Introduction The prevalence of diabetes mellitus in the United Arab Emirates stands significantly high. Considering the etiopathogenesis for diabetic foot ulcers, studies suggest that increased plantar pressure, also referred to as the peak plantar pressure beyond a threshold value leads to the breakdown of skin and thus causes an ulcer. The accurate analysis of ground reaction force and peak plantar pressure could be suggestive and predictive for the occurrence of foot ulceration among diabetes mellitus and the study aims to analyze the kinetics at the ankle joint among diabetics in the UAE. Methodology The cross-sectional study was conducted at the Thumbay Physical Therapy and Rehabilitation Hospital, Gulf Medical University, Ajman, United Arab Emirates. 38 out of a total of 120 participants screened and diagnosed with Type 2 diabetes mellitus were taken for data collection and analysis. BTS motion analysis and Wintrack foot scan mat were used for kinetics at the ankle joint. Results Higher mean peaks of plantar pressure, 810, 654, and 911 kPa respectively were found at all three phases of the gait cycle. A positive and high correlation was found between peak plantar pressure risk of foot ulcer (r= 0.84). A negative and moderate correlation was observed for ankle joint moment and power. Conclusion The diabetic population in the United Arab Emirates could be at higher risk of foot ulceration with significantly increased peak plantar pressure. The altered kinetics such as reduced ankle joint moment and power could further add to the risk.### Competing Interest StatementThe authors have declared no competing interest.### Funding StatementThe author(s) received no specific funding for this work.### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.Not ApplicableThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Thumbay Physical Therapy and Rehabilitation Hospital, Gulf Medical University, Ajman, (IRB/COHS/FAC/21/May 2021),I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.Not ApplicableI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Not ApplicableI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.Not ApplicableAll relevant data are within the manuscript and its Supporting Information files.

In the shoulder, a rotator cuff tear refers to a rupture of one or more of the tendons of one or more of the four rotator cuff muscles. Magnetic Resonance Imaging (MRI) is an effective method for diagnosing rotator cuff injuries, including tears. MRI can provide clear images of ligaments, tendons and muscles. Rotator cuff tears were diagnosed by MRI at King Salman Hospital and King Khalid Hospital in Hail. MR Unit with 1.5-T Siemens scanners was used to evaluate all patients with shoulder MRI protocol including fast spin echo sequence T1W & T2W was used. The fat saturating proton density (FSPD) can be obtained in four planes of imaging, namely axial, oblique, coronal, and sagittal oblique, three planes of axial, oblique, coronal, and sagittal oblique, as well as three planes of oblique. In this study, 50 patients were enrolled, ranging in age from 20 to 80 years, 28 of whom were males and 22 of whom were females. There were 61 to 80-year-old patients (40%) who were the oldest. Meanwhile, there were only 4 cases among the youngest patients between the ages of 20 and 30 (8%). Out of 50 patients, 28 were diagnosed with full-thickness tears (56%) and 22 cases were diagnosed with partial tears (44%) using MRI. The findings from this study suggest that MRI is highly effective for the detection of rotator cuff tears, both full-thickness tears and partial -thickness tears. In addition, it provides details regarding the tear, tendon retraction, joint effusion, and subacromial-subdeltoid bursa.

The Magnetic Resonance Imaging (MRI) examination has proven to be the preferred examination in the assessment of patients with low back pain. MRI is a non-invasive imaging technique with excellent spatial and contrast resolution. The objective of this study was to describe the efficiency of MRI in determining lower back pain and classify the range of lumbar disc pathology in our geographical region. In this study, 80 patients were included and their consent was obtained. Patients reported their intensity of back and leg pain in Visual Analogue Scale (VAS) and recorded their disability in the Roland Morris Disability Questionnaire (RMDQ-Arabic version). Clinical examination of the spine and the lower extremity was done, followed by MRI for all all the patients. The degree of the disc displacement and nerve root compression was graded according to the Michigan State University (MSU) classification of disc herniation. Correlation between the pain intensity (VAS), Functional Disability (RMDQ) and grade-2 disc herniation in MRI were measured with Pearson correlation coefficient. Pain intensity (VAS) pain did not correlate with age of the patient (r = 0.03) and duration of their LBP (r = 0.01). Similarly, the disability index (RMDQ) also did not correlate with age of the patients (r = 0.12) and duration of their LBP (r = 0.03). Pain intensity (VAS) however has correlation with the disability (r = 0.32). Level of the disc herniation did not correlate with pain (r = 0.14) and disability (r = 0.03)The level of disc herniation is not correlated with either level of pain or level of functional disability; as a result, it is prudent to correlate the clinical symptoms of the patients with an MRI before determining the course of treatment for the patient.

Teaching is one of the most stressful professions since teachers have many responsibilities to meet the targets such as teaching, lesson planning, classroom management and discipline, supervisory role, extracurricular activity, etc. However, during the COVID-19 outbreak, teaching has become challenging for professional teachers. A total number of 85 professional teachers were screened, by which 73 subjects provided informed consent to take part in the study and were included in the study. A stress questionnaire developed by International Stress Management Association UK (ISMA) was used to assess the stress among professional teachers. Among the 50 subjects, five subjects had a history of hypertension, one subject had diabetes mellitus, 11 subjects had low back pain, five subjects had knee pain, and two subjects had migraine. The stress assessment questionnaire revealed that 64% of subjects were towards moderate risk, 34% high risk, and 2% low risk for stress. The present study concludes that professional teachers are at moderate to high risk of developing occupational-related stress associated with health-related problems.

An evaluation of myocardial function is necessary to assess the condition of a patient's heart. Although ejection fraction is used as a measure of myocardial function, many common cardiac illnesses affect the myocardium locally rather than globally. It may therefore be possible to determine the motion of the regional wall of the heart by evaluating myocardial strain. Studying the efficacy of CMR feature tracking in diabetics Type 2 To determine whether the use of MRI feature tracking is effective in detecting myocardial strain deformations in diabetics and healthy individuals.This study involved 80 patients, 40 of whom had Type 2 diabetes and 40 of whom did not, who were subjected to cardiac MRI and echocardiography. Post-processing was done offline using CMR feature tracking and echocardiography speckle tracking, followed by SPSS analysis of the data. T2DM patients and controls did not demonstrate any significant differences in the study. There was a significant decrease in the LV GLS and LV GRS values among T2DM patients (p 0.0001) as compared to normal controls. Where the LV GLS was in controls (-20 +/- 5) and diabetes (-15 +/- 2). The CMR-FT method is well suited for accommodating STE, providing additional information in clinical trials, which can be used interchangeably. This study recommends that feature tracking (FT-CMR) and speckle tracking echocardiography (STE-Echo) be incorporated into the clinical practices of hail hospitals due to their positive results in diagnosing myocardial deformation.

Calcium levels in the Coronary Artery are an indicative marker of the presence and extent of atherosclerosis. This serves as an additional prognostic indicator in addition to traditional risk factors. Moreover, the coronary calcium test is associated with a descriptor known as the calcium score or calcium score (Cs), which is primarily useful for stratifying the risk of asymptomatic patients, while for patients with acute or chronic chest pain, coronary axial computed tomography is generally req

BackgroundCOVID-19 survivor's population is often associated with a long term impact on mental and psychological health. Recent included studies have also stated affliction of mental health due to fear of virus and preventive policies among the college students. ObjectivesThe research was conducted to find the psychological and mental impacts of SARS-CoV-2 affliction among the students' survivors in the university. MethodsThe study design of the experiment was cross-sectional, sampling technique was non probability and sampling method being applied was convenience sampling. IBM Statistical Package for the Social Sciences version 20 was used for analyses. Descriptive data was examined and results were showed as mean and standard deviations, percentages, frequencies for continuous variables of IES-R scale (Intrusion, Avoidance, and Hyperarousal) using the total sample of n = 34. ResultsOut of 34 only 24 student survivors responded to the online survey post COVID-19 recovery, with an overall participation level of 71%. Grading was given for the total IES-R score which was subdivided into a predefined range. Out of 24 participants, 9 (38%) participants showed the symptoms of mild (n = 2)-severe (n = 7) psychological impacts. On correlation of factors total IES-R score and taste and sense of smell were moderately correlated. The ordinal regression for complete loss of sense of taste and smell was also significant. ConclusionThe results from IES-R evaluation clearly outlines the presence of psychological sequels post recovery of COVID-19 episodes among the young college survivors. Complete loss of sense of smell and taste may be an indicator of psychological sequelae as compared to reduce sense of smell.

Globally, 643 million people will be affected by 2030, and 783 million by 2045 with diabetes mellitus (DM), a severe disease that affects 537 million people worldwide in 2021. Kingdom of Saudi Arabia (KSA) has the highest prevalence of diabetes mellitus among the top ten countries worldwide. Therefore, the present study aimed to identify the factors influencing diabetes care and assess their relative importance. Research was conducted in the Hail region of the Kingdom of Saudi Arabia. The study recruited 258 diabetes patients visiting the Primary Health Centers in Hail City as part of their routine healthcare. Analyzing the data was performed using the Statistical Package for Social Sciences (SPSS-22). As far as Cronbach's Alpha is concerned, it was 0.717, and Kaiser-Meyer-Olkin (KMO) was 0.705. The study has found that the six factors including accessibility of diabetes care (p = .024), availability of diabetes services (p = .029), quality of diabetes care (p = .024), disease management strategies (p = .037), basic amenities of health system (p = .028) and health education resources (p = .030) play a significant role in providing diabetes care services to patients. According to the adjusted R2 of 0.773 (p 0.001), diabetes care is significantly influenced by these six variables. The comparative importance of the factors indicates that, out of six, quality of diabetes care is the most influential; the availability of diabetes services and health education resources are the second and third most influential factors. In order to provide better care for diabetic patients, healthcare organizations should focus on these factors.

The fruit of Canarium odontophyllum Miq. are a traditional delicacy in Borneo for its anti-aging benefit. This study evaluated the protective effect of C. odontophyllum leaf aqueous extract on the damaged liver in streptozotocin-induced diabetic rats. A total of 30 male Spraque-Dawley rats (150-250g) were randomly divided into three groups: control group, diabetic without treatment and diabetic treated with 300 mg/kg aqueous extract once a day for 28 days. The diabetic condition was induced by intravenous injection of 65 mg/kg streptozotocin (STZ). The blood was collected to assess the biochemical changes and the oxidative stress marker whereas the liver section was examined for morphological changes. Result showed that the level of blood aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin, gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) in STZ-induced rats treated with C. odontophyllum were significantly reduced (p<0.05) compared to STZ group. Oxidative stress test showed lower level of malondealdehid (MDA) and protein carbonyl but significantly (p<0.05) higher activity of GSH, SOD and GPx compared to untreated diabetic group. Abnormal cells were not detected from the histological observation. These findings demonstrated that the aqueous extract of C. odontophyllum has the potential to provide protective effect against liver damage in diabetic rat.

Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Therefore they are prone to develop frequent and often foot problems with a relative high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. Thus the review on study of foot kinematic and kinetic in type 2 diabetes mellitus to understand the biomechanical changes is important.

There has been a profound increase in the prevalence of diabetes mellitus especially among the Asian The biomechanical alteration in the foot structure and function are an important predictive risk factor for development of foot complications in type 2 diabetes mellitus. The routine biomechanical analysis using advanced motion analysis software in a clinical population like diabetes mellitus is still lacking in Indian settings. Therefore the aim of the study was to analyse and compare the biomechanical parameters of foot in diabetes mellitus with and without neuropathy and normal individuals of similar age group. The study was conducted in the biomechanical lab, diabetic foot clinic, Kasturba Hospital, Manipal, Karnataka, India. Sixty participants (n=20 DM type 2 with neuropathy, n=20 DM Type 2 without neuropathy and n=20 normal healthy) participated in the study. The kinematic analysis was done at knee and ankle joint using 3D SIMI REALITY MOTION SYSTEM GmbH, Germany, with two high speed Basler (1394a/b, GigE, [email protected])cameras. For kinetics I step software, Aetrex, U.S.A and Wintrack dynamic Scan foot mat, Medicapteure software, France, U.S.A was used. Significant difference was seen in kinematic and kinetic variables like knee joint angle at toe off (p=0.002), knee velocity at static, heel strike, midstance and toe-off (p=0.000), knee acceleration at static, heel strike and midstance (p=0.001,0.002,0.006 respectively), ankle joint angle at midstance (p=0.006), ankle velocity at static, heel strike and midstance (p=0.022,0.001,0.002)ankle acceleration at static, heel strike, mistance and toe-off (p=0.013,0.002,0.000,0.000 respectively), gait cycle duration (p=0.000), max average plantar pressure (0.021) and max. great toe pressure (p=0.025). There biomechanical differences among the diabetes with and without neuropathy and normal healthy are high and therefore biomechanical analysis is an important tool and can be used for early screening and prediction of altered kinematic and kinetics in diabetes mellitus population in India.

To find out the role of infrared thermal imaging as an outcome measure in physiotherapy based intervention in low back pain. After obtaining informed consent, seventeen participants clinically and radiologically diagnosed with low back pain were included in the study. After baseline assessment for pain and tissue temperature using thermal imaging, all the participants were given interferential therapy at a frequency of 90Hz for 15mins & Low Level Laser Therapy with dose of 3.1 j/cm2(8 minutes) for low back pain. Pain assessment was done using the Visual Analog Scale (VAS), Facial Pain Scale (FPS). All participants received treatment for ten days and at the end of the last session all the subjects were re-evaluated for pain and tissue temperature. Both outcome measures were analysed by paired t test. Level of significance was kept at p<0.05. The analysis showed significant reduction in tissue temperature and pain in all participants. VAS score was significantly reduced from 6.71±2.114 to 4.06±1.853 (p<0.001) and FPS was reduced from 4.82±1.01 to 2.71±1.16 (p=0.001). Temperature was significantly reduced from 32.35±2.44 degree Celsius to 29.91±2.48 degree Celsius (p=0.002) In the present study, we found that, Infrared thermal imaging can be objectively used as an outcome measure in the treatment of low back pain.

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, which results from defects in insulin secretion, insulin action, or both. Deficiency in insulin leads to chronic hyperglycemia with disturbances of protein, carbohydrate and fat metabolism. 1) Most of the diabetics belong to developing countries with the age range of 40-60 years at a higher risk of developing complications related to diabetes 2).The changing lifestyle, decreased physical activity and dietary habits clearly signify that there is a shift in the global epidemiology of type 2 diabetes and its complications like neuropathy, retinopathy and nephropathy, myocardial infarction and stroke or even mortality. 3) Diabetic peripheral neuropathy is the most frequently occurring complication in type 2 diabetes. Peripheral neuropathy affects up to 50-70% of the population with diabetes. 3) The presence of autonomic neuropathy dramatically shortens the patients’ longevity and increases the mortality. Loss of sensation in the lower limbs is a high risk for foot ulcers and limb amputation, which occurs in 1–2% of diabetic population. 4) Diabetes mellitus and its complications like peripheral neuropathy does not spare any professionals including doctors, businessmen, teachers, and road transport drivers etc. Road transport drivers are among the professional groups whose activities have a strong impact on public safety. Road transport drivers like passenger transport operations and truck driving are closely associated with the responsibility for other people’s lives. 5) In view of the nature of their professional activity, which involves exposure to stress, a sitting working mode, and a shift and night work, the drivers are at a higher risk for developing diabetic complications as most of the drivers doesn’t not follow appropriate diabetes foot care due to their busy professional schedule. 6) This can increase the risk for traffic accidents due to loss of sensation and proprioception of the feet while driving public vehicles as a result of peripheral neuropathy. Therefore the purpose of this case study is to emphasise the need for early screening for diabetes and its complications among public transport professionals.

Patients with diabetes mellitus (DM) are prone to develop heart failure even in the absence of evident hypertension and coronary artery disease. This entity is difficult to detect in early stages by conventional echocardiographic techniques. 32 asymptomatic TMT (tread mill stress test) negative DM patients compared with control subjects were screened and performed LV (left ventricle) strain, strain rate and tissue Doppler imaging. Tissue Doppler imaging revealed increased E/E’ of IVS (Inter ventricular septum) (p value<0.001) among DM suggestive of diastolic dysfunction. The tissue velocities E’ of both the LV lateral wall (p value=0.004) and RV (right ventricle) (p value =0.003) were reduced among DM. Similarly, the peak systolic strain (p value<0.001), and strain rate (p value<0.001) were significantly reduced among diabetic subjects. DM is an independent risk factor for myocardial dysfunction even in asymptomatic normotensive subjects. The changes that occur in the myocardium due to diabetic cardiomyopathy can be detected early, as the novel tissue Doppler is a noninvasive technique for early detection of Diabetic cardiomyopathy.

BACKGROUND & AIMSDiabetic peripheral neuropathy (DPN) accounts for most common complications of T2DM. Painful DPN is associated with functional limitation & poor quality of life. Therefore, objective of the study is to find the effect of low level laser therapy on painful diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) Materials & methods: The study design is pre-post observational design. After obtaining ethical clearance and informed consent, 19 T2DM subjects were screened and confirmed for peripheral neuropathy in an outpatient setting with biochemical parameter, pain scale and Michigan Neuropathy Screening Instrument (MNSI). Low Level Laser therapy was irradiated through scanning mode with dosage of 3.1J/cm(2) on the plantar and dorsum of the foot and 3.4j/cm(2) with contact method for 10days and all subjects were reassessed at the end of the 10 day. Descriptive statistics and paired' test was used to analyze the pre-post finding within the group. Level of significance was set at p<0.05 RESULTS: The result analysis showed significant reduction in Pain using VAS scale (6.47 ± 0.84 to 1.21 ± 0.78 (p<0.001), MNSI (5.52 ± 1.26 to 2.71 ± 0.97 (reduction in Vibration perception threshold (32.68 ± 6.08 to 24.84 ± 4.29 (<0.001) and a significant increase in the temperature from baseline to post intervention (30.01 ± 2.11 to 31.75 ± 1.03 (p<0. 001).CONCLUSIONIn the present study, Low level laser therapy was found to be effective in type 2 DM with peripheral neuropathy.

Objectives: The objective of the present study was to identify the gait changes in T2DM subjects without PN (Peripheral Neuropathy). Methods: 36 T2DM subjects without PN and 32 age matched non-diabetic subjects (NDM) were recruited. Gait characteristics were analyzed using Win-track dynamic foot scanner. Data were analyzed using independent ‘t’ test. Level of significance was kept at P<0.05. Results: Analysis showed no significant differences in gait characteristics in T2DM subjects without PN as compared to NDM subjects. Conclusions: T2DM subjects without PN presents with a gait same as subjects without T2DM. Gait changes in T2DM are dependent on loss of protective sensation of the foot and intrinsic foot muscle atrophy. Therefore, dynamic foot analysis should be incorporated in routine diabetic foot evaluation to understand the gait in T2DM and hence many complications can be prevented.

Corresponding author: Snehil Dixit, Department of Physiotherapy, School of Allied Health Sciences (SOAHS), Manipal University, Manipal 576104, Karnataka, India, E-mail: snehildixit83@gmail.comRec date: Apr 05, 2014, Acc date: Apr 23, 2014, Pub date: Apr 28, 2014Copyright: © 2014 Dixit S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,distribution, and reproduction in any medium, provided the original author and source are credited.

BackgroundDiabetes mellitus is a metabolic disorder with involvement of the neurovascular and muscular system. Peripheral neuropathy (PN) is thought to be the principal cause of foot complications in type 2 diabetes mellitus (T2DM). However, foot evaluation using ultrasonography early in the course of diabetes has not gained due importance. The aim of the present study was to evaluate the thickness of intrinsic foot muscles, plantar skin, plantar fascia, and plantar fat pad in T2DM subjects with and without PN using musculoskeletal ultrasonography.MethodsThis study was conducted in 30 T2DM subjects with and without PN and 30 age-matched non-diabetes mellitus (NDM) subjects. After detailed clinical evaluation, high-frequency musculoskeletal ultrasonography was used to measure the thickness of the intrinsic foot muscles and plantar tissue thickness under the metatarsals. Data were analyzed using independent t-tests to compare T2DM groups with NDM subjects, and one-way ANOVA followed by Tukey's honestly significant difference test for between- and within-group analyses.ResultsThere was a significant reduction in the thickness of the intrinsic foot muscles and plantar tissue in T2DM compared with NDM subjects (P<0.05). However, there were differences in intrinsic foot muscle and plantar tissue thickness between T2DM subjects with and without PN.ConclusionThere was a substantial decrease in intrinsic foot muscle and plantar tissue thickness in T2DM compared with NDM subjects, indicating that structural changes appear in the foot before PN develops. The techniques used in this study cannot exclude the possibility that neuropathic changes that are clinically undetectable may develop in parallel with changes in plantar tissues.

Objective: To determine the position sense acuity across shoulder rotational range of motion in healthy subjects. Design: Cross-sectional study. Setting: Sports Medicine Department, Manipal hospital, Bangalore. Participants: Thirty healthy subjects with right hand dominance. Method: The ability of the subjects to replicate two criterion positions (mid-range and outer range) was examined in subjects' shoulder joints by using a standard goniometer. 50% and 90% range of total passive shoulder rotational range of motion were the two criterion positions. The difference between the test range of motion and repositioning range of motion indicates the position sense acuity. Results: There was a better position sense acuity in 90% range compared to that at 50% and was more in dominant shoulder than nondominant shoulder. Conclusion: Outer range shoulder rotational range of motion has minimum error in position sense acuity due to the tension in the peri articular structures of shoulder joint.