Aim : The aim of this study was to assess the relationship between problem behavior and traumatic dental injury amongst children aged 12-15 years. Further, it also aimed to analyze by age and sex, a) the prevalence of traumatic injuries to permanent incisors and canines, and b) their distribution according to type of fracture. Materials and Methods: A cross-sectional study was conducted among 200 children aged 12-15 years in Panchkula, India. Data was collected through clinical examinations and interviews. A hospital based matched (age and sex) case-control design was adopted. A questionnaire was answered by either the children themselves through interview or by any one of their parents. Results: In case study, it was revealed that 16.4% subjects had more than 5 mm overjet and 20.4% subjects had inadequate lip coverage. The largest number of injuries were presented by 15 year old children (43.90%) followed by 14 and 13 years old children. In specification, boys had more injured teeth compared to girls. Conclusion: Problem behavior plays an important role in the occurrence of traumatic dental injury.

Plantar fasciitis (PF) is one of the most common causes of inferior heel pain managed by many physical therapists in a variety of clinical settings and wildly treated conservatively and it is usually caused by a biomechanical imbalance resulting in tension along the plantar fascia. It is estimated that 11-15% of all foot complaints requiring medical attention can be attributed to this condition. In general, the patient presents with inferior heel pain on weight bearing. Pain associated with PF may be throbbing, searing, or piercing, especially with the first few steps in the morning or after periods of inactivity. This article presents on overview of the current knowledge on PF and focuses on biomechanics, etiology, diagnosis and treatment strategies, conservative treatment including the physical therapy management are discussed. This information should assist health care practitioners who treat patients with this disorder.

The aim of this mini review article is to highlight the causes and recommend some policy about vitamin D deficiency worldwide. Vitamin D deficiency is the most common nutritional deficiency and very likely the most common medical condition in the world. The body requires higher intake of Vitamin D. The spectrum of these common disorders is of particular concern because observational studies have demonstrated that vitamin D insufficiency is widespread in many regions of the world, including industrialized countries. In conclusion, improving the availability of diets rich in vitamin D, to all people at a cheap price in the community markets is important. Exposure to sun is also a main source of vitamin D, so it is essential to increase health education about the importance of sun exposure to all age groups. It is important to plan according to each country's social and cultural aspects, without creating anxiety in the public.

Aim: The purpose of this study was to translate the short form international physical activity questionnaire (IPAQ-SF) to the Punjabi language and evaluate the validity of Punjabi version of IPAQ-SF in India. Settings and Design: This was cross-sectional study conducted in Amritsar. Subjects and Methods: The English IPAQ-SF was translated into the Punjabi language, synthesized, back translated, and subsequently subjected to an expert committee for review and pretesting. The final product (Punjabi IPAQ-SF) was tested for concurrent and construct validity in a sample population of 100 apparently healthy adults. Statistical Analysis: Spearman coefficient correlation was applied using SPSS 17. Results: The Spearman coefficient ranged from (ρ = 0.994) to (ρ = 1.00), indicating good concurrent validity of Punjabi version of IPAQ-SF. High significant positive correlation was found for time spent (metabolic equivalent of task-min/week) in vigorous (ρ =1.00, P < 0.001), moderate (ρ = 0.995, P < 0.001), and walking (ρ = 0.999, P < 0.001) activities between Punjabi IPAQ-SF and original IPAQ-SF. Poor construct validity was observed with cardiorespiratory fitness and body mass index (BMI). Total time spent in sitting (min/week) of Punjabi IPAQ-SF was significantly correlated to BMI was observed (ρ = 0.285, P < 0.001). Conclusion: The Punjabi IPAQ-SF indicated good concurrent validity among all the variables. The Punjabi IPAQ-SF can be used for physical activity assessment in India.

Aims: To determine the efficacy of strain counterstrain (SCS) technique and muscle energy technique (MET) in limiting pain and disability among individuals with mechanical low back pain. To identify an effective treatment for earlier recovery from mechanical back pain to prevent further aggravation of the condition. Settings and Design: Randomized double-blinded study design in which 90 subjects were recruited using simple random sampling from 180 community dwelling mechanical low back pain subjects. Forty-five subjects randomized into each groups. Mean age of Groups A and B subjects were 37 and 40 years, respectively. Double blinded baseline and post interventional assessment was performed. Intervention includes moist hot pack for both groups, with group A receiving SCS and group B receiving MET. Outcome measures were visual analog scale (VAS), Modified Oswestry Disability Index, and lumbar flexion range of motion (ROM) using modified Schober's test. Statistical Analysis and Results: Data was coded and entered using EPI INFO version 3.5.1 and exported to Statistical Package for Social Sciences (SPSS) version 16. Statistical evidences suggest that Group B (MET) showed significant prognostic changes with all outcomes (P <0.0001) at 3 months. But, Group A (SCS) showed significant changes only with Schober's test and no trends favoring treatment were found with VAS and Modified Oswestry Disability Index. Conclusion: Hot moist pack with MET was effective in alleviating mechanical low back pain in terms of pain, increases in lumbar ROM, and reduces disability.

Background: A case series demonstrating functional outcomes of 36 patients 2 years following anterior cruciate ligament (ACL) reconstruction utilizing hamstring autografts is presented here. We employed a quadruple bundle technique with cortical endobutton fixation. Materials and Methods: The methods of evaluation comprised of the 2000 International Knee Documentation Committee (IKDC) knee forms, clinical hamstring and quadriceps muscle strength testing in guidance with the Medical Research Council (MRC) grading, single leg triple hop assessment for distance, and the 'Aircast Rolimeter' arthrometer for objective joint laxity. Results: Mean IKDC score was 84.05 ± 14.37. A clinical final evaluation of normal or nearly normal was obtained by 97.2% (35/36) the participants. Passive motion deficit measured clinically using a goniometer was also found to be normal or nearly normal in 97.2% (35/36). One hundred percent of patients had normal or near normal grades for clinical manual knee ligament tests, 94.4% (34/36) patients had normal or near normal compartmental findings, and 100% of patients had normal or near normal harvest site findings. Hamstring muscle strength of the operated knee was clinically assessed to be 5/5 in 86.11% of candidates, while quadriceps muscle strength measured 5/5 in 100% of the subjects. The triple leg hop for distance demonstrated optimal performance with a limb symmetry index of 95.3 ± 13.3%. Arthrometric measurements revealed a mean side to side difference of + 0.70 ± 1.78 mm with Lachman's test and + 0.67 ± 1.43 mm with the anterior drawer test between the operated knee and the normal contralateral knee. Conclusion: We conclude that at 18 months following ACL reconstruction with hamstring auto grafts, our subject group displayed exceptionally satisfactory functional outcomes.

Introduction: Cricket is one of the world's major team sports in terms of regular international games. Bowling action is a highly skilled activity acquired over years of fine tuning. The presence of an imbalance between the agonist and antagonist groups is one of the major risk factors for developing shoulder injuries in bowlers. Upper extremities account 25% and 22% of injuries in schoolboys and provisional cricket bowlers, respectively. "Ballistic six" plyometric training prevented shoulder injuries due to overhead throwing and improve its velocity in baseball pitcher. Purpose of study: The purpose of this study was to find out the effect of 8 weeks "Ballistic six" plyometric training on bowling velocity in medium pace cricket bowlers. National level medium pace cricket bowlers were given 8 weeks Ballistic Six plyometric training program. Average of 3 bowling velocities was taken using Bushnell (50 Hz) Doppler Radar Gun pre- and post-training program and compared. Results: The increase in bowling velocities following the 8 weeks training protocol was statistically significant (P < 0.05) when compared to the pre-training velocities. Conclusion: It is concluded that Ballistic Six plyometric training increases the bowling velocity in medium pace cricket bowlers hence improves their performance.

Purpose: Ganglion cysts of the knee associated with anterior cruciate ligament (ACL) are a very rare entity and commonly a missed clinical diagnosis. High clinical suspicion and magnetic resonance imaging (MRI) scan aids in the diagnosis. Materials and Methods: We present three cases (2 men and a woman) of ganglion cysts associated with ACL. All of them had knee pain for more than a year without any prior injury. Clinical examination revealed joint line tenderness and significant restriction in range of movements. MRI showed ganglion cyst closely associated with ACL. Arthroscopic examination and cyst excision was done. In one patient after the cyst was debrided, only a few fibers of ACL were attached to the femoral site. Intra-operatively, the Lachman's test was positive and an ACL reconstruction using hamstring tendon was performed. Results: Post operatively, all the patients were relieved of pain and regained full range of movements with a minimum follow up of one year. Conclusion: Although a rare condition, ganglion cyst has to be considered as a differential diagnosis in young patients without injury presenting with significant knee pain and restricted movements. Arthroscopy is an effective tool in the management of such condition.

Background: Physical exercise is the nature's panacea for preventing ill health. Objectives: To study the effects of regularized training programs in an urban population. Materials and Methods: This cross sectional pilot project was carried in a time span of 6 months on two study populations located at the Medical College and Physical training unit in Pune. Untrained Group comprised of 50 healthy young male students and Trained Group comprised of 50 physically trained young males. History was recorded followed by anthropometry and clinical examination. Body mass index (BMI) and Body surface area (BSA) were calculated. Resting pulse rate and blood pressure, resting respiratory rate, VO ₂ Max, Physical fitness index (PFI), breath holding time (BHT), and 40 mm endurance test time were measured. Statistical analysis was done using SPSS software version 16. Results: There was no significant difference in age, and height between the two groups, while BMI, BSA, pulse rate, and respiratory rate were significantly lower in trained individuals. Physically untrained subjects had a VO ₂ Max value of less than 55 ml/kg/min (range, 30 to 55 ml/kg/min), while all the physically trained subjects had VO ₂ Max of more than 50 ml/kg/min (range, 50 to 80 ml/kg/min) (P < 0.0001). The mean PFI, BHT, and the mean 40 mm endurance time were significantly higher in trained subjects. Conclusion: Various cardio-respiratory and other fitness parameters are markedly better in youths who undertake couple of hours of exercise. This better cardio-respiratory fitness is known to translate into a lower cardiac disease risk in future.

Background: While the benefits of sport such as gain of fitness, reducing risk of diseases, or recreation are well-known among policy makers, relatively very little attention is paid to its unwanted side-effect, the injuries. Sports injuries are a burden to both individuals and the society. Therefore, a study was conducted to determine the prevalence and pattern of sport injuries among college students in Delhi, India. Materials and Methods: The study was cross-sectional and pretested, self-administered questionnaire was used. The study was primarily directed towards the members of sports teams (both intra- and intercollege teams) and athletes in selected college in Delhi and complete enumeration of the study subjects was performed. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Results: The prevalence of sport injury was 73.4%. Males suffered more injuries than females. There was a significant statistical difference with age (P = 0.008), students of 20 years and above suffering more injuries than their younger participants. The prevalence of sport injuries was more among those who do not have coaches (P = 0.001, odds ratio (OR) 3.49) and also those who did not receive any formal training (P = 0.000, OR 2.26). Only 68.8% took some form of treatment and very few (26.1%) practiced injury preventive measures. Conclusion: A diligent search for factors contributing to sports injuries is essential for injury management. Attention to preventive measures and appropriate supervision will allow youngsters to continue to enjoy sports in a safer way.

Context: The 6-min walk distance test (6MWT) is commonly used to assess the exercise tolerance and to identify functional changes resulting from disease progression or therapeutic intervention in patients with chronic obstructive pulmonary disease (COPD). Understanding the factors related to exercise capacity can create a way to a better understanding of physical activity limitations. Aims: The aim of this study was to determine the relationship between 6MWT, dyspnea, quality of life (HRQL), and disease severity and identify the predictors of 6MWT in COPD patients. Settings and Design: A cross-sectional study was developed on COPD patients referred to the outpatient pulmonary clinic of the Ahvaz Jundishapur University of Medical Sciences. Materials and Methods: A total of 72 patients with mild to very severe COPD participated in this study. The 6MWT was performed based on American Thorax Society's protocol. Disease severity was evaluated using spirometry. The health-related quality of life (HRQL) was assessed by the St George's Respiratory Questionnaire (SGRQ), and exertional dyspnea was measured by Borg score. Statistical Analysis Used: The data were evaluated using Pearson's linear correlation coefficient, Spearman's correlation coefficient, and multivariate linear regression. Results: The 6-min walk distance (6MWD) correlated positively with forced expiratory volume in 1 s (FEV ₁ ) (r = 0.36, P < 0.05) and forced vital capacity (FVC) (r = 0.37, P < 0.05), whereas there was no significant correlation between disease severity based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification and 6MWD. Moreover, no statistically significant correlation was found between exertional dyspnea and 6MWT. A negative correlation was observed between 6MWD and total score of QOL, activity, and impact domain, respectively (r = −0.39, r = −0.44, r = −0.40, P < 0.01). Multiple regression analysis indicated that the age was identified as independent predictor of the 6MWD. Conclusions: This study showed that there is stronger relationship between 6MWD and HRQL (activity and impact) compared with physiological measures of disease severity such as FEV ₁ .

Obesity and being overweight are considered as global health problems because obesity increases the risk of several chronic diseases such as cardiovascular disease (CVD) and diabetes. Physical activity plays an important role in preventing overweight and obesity in young people and stemming its progression into young adulthood. Adolescence is a particularly vulnerable time for the development of obesity because it is marked by a slowing of growth and corresponding decrease in physical activity levels. In addition, physically active youth have lower levels of adiposity than youth who are less active. Several studies have identified the role of physical activity in attaining a healthy body weight. A study carried out at the University of Kalamoon, revealed that the prevalence of overweight and obesity in Syria is almost 47%. The objective of this study was to find out the association between physical activity, overweight and obesity in Syrian university students. An accurate assessment of physical activity is important in determining the risk of overweight and obesity. The absence of local and national relevant data in the Arab world could pose challenges to epidemiological studies on physical activity in these countries. Data from the International Physical Activity Questionnaires (IPAQ) short format on 320 Syrian university students (age 18-26) were analyzed. The prevalence of overweight/obesity had a strong inverse association with physical activity among males and females alike but was more visible in females. The low intensity and short duration of the physical activity has also played a role in shigher body mass index (BMI) values. More metabolic equivalent of tasks (METs) minutes/week resulted in lower BMI values and on the contrary, sitting time had a positive relationship with higher BMI values. There was a significant difference (P < 0.05) between males and females with regard to METs minutes/week which was 4854 ± 1272 and 4408 ± 1136 for males and females respectively in the normal weight group and for 4368 ± 984 and 4041 ± 985 for males and females, respectively in overweight group and 3385 ± 982 and 3063 ± 801 for males and females, respectively in obesity group. This trend also applies to sitting METs minutes/week. In the normal weight group, males had higher values than females whereas females had higher values in the overweight and obesity group but thedifference was significant (P < 0.05) between males and females in the three groups. These results underscore the importance of promoting physical activity among adolescence to prevent and control overweight and obesity.

Context: Cortisol and tumor necrosis factor-α (TNF-α) has a significant role on the immune system. Previous studies have shown a significant increase in cortisol and TNF-α in athlete; however, the alteration of adenosine deaminase (ADA) activity in athletes has not been previously reported. Aims: This study was aimed to investigate the effect of exhaustive exercise on cortisol, TNF-α and serum ADA activity in endurance runners. Settings and Design: All endurance male athletes were enrolled in this case control study. Subjects and Methods: The participants were submitted to the same experimental protocol used in the exercise trials, they run on a treadmill until exhausting state. Saliva and blood sample were collected in resting and immediately after exercise; serums were separated and stored at −70°C pending assays. Serum was analyzed for ADA activity and TNF-α. Salivary cortisol measured by enzyme-linked immunosorbent assay method. Statistical Analysis Used: Data was analyzed using the statistical package for the social sciences 16 (SPSS Inc., Chicago) and one-sample Kolmogorov-Smirnov test. Results were presented as mean ± standard deviation and independent samples t-test used to compare mean differences. In addition, linear regression analysis was performed and means of the Pearson's correlation coefficient (r) were determined to show the correlation between variables. Results: Cortisol and TNF-α elevated following intensified training compared with the resting state. There was a significant increase in serum ADA activity between athletes and non-athletes groups. In addition, our results showed a strong direct correlation between serum total ADA activity and TNF-α. Conclusions: Based on the obtained data, an acute period of intensified training can induce an increase of ADA activity accompanies with the increase of cortisol and TNF-α. ADA is involved in the immune system development. Our results hypothesized that ADA can be associated with an increase in fatigue which lends to reduced physical activity. We showed that excessive exercise can induce an inflammatory response resulting in elevated levels of cortisol and TNF-α and perhaps by increasing activity of adenosin deaminase.

Background: Football is the world's most popular sport with new players added every year. Recreational football is considered to as health promotion activity for untrained subjects. With the requirement of maintaining balance over one leg at different stages of the game, football players are expected to have superior unipedal stability. Stretching, either static or dynamic, has proven to be of utmost significance as a warm strategy. However, experiemental trials on evaluation of acute effects on dynamic balance are seen limited in scope and implementation. Thus, the purpose of this study was to compare the effects of dynamic and static stretching on dynamic balance performance in recreational football players. Materials and Methods: Thiry male recreational football players participated in the study. Subjects who participated in a minimum of one football session per week for the preceding two months were included in the study on the condition that they should not participate in a structured training or exercise session from last 2 months. Subjects were divided intotwo groups. Group A(n=15) were given dynamic stretching of ankle plantaflexors, hamstrings, quadriceps, hip adductors, hip flexors and hip extensors.Group B(n=15) were given static stretching of same muscle groups. Star excursion balance test was used as main outcome measure. Results: Paired t-tests were used for pre and post score measures for within group comparisons. Independent t-tests was used for comparison of pre and post test score difference for between group comparisons. Significant difference was found between pre and post normalized combined composite scores of SEBT within group A (P<0.001) and Group B(P<0.001). There was non significant difference between the combined normalized composite scores for between group comparisons (P=0.901). Conclusion: Both dynamic stretching and static stretching are equally effective in improving dynamic balance performance in recreational football players. However, the nature of dynamic stretching being more functional , it may prove to have better compliance and acceptability by the coaches and players and may also be used as a preventive strategy for injury management.

Background: There are diverse opinions about the degree of adaptability of the respiratory system in delivering the physiological needs in case of severe exercise. Role of the normal respiratory system in delivering oxygen to meet the demands of various degrees of exercise has been a topic of considerable debate. One view holds that the respiratory system is not normally the most limiting factor in the delivery of oxygen; others hold the absence of structural adaptability to physical training cause of limitation of the pulmonary system. The role of ventilator functions in evaluating the respiratory functions in amateur university level sprinters has not been studied adequately in previous studies, hence the need for this study. Materials and Methods: Pulmonary function tests were performed before and after maximal exercise testing to assess dynamic lung functions in two group's viz., athletes and non-athletes. The athletes were sprinters of the university team. Results: On studying the differences in dynamic lung functions in two groups of non-athletes and athletes, there was no difference in forced vital capacity and forced expiratory volume in first second, before or after exercise testing (AE) in either. The other flow rates maximum mid expiratory flow, peak expiratory flow rate, mid expiratory flow 25-75% were on the higher side in trained subjects, which was consistently maintained AE. Conclusion: A higher adaptability of the respiratory system to the training stimulus in the form of a higher elastic recoil pressure of the lungs and a lower resistance of medium to small airways is suggested as the mechanism of adaptability in this study.

Context: While the importance of physical fitness for cadets is well-documented, no study has ever been conducted to investigate if there is an optimal body mass index (BMI) for physical fitness in army cadets. Aims: The aim of this study was to examine the association between BMI and physical fitness in cadets. Settings and Design: Cross-sectional study. Materials and Methods: Male army cadets (n = 196, aged 18-19 years) were examined for weight and height, their BMI was calculated, and they performed three tests: 1,600 m running, 50 m swimming, and pull-ups. Statistical analysis used: Student's t-test was used to examine differences between normal weight and overweight cadets, while a one-way analysis of variance (ANOVA) examined differences between BMI quartiles with regard to physical fitness. Results: BMI was directly related to running (r = 0.30, P < 0.001) and inversely related to pull-ups (r = −0.22, P = 0.002), while there was no significant correlation between BMI and swimming time (r = −0.05, P = 0.517). The comparison between normal weight and overweight (n = 54, 27.6%) participants revealed differences with regard to running (t192= −2.86, P = 0.005) and pull-ups (t194 = 2.41, P = 0.017), but not in swimming (t193 = 0.52, P = 0.605). One-way ANOVA revealed also differences between BMI quartiles with regard to running (F3,190 = 3.91, P = 0.010) and pull-ups (F3,192 = 5.73, P = 0.001), but not for swimming (F3,191 = 0.74, P = 0.528). Conclusions: In summary, the correlation analysis revealed that the higher the BMI, the lower the performance in running and pull-ups. Normal weight performed better in these tests than overweight participants, but BMI did not influence performance in swimming. Our findings confirmed previous observations about the negative effect of overweight on physical fitness. However, since the best performances in running and in pull-ups were achieved by different BMI quartiles, we concluded that the optimal BMI depends on the physical fitness parameter that one is interested in.

Background: Lateral epicondylitis (LE) is a common disorder and as of now no consensus exists as to the most appropriate management strategy for lateral epicondylitis. Aim: To compare the outcome of different nonsurgical treatment modalities in lateral epicondylitis. Materials and Methods: One hundred and twenty patients were randomly distributed in three groups. Group A patients received 2 ml of corticosteroid injection, Group B 2 ml of autologous blood, and Group C 2 ml of 5% dextrose. The visual analogue scale (VAS) scores were recorded at preprocedure and postprocedure at 4 weeks and 6 months. Results: The mean VAS scores changed at 4 weeks from a preprocedure mean of 7 to 3 in Group A, 8 to 5 in group B, and a mean of 7 to 6 in group C. The VAS scores changed at 6 months from 7 to 5 in Group A, 8 to 2 in group B, and 7 to 5 in group C. Conclusion: In our study, although corticosteroid showed an early advantage over the autologous blood group, but long-term follow-up results were better for autologous blood group. It is hence proposed that further research studying the effect of combination of steroid followed later by an autologous blood injection would show the efficacy of this combined treatment modality.

Sports related injuries among professional and recreational athletes are increasingly encountered and diagnosed and demand a quick return to preinjury level. At present cartilage injury cases are treated with multiple drilling, abrasion arthroplasty, mosaicplasty, autologous chondrocyte implantation (ACI) and matrix induced autologous chondrocyte implantation (MACI;). The construction of engineered cartilage tissue on a ECM (Extracellular Matrix) composite have high degree of feasibility. Since cartilage cells at the site do not grow to form new cartilage cells,tissue engineered cartilage aim at cultivating chondrocytes in vitro, and to reintroduce the engineered cultured cartilage tissue into the damaged region. To overcome the limitations that currently exist , a multidisciplinary field, in which bioengineering and medicine should emerge).

Osteochondroma is a common primary bone tumor that is most often occurring around the knee. Osteochondromas are usually asymptomatic; however, they might cause a variety of symptoms depending on their size and location. Solitary osteochondroma of the femoral neck is an exceedingly rare condition. We are describing a rare cause of groin pain and hip stiffness in an athlete. Clinical and radiological evaluation revealed that the symptoms were due to a solitary osteochondroma of the femoral neck. To the best of our knowledge, this is the only report that describing a groin pain in an athlete due to a femoral neck osteochondroma. Osteochondroma of the femoral neck should be included in the differential diagnosis of groin pain in athletes. Sport-medicine physician's awareness of these lesions together with a high index of suspicion is crucial for diagnosis.

Introduction: Bilateral and spontaneous quadriceps tendon rupture is a very rare phenomenon in clinical scenario. It is usually associated with trivial trauma superimposed on pathological and weakened quadriceps tendon due to various conditions. Because of its uncommon nature it is frequently misdiagnosed and mistreated. Case Report : A 57-year-old gentleman developed bilateral spontaneous quadriceps tendon rupture following a trivial fall. Further evaluation revealed that he was suffering from gout. Bilateral quadriceps tendon tears were surgically repaired with Krackow technique. He was started on treatment for hyperuricemia. He achieved good functional results at 20-week follow-up. Conclusion : Bilateral spontaneous quadriceps tendon rupture occurs in pathologically weakened tendon due to various disease processes. Correct diagnosis and early treatment provides best functional results.

Aneurysmal bone cysts (ABCs) are uncommon lesions accounting for less than 1% of reported primary bone tumors.   Of all the ABCs occurring in the body, less than 1% are seen in the patella. We report an extremely rare case of ABC of the right patella in a 20-year-old male patient who presented to our hospital with pain and swelling in the right knee since 4 months. Radiograph and computerised tomography (CT) scan were suggestive of osteolytic lesion involving whole of the patella without soap bubble appearance and with thinning of articular cortex. Whole of patella was involved. Patient was managed with total patellectomy and quadriceps and patellar tendon approximation and suturing. Physiotherapy and mobilization started. Patient was followed for 4 years with painless full range of movement, with no signs of local recurrence. Level of clinical evidence - 4 (highlight Query)

The Galeazzi fracture is a fracture of the middle to distal third of the radius associated with dislocation and/or instability of the distal radioulnar joint (DRUJ). Operative treatment followed by conventional immobilization of 6-8 weeks is usually followed by good outcome, but it takes nearly 1 year for occupational rehabilitation and most cases are associated with restricted terminal range of motion. To avoid these consequences, early commencement of rehabilitation is necessary but for that the DRUJ must be stable after radial fixation. Here, we report a case of early rehabilitation in a 36-years-old horse trainer with bilateral Galeazzi fracture dislocation where both DRUJ were unstable after fixation of radius but transfixing K wires provided the required stability needed for early mobilization. The patient had complete range of motion and occupational rehabilitation by 4 months.

Stress fractures are relatively common in runners and must be diagnosed early to prevent serious potential complications. A 25-year-old male patient, Borderline Security Force (BSF) trainee by occupation, with complaints of pain in the bilateral thigh with no history of trauma. On evaluation found to have bilateral stress fracture of proximal femur. The systematic protocol in treatment results in favorable outcome.