Effects of active isolated stretching on exercise-induced muscle damage in untrained subjects: a randomized controlled trial.

Objectives: To investigate the prophylactic effect of the active isolated stretching technique on exercise-induced muscle damage of wrist flexors. METHODS: The mixed model randomised controlled interventional study was conducted at the University of Sargodha, Sargodha, Pakistan, from November 2018 to May 2019, and comprised young adults who were untrained, sedentary and healthy who were randomly divided into intervention group A and control group B. Group A participants received self-assisted active isolated stretching before inducing muscle soreness of wrist flexors by eccentric exercises. Group B did not receive any intervention. The outcome measures were pain intensity, muscle soreness, pressure pain threshold, range of motion, and grip strength. Data were collected at baseline, after one hour, and daily from day 1 to 7 after inducing muscle soreness. Data were analysed using SPSS 21. RESULTS: Of the 60 subjects, there were 30(50%) in each of the two groups. There were 14(23.3%) males and 46(76.7%) females. The overall mean age was 21.47±1.9 years. Group A showed early recovery in pain and muscle soreness compared to group B (p<0.05). Also, a limited deficit in the range of motion, grip strength, and pain pressure threshold was found in group A compared to group B (p<0.05). CONCLUSIONS: Active isolated stretching before strenuous, unaccustomed exercise was found to be useful in ameliorating the symptoms of muscle soreness.

Capsaicin: Plants of the Genus Capsicum and Positive Effect of Oriental Spice on Skin Health.

BACKGROUND: Capsaicin, the main pungent ingredient in hot chili peppers, causes excitation of small sensory neurons. It also provides the basic pungent flavor in Capsicum fruits. SUMMARY: Capsaicin plays a vital role as an agonist for the TRPV1 (transient receptor potential cation channel, subfamily V, member 1) receptor. TRPV1 is essential for the reduction of oxidative stress, pain sensations, and inflammation. Therefore, it has many pros related to health issue. Activation and positive impact of TRPV1 via capsaicin has been studied in various dermatological conditions and in other skin-related issues. Past studies documented that capsaicin plays a vital role in the prevention of atopic dermatitis as well as psoriasis. Moreover, TRPV1 is also very important for skin health because it acts as a capsaicin receptor. It is found in nociceptive nerve fibers and nonneural structures. It prompts the release of a compound that is involved in communicating pain between the spinal cord nerves and other parts of the body. Key Messages: Here, we summarize the growing evidence for the beneficial role of capsaicin and TRPV1 and how they help in the relief of skin diseases such as inflammation, permeation, dysfunction, atopic dermatitis, and psoriasis and in pain amplification syndrome.

Beat the exercise-induced muscle damage.

Eccentric exercises are being used widely as a strategy to manage sarcopenia. However, eccentric exercises are linked to increased risk of myofibre damage and delayed recovery. There is elevated muscle soreness, decrease muscle strength and increased levels of muscle-specific circulatory protein. There is a huge variation in the severity of the symptoms after eccentric exercise. Several factors affect the degree and severity of muscle soreness. It includes exercise intensity, duration, mode, muscle group, age, gender, genetics and nutritional status. Therefore, designing a specific individual exercise plan is required to overcome injuries, myofibre damage and muscle soreness. At present, we still do not have enough knowledge about the exact sources and factors that trigger muscle soreness linked with strenuous exercise. Deep insight and identification of the risk factors which predispose individuals at an increased risk of muscle soreness after unaccustomed exercises may be a key to help them by prescribing personalised exercise therapy to speed up recovery and adaptation. Non-steroidal anti-inflammatory drugs are being used widely to manage muscle soreness, pain and tenderness linked with post exercise complications. But there is more to it than just treating pain. Is there any substantive gain besides pain relief? Can they improve muscle function? Could they prevent muscle soreness or speed up recovery? The current narrative review was planned to discuss the sources and factors that trigger exercise-induced muscle damage. Furthermore, it also provides a comprehensive analysis of the literature concerning the effectiveness of non-steroidal anti-inflammatory drugs in reducing symptom and improving muscle function in exercise induced muscle soreness.

Non-pharmacological interventions to combat exercise-induced muscle damage, a little natural tax on work out.

Debilitating pain, stiffness, tenderness, fatigue, impaired muscle function, lack of strength subsequent to exercise are not welcomed by those not accustomed to it. It may discourage an individual from participating in regular exercise. Numerou s ph armacological and non - pharmacological strategies have been used to alleviate symptoms of muscle soreness, muscle pain, improving muscle function, the range of motion and recovery time. Non-steroidal anti-inflammatory drugs are suggested to have a beneficial impact on muscle soreness, but fail to rejuvenate muscle weakness and range of motion coupled with muscle soreness. Furthermore, oral antiinflammatory drugs are widely used to mitigate muscle soreness symptoms, but chronic use can lead to different side effects in terms of peptic ulcer and liver toxicity. Non-pharmacological remedies and interventions can be a better choice. This narrative review is intended to provide insight into the non-pharmacological strategies to combat exercise-induced muscle damage.

Identification and Expression Analysis of CD73 Inhibitors in Cervical Cancer.

AIMS: The present study was conducted to examine the inhibitory effects of synthesized sulfonylhydrazones on the expression of CD73 (ecto-5'-NT). BACKGROUND: CD73 (ecto-5'-NT) represents the most significant class of ecto-nucleotidases, which are mainly responsible for the dephosphorylation of adenosine monophosphate to adenosine. Inhibition of CD73 played an important role in the treatment of cancer, autoimmune disorders, precancerous syndromes, and some other diseases associated with CD73 activity. OBJECTIVE: Keeping in view the significance of CD73 inhibitor in the treatment of cervical cancer, a series of sulfonylhydrazones (3a-3i) derivatives synthesized from 3-formylchromones were evaluated. METHODS: All sulfonylhydrazones (3a-3i) were evaluated for their inhibitory activity towards CD73 (ecto-5'-NT) by the malachite green assay and their cytotoxic effect was investigated on the HeLa cell line using MTT assay. Secondly, the most potent compound was selected for cell apoptosis, immunofluorescence staining, and cell cycle analysis. After that, CD73 mRNA and protein expression were analyzed by real-time PCR and Western blot. RESULTS: Among all compounds, 3h, 3e, 3b, and 3c were found to be the most active against rat-ecto- 5'-NT (CD73) enzyme with IC50 (µM) values of 0.70 ± 0.06 µM, 0.87 ± 0.05 µM, 0.39 ± 0.02 µM, and 0.33 ± 0.03 µM, respectively. These derivatives were further evaluated for their cytotoxic potential against cancer cell line (HeLa). Compounds 3h and 3c showed the cytotoxicity at IC50 value of 30.20 ± 3.11 µM and 86.02 ± 7.11 µM, respectively. Furthermore, compound 3h was selected for cell apoptosis, immunofluorescence staining, and cell cycle analysis, which showed a promising apoptotic effect in HeLa cells. Additionally, compound 3h was further investigated for its effect on the expression of CD73 using qRT-PCR and western blot. CONCLUSION: Among all synthesized compounds (3a-3i), Compound 3h (E)-N'-((6-ethyl-4-oxo-4Hchromen- 3-yl) methylene)-4-methylbenzenesulfonohydrazide was identified as the most potent compound. Additional expression studies conducted on the HeLa cell line proved that this compound successfully decreased the expression level of CD73 and thus, inhibited the growth and proliferation of cancer cells.

Fetomaternal Outcome In Women With Oligohydramnios Induced With Misoprostol.

BACKGROUND: Oligohydramnios, defined as an amniotic fluid index (AFI) of less than the 5th percentile (at term ≤5 cm, or at per-term ≤8.0 cm), has an incidence of 8.5-15.5%. It is associated with an increased perinatal morbidity and mortality. The objective of this study was to explore whether induction with misoprostol can safely be offered to patients with reduced amniotic fluid index and that vaginal delivery can be achieved without major adverse effects. METHODS: All women at term who gave consent to be part of the study and required labour induction were recruited. Total 120 women were included in study. They had a per-induction ultrasound to calculate amniotic fluid index (AFI). Based on AFI., the patients were divided into two groups: group 1, had AFI ≤5 cm and was oligohydramnios group. The other was group 2 with normal amniotic fluid, i.e., AFI >5 cm. Both these groups then underwent labour induction with misoprostol (cytotec-Pfizer) 50microgram. The dose was repeated 6 hourly for a maximum of three doses. The outcomes studied were number of tablets used, induction to labour interval, induction to the delivery interval and method of delivery. The foetal outcomes were meconium staining, Apgar score, NICU admission and advance neonatal resuscitation. RESULTS: In maternal parameters, it was observed that there was a significant difference in induction to delivery interval only and in foetal parameters it was observed that in group 1, there was statistical significance in meconium staining, Apgar score and NICU admission. CONCLUSIONS: Induction with misoprostol and vaginal delivery can safely be offered to women with oligohydramnios at term.

Successful use of balloon tamponade in the management of postpartum hemorrhage in a case of bicornuate uterus.

Worldwide 50%-70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed by massive postpartum hemorrhage managed successfully with balloon tamponade. The use of uterine balloon tamponade as an effective method to control postpartum hemorrhage has been studied extensively, but use in cases of hemorrhage associated with uterine malformations has not been reported much in literature. Use of uterine balloon tamponade in case of uterine malformations has been highlighted in our case as an effective non-surgical method to control hemorrhage.

Treatment for Symptomatic Bacterial Vaginosis: ARandomized Controlled Trial.

OBJECTIVE: To compare the efficacy of multiple doses of vaginal clindamycin with a single oral dose of secnidazole for the treatment of bacterial vaginosis. STUDY DESIGN: Double-blinded randomized controlled trial. PLACE AND DURATION OF STUDY: Shifa Foundation Community Health Center, from March 2012 till February 2015. METHODOLOGY: After obtaining written informed consent, a pelvic examination was performed for the confirmation of symptoms of milky white vaginal discharge on speculum examination, positive Amine test and presence of clue cells on microscopy. Pregnant women, known diabetes or any immunocompromised condition, were excluded. Blinding of the patient, doctor, and the pharmacist was done. Study cohort was then divided into two groups, Group Areceived medicine pack Awhich contained active clindamycin and placebo oral preparation, whereas group B was given pack B which contained active 2-gm secnidazole with placebo vaginal cream. Primary outcome and therapeutic success were defined by correction of two out of three (normal Nugent score, negative Amine test, and no milky white discharge) on day 15. RESULTS: At 15th day of treatment, 96.6% participants in vaginal clindamycin group (Group A), recovered from the bacterial vaginosis; whereas, (group B) 23% patients were cured in oral secnidazole group. CONCLUSION: Multiple doses of vaginal clindamycin are superior to single dose of oral secnidazole for the treatment of bacterial vaginosis.