Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study

Ankle dorsiflexion range of motion (ROM) typically decreases after prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsiflexion ROM and decrease joint stiffness after immobilization. The purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately affected measures of dorsiflexion ROM, posterior ankle joint stiffness, and posterior talar translation in ankles of patients who had been immobilized at least 14 days. Ten physically active patients (5 males, 5 females; age=21.4±3.3 years) participated. Each had the ankle immobilized following a lower extremity injury for at least 14 days and presented with at least a 5° dorsiflexion ROM deficit compared to the contralateral ankle. A crossover design was employed so that half of the subjects received joint mobilizations first and half of the subjects received the control intervention (no treatment) first. All subjects ultimately received both treatments. Active dorsiflexion ROM was assessed with a bubble inclinometer, and posterior ankle stiffness and talar translation were assessed with an instrumented ankle arthrometer. After a single application of grade III anterior-to-posterior talocrural joint mobilization, dorsiflexion ROM and posterior ankle joint stiffness were significantly increased. There was also a trend toward less posterior talar translation immediately after mobilization. The trend toward decreased posterior talar translation and increased posterior ankle joint stiffness supports the positional fault theory. Correction of an anterior talar positional fault offers a possible explanation for these results.     

Bio-threat preparedness: Need for a paradigm shift

India of late has been vulnerable to Chemical, Biological, Radiological and Nuclear (CBRN) threat, on account of its unique geographic position. Biological threat is an imminent threat in the hands of a terrorist. The public health system of our country is overburdened due to its present role and bio-attack response is not a priority area. This paper suggests that as the prime focus is on the CR and N threats in the integrated CBRN preparedness strategy and that specialized and technical forces are needed to deal with a bio-threat; hence there is a need for a paradigm shift in policy. The emerging field of bio-threat needs to be delinked from the joint family of ‘CBRN’, with consequent structural and functional changes. A separate specialized cadre needs to be formed for dealing with bio-threat, created from the pool of doctors and non-medical scientists from the AFMS and the DRDO. Structural changes are needed in the organization, to bring in the resources of NCDC, New Delhi for enhanced disease surveillance capacity and creation of a bio-threat mitigation node in the AFMC, Pune.     

Comparison of fiber reinforcement placed at different locations of pontic in interim fixed partial denture to prevent fracture: An in vitro study

Background:

The interim restoration is an important phase in fixed prosthodontic therapy. It should provide sufficient durability to withstand the forces of mastication. A fractured interim restoration is damaging to the prosthodontic care and may lead to an unscheduled appointment for repair. Several attempts have been made to reinforce interim fixed partial dentures (FPDs). These have included the use of metal wire, a lingual cast metal reinforcement, a processed acrylic resin interim restoration, and different types of fibers, e.g., carbon, polyethylene, nylon and glass. These fibers can be placed in the occlusal, middle or cervical thirds in the FPD. There is no scientific data to evaluate the effect of fiber placement methods on the fracture resistance of clinical interim FPDs.

Purpose of the Study:

Hence this study was designed to evaluate fracture load values of interim FPDs with different locations of fiber reinforcement.

Materials and Methods:

30 interim FPD samples with polymethyl methacrylate (PMMA) reinforced with fibers at three different locations mainly occlusal, cervical and middle (10 samples each) were fabricated using a metal FPD on a master die. They were tested for fracture resistance in universal testing machine.

Results:

The fracture resistance was recorded and is tabulated and analyzed statistically. The results showed that the placement of the reinforcement in the occlusal third of the pontic resulted in higher fracture resistance which was significantly higher (P < 0.05) than all other locations.

Conclusion:

The occlusal third of the pontic region from mesial to the distal end of the connector is the best site of placement of the fiber for reinforcing the PMMA interim restorative resin.Key Words: Fiber placement, fracture resistance, interim fixed partial denture, polymethyl methacrylate, reinforcements     

III. Prior Life Change and Illness Onset in an Attack Carrier’s Crew

Approximately one third of the enlisted crew of an attack carrier (N = 687) was studied during a six-month deployment to Vietnam. The Schedule of Recent Experience (SRE), designed to document significant recent life change, was administered at the beginning of the cruise, and the illnesses developed by these men during the cruise were tabulated. This paper discusses the relationship of prior life change to illness onset.

Initially, an item weighting system which was constructed from civilian populations was used in scoring, but this scoring system failed to discriminate future illness. A new weighting system was then derived by stepwise multiple regression analysis, which was done separately for unrated seamen and petty officers. Several different items emerged as unique predictors for these two groups of men. The life change scores based on the regression-derived weighting system clearly and significantly discriminated future illness, indicating that new SRE scoring methods can be useful in illness prediction in small samples.