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Background: Snake bite is one of the most neglected diseases in South East Asian region. Common Krait (CK) (Bungarus caeruleus) is the deadliest snake found in the dry zones of India. With the polyvalent anti-venom serum (AVS) remaining the cornerstone of treatment of neurotoxic snake envenomation, there is no universally accepted treatment for CK envenomationassociated neuroparalysis, except supportive measures. Aims and Objectives: Our study was conducted to describe the epidemiology, define clinical features, study outcome, and apparent efficacy of calcium gluconate in preventing or reversing neuromuscular paralysis with respiratory failure in CK bite patients. Materials and Methods: This study is a prospective observational study done on 52 CK bite patients. Patients were enrolled according to inclusion and exclusion criteria and were treated with AVS and calcium gluconate infusion according to National Standard Guideline, 2016. Patients developing severe respiratory muscle paralysis were offered mechanical ventilation. Results: Patients developed ptosis and dysphagia, pain abdomen, cyanosis, paralysis of jaw and tongue, perioral numbness, altered sensorium, dysphonia, ophthalmoplegia, and paradoxical breathing. 21.15% of patients developed respiratory failure and needed ventilator support with average critical care unit stay of 3 days and average stay on a ventilator of 2 days. 3 patients expired (case fatality rate 5.77%). The average hospital stay was 3.33 days. Conclusion: Our study shows that early intervention in patients of CK bite with neurotoxic envenomation, with calcium gluconate infusion, leads to less mortality and morbidity compared to other relevant studies. Further large-scale studies are required for better understanding and implementation. [ABSTRACT FROM AUTHOR]

Thoracotomy is used to manage a variety of medical conditions, including lung cancer, pulmonary infections, and chest injuries. Decortication surgery is indicated in the case of a thickened pleural layer leading to atelectasis of the underlying lung parenchyma. It is done to prevent further restriction of the lung parenchyma. Atelectasis, pleural effusion, pneumonia, and consolidation following decortication are common complications of the surgery. Physiotherapy following decortication helps in preventing damage to the lungs and also helps in maintaining and regaining good lung function postsurgery. This is a right-sided lung decortication thoracotomy surgical procedure where physiotherapy interventions were given preoperatively and early postsurgical care was taken for adequate lung expansion and to reduce respiratory complications following it. Incentive spirometer (4 times/day) with breath hold technique (3 s.) along with conventional physiotherapy interventions such as chest mobility exercise, breathing exercises, breath control techniques, and early mobilization in the form of long sitting at the end of a bed, high sitting, chair sitting, standing, walking, and stair climbing were improved in chest expansion, functional activities, rating of perceived exertion level, and reduced pain level. [ABSTRACT FROM AUTHOR]

BACKGROUND and objective: Obesity is a major health issue and there is steady trend of increasing obesity over the past several decades. Obesity can alter the respiratory function and may impair the health of an individual. Although several factors such as respiratory muscle strength, lung compliance, resistance to airflow and even obesity affect the lung functions, the nature of relationship with markers of adiposity, the role of body fat distribution has received limited attention. So the objective of this study was to correlate PEFR and WC in overweight women. Methods: 100 overweight women whose BMI was 25-29.9 kg/m2, who fulfill the inclusion and exclusion criteria, aged between 20-50 years were selected for the study. Waist circumference (WC) and Peak expiratory flow rate (PEFR) of all the subjects were measured. Results: Data were analyzed using Spearman's correlation coefficient. The result showed non-significant correlation (p=0.057) (r = -0.057) between PEFR and WC in overweight women. CONCLUSION: The study concluded that obesity, measured as WC did not significantly affect the PEFR in young overweight females in the age group of 20 to 50 years. A central pattern of fat distribution, as measured by WC alone was not associated with lower values for PEFR in young female overweight adults. [ABSTRACT FROM AUTHOR]

The clinico-genetic architecture of sarcoglycanopathies in Indian patients is reported only as short series. In the present study, we aimed to investigate the clinical picture, genetic basis, and disease progression of patients genetically confirmed to have sarcoglycanopathy. Next-generation sequencing was performed in 68 probands with suspected sarcoglycanopathy. A total of 35 different variants were detected in the sarcoglycan genes in 68 probands (M = 37; age range, 5–50 years). Consanguinity was present in 44 families. Thirty-two variants are predicted to be pathogenic/likely pathogenic, among which 25 (78.13%) are reported, and 7 (21.87%) are novel. The clinical diagnosis was confirmed in a total of 64 (94.12%) probands with biallelic variations [SGCA(n=18); SGCB(n=34); SGCG(n=7); SGCD(n=5)]. The most common mutation was c.544A > C (p.Thr182Pro) in SGCB, and detected in 20 patients (29.42%). The majority of pathogenic mutations are homozygous (n = 30; 93.75%). Variants in 4 cases are of uncertain significance. Thirty-three patients lost ambulation at a mean age of 15.12 ± 9.47 years, after 7.76 ± 5.95 years into the illness. Only 2 patients had cardiac symptoms, and one had respiratory muscle involvement. The results from this study suggest that mutations in SGCB are most common, followed by SGCA, SGCG, and SGCD. The novel variations identified in this study expand the mutational spectrum of sarcoglycanopathies. To the best of our knowledge, this is the first study from India to describe a large cohort of genetically confirmed patients with sarcoglycanopathy and report its disease progression. [ABSTRACT FROM AUTHOR]

Introduction: Proprioceptive Neuromuscular Facilitation (PNF) of respiratory muscles was found to improve lung function and haemodynamic parameters in mechanically ventilated patients. It has been proven that respiratory PNF had immediate significant effects in Chronic Obstructive Pulmonary Disease (COPD) patients. As pulmonary rehabilitation for COPD patients is a long-term hospital based service, there arises a need to provide a therapy that provides optimal benefit in short term. Aim: To study the effect of short term respiratory PNF on Peak Expiratory Flow Rate (PEFR) and six-minute walk test in patients with stable COPD. Materials and Methods: This quasi-experimental study was carried out in the Department of Physical Medicine and Rehabilitation, Rajah Muthiah Medical College and Hospital at Annamalai University, Chidambaram, Tamil Nadu, India. Twelve male COPD patients attending Medicine Department outpatient service between December 2020 to January 2021 were conveniently recruited. They were assessed for their PEFR using peak flow meter and exercise tolerance by six-minute walk test. They were treated with three respiratory PNF techniques namely, intercostal stretch, vertebral pressure high and anterior stretch by lifting posterior basal area for five consecutive days. Each treatment session lasted for about 30-40 minutes. The post intervention assessment of PEFR and six-minute walk was made. The pre and post intervention data were statistically analysed using paired samples t-test. Results: In this study, the mean age of the participants was 63.0 ± 5.80 years. The mean post intervention measurement of PEFR (226.67±51.09 L/min) and six-minute walk distance (271.92±50.55 m) was found to be significantly higher (p=0.001) than the mean pre interventional values (165.42±46.19; 219.58±43.24 respectively). Conclusion: Implementation of respiratory PNF techniques on short term basis optimally improves the functional exercise capacity and PEFR in patients with stable COPD. [ABSTRACT FROM AUTHOR]

Purpose: As the values of respiratory muscle strength vary according to race, ethnicity, and geographical area, there is a wide-ranging difference among different populations. Thus, the available reference values may not have an application for use in the Indian paediatric population, creating a need for generating values which will be appropriate for the Indian paediatric context. Materials and Methods: Assessment of respiratory muscle strength was carried out by assessing maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) and synthesising predictive formulas using anthropometric variables like height, gender and age, which will be suitable for Indian children. Results: We calculated MIP and MEP of 320 (boys=160 and girls= 160) children in the age range of 7 years to 17 years of Mangaluru city, India. Results stated that mean MIP and MEP for boys were 72.5± 32.8 cm H2O and 73± 33.2 cm H2O, while for the girls it was 67± 30.2 cm H2O and 68± 30.1 cm H2O, respectively. Conclusion: This study concluded that there is a difference in respiratory pressure values of Indian children with respect to those of other countries. Age, gender, height and BMI have a significant role in determining respiratory muscle strength. Boys demonstrated higher MIP and MEP. As age, height, weight and BMI increases, so does MIP and MEP. [ABSTRACT FROM AUTHOR]

Background: Resisted Abdominal curl-up exercise training has been used to increase respiratory muscle strength, but no studies have been done to determine whether this type of non - respiratory activity can lead to respiratory fatigue. Objective: To compare the effect of abdominal resisted exercises on pulmonary function test values during summer and winter season in healthy female subjects. Procedure: 50 subjects were taken on the basis of criteria of selection and their baseline values were documented. Intervention given were abdominal curl up exercise in form of Grade-3 for 30 repetitions in one minute for one session per day which was carried out for 3 continuous days. Post Intervention PFT Values were taken immediately after Abdominal Resisted Exercises. Pre and post intervention values of 3 days were taken in form of PFT values. This procedure was carried out in summer and winter season for the recruited subjects in temperature of above 350 and below 250. Results: Thus, it can be analyzed that P≥ 0.05 in case of pre and post values of FVC and MVV in winter season but P≤0.05 in case of pre and post values of FVC and MVV in summer season which is due to increased metabolic activity in summer season. Conclusion: This study concludes that implementing a primarily non respiratory activity induces fatigue on respiratory muscle strength by reducing FVC and MVV measurements of pulmonary function test more in summer season than in winter season in healthy female subjects. [ABSTRACT FROM AUTHOR]

Introduction: Water-based exercises are widely accepted exercises due to its acceptance and additional benefits from them. Exclusively, aquatic exercises are more advantageous than Land Exercises (LE), particularly in the early phase after rehabilitation for respiratory benefits. Aim: To evaluate the efficacy of water-based inspiratory muscle training in respiratory muscle strength, lung functions and functional capacity in patients with Parkinson's Disease (PD). Materials and Methods: A longitudinal study was conducted on 30 participants with idiopathic PD, at Chandigarh University, Mohali, Punjab, India, between 50-65 years and in stages I-III (Modified Hoehn and Yahr Scale). Respiratory muscle strength was evaluated through inspiratory muscle training and functional capacity was evaluated with a 6-minute walk test. After the assessment, the participants were randomly assigned into two groups. Group A: Along with conventional exercise, waterbased inspiratory muscle training was given to the population of this group. Group B: Along with conventional exercise, landbased respiratory muscle training was given to the population of this group. Results: Mean age of group A was 69±6 years and group B was 69±4 years (p-value=0.90). As per statistical analysis using paired t-test, both the groups showed improvement from baseline in all the parameters {Forced Vital Capacity (FVC)%, Forced Expiratory Volume in one second (FEV1)%, Maximal Expiratory Pressure (MEP) (cmH2O)} after the intervention. When compared within the groups using independent sample t-test, there was statistically significant change seen in mean value of the parameters and group A was found to be better as compared to Group B. Conclusion: The study revealed that water-based respiratory muscle training is safe and more effective intervention as compared to land-based exercise. Further, water-based intervention safely helps in improvement of inspiratory and expiratory muscle strength, pulmonary functions as well as for general body activity in patients with mild-to-moderate PD. [ABSTRACT FROM AUTHOR]

Introduction : Aging is the universal phenomenon, India is the Second Largest country in the world with 72 million elderly person in 2011. It is suspected that it will be 172 millions by 2031.People above the age of 60 years are consider as Geriatric. Aging is associated with decrease in lung compliance and Thoracic Mobility. Kyphotic curvature of spine occurs due to aging, which increases AP diameter of the thorax. Increase in AP diameter of thorax alters the curvature & optimal length of Diaphragm and decreases its force generation capacity. Also due to poor posture Shoulder Quadrant muscle undergoes Shortening due to which pump handle and bucket handle movement do not occur properly, ultimately reducing the Thoracic Mobility & Flexibility. So there is a need to improve Pulmonary function among Geriatric Population. Aim : To compare the effect of respiratory muscle stretch gymnastic (RMSG) and diaphragmatic breathing on pulmonary function test among geriatric population Objectives : (1)To find out the effect of RMSG on FEV1, FVC and FEV1/FVC ratio in geriatric population (2) To find out the effect of diaphragmatic breathing on FEV1,FVC and FEV1/FVC ratio in geriatric population (3) To compare the effect of RMSG & diaphragmatic breathing on FEV1,FVC and FEV1/FVC ratio in geriatric population. Method: Subjects who fulfil exclusion and inclusion criteria were selected by purposive sampling and were assigned to group A and group B by simple random sampling. They were explained about the study, its usefulness and written consent were taken. 60 subjects were divide into two Groups: Group A: 30 subjects were given RMSG Group B: 30 subjects were given Diaphragmatic Breathing. Results: Data were analyzed using software SPSS version 20 . Paired t-test was applied within the group and Unpaired t-test was applied between the two groups. Pre-treatment and post-treatment FVC, FEV1 and FEV1/FVC ratio was analyzed, it showed statistically significant (P value < 0.05) difference in both the group but when comparison was done between two groups, it was statistically non-significant (P value > 0.05). Conclusion: Respiratory Muscle Stretch Gymnastic and Diaphragmatic breathing both were effective in improving pulmonary functions in geriatric population after performing breathing techniques for consecutive 3 days (once a day). But there was no significant difference between the two Groups in improving pulmonary function in geriatric population. [ABSTRACT FROM AUTHOR]

Background and objective: Cotton industry workers are more prone to exposure to cotton dust which causes acute respiratory responses such as chest tightness, bronchoconstriction and respiratory disease including byssinosis. These symptoms make changes on lung function and functional activities. Physical activity includes respiratory muscle strengthening and training larger group of muscles plays an important role in health outcomes to improve pulmonary ventilation capacity, exercise capacity and decreased in dyspnea. So the purpose of this study was to find the effect of inspiratory muscle trainer on lung function and six min walk distance (6MWD) in cotton industry worker. Method: 30 cotton industry workers between the age group (30-55 years) were randomly selected and assigned randomly into two equal groups; group- A received aerobic training and group-B received aerobic training and inspiratory muscle training for 4 times per week for 4 weeks. Pulmonary function, 6MWD and quality of life were used to measures before and after a training program. Results: Lung function was not significantly (p>0.01) improved in group A while in group B improved significantly (p<0.01) except forced vital capacity. Comparison between both groups was statistically (p>0.01) not improved. 6MWD was improved significantly (p<0.01) in both groups but between the groups was not improved. Conclusion: Outcomes from this preliminary study were encouraging. Inspiratory muscle trainer produced significant improvement in 6MWD and lung function except forced vital capacity. Further research is required to examine the effect of inspiratory muscle trainer on a larger scale. [ABSTRACT FROM AUTHOR]

The article previews the Airofit PRO respiratory muscle training (RMT) tool/device from Xplore Health Technologies and Airofit.