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A comparative study on outcome of surgical management of varicose veins with and without venous stripping

A comparative study on outcome of surgical management of varicose veins with and without venous stripping

MANIKKAM 29/M 27060 19.05.12 VARICOSE VEINS RIGHT LOWER LIMB VARICOSE VEINS LEFT LOWER LIMB VARICOSE VEINS LEFT LOWER LIMB VARICOSE VEINS LEFT LOWER LIMB VARICOSE VEINS RIGHT LOWER LIMB [r]

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Vol 31, No 10 (2018)

Vol 31, No 10 (2018)

Figure 2 – Origin of the sciatic nerve, bilaterally dissected, in a 66-year female cadaver: A: Left lower limb – The low origin of the nerve (5) is shown, with the roots of the lumbosacral plexus (1; 2; 3; 4) merging together, upon the emergence of the superior and inferior gluteal nerves (6), deeply found within the gluteal region, up to the ischial tuberosity (). B: Right lower limb – The dissection of the contralateral limb is shown in image B, in which the origin of the nerve is found below the Piriformis muscle (P), with a 10-cm short path to the ischial tuberosity, where the fibres of the common tibial and peroneal nerves run together with the sciatic artery and the whole of the components involved by the sciatic sheath. C: Artistic version of the origin of the sciatic nerve, by Daniel Casanova-Martinez (Chile), 2017.
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Gangrene of an Extremity in the Newborn

Gangrene of an Extremity in the Newborn

A second-born twin with intra-utenine gan- grene of the right lower limb secondary to a dissecting intramural hematoma of the femoral artery is reported. Although trauma seems most likel[r]

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Original Article Ultrasound-induced microbubble cavitation promotes angiogenesis in ischemic skeletal muscle of diabetic mice

Original Article Ultrasound-induced microbubble cavitation promotes angiogenesis in ischemic skeletal muscle of diabetic mice

min), US group (n=10; only ultrasound was used at the skeletal muscle), MB group (n=10; mice were injected with 0.1 ml of SonoVue via the tail vein) and control group (n=10). After ultrasound treatment, 3 mice in each group were sacri- ficed, and the right lower limb was harvested for H&E staining. Seven days later, remaining mice were sacrificed and the right lower limb was collected for RT-PCR and Western blot assay for the detection of mRNA and protein expressions of P-selectin, intercellular adhe- sion molecular (ICAM)-1 and vascular endothe- lial growth factor (VEGF) and immunohisto- chemistry for VEGF.
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 A CASE STUDY ON TAKAYASU ARTERITIS WITH DILATED CARDIOMYOPATHY: AN UNCOMMON SYSTEMIC INFLAMMATORY DISORDER OBSERVED IN TERTIARY CARE TEACHING HOSPITAL

 A CASE STUDY ON TAKAYASU ARTERITIS WITH DILATED CARDIOMYOPATHY: AN UNCOMMON SYSTEMIC INFLAMMATORY DISORDER OBSERVED IN TERTIARY CARE TEACHING HOSPITAL

Patient was coherent and conscious. Arterial pulse was felt for carotid, brachial, femoral, popliteal arteries and absent in radial and post tibial arteries. The deep tendon reflexes were very much reduced in right lower limb. The therapy was continued same as DAY 4. Tab. aldactone was removed from the therapy as it has serious interaction with furosemide if taken at a time. Co- administration of similar diuretics was not safe for the patient as it causes severe hypotension. Patient was experience symptoms like weakness, movement disorders, dysphonic which was concluded as functional neurological disorder (FND).
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A Case of Multiple Sclerosis to Gabon: Myth or Reality!

A Case of Multiple Sclerosis to Gabon: Myth or Reality!

Our patient presented a much more encephalic symptomatology revealed by the neurological examination in front of a disabling headache on frontal sinusi- tis. The clinical picture has evolved to a heaviness of the right lower limb asso- ciated with tingling.

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A Case of Retained Guidewire Spontaneous Emerging from Skin Near Right Knee 8 Months after Central Venous Catheterization

A Case of Retained Guidewire Spontaneous Emerging from Skin Near Right Knee 8 Months after Central Venous Catheterization

A 22 years old female patient presented with right knee pain, right lower limb swelling for about 3 months and with emerging out the end of guidewire from skin below right knee. The patient has past history of cerebral venous thrombosis about 10 month previously.

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Polyostotic Melorheostosis: Approach to Clinical Evaluation and Management

Polyostotic Melorheostosis: Approach to Clinical Evaluation and Management

In view of no evidence of fracture involving the knee joint, surgical interven- tion was not indicated in this case. As such, conservative management was cho- sen to address his complaints. The patient was started on Paracetamol 1000 mg QID, Tramadol 50 mg TDS and Celecoxib 200 mg PRN dosing for pain control, and further pain control modalities were not needed as his pain is well con- trolled with regular 2 monthly follow-ups and review. He was also referred to physiotherapy for the range of motion and stretching exercises of the left knee to alleviate his joint stiffness problem. Occupational therapist was also involved for a shoe lift over the right lower limb to optimize ambulation in view of limb length discrepancy of 5 cm. Subsequent follow-ups showed improvement of symptoms in terms of pain alleviation and improved mobility. Patient is able to return to work as well with no worsening of symptoms.
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Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms

Pain perception in schizophrenia: influence of neuropeptides, cognitive disorders, and negative symptoms

In the patient sample, negative correlation was found between time of performance on the Stroop test and inten- sity of the current stimulus needed to trigger painful sensa- tion (a subjective pain threshold) in the right lower limb. Additionally, negative correlation was found between time of TMT performance and currents needed to trigger a pain- ful sensation and to trigger RTIII in the right lower limb (Table 1). In other words, those who performed TMT and Stroop test in a shorter time reported a painful sensation at a higher current. Moreover, higher current was necessary to elicit RTIII in these individuals. In patients with schizophre- nia, a strong negative correlation (P,0.001) was also found between PANSS N scores and the intensity of the current needed to trigger a painful sensation on the right lower limb. Negative correlation between PANSS N scores and current intensity needed to trigger RTIII in the right lower limb was shown in this sample (Figures 3 and 4).
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Effectiveness of avoiding collision with an object in motion – virtual reality technology in diagnostic and training from perspective of prophylactic of body injuries

Effectiveness of avoiding collision with an object in motion – virtual reality technology in diagnostic and training from perspective of prophylactic of body injuries

Results: Man B avoided collision head with an object in motion three times. Man A avoided it only with a velocity of 3 m/s. Mean time of reaction of man A was 0.407 ±0.27s and was 35% longer than man B (0.263 ±0.05s). Man A performed body rotation faster (0.870 ±0.636s) than B (1.133 ±0.054s); moves his centre of mass more efficiently in the frontal plane (5.953 ±0.034deg) and sagittal plane (6.185 ±0.959deg) than man B (9.825 ±2.909deg) and (13.001 ±0.451deg). Man A managed to avoid collision with a ball with a diameter of 12 cm for the left knee at the highest velocity (10 m/s). Man B did not avoid collision nor for the left or right knee in the same circumstances. Kinematic trajectory for following velocities registered for 27 years old man differs significantly.
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Research priorities in children requiring elective surgery for conditions affecting the lower limbs: a James Lind Alliance Priority Setting Partnership

Research priorities in children requiring elective surgery for conditions affecting the lower limbs: a James Lind Alliance Priority Setting Partnership

Participants 388 individuals (29 patients, 155 parents/carers, 204 healthcare professionals) were recruited through hospital clinics, patient charities and professional organisations and participated in the initial prioritisation survey; 234 individuals took part in the interim prioritisation survey. 33 individuals (3 patients, 9 parents/carers, 11 healthcare professionals, 7 individuals representing the project’s steering group and 3 James Lind Alliance (JLA) facilitators) attended the final face- to- face workshop to rank the top 10 research priorities. Interventions Surveys were distributed using various media resources such as newsletters, internet messaging boards and the ‘Paediatric Lower Limb Surgery Priority Setting Partnership (PSP) website. Printed copies of the questionnaire were also made available to families in outpatient clinics.
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Ergonomics of perforator/propellar flaps in lower limb

Ergonomics of perforator/propellar flaps in lower limb

This is to certify that the dissertation entitled, “ERGONOMICS OF PERFORATOR/PROPELLAR FLAPS IN LOWER LIMB” Submitted by DR.J.ROMUL DHAYAN RAJA in partial fulfilment of the requirements for the award of the degree of M.Ch in Plastic & Reconstructive Surgery by The Tamilnadu Dr.M.G.R. Medical University Chennai is a bonafide record of the work done by him in the Department of Plastic Reconstructive & Facio-Maxillary Surgery, Madras Medical College, Chennai, during the academic year 2010 to 2013.

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Comparison of upper limb and lower limb exercise training in patients with intermittent claudication

Comparison of upper limb and lower limb exercise training in patients with intermittent claudication

week time-point was only improved in the upper-limb exercise training group (P < 0.05). An increase in peak blood lactate concentration (1.95 ± 0.14 vs. 2.40 ±0.17 mM, mean ± SEM; P < 0.05) and amount of pain experienced at MWD (P < 0.05) was only observed in the upper-limb exercise training group. This suggests that an alteration in exercise pain tolerance accounted, at least in part, for the improvement in MWD in this group. Upon completing the intervention period the general health status of both exercise training groups was improved in relation to the control group (P < 0.05). However, improvements in physical functioning and bodily pain in relation to baseline (P < 0.05) and energy and vitality in relation to control patients (P < 0.05) were only observed in the upper-limb training group. At 48-weeks follow-up, CD remained improved by 39% and 48% (P < 0.05) and MWD remained improved by 18% and 26% (P < 0.05) in the upper-limb and lower-limb exercise groups, respectively, compared to baseline measures. A retained improvement in walking confidence (P <0.01) and community-based walking distance (P < 0.05) was also observed, however global physical activity status in both exercise trained patient groups, returned to baseline. Conclusions: Both upper- and lower-limb aerobic exercise training can be useful exercise training modalities for improving cardiovascular function, walking
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SPECT/CT-plethysmography – non-invasive quantitation of bone and soft tissue blood flow

SPECT/CT-plethysmography – non-invasive quantitation of bone and soft tissue blood flow

ured by a strain gauge plethysmography (ECR5, Hokan- son, Inc, Bellevue WA, USA). A 7-second deflation period was allowed before the subsequent measurement. The flow to the hand and foot was excluded by inflating a cuff above the systolic BP in the wrist or ankle, respectively. Baseline blood flow was the average of at least 4 stable repeated flow measurements. In order to test the repro- ducibility of the introduced method, all four limbs were measured in the same session. Each limb was taken as control for its contralateral. It is important to note that the plethysmography method measures the whole limb blood. While apparently it is the soft tissue volume that is changed in response to venous occlusion, it is the venous vasculature congestion within the soft tissue rather than soft tissue congestion per-se that is responsible for the vol- ume changes that allow us to measure the blood flow. Quantitative SPECT/CT scintigraphy
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Rehabilitation Outcome of Bilateral Lower Limb Amputees

Rehabilitation Outcome of Bilateral Lower Limb Amputees

The loss of both lower limbs complicates the rehabilitation process, especially if the loss occurs simultaneously. In developing countries like INDIA, the incidence of simultaneous limb loss is more frequent. Vascular disease affects both limb, Hence, patients with a single dysvascular amputation face a significant risk of eventual bilateral limb loss. When compared to single artificial limb, using two artificial limb is physically more difficult. Training, like prosthetic fitting must be individualized for each patient, taking into account physical condition, biomechanical loss and prosthetic characteristics.
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Effect of Lower Limb Irradiation by Proprioceptive Neuromuscular Facilitation on Balance in Stroke Patients

Effect of Lower Limb Irradiation by Proprioceptive Neuromuscular Facilitation on Balance in Stroke Patients

Eszter Németh, et al., 2008 conducted a study on “PNF induced irradiation on the contralateral lower extremity with EMG measuring”. The study was conducted with 20 healthy physiotherapist students: 15 females and 5 males took part in a single electomyographic measure. They have already known the PNF technique. Flexion PNF pattern was applied on lower extremity to facilitate the muscles on the opposite side. This investigation is based upon a single electromyographic measurement. They concluded that the abduction setting of the unmoved limb and the hip flexion on the moved limb has a significant effect on irradiation. A hip abduction of a lesser degree and a hip flexion of a higher degree induced significantly stronger contralateral muscle activity [8] .
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Balance disorder after traumatic brain injury : A multifactorial observational study

Balance disorder after traumatic brain injury : A multifactorial observational study

service. However, he was still having problems achieving binocular single vision (still having two images in the vertical plane) and apparently adopting an abnormal head posture (in extension) to bring the stronger of the two images into central vision. This abnormal head position was associated with soft tissue adaptation and limitations of neck movement. He had a right-sided hemiplegic type gait with mixed resting muscle tone and hyperaesthesia, often verging on pain, throughout the right side. There were also problems of sensory discrimination on this side. Postural drift to the left, increased on eye closure and rotation to the left during the Fukuda Stepping Test was observed in contrast to reports of fear of falling to the right and sometimes feelings of being pulled backwards. Fusion problems here were contributing to biomechanical problems and to postural vulnerability. There also seemed to be two possible issues of imbalance, one relating to vestibular system tone and one to hemisensory loss and muscular dyscontrol, particularly proximal instability for weight bearing.
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Autopsy Study of Renal Lesions in Snake Bite Cases

Autopsy Study of Renal Lesions in Snake Bite Cases

In the present study, out of 107 cases of snake bite, age group commonly involved is 50 years and above, most affected being agricultural labourer, maximum fatality occurred at winter and during activity. Lower limb is the commonest site involved and majority of cases received antisnake venom, eventhough bite to ASV time is more. Among the local findings, local pain and swelling predominated. Histopathological study of kidney revealed that tubular lesions (acute focal tubular necrosis) predominant in Viperine bites, tubular (diffuse ATN) and interstitial changes (severe inflammation ) in Krait bite and glomerular (congested capillary loop) and interstitial (severe inflammation) changes in Cobra bite.
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Crash Simulation of Lower Limb with Motorcycle Basket

Crash Simulation of Lower Limb with Motorcycle Basket

Crash Simulation of Lower Limb with Motorcycle Basket ORIGINAL ARTICLE I Crash Simulation of Lower Limb with Motorcycle Basket C K How, B Eng *, M M H Megat Ahmad, Ph D **, R S Radin Umar, Ph D *, A M[.]

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Initial subjective load carriage injury data collected by interviews and questionnaires

Initial subjective load carriage injury data collected by interviews and questionnaires

This study aims to identify the types, incidence and causes of any potential load carriage injuries or discomfort, as a result of a 2 hour forced-speed treadmill march carrying 20 kg. Subjective load carriage data were collected by both interviews and questionnaires from relatively inexperienced soldiers after a period of load carriage. Results from the study showed that the upper limb is very susceptible to short-term discomfort whereas the lower limb is not. The shoulders were rated significantly more uncomfortable then any other region and blisters were experienced by around 60% of participants. Shoulder discomfort commences almost as soon as the load is added and increases steadily with time; however, foot discomfort increases more rapidly once the discomfort materialises. In conclusion, early development of shoulder pain or blisters may be a risk factor for severe pain or non-completion of a period of prolonged load carriage.
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