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   2013| July-December  | Volume 13 | Issue 2  
    Online since December 20, 2013

 
 
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ORIGINAL ARTICLES
The incidence, severity and etiology of injuries in players competing in the Saudi Premier League between 2010 and 2012
Mubarak Almutawa, Mark Scott, Keith P George, Barry Drust
July-December 2013, 13(2):90-97
DOI:10.4103/1319-6308.123388  
Purpose of the Study: The purpose of this study is to evaluate the incidence of injuries sustained by Saudi Premier League clubs over two consecutive competitive seasons (2010/11 and 2011/2012. Specifically, we compared injuries sustained in match play versus training and we provide an initial exploration of the impact of environmental conditions on match play injuries. Materials and Methods: A total of 198 players were studied (mean ± SD; age 28.2 ± 1.8 year; height 177.3 ± 1.0 cm; weight 71.6 ± 1.4 kg; body mass index 22.8 ± 0.3 kg/m 2 ). A prospective cohort design was used to investigate the injuries that occurred in training and match play. Injury definition was set at "any injury that resulted in medical attention or assessment, irrespective of the impact on time lost from subsequent football activity." Club medical staff recorded injuries and match play and training exposure on a standard proforma. Ambient temperature and relative humidity were recorded for all games. Results: A total of 617 injuries were recorded at an incidence rate of 8.3 injuries/1,000 h player exposure. 355 injuries were recorded during training (5.5/1,000 h) and 262 during match play (29.7/1,000 h). For total injuries as well as subcategories of severity, location, type, recurrence, diagnosis and the role of contact, the incidence rate was substantially higher with match play. Post-hoc categorization of ambient weather suggests a greater risk of match play injury in hot (>30΀C) and dry (<50% relative humidity) conditions. Conclusion: This study detailed the total "medical-attention" injury load presented by professional football players to medical teams in 6 Saudi Premier League Clubs. Injury incidence was higher in match play than training and match play. This data provisionally indicates that injuries may be mediated by the prevailing environmental conditions.
  3 4,370 170
CASE REPORTS
Avulsion fracture of tibial spine: A case report and review of literature
Manoj Kumar, Monika Malgonde, Pramod Jain
July-December 2013, 13(2):102-104
DOI:10.4103/1319-6308.123394  
Fracture of the tibial spine is an uncommon injury, with an incidence estimated at 3:1,00,000 children per year. Sports and bicycling are the usual activities resulting in this fracture. The anterior spine is fractured many times more than the posterior. We are reporting a case of a 12-year-old female who presented with complaints of pain and swelling over left knee after falling from bicycle. Plane radiography and computed tomography scan showed tibial spine fracture with anterior cruciate ligament avulsion. Closed method was tried but reduction can not be achieved, finally open reduction and internal fixation done using 18 G stainless steel wires. Intraoperative movements of knee checked and fixation was found stable. The patient recovered progressively without any clinical signs of joint instability and returned to the same sport activity level that they had before the fracture.
  - 5,863 140
Zygomatic arch fracture in a kabaddi player
Shishir Ram Shetty, Prasanna Kumar Rao
July-December 2013, 13(2):105-106
DOI:10.4103/1319-6308.123397  
Kabaddi is a contact sport played in some of the Asian countries. Injuries occurring in this contact sport has not been highlighted or researched to the optimum level. We are hereby presenting a rare report of zygomatic fracture in a kabaddi player.
  - 2,631 90
Role of therapeutic ultrasound in healing of tibial stress fracture in a runner: A case study
Mohammad Hassan Manzer
July-December 2013, 13(2):107-109
DOI:10.4103/1319-6308.123399  
Stress fractures are a recognized complication of the chronic, intensive, weight-bearing training familiar to athletic, dance and military populations. Various studies have suggested that ultrasound therapy promotes healing in stress fractures. Some authors have even studied its role in the diagnosis of stress fractures. A 20-year-old male, runner presented with complains of pain in the anterior margin of the lower end of left tibia during walking and increases with running. Application of ultrasound on continuous mode for diagnosis of stress fracture precipitated the pain in 28 second at the site of tenderness. The subject was administered low intensity pulse ultrasound. Subject was re tested after 4 weeks of treatment. The patient has reported a significant improvement in pain during his functional activities after completion of treatment. The time duration of awareness of pain with the application of continuous ultrasound for the diagnosis of stress fracture increased to 58 seconds. This case demonstrates that low intensity pulse ultrasound may be effective in treatment of stress fracture and therapeutic ultrasound may be utilized for the diagnosis of stress fracture on the basis of time duration of awareness of pain and comparing it with the sound side.
  - 4,006 109
EDITORIAL
Sport related proteinuria
Suzan Sanavi, Mohammad-Ali Kohanpour
July-December 2013, 13(2):57-59
DOI:10.4103/1319-6308.123366  
  - 2,724 121
ORIGINAL ARTICLES
Injection of bone marrow concentrates for treatment of refractory tennis elbow
Ajit Singh, DS Gangwar, Shekhar Singh
July-December 2013, 13(2):98-101
DOI:10.4103/1319-6308.123392  
Objective: The objective of this prospective study was the assessment of efficacy of bone marrow concentrate (BMC) (containing plasma rich in growth factors and mesenchymal stem cells) injection in treatment of refractory tennis elbow. Materials and Methods: A total of 30 adults with at least 6 months of refractory tennis elbow were administered single injection of BMC. This concentrate was made by centrifugation of iliac BM aspirate at 1800 rpm for 20-30 min and only upper layer containing platelet rich plasma and mononuclear cells was injected. Assessment was performed at baseline, 4 weeks and 12 weeks using Nirschl and visual analog scale (VAS) pain score. Results: Post-injection, significant reductions were reported in Nirschl, which decreased from a mean pre-injection score of 5.92 ± 0.85-3.19 ± 0.94 at 4 weeks (P < 0.001) and 1.65 ± 0.94 at 12 weeks (P < 0.0001). Similarly, significant reductions were found for VAS from a mean pre-injection score of 8.35 ± 0.94, to a mean VAS score of 5.23 ± 1.42 at 4 weeks (P < 0.0001) and to 1.85 ± 1.12 at 12 weeks (P < 0.0001). There were no adverse events. Conclusion: Treatment of patients with refractory tennis elbow with a single injection of BMC showed a significant improvement in short to medium term follow-up. This could be considered to be an alternative treatment for those patients who have failed non-operative treatment before surgical intervention is taken.
  - 3,314 93
Comparison of adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of trained and untrained perimenopausal women
Amrith Pakkala, T Ragavendra, CP Ganashree
July-December 2013, 13(2):78-80
DOI:10.4103/1319-6308.123375  
Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone and leutinising hormone (FSH and LH)was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of the menstrual cycle in perimenopausal women. Materials and Methods: 10 Subjects in each group were subjected to treadmill exercise testing and cardio-respiratory parameters were recorded. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow (MMEF), peak expiratory flow rate, mid expiratory flow 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.
  - 2,394 81
A study of the short term effect of cigarette smoking on cardiopulmonary efficiency
Amrith Pakkala, Thippeswamy Raghavendra, Chitradurga Palaiah Ganashree
July-December 2013, 13(2):81-86
DOI:10.4103/1319-6308.123379  
Background: All over the world, tobacco is taken in several forms. Use of tobacco in cigarettes indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of cigarettes often becomes a lifelong habit with cumulative and deleterious effects on health. Smokeless tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long-term harmful effects of nicotine on various body parameters, little is known about acute effect of cigarette smoking on cardiopulmonary parameters. Very few studies have been undertaken on the acute effect of use of cigarettes, a common form of tobacco use in India on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill exercise testing and pulmonary function tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups' viz., healthy sedentary controls and healthy cigarette smokers. Results: On studying the differences in cardiopulmonary efficiency in the two groups the resting heart rate (HR) was found to be statistically significantly higher in the study group and the delta heart rate (δ HR) was found to be statistically significantly lower among cigarette smokers. There was no significant difference seen in parameters like VO 2 max, maximum oxygen pulse, maximal voluntary ventilation, VE max as an acute effect of cigarette smoking. Conclusion: In this study, it appears that cigarette smokers are physically fit like controls, but after immediate smoking a lesser δ HR suggests a higher risk for cardiovascular mortality. Stopping smoking at this juncture can be helpful in reverting back the risk and parameters such as resting HR, recovery HR, and δ HR can be used as prognostic assessment tools for any intervention therapy to stop cigarette smoking in asymptomatic individuals.
  - 3,532 115
A study of the effect of automobile pollution on pulmonary function tests of exposed Sportsmen
Amrith Pakkala, T Raghavendra, CP Ganashree
July-December 2013, 13(2):87-89
DOI:10.4103/1319-6308.123384  
Background : Urbanization is associated with an enormous increase in vehicular traffic emitting exhausts and polluting the atmosphere. Airborne dust plays a key part in the overall atmospheric pollution and motor vehicle emissions constitute the most significant source of ultra-particle in an urban environment. Traffic related air pollution is an occupational health hazard to individuals with a work environment close to traffic. Sportsmen who practice near grounds located in the vicinity of traffic junctions through which the maximum number of vehicles passes are more prone to develop health issues pertaining to the respiratory system. The present study intends to study the effect of air pollution on the pulmonary system in sportsmen exposed to automobile exhaust. Material and Methods: This study was conducted by performing pulmonary function tests (PFT) on 20 sportsmen who are exposed to automobile exhaust by virtue of their practicing venue nearer to traffic junctions and comparing them with 20 other age, gender matched and similar anthropometric profile sportsmen who practice in a rural setting free from vehicular air pollution., PFT by computerized spirometer measuring forced vital capacity (FVC), forced expiratory volume in first second (FEV 1 ) , FEV 1 /FVC, peak expiratory flow rate (PEFR) and forced expiratory flow (FEF) 25-75% were measured. Statistical analysis was carried out by Student t-test (two tailed, independent) for inter group analysis. Results: On comparison of pulmonary function test PFT in the study and control group was seen that there is a decline in dynamic pulmonary function parameters in the study group when compared to controls which is statistically significant. Conclusion: This was a comparative study to demonstrate the effect of air pollution due to automobile exhaust on pulmonary functions of sportsmen exposed to a polluted urban environment with a similar group in the rural relatively pollution free environment., PFT by computerized spirometer measuring FVC, FEV 1, FEV 1 /FVC, PEFR and FEF 25-75% were measured. The results were tabulated and statistically analyzed. It was found that there is a significant decline in various PFT parameters recorded in the study group as compared to the control group.
  - 2,864 101
REVIEW ARTICLES
Sports manpower loss and its impact on sports coaching in a developing country
Amrith Pakkala, Thippeswamy Raghavendra, Chitradurga Palaiah Ganashree
July-December 2013, 13(2):60-62
DOI:10.4103/1319-6308.123368  
Sports manpower is an important aspect of coaching services. Most of the countries in the world lack resources for sports coaching; hence, the need for proper allocation and efficient utilization. There is no policy on sports manpower or materials provided in the National Health Policy. In the absence of this, there is nothing in the policy to prevent brain drain of coaches trained on public money. As a developing country, we can ill afford to have the dubious distinction of losing qualified coaches, accounting for highest international certifications and verification of credentials. The government should urgently address the need for arresting the trend of brain drain among qualified coaches.
  - 2,455 93
Femoroacetabular impingement in athletes: A review of the current literature
Abdulrahman D Algarni
July-December 2013, 13(2):63-69
DOI:10.4103/1319-6308.123370  
There are several well-recognized causes of hip and groin pain that commonly affect athletes. Femoroacetabular impingement (FAI), also known as hip impingement, is increasingly recognized as a common; and possibly often overlooked; etiology of hip pain in athletes. FAI is characterized by the abutment of the acetabular rim and the proximal femur, which may occur by two mechanisms known as "cam" or "pincer" impingement, although most commonly by a combination of the two. It affects athletes at a young age causing significant pain and disruption to athletic performance and activities of daily living. It injures the labrum and articular cartilage and can lead to early osteoarthritis of the hip if left untreated. Patients often report a groin pain, which is typically reproduced by the use of flexion, adduction and internal rotation of the supine hip. Early diagnosis is crucial in order to avoid the severe secondary damage that can occur. Although, FAI is significant for all patients, in athletic individuals they may bring about the end of their sporting careers. Both open and arthroscopic surgical methods are used, with recent reports in athletes showing excellent results for life-style improvement and frequency of returning to the sport. Whether treatment prevents or delays osteoarthritis of the hip is unknown. This article reviews the latest scientific literature in reference to FAI in athletes. It goes some way to explaining the principles, approach and guidelines for management of FAI in athletes.
  - 6,472 131
Physiological mechanisms underlying catch-up growth
Sharat Gupta, Shallu Mittal, Manshu Mittal, Prerna Gulati
July-December 2013, 13(2):70-73
DOI:10.4103/1319-6308.123372  
Linear growth is impaired by a variety of systemic illnesses. However, on remission, body growth usually normalizes or even accelerates beyond the normal rate for age, a phenomenon commonly known as catch-up growth. Until date, the exact mechanisms underlying this unique phenomenon are unclear. However, two possible mechanisms have been put forward to explain it. One theory postulates a central mechanism, which compares the target and actual body sizes and accordingly makes corrective adjustments in body growth. However, the second mechanism, which provides a newer explanation for this phenomenon, states that growth restricting illnesses reduce the proliferation of stem cells, thus conserving their proliferative potential temporarily. As soon as the crisis is over, the stem cell proliferation resumes at an accelerated rate. Further research into the exact mechanisms underlying catch-up growth may prove helpful in discovery of effective strategies for reversing the growth stunting in children with chronic diseases.
  - 3,474 127
Sports dentistry: Role of dentist in protecting a winning smile
Amandeep Chopra, NC Rao, Nidhi Gupta, Shelja Vashisth
July-December 2013, 13(2):74-77
DOI:10.4103/1319-6308.123373  
Dental injuries are the most common type of orofacial injury sustained during participation in sports. Sports dentistry is the branch of dentistry, which involves the prevention and treatment of orofacial athletic injuries and related oral diseases, as well as the collection and dissemination of information on dental athletic injuries and the encouragement of research in the prevention of such injuries. The complete information about sports dentistry had been collected from various journals, books, online databases and various reports from international conferences for the time period of 1972-2013. This article will give an overview of sport injuries in orofacial region-incidence, evaluation, treatment and their prevention.
  - 5,835 407
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