Runners high refer to the feeling of exaltation that is experienced by some people who are engaged in strenuous exercise. Until the date, the exact mechanisms underlying this unique mental state continue to be a matter of debate, mainly due to a lack of credible evidence in support of the same. There are many sceptics who dismiss the very notion of runners high because they consider it to be nothing but a mere confabulatory act, which stems from the sense of achievement felt upon successful completion of a physical activity. However, some recent studies have put forth two different mechanisms to explain the exact cause behind this intriguing human emotion. The first and perhaps the most widely accepted notion is related to the exercise-induced endorphin release in the brain, while the second theory proposes the presence of an endocannabinoid system within the human brain, which releases special neurotransmitters during vigorous physical activity. Through this review, we have tried to put together the nitty-gritty of both these theories, with the hope of instigating further research in this hitherto unexplored field.

Aim: Assess the prevalence of traumatic teeth injury among sports personnel of central India including contact and non contact sports. Materials and Methods: A cross-sectional study was conducted among all professional sports personnel to assess the traumatic tooth injury among sportspersons in Bhopal city. Clinical examination was done using Ellis And Dewis Classification Of traumatic injuries and Angle's Classification Of Malocclusion. Result: Out of 320 sportspersons, 54(16.8%) subjects had anterior tooth injuries. majority of contact sports personnel 15(9%) had 4-6 number of traumatic teeth injury as compare to non contact sports 4(2.5%). Similarly in all the other segments contact sports personnel has more number of teeth injured as compare to non contact sports, which shows a statistical relevance. Conclusion: The dental services provided at sporting events are of consultative nature and not an integrated component of multidisciplinary sports medicine. However it is essential so that immediate availability of the dentist can allow athlete to return to competition and prevents secondary complications.

Purpose: In the present study, we measured medial tibial slope (MTS) and lateral tibial slope (LTS) separately, using conventional magnetic resonance images (MRIs) of knee joint. The Purpose of the study was to provide reference value of the posterior tibial slope in normal Indian population, and noncontact anterior cruciate ligament (ACL) injured Indian population and, to assess the association between steeper posterior tibial slope and noncontact ACL injury. Methods: In the present study, 60 ACL injured (I) patients (30 male, 30 female) were compared with 60 ACL uninjured (UI) or control population (30 male, 30 female) regarding LTS and MTS. MTS and LTS of each subject were measured using 1.5 tesla MRI of knee joint. Data were analyzed using appropriate statistical analysis. Results: Mean ± standard deviation (SD) MTS of uninjured male, female and pooled population are 6.94 ± 3.205°, 9.28 ± 2.657° and 7.73 ± 3.204° respectively. Mean ± SD MTS of injured male, female and pooled population are 8.13 ± 2.11°, 10.56 ± 1.691°, 8.73 ± 2.261° respectively. Mean ± SD LTS of uninjured male, female and pooled population are 3.77 ± 1.859°, 6.45 ± 3.364°, 4.68 ± 2.757° respectively. Mean ± SD LTS of injured male, female and pooled population are 4.88 ± 2.032°, 8.85 ± 2.22°, 5.85 ± 2.689° respectively. In normal population, MTS and LTS are steeper in female compared to male P < 0.05). LTS is steeper in injured male and female compared to uninjured (P < 0.05). MTS is steeper in injured male compared to uninjured (P < 0.05). Conclusion: Posterior tibial slope specifically LTS could be considered as a significant risk factor for noncontact ACL injury. Steeper posterior tibial slope (MTS and LTS) in female also is an important risk factor that explains the disparity in ACL injury rates between genders.

Background and Objectives: Measures of reaction time performance (RTP) to visual stimuli have been used as indicators of the speed of processing and also used to discriminate individuals with brain damage from controls. However, little is known about the relationship between RTP and change-of-direction speed, which is an important quality to performance in multi-direction sports. The Illinois agility test (IAT) and the 20-meter swerve-sprint test (20 m-SST) were designed to assess field sport change-of-direction speed and include linear sprint. This study examined the association between these two tests and their reliability with the RTP in football players. Methods: A total of 20 male soccer players (age: 24.04 ± 1.45 years; height: 175.75 ± 4.95 cm; body mass: 70.91 ± 8.90 kg), completed three tests. The 20 m-SST and IAT were evaluated using photoelectric cells timing gates while the software "reaction" was used to measure RTP in response to a visual stimulus. Pearson's correlations (P ≤ 0.05) was used to assess whether there are relationships between these variables. Results: The 20 m-SST was significantly and positively correlated with IAT while RTP was significantly correlated to IAT and 20 m-SST (P < 0.05). Interpretation and Conclusions: The significant relationships observed between IAT and RTP provides evidence to support the view that RTP can detect moderate performance changes in change-of-direction speed in football players. The results of this study indicate that RTP could be used as a valid assessment of change-of-direction speed as 20 m-SST and IAT in field sport athletes and particularly in soccer.

Aim: To compare tooth erosion among contact and noncontact sports personnel. Materials and Methods: A cross-sectional study was conducted among all active professional sports players from Madhya Pradesh representing India at national and international. Information on demographic characteristics of participants along with oral health behavior such as their oral hygiene habits, frequency of beverages consumption during sports activity was collected by means of personnel interview administered by the examiner. Clinically erosion index was used based on a Survey of Children Dental Health in UK 1993 along with CPI probe to diagnose the erosion. Results: Statistically significant difference (<0.05) was noted among the type of beverages intake in contact and noncontact sports.

Background: Arthroplasty of one form or another is an appropriate treatment for many patients with a displaced femoral neck fracture; there is an ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. Aims: This study was conducted to compare functional outcomes of different modalities of hemiarthroplasty (HA) in the treatment of fracture neck of femur in an elderly population of rural Bengal. Materials and Methods: This study was conducted in a time span of 3 years after taking Institutional ethical clearance and informed consent of the subjects. In the study 20 patients in each modality of HA (Austin Moore [AM] prosthesis, cemented Thompson prosthesis and cemented bipolar prosthesis) were taken into consideration. First generation cementing technique was applied. The cases were assessed on the basis of Harris Hip Score (HHS). Results: At 6 months follow-up satisfactory results of AM was −56%, Thompson was 80% and bipolar was 85%. At 12 months of follow-up satisfactory results of AM prosthesis was 60.5%, Thompson was 87% and bipolar was 91%. After 2 years average HHS of AM prosthesis was about 60%, Thompson prosthesis was 86% and the bipolar prosthesis was 91%. Conclusions: The functional outcome was relatively better in cemented bipolar and cemented Thompson group. Most of the unsatisfactory result (unipolar) group was due to shortening, acetabular erosion, and anterior thigh pain. Therefore, it should not be recommended in all cases of intracapsular fracture neck of the femur with poor bone quality relatively less physiological age. Bipolar and Thompson almost equal clinical and radiological outcome in clinical practice in such cases. Cemented Thompson may provide equally effective satisfactory outcome in comparison to nonmodular bipolar prosthesis.

Introduction: Intramedullary nail fixation has become the standard of treatment for tibial shaft fractures. Aims: The aim was to compare the results of the interlocking nail with Ender's nail, which are less expensive in our country for diaphyseal fracture of the tibia. Materials and Methods: This prospective pilot project was conducted on 30 patients after taking institutional ethical clearance and consent of the subjects in a time period of 1-year. Fifteen patients were treated with intramedullary nailing (Group I) in the tertiary care hospital while 15 with Ender's nail (Group II) in a rural hospital (with the lack of modern operative facilities). Results: The skeletal injury was classified according to AO/OTA classification. The majority of the patients were operated in 2 ^nd week of injury in our study. Average time taken for Ender's nail was 41.33 min and the average time for interlocking nail was 74 min, and the difference was highly significant (P < 0.01). The mean c-arm shot needed 18.66 and 49.00 for Ender's nail and interlocking nail, respectively; which was highly significant (P < 0.01). The majority of Ender nail group were allowed partial weight-bearing after 6 ^th weeks postoperatively while in interlocking nail group it could be allowed as early as 3 weeks. The majority of cases shows sign of clinical union in 8-12 ^th week in the interlocking group (%) and 13-16 ^th week in Ender's nail group. About 60.00% cases in Ender group and 86.66% cases in interlocking nail group had excellent results. Conclusion: Interlocking nails should be the first implant of choice to operate tibial diaphyseal fractures and the use Ender's nails should be done with caution in selected low-demand patients with suitable fracture patterns having financial constraints as well.

Objective: The chief blood supply to long bones is through the nutrient arteries, which enter the bone through the nutrient foramina. This supply is important during early stages of ossification, and in various procedures like bone grafts and while doing surgeries for fracture after sports injury. The information of dimensions of tibia segments is vital for forensic experts in order to recognize unidentified bodies. Hence, this study was done to measure various dimensions of the tibia and to analyze the position and the number of nutrient foramina in tibia. Materials and Methods: Fifty adult fully ossified dry tibias were taken and various parameters of the proximal and distal end of both right and left tibia were measured using Vernier caliper to calculate cross-section index in middle, cnemicus index and length-thickness index, foramina index. The position and the number of nutrient foramina in the tibia were also noted down. Statistical analysis of the parameters was done. Results: In our study, the mean length of tibia, anteroposterior diameter at nutrient foramen, transverse diameter at nutrient foramen, length from intercondylar region to nutrient foramen and tibial circumference at nutrient foramen was 37.7, 3.22, 2.21, 13.11 and 8.33 cm. The mean length-thickness index, cross-section index, cnemicus index, and foramina index in our study was 22.08, 70.56, 68.63, and 34.75. Conclusion: The results of this study will be useful for forensic experts in order to identify unidentified bodies and orthopedic surgeons in cases of inserting different implants in the restoration of tibial fractures.

Background: Total hip replacement (THR) arthroplasty at present it is the most commonly performed adult re-constructive hip procedure. Aims: To assess the clinical and functional outcome of the cementless ceramic THR. Materials and Methods: This pilot study was conducted in a tertiary care hospital of eastern India after taking institutional clearance and informed consent of the subjects. THR components were made from aluminum oxide from Central Glass and Ceramic Research Institute, Kolkata. During each visit, medical history was taken and physical examination was done. The deformity and range of motion (ROM) were measured with a goniometer. The clinical and functional outcomes were evaluated by modified Harris hip score. Results: 16 (80%) THR were on left and 4 (20%) were on left and age ranging from 34 to 66 years with a mean age of 52.2 years at the time of surgery. 14 (70%) were males and 6 (30%) females. At 2 years follow-up, the mean modified Harris hip score was 89.·With regards to the different parameters in the scoring system that is, pain, gait, functional activity, and ROM, there was significant improvement as per history. The results showed a significant improvement, wherein 33.33% had an excellent score and 50% showed good, and 16.7% had fair results. No patient had a poor score. Conclusion: Our study suggests that the current generation implants without cement can provide satisfactory clinical and radiographic outcomes after an intermediate duration of follow-up. Though the study was not free of complications, the overall functional and clinical outcome showed good results.

Context: Understanding the effect of "sportsmetric training (SMT) on reducing the risk of noncontact anterior cruciate ligament (ACL) injuries and performance adaptations in elite female basketball players." Aims: The purpose of this study was to determine if the sportsmetrics basketball training program would be effective in improving neuromuscular performance indices, thereby allowing recommendation for the program for both an injury prevention and enhancement of sport activity. Settings and Design: Present experimental study conducted at basketball court in Guru Nanak Dev University, Punjab (India). Subjects and Methods: Forty interuniversity female basketball elite players (mean age 20.0 ± 1.2 years; mean height, 163.4 ± 4.4; mean mass 52.1 ± 4.9 kg) volunteered and were randomly assigned into two groups. Both experimental group and control group were assessed for lower limb alignment on the video drop-jump test, vertical jump height assessed by kinematic measuring system and agility assessed by Illinois test. Control group had followed their routine training, and experimental group had performed sportsmetrics training for 6 weeks. After 6 weeks of training postmeasures were taken. Statistical Analysis Used: Significance was defined as P ≤ 0.05. Paired t-test was conducted for all the variables of within the groups. Unpaired t-test was run for comparison of all the parameters of between the SMT and control groups. Results: In the video drop-jump test, significant changes were found in the mean absolute knee separation distances on landing phases of jump in within training group and between the groups. There were also significant changes observe in vertical jump and Illinois agility test in within training group as well as between the groups. Conclusions: This program significantly improved lower limb alignment on a drop-jump test and thereby reducing the risk of noncontact ACL injury as well as improved performance indices and may be implemented preseason or off season.

Background: Tibial diaphyseal injuries with severe open fractures have always been a troublesome concern for treatment. Aims: The aim was to compare results of external fixator and unreamed interlocking nail in treating Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures to come to a conclusion to establish their appropriateness in the respective fractures. Materials and Methods: This pilot project was conducted in a tertiary care hospital of eastern India after taking institutional ethical clearance and informed consent of the subjects. Forty-five patients were selected. Results: A total of 23 cases were treated by external fixator and 22 cases were treated by unreamed solid interlocking nail. A total of 14 cases, that is, 31% showed delayed union. Type II injury 3/15 = 20%; Type IIIA injury 6/22 = 27.3%; Type IIIB injury it is -5/8 = 12.5%. For cases treated with unreamed nail it was 22.7%; external fixator it was 39.1% among 45 cases, 05 cases showed nonunion. For cases treated with unreamed nail it was 13.6%; external fixation it was 8.7%. The overall rate of deep infection is 11.1%. The rate in interlocking nail was 13.6%, and external fixation was 8.7%. Reoperation in the form of dynamization and bone graft application after 20 weeks in unreamed nail was 36.4%, whereas in external fixation the rate was high, almost 48%. The average time of union with unreamed interlocking was about 25.4 weeks, wherein external fixation it was 28.6 weeks. Conclusions: Though external fixators are good and reliable method of stabilization of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures, unreamed interlocking intramedullary nail yields better results in treating Gustilo type II and type IIIA tibial shaft fractures.

Background: Biochemical markers provide a dynamic view of the remodeling process of bone. Aims: To monitor biochemical markers in long bone fractures as they reflect the actual status of fracture healing. Materials and Methods: The present study after taking Institutional ethical clearance and informed consent of the subjects. Patients with normal fracture union served as controls (50); Patients with impaired fracture union served as cases. They were further divided into two groups: Fracture nonunion (20) and fracture malunion (30). Serum calcium, serum alkaline phosphatase (ALP), urinary calcium to creatinine ratio, and urinary total and free hydroxyproline were measured. Results: Serum ALP, serum calcium, urinary total and free hydroxyproline, and urinary calcium to creatinine ratio were increased in all patients after fracture. Serum ALP, urinary total and free hydroxyproline decreased after treatment in nonunion patients. Serum ALP reached to lower level of reference interval in this group. But urinary total and free hydroxyproline decreased to less than normal level. Serum calcium increased up to 2 weeks following treatment and then reduced to normal level within 1-month in fracture normal union and malunion groups. Serum calcium reduced at a very slow rate after treatment in nonunion patients and remained within reference interval. Significant differences were found between normal union and nonunion groups in case of serum ALP, urinary total and free hydroxyproline levels after treatment. Significant differences were found between normal union and nonunion groups in serum calcium level after treatment on day 7 and 14. Conclusions: Serial monitoring of biochemical markers of bone turnover reflect the actual status of bone resorption and bone formation, respectively. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.

Objective: The present study is an attempt to investigate the gender difference in relation to emotional intelligence and conflict among boxing players and extending researches that found a strong relationship between these two constructs. Methods: The total 50 Elite boxers participated in the study, out of which 25 are Elite male boxers and 25 Elite female boxers of age 18 and above. Who completed the Emotional Intelligence Test by Anjum and Roqiya and Thomas Killman Conflict Mode Instrument by Kilmann and Thomas. Results: Comparison of means reveals significant gender difference on emotional intelligence, male boxing players have significantly scored higher on emotional intelligence than female boxers. The pattern of handling interpersonal conflict also differ significantly for male and female boxers. Male boxers emphasis more on competing, collaborating and avoiding, whereas female boxers use accommodating and compromising as a mode of handling interpersonal conflict. The correlation analysis reveals insignificant relationship between emotional intelligence and conflict mode for males, however significant but negative relation found between emotional intelligence and avoiding for female boxers, which implies that female boxers who are high in emotional intelligence are less in avoidance.

Fat embolism is the presence of fat droplets within the circulation following trauma with or without clinical sequel. Fat embolism syndrome (FES) is a rare, but serious sequel of fat embolism usually occurring within 24 h of trauma and mostly causing petechial rashes, respiratory insufficiency, and central nervous system dysfunction. We report a young male who developed clinical FES while awaiting surgery for definitive fixation of bilateral closed tibial fracture following initial stabilization with long leg slab, was treated in the intensive care unit and underwent internal fixation under epidural anesthesia after clinical improvement. FES is a multisystem disorder with variable clinical presentation. Timely organ support improves prognosis. Epidural anesthesia can be a safe option for definitive fixation of lower limb fractures after improvement of organ dysfunctions.

Sartorius is a long strap muscle that originates from the anterior superior iliac spine and inserts on the upper medial surface of the tibia. It crosses the anterior thigh obliquely, and its medial edge forms the lateral boundary of the femoral triangle. Since it crosses two joints of the lower limb, it is also known as a bi-articulate muscle. It confers its action on both hip joint and knee joint. Its variations are extremely rare and seldom reported. We report here an exceptional variant accessory Sartorius muscle (SM) originating from the inguinal ligament, and joining the main SM eventually at the level of the junction between upper one-third and lower two-third of the thigh. In the present case, we discuss the clinical and functional implications of this exceptional case of accessory SM.

Compound palmar ganglion of tubercular origin with carpal tunnel syndrome is an uncommon condition. The aim of this study is to make awareness among practitioners so that the condition can be diagnosed and treated at an early stage before it spreads and destroy the surrounding structures. We present a 50-old-female with a painless swelling of the right wrist and palm of 1-year duration. Furthermore, the patient had a history of paresthesias and numbness of median nerve distribution. Local examination revealed a fluctuating, dumbbell-shaped swelling of the right wrist and palm with numbness of radial three and a half fingers. All the radiographic and laboratory tests were within the normal limits. Patient was treated with thorough debridement and decompression of carpal tunnel along with anti-tubercular therapy. Although rare, tubercular tenosynovitis with carpal tunnel syndrome must be kept in mind as a differential diagnosis of chronic tenosynovitis especially in the developing countries.

Isolated coronal fractures of the femoral condyle called as Hoffa's fracture is an uncommon injury. Hoffa fractures occur following high energy trauma with a preponderance of lateral femoral condyle. A medial condyle Hoffa fracture is even rare with very few cases reported in the literature. A careful examination along with oblique radiographs and computed tomography scan is needed for an accurate diagnosis. Conservative management is associated with poor results due to continuous shear stresses imposed on the fracture. Surgical management with anatomical reduction and rigid fixation allows early functional rehabilitation. We report a case of 19-year-old female injured during a fall and suffered medial condyle Hoffa fracture. The fracture was fixed with cannulated cancellous screws. Physiotherapy was initiated early promoting early mobilization and decreasing the risk of complications although weight bearing was graduated. After 6 months, the patient demonstrated full motion at the knee with no complaints of instability and snapping.

A simple bone cyst is an intramedullary cyst usually filled with serous and serosanguinous fluid. We hereby present a case of a 16-year-old male patient with simple bone cyst with pathological fracture of left humerus, who underwent extensive curettage of the lesion followed by incorporation of autogenous nonvascularized fibular strut-graft taken from ipsilateral limb. Simple bone cyst complicated with pathological fracture may be treated with cortical bone grafting with fibular strut-graft and synthetic fillers. Additional internal fixation with suitable implant is required to fix the pathological fracture. Therefore, by this methodology, we can take care of the disease and its complications as well in a same sitting reducing patient's morbidity.

The patient was a 25-year-old male who was currently enrolled in a military security forces training program. He had a 1-month history of worsening left anterior hip pain that was insidious in nature and limiting his ability to run. History and physical examination findings led to the possibility of femoral neck stress fracture. Radiography of the left hip was obtained, which revealed a stress fracture of the left femoral neck. The patient underwent open reduction internal fixation of the left hip. After a period of convalescence and completion of a comprehensive rehabilitation program, the patient successfully returned to full military duty without limitations.