and lipoprotein(a) was found as atherogenic factors while high-density lipoprotein cholesterol (HDL-C) was anti-atherogenic. Methods and Results: The study group consists of 40 MI subjects as cases and 40 healthy as controls. Monocytic PON 2 Lactonase (LACT) activity was measured by using Dihydrocoumarine (DHC) as substrate. Phenotyping was done by method of Mogarekar MR et al, serum AOPP by modified method of Witko-Sarsat V et al and Apo B by Turbidimetric immunoassay. PON 2 LACT activities were significantly lower (p< 0.05) and AOPPs & Apo B were higher in MI subjects (p> 0.05). Trimodal distribution of QQ, QR & RR phenotypes of study population showed no significant difference among cases and controls (p> 0.05). Univariate binary logistic regression analysis showed independent association of TC, HDL, LDL, AOPP, Apo B, and PON 2 LACT activity with MI and multiple forward binary logistic regression showed PON 2 LACT activity and serum Apo B as an independent predictor of MI. Conclusions- Decrease in PON 2 LACT activity in MI subjects than in controls suggests increased oxidative stress in MI which is reflected by significantly increased AOPP and Apo B. PON 1 polymorphism of QQ, QR and RR showed no significant difference in protection against MI. Univariate and multiple forward binary logistic regression showed PON 2 LACT activity and serum Apo B as an independent predictor of MI.

Keywords: advanced oxidation protein products, apolipoprotein-B, myocardial infarction, paraoxonase 2 lactonase

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Authors: Saleh N. Maodaa

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Perinatal exposure to nicotine imbalances the redox status in newborns. This study investigated the effect of Anethum graveolens (dill) extract on oxidative stress and tissue injury in the liver and kidney of mice newborns exposed to nicotine perinatally. Pregnant mice received nicotine (0.25 mg/kg) on gestational day 12 to day 5 after birth and/or A. graveolens extract on a gestational day 1 to day 15 after birth. Newborn mice exposed to nicotine showed multiple histopathological alterations in the kidney and liver, including inflammatory cell infiltration and degenerative changes. Nicotine exposure increased hepatic and renal reactive oxygen species (ROS), lipid peroxidation, tumor necrosis factor (TNF-_), interleukin-6 (IL-6), and inducible nitric oxide synthase (iNOS) (p < 0.001), and decreased antioxidant defenses (p < 0.001). A. graveolens supplementation significantly prevented liver and kidney injury, suppressed ROS generation (p < 0.001), lipid peroxidation (p < 0.001), and inflammatory response (p < 0.001), and enhanced antioxidant defenses. In addition, A. graveolens upregulated hepatic and renal Nrf2 and HO-1 mRNA and increased HO-1 activity in normal and nicotine-exposed mice. In conclusion, A. graveolens protects against perinatal nicotine-induced oxidative stress, inflammation, and tissue injury in the liver and kidney of newborn mice. A. graveolens upregulated hepatic and renal Nrf2/HO-1 signaling and enhanced antioxidant defenses in mice.

Keywords: dill, oxidative stress, cytokines, nicotine

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Authors: Omar Khan, Shana Krstevska, Edwin George, Veronica Gorden, Fen Bao, Christina Caon, NP-C, Carla Santiago, Imad Zak, Navid Seraji-Bozorgzad

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Objective: To quantify cellular injury in the substantia nigra (SN) in patients with Parkinson's disease (PD) and to examine the effect of rasagiline of tissue injury in the SN in patients with PD. Background: N-acetylaspartate (NAA) quantified with MRS is a reliable marker of neuronal metabolic function. Fractional anisotropy (FA) and mean diffusivity (MD) obtained with DTI, characterize tissue alignment and integrity. Rasagline, has been shown to exert anti-apototic effect. We applied these advanced MRI techniques to examine: (i) the effect of rasagiline on cellular injury and metabolism in patients with early PD, and (ii) longitudinal changes seen over time in PD. Methods: We conducted a prospective longitudinal study in patients with mild PD, naive to dopaminergic treatment. The imaging protocol included multi-voxel proton-MRS and DTI of the SN, acquired on a 3T scanner. Scans were performed at baseline and month 3, during which the patient was on no treatment. At that point, rasagiline 1 mg orally daily was initiated and MRI scans are were obtained at 6 and 12 months after starting rasagiline. The primary objective was to compare changes during the 3-month period of “no treatment” to the changes observed “on treatment” with rasagiline at month 12. Age-matched healthy controls were also imaged. Image analysis was performed blinded to treatment allocation and period. Results: 25 patients were enrolled in this study. Compared to the period of “no treatment”, there was significant increase in the NAA “on treatment” period (-3.04 % vs +10.95 %, p= 0.0006). Compared to the period of “no treatment”, there was significant increase in following 12 month in the FA “on treatment” (-4.8% vs +15.3%, p<0.0001). The MD increased during “no treatment” and decreased in “on treatment” (+2.8% vs -7.5%, p=0.0056). Further analysis and clinical correlation are ongoing. Conclusions: Advanced MRI techniques quantifying cellular injury in the SN in PD is a feasible approach to investigate dopaminergic neuronal injury and could be developed as an outcome in exploratory studies. Rasagiline appears to have a stabilizing effect on dopaminergic cell loss and metabolism in the SN in PD, that warrants further investigation in long-term studies.

Keywords: substantia nigra, Parkinson's disease, MRI, neuronal loss, biomarker

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Authors: Hakan Akgul

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Purpose: The use of firecrackers (i.e., Ramadan Cannon) during the month of Ramadan is a traditional way of indicating that the fasting period is over in Muslim countries. Here, we report the rehabilitation of a case of hand injury with pluridigital fractures due to premature explosion of a Ramadan cannon. Materials and Methods: A 48-year old man admitted to the Emergency Department due to left hand injury as a result of a premature explosion of a Ramadan cannon. The patient was immediately taken to operation room because of the multiple fractures, tendon loss, and soft tissue loss in the left hand. Range of motion (ROM) of joints was measured with goniometer, pain and oedema were measured and splinting was performed. Results: Rehabilitation team took over the patient at postoperative 9th week. During the 3 month rehabilitation, range of motion increased, oedema was taken under control, pain was reduced, the colour of the skin turned to the normal tone. According to the visual analog scale (VAS), pain decreased from 9 to 4. Oedema, around the metacarpofalangeal (MCP) joints, decreased from 27,5 cm to 23,5 cm. Total active range of motion of the wrist increased from 5 degrees to 50 degrees.Total active range of motion of supination and pronation increased from 55 degrees to 70 degrees. Discussion: The rehabilitation of multiple hand injury is quite difficult. Different aspects of trauma should be taken into consideration when rehabilitation is planned. Factors such as waiting for the bone union, wound healing, and use of external fixators may delay rehabilitation process. Joint mobilization, massage for reducing oedema and preventing scar tissue, exercise within the range of motion are efficient measures. Poor patient compliance to treatment may lead to poor outcome. First of all, oedema and scar formation must be taken under control. Removing fixators should not be delayed depending on the bone union, and exercise within the range of motion should be started.

Keywords: explosion, fracture, hand, injury

Procedia PDF Downloads 216

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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Authors: Ahmed A. Sedik, Doaa Mahmoud Shuaib

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Brain injury is a cause of disability and death worldwide. Potassium dichromate (PD) is an environmental contaminant widely recognized as teratogenic, carcinogenic, and mutagenic towards animals and humans. The aim of the present study was to investigate the possible neuroprotective effects of tangeretin (TNG) on PD-induced brain injury in rats. Forty male adult Wistar rats were randomly and blindly allocated into four groups (8 rats /group). The first group received saline intranasally (i.n.). The second group received a single dose of PD (2 mg/kg, i.n.). The third group received TNG (50 mg/kg; orally) for 14 days, followed by i.n. of PD on the last day of the experiment. Four groups received TNG (100 mg/kg; orally) for 14 days, followed by i.n. of PD on the last day of the experiment. 18- hours after the final treatment, behavioral parameters, neuro-biochemical indices, FTIR analysis, and histopathological studies were evaluated. Results of the present study revealed that rats intoxicated with PD promoted oxidative stress and inflammation via an increase in MDA and a decrease in Nrf2 signaling pathway and GSH levels with an increase in brain contents of TNF-α, IL-10, and NF-kβ and reduced AKT levels in brain homogenates. Treatment with TNG (100 mg/kg; orally) ameliorated behavioral, cholinergic activities and oxidative stress, decreased the elevated levels of pro-inflammatory mediators; TNF-α, IL-10, and NF-κβ elevated AKT pathway with corrected FTIR spectra with a decrease in brain content of chromium residues detected by atomic absorption spectrometry. Also, TNG administration restored the morphological changes as degenerated neurons and necrosis associated with PD intoxication. Additionally, TNG decreased Caspase-3 expression in the brain of PD rats. TNG plays a crucial role in AKT/Nrf2 pathway that is responsible for their antioxidant, anti-inflammatory effects, and apoptotic pathway against PD-induced brain injury in rats.

Keywords: tangeretin, potassium dichromate, brain injury, AKT/Nrf2 signaling pathway, FTIR, atomic absorption spectrometry

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Authors: Jarmila Štěpánová, Martin Kudláček, Lukáš Jakubec

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The people with spinal cord injury are one of the least sport active members of our society. Their hypoactivity is determined by primary injury, i.e., the loss of motor function, the injured part of the body is connected with health complications and social handicap. Study performs one part of the standardization process of semi-structured interview PARA-SCI.CZ (Czech version of the Physical Activity Recall Assessment for People with Spinal Cord Injury), which measures the type, frequency, duration, and intensity of physical activity of people with spinal cord injury. The study focused on persons with paraplegia who use a wheelchair as their primary mode of mobility. The aim of this study was to perform a process to determine the criterion validity of PARA-SCI.CZ. The actual physical activity of wheelchair users was monitored during three days by using accelerometers Actigraph GT3X fixed on the non-dominant wrist, and semi-structured interview PARA-SCI.CZ. During the PARA-SCI.CZ interview, participants were asked to recall activities they had done over the past 3 days, starting with the previous day. PARA-SCI.CZ captured frequency, duration, and intensity (low, moderate, and heavy) of two categories of physical activity (leisure time physical activity and activities of a usual day). Accelerometer Actigraph GT3X captured duration and intensity (low and moderate + heavy) of physical activity during three days and nights. The study presented three potential recalculations of measured data. Standardization process of PARA-SCI.CZ is essential to critically approach issues of health and active lifestyle of persons with spinal cord injury in the Czech Republic. Standardized PARA-SCI.CZ can be used in practice by physiotherapists and sports pedagogues from the field of adapted physical activities.

Keywords: physical activity, lifestyle, paraplegia, semi-structure interview, accelerometer

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Authors: Seung Ju Yeon, Seul Ki Min, Jun Sang Park, Yeo Seon Kwon, Hoo Cheol Lee, Hyun Jung Shim, Il-Doo Kim, Ja Kyeong Lee, Hwa Sung Shin

Abstract:

In brain injury, depleting oxidative stress is the most effective way to reduce the brain infarct size. C-phycocyanin (C-Pc) is a well-known antioxidant protein that has neuroprotective effects obtained from green microalgae. Astrocyte is glial cell that supports the nerve cell such as neuron, which account for a large portion of the brain. In brain injury, such as ischemia and reperfusion, astrocyte has an important rule that overcomes the oxidative stress and protect from brain reactive oxygen species (ROS) injury. However little is known about how C-Pc regulates the anti-oxidants effects of astrocyte. In this study, when the C-Pc was treated in oxidized astrocyte, we confirmed that inflammatory factors Interleukin-6 and Interleukin-3 were increased and antioxidants enzyme, Superoxide dismutase (SOD) and catalase was upregulated, and neurotrophic factors, brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) was alleviated. Also, it was confirmed to reduce infarct size of the brain in ischemia and reperfusion because C-Pc has anti-oxidant effects in middle cerebral artery occlusion (MCAO) animal model. These results show that C-Pc can help astrocytes lead neuroprotective activities in the oxidative stressed environment of the brain. In summary, the C-PC protects astrocytes from oxidative stress and has anti-oxidative, anti-inflammatory, neurotrophic effects under ischemic situations.

Keywords: c-phycocyanin, astrocyte, reactive oxygen species, ischemia and reperfusion, neuroprotective effect

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of ‎death in the world. Some of these deaths occur even before the patient ‎reaches the hospital. Myocardial infarction occurs as a result of ‎impaired blood supply. Because the most of these deaths are due to ‎coronary artery disease, hence the awareness of the warning signs of a ‎heart attack is essential. Some heart attacks are sudden and intense, but ‎most of them start slowly, with mild pain or discomfort, then early ‎detection and successful treatment of these symptoms is vital to save ‎them. Therefore, importance and usefulness of a system designing to ‎assist physicians in the early diagnosis of the acute heart attacks is ‎obvious.‎ The purpose of this study is to determine how well a predictive ‎model would perform based on the only patient-reportable clinical ‎history factors, without using diagnostic tests or physical exams. This ‎type of the prediction model might have application outside of the ‎hospital setting to give accurate advice to patients to influence them to ‎seek care in appropriate situations. For this purpose, the data were ‎collected on 711 heart patients in Iran hospitals. 28 attributes of clinical ‎factors can be reported by patients; were studied. Three logistic ‎regression models were made on the basis of the 28 features to predict ‎the risk of heart attacks. The best logistic regression model in terms of ‎performance had a C-index of 0.955 and with an accuracy of 94.9%. ‎The variables, severe chest pain, back pain, cold sweats, shortness of ‎breath, nausea, and vomiting were selected as the main features.‎

Keywords: Coronary heart disease, Acute heart attacks, Prediction, Logistic ‎regression‎

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Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

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The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

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Authors: Stoyanka Vladeva, Elena Kirilova, Nikola Kirilov

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Background: The creatinine clearance is a widely used value to estimate the GFR. Increased creatinine clearance is often called hyperfiltration and is usually seen during pregnancy, patients with diabetes mellitus preceding the diabetic nephropathy. It may also occur with large dietary protein intake or with plasma volume expansion. Renal injury in lupus nephritis is known to affect the glomerular, tubulointerstitial, and vascular compartment. However high creatinine clearance has not been found in patients with SLE, Target: Follow-up of creatinine clearance values in patients with systemic lupus erythematosus without history of kidney injury. Material and methods: We observed the creatinine, creatinine clearance, GFR and dipstick protein values of 7 women (with a mean age of 42.71 years) with systemic lupus erythematosus. Patients with active lupus have been monthly tested in the period of 13 months. Creatinine clearance has been estimated by Cockcroft-Gault Equation formula in ml/sec. GFR has been estimated by MDRD formula (The Modification of Diet in renal Disease) in ml/min/1.73 m2. Proteinuria has been defined as present when dipstick protein > 1+.Results: In all patients without history of kidney injury we found elevated creatinine clearance levels, but GFRremained within the reference range. Two of the patients were in remission while the other five patients had clinically and immunologically active Lupus. Three of the patients had a permanent presence of high creatinine clearance levels and proteinuria. Two of the patients had periodically elevated creatinine clearance without proteinuria. These results show that kidney disturbances may be caused by the vascular changes typical for SLE. Glomerular hyperfiltration can be result of focal segmental glomerulosclerosis caused by a reduction in renal mass. Probably lupus nephropathy is preceded not only by glomerular vascular changes, but also by tubular vascular changes. Using only the GFR is not a sufficient method to detect these primary functional disturbances. Conclusion: For early detection of kidney injury in patients with SLE we determined that the follow up of creatinine clearance values could be helpful.

Keywords: systemic Lupus erythematosus, kidney injury, elevated creatinine clearance level, normal glomerular filtration rate

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Authors: Ravi Nandu, Kuldeep Singh

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A helmet is a protective layer that is worn in order to prevent head injury. Helmet is the most important safety gear for two wheeler riders. However, due to carelessness of people, less importance toward safety, lot of causalities is every year. According to National Crime Records Bureau (NCRB) two wheelers claimed 92 lives every day out of which most were due to helmetless drive. The system design will be such that without wearing the helmet the rider cannot start two wheelers. The helmet will be connected to vehicle key ignition systems which will be electronically controlled. The smart helmet will be having proximity sensor fitted inside it, which will act as our switch for ignition and further with wireless connection the helmet sensor circuit will be connected to the vehicle ignition system.

Keywords: helmet, proximity sensor, microcontroller, head injury

Procedia PDF Downloads 282

Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi

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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.

Keywords: coagulopathy, trauma, thromboelastography, mortality

Procedia PDF Downloads 132

Authors: Ezri Coda, Kris Justine Miparanum, Relvin Jay Sale

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The study dealt on suicide risk level of college students in UM Tagum College. The primary goal of the study was to assess the level of suicide risk among students at the UM Tagum College in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury utilizing quantitative non- experimental study with 380 students in UM Tagum College as respondents of the study. Mean was the statistical tools used for the data treatment. Moreover, the study aims to determine the mean of the level of the suicide risk assessment in terms of program, type of student, age, year level, civil status and gender, and lastly, to design an intervention program for those identified students with high suicide risk. Results showed a low level of suicide risk in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury.

Keywords: suicide risk, perceived burdensomeness, low belongingness/social alienation, acquired ability to enact lethal self-injury, UM Tagum College, Philippines

Procedia PDF Downloads 106

Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: Nabeel Abdulkadhim Athab

Abstract:

The purpose of this research is to conduct a comparative study according analysis of programmed to some of physical and mechanical variables for joint wrist injury. As it can be through this research to distinguish between the amount of variation in the work of the joint after sample underwent rehabilitation program to improve the effectiveness of the joint and naturally restore its effectiveness. Supposed researcher that there is statistically significant differences between the results of the tests pre and post the members research sample, as a result of submission the sample to the program of rehabilitation, which led to the development of muscle activity that are working on wrist joint and this is what led to note the differences between the results of the tests pre and post. The researcher used the descriptive method. The research sample included (6) of injured players in the wrist joint, as the average age (21.68) and standard deviation (1.13) either length average (178cm) and standard deviation (2.08). And the sample as evidenced homogeneous among themselves. And where the data were collected, introduced in program for statistical processing to get to the most important conclusions and recommendations and that the most important: 1-The commitment of the sample program the qualifying process variables studied in the search for the heterogeneity of study activity and effectiveness of wrist joint for injured players. 2-The analysis programmed a high accuracy in the measurement of the research variables, and which led to the possibility of discrimination into account differences in motor ability camel and injured in the wrist joint. To search recommendations including: 1-The use of computer systems in the scientific research for the possibility of obtaining accurate research results. 2-Programming exercises rehabilitation according to an expert system for possible use by patients without reference to the person processor.

Keywords: analysis of joint wrist injury, physical and mechanical variables, wrist joint, wrist injury

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Authors: Nisha Nandlal Sharma, Julaluk Carmai, Saiprasit Koetniyom, Bernd Markert

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Whiplash Injuries are mostly experienced in car accidents. Symptoms of whiplash are commonly reported in studies, neck pain and headaches are two most common symptoms observed. The whiplash Injury mechanism is poorly understood. In present study, hybrid neck muscle model were developed with a combination of solid tetrahedral elements and 1D beam elements. Solid tetrahedral elements represents passive part of the muscle whereas, 1D beam elements represents active part. To simulate the active behavior of the muscle, Hill-type muscle model was applied to beam elements. To simulate non-linear passive properties of muscle, solid elements were modeled with rubber/foam material model. Some important muscles were then inserted into THUMS (Total Human Model for Safety) THUMS was given a boundary conditions similar to experimental tests. The model was exposed to 4g and 7g rear impacts as these load impacts are close to low speed impacts causing whiplash. The effect of muscle activation level on occupant kinematics during whiplash was analyzed.

Keywords: finite element model, muscle activation, THUMS, whiplash injury mechanism

Procedia PDF Downloads 306