Balm is a topical preparation commonly used to relieve muscle pain through a warming effect. The innovation of balm in stick form offers more prac tical and hygienic application. This study aimed to formulate a balm stick from lemongrass (Cymbopogon nardus L.) essential oil, evaluate its physical stability, and conduct a skin irritation test. This experimental study employed steam distil lation and melting methods for preparation. Three balm stick formulations were developed based on varying concentrations of lemongrass essential oil: FI (20%), FII (25%), and FIII (30%). Stability tests included organoleptic observation, ho mogeneity, pH measurement, spreadability, and skin irritation assessment. Results showed that all formulations maintained stable color, aroma, and form for up to one week of storage. All three formulations exhibited good homogeneity and pH values within the skin standard (pH 5). The spreadability test indicated good ad herence to the skin, and no irritation was observed before or after storage. In conclusion, variations in essential oil concentration can be successfully formulat ed into an aromatherapy balm stick for muscle pain relief. The concentration all variations did not affect the stability of the preparations, and all formulations passed the skin irritation test, supporting their use as topical aromatherapy and muscle pain relief products.

Low-load resistance training with blood flow restriction (BFR) has gained popularity for eliciting muscular adaptations comparable to high-load resistance training. However, its acute metabolic and electrolyte responses within the exercising limb, particularly under exhaustive conditions, remain insufficiently characterized. This study aimed to assess these responses using simultaneous arterial and venous blood sampling during unilateral elbow flexion to volitional failure under three conditions: low-load (LL-RT, 30%1RM), low-load with BFR (LL-BFR-RT, 30%1RM, 50%LOP), and high-load (HL-RT, 75%1RM). Ten healthy men (26.8 ± 4.6 years) completed all exercise conditions in a randomized cross-over design. Catheters were placed in the radial artery and antecubital vein of the exercising arm. Serum creatine kinase (CK) and lactate dehydrogenase (LDH) were assessed as indirect muscle damage markers. LL-RT produced the highest total workload (692 ± 251kg), exceeding both LL-BFR-RT (378 ± 58.7kg) and HL-RT (327 ± 65.1kg, p < 0.001). Muscle pain perception assessed using a visual analog scale increased during exercise, with a highest level in LL-BFR-RT (p < 0.01). LL-BFR-RT also induced the most pronounced venous perturbations (e.g., reduced pH and sO2, elevated pCO2 and K+), while arterial responses remained modest across conditions. CK increased slightly at 48h post-exercise across all conditions (p = 0.036), while LDH was highest following HL-RT (p < 0.001). These findings suggest that LL-BFR-RT to failure induces substantial local metabolic and ionic stress within the exercising limb despite reduced mechanical loading. The marked venous disturbances, alongside minimal increases in systemic damage markers, support its use as a metabolically potent yet mechanically efficient training modality when applied with care.

Abstract Background Chronic low back pain (CLBP) is a prevalent condition affecting millions globally, often leading to disability and impaired quality of life. It is a leading cause of disability, with significant impacts on functionality, social participation, and mental health. Various interventions, including progressive postural control exercise (PPCE), yoga, and conventional physiotherapy, are used to manage CLBP, but their comparative efficacy remains unclear. This study aimed to compare the effectiveness of PPCE, yoga, and conventional therapy in improving pain, disability, and core muscle endurance in individuals with CLBP. Methods A total of 36 participants were recruited for the study and assigned to three groups: group A (PPCE), group B (yoga), and group C (control). The study utilized a comparative experimental design with convenience sampling. Interventions lasted for 6 weeks. Outcome measures included pain intensity (measured using the Numeric Pain Rating Scale), pain-related disability (Roland-Morris Disability Questionnaire), and core muscle endurance (Prone Plank Test). Statistical analysis was performed using one-way ANOVA and post hoc Tukey tests. Results Over 6 weeks, both PPCE and yoga significantly improved pain, disability, and core endurance compared to baseline. PPCE showed the largest reductions in NPRS (Δ = 5.08, 95% CI 4.14–6.03) and RMDQ (Δ = 12.17, 95% CI 8.21–16.12), while yoga produced the greatest increase in Prone Plank (Δ = 39.00 s, 95% CI −61.72 to −16.29). Post hoc analysis revealed PPCE reduced pain more than control ( P = 0.01), and yoga improved core endurance versus control ( P = 0.04). Conclusion At the end of 6 weeks, the PPCE group showed significant improvements in pain, disability, and core endurance, making it the most effective intervention. The yoga group showed significant gains in core endurance but not in pain or disability, while the control group showed minimal improvements. These findings suggest that progressive core exercises and yoga can be effectively integrated into conventional physiotherapy for managing chronic low back pain, enhancing overall outcomes through pain relief, functional improvement, and core stability.

Generally, triathletes participating in short events should aim to finish the swim stage with the leading group to improve their chances in the subsequent cycling and running stages. However, the fatigue associated with very intense swimming can impair subsequent split times. This study aimed to investigate the impact of swimming bout intensity on performance in subsequent cycling, running, and overall racing among well-trained male and female amateur triathletes. Twenty athletes (12 men and 8 women) participated in this study. Critical velocity (CV) was estimated for swimming using a simple linear model. Body composition and maximal oxygen uptake were measured. Participants visited the laboratory three times to swim 750 m at intensities below CV, at CV, and above CV (in randomized order), before they cycled 20 km and ran 5 km as fast as they could to simulate a sprint triathlon. Heart rate, blood lactate level, perceived exertion, muscle pain, and dyspnea levels were measured at the end of each modality. For women, on the day on which swimming intensity was below the CV, the overall race time was higher than on the day on which swimming intensity was at the CV (p = 0.041) or faster than the CV (p = 0.002). For men, there was no significant difference in the overall race time among the three intensities (p > 0.05). The results showed that, for men, swimming at higher intensity did not significantly change total time, whereas for women, lower intensity was associated with poorer performance. The study was registered in ReBEC - Registro Brasileiro de Ensaios Clinicos: Rio de Janeiro (RJ): Instituto de Informação Científica e Tecnológica em Saúde (Brazil); 2010 - Identifier RBR-73vcyff. Available from http://ensaiosclinicos.gov.br/rg/RBR-73vcyff .

Blood flow restriction training (BFRT) is increasingly used after orthopedic surgery. Previous systematic reviews have examined the effects of BFRT, but most have focused solely on strength and growth. This systematic review and meta-analysis aimed to evaluate the effectiveness of BFRT compared to traditional rehabilitation for improving muscle strength, size, pain, and balance in patients recovering from orthopedic surgery. A thorough search of PubMed, Web of Science, Embase, Cochrane Central, and Google Scholar yielded 11 randomized controlled trials (RCTs) involving 293 participants, and risk of bias (ROB) was assessed using the RoB 2 tool. Out of the 11 studies, nine reported on muscle strength, six on muscle size, six on pain, and three on balance. Seven out of nine studies showed improvements in muscle strength, and four out of six indicated increases in muscle size with BFRT. The combined estimates revealed significant benefits for strength (standardized mean difference [SMD] = 0.90; 95% confidence interval [CI]: 0.44, 1.35; I squared statistic [I 2 ] = 77%) and muscle size (SMD = 0.74; 95% CI: 0.34, 1.14; I 2 = 46%). Pain (SMD = 0.33; 95% CI: −1.16–1.82; I 2 = 94%) and balance (SMD = −0.07; 95% CI: −0.77–0.63; I 2 = 71%) were not significantly different. BFRT was generally safe and demonstrated superiority over standard rehabilitation for improving muscle strength and size. For pain and balance outcomes, there was limited evidence of benefit. This review highlights the need for higher-quality trials and examines less-studied outcomes, such as balance, thereby filling a gap in the literature.

IntroductionChronic fatigue syndrome (CFS) is characterized by persistent fatigue and multiple symptoms such as cognitive impairment and muscle pain, often linked to immune-inflammatory dysfunction. Sarcoidosis, a granulomatous disease with systemic inflammation, commonly causes fatigue, even during remission. This study examined whether fatigue and depressive symptoms in sarcoidosis remission relate to residual inflammation or oxidative stress. Recent studies highlight parallels between post-infectious fatigue syndromes, including Long COVID, and sarcoidosis-related fatigue, emphasizing IL-6 mediated pathways. Theoretical frameworks of immune–metabolic interactions further support the hypothesis that residual inflammation drives persistent fatigue in remission.Materials and methodsSeventy-one sarcoidosis patients were divided into three groups: remission with fatigue (RS/CFS, n=22), remission without fatigue (R/S, n=23), and active sarcoidosis (A/S, n=26). Fatigue was assessed with the Fatigue Assessment Scale (FAS), depressive symptoms with the Beck Depression Inventory (BDI), and quality of life with PHQ-9. Pulmonary function tests measured FEV1 and FVC. Serum biomarkers (hsCRP, IL-6, TNF-α, total antioxidant status, and 8-isoprostanes) were measured by ELISA.ResultsRS/CFS and A/S groups showed significantly higher fatigue, and depressive scores compared to R/S (P <0.05). HsCRP and IL-6 levels were elevated in fatigued patients (RS/CFS and A/S) versus non-fatigued (R/S) (P <0.05). IL-6 correlated moderately with fatigue and depression scores (r =0.33). No significant differences were found in TNF-α or oxidative stress markers. Pulmonary function was slightly reduced in fatigued patients and weakly correlated with mental fatigue (r = –0.26).ConclusionOur data support a role for low-grade systemic inflammation, especially elevated hsCRP and IL-6, in fatigue and depressive symptoms during sarcoidosis remission. Further research integrating inflammatory, oxidative, metabolic, and neuroendocrine pathways is needed to elucidate fatigue pathogenesis and develop targeted interventions. IL-6 may represent a potential biomarker of fatigue in sarcoidosis. These findings highlight the importance of persistent low-grade inflammation and may guide the development of future therapeutic strategies.

Aims: To analyze vitamin D deficiency-related symptoms and disorders among vegetarian and non-vegetarian individuals. Introduction: Vitamin D is a fat-soluble essential micronutrient crucial for maintenance of bone health, dental strength, immune function and overall well-being. Although Indians are living in a tropical climate with an abundance of sunlight, vitamin D deficiency symptoms and related disorders are prevalent across the population. The comparative cross-sectional study assessed the prevalence of vitamin D deficiency-related symptoms and disorders among vegetarian and non-vegetarian adults of rural and urban areas in Varanasi District, Uttar Pradesh, India Methodology: Samples were selected using simple random sampling method. Data collected from a sample of 200 individuals, i.e.,100 each from both vegetarian and non-vegetarian populations through survey using a structured questionnaire. The collected data were analyzed using SPSS software for statistical findings. Results: The outcomes revealed that symptoms related to vitamin D deficiency, such as fatigue, Muscle pain, Bone and joint pain are prevalent among both the dietary groups with vegetarians showing slightly higher percentages. However, the overall distribution of deficiency-related symptoms and disorders was similar across both groups. While clinical signs and symptoms provided useful evaluations to study the vitamin D deficiency-related symptoms and disorders, future studies should incorporate serum 25-hydroxyvitamin D/25(OH)D level for a more objective and accurate assessment of vitamin D status to determine the deficiency. Conclusion: Dietary patterns influence vitamin D intake but, factors such as sun exposure, skin pigmentation and supplement use have greater effects on vitamin D levels. This study underscores the urgent need for public health interventions endorsing screening, adequate sunlight exposure, dietary fortification and supplementation strategies to be applicable for all individuals regardless of their dietary habits.

Nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels mediating synaptic transmission at neuromuscular junctions and within both the central and peripheral nervous systems. The psychrophilic fungal tetrapeptide WvVf-OCH3 exhibits ∼55% inhibition of human muscle-type nAChR (hα1β1εδ) at 10 μM, suggesting potential for optimization. Structure-activity studies identified analogues, WrFr-OCH3 and WrFk-OCH3, with significantly increased potency (75-90% inhibition at 1 μM) against hα1β1εδ nAChRs and, notably, the hα9α10 subtype. These analogues exhibit high-affinity binding through stable π-π stacking with the principal face and electrostatic interactions with the complementary face of the receptor binding site. Their unique alternating L/D chirality enhances proteolytic stability. In vivo, intravenous application of WrFr-OCH3 alleviated oxaliplatin-induced cold allodynia, while intramuscular injection reduced forelimb grip strength, consistent with muscle relaxant activity. Together, these findings identify WrFr-OCH3 as the shortest high-activity peptide ligand of human nAChRs reported to date, with therapeutic potential for both inflammatory pain management and muscle relaxation.

The effect of subliminal music on muscle tone, pain, and vital signs in female athletes: A community-based clinical trial based on the Schopenhauer's theory.

COVID-19 related symptoms and the second infection status of SARS-CoV-2 in patients with lung cancer: A single-center, six-month longitudinal observational study.

In many rural areas of developing countries, solid fuel use is still widespread. The present study aims to investigate the Household Air Pollution (HAP) exposure effect from traditional biomass fuels and biogas on the health of rural women. The results revealed that nearly 93% of rural families utilize conventional fuels for daily cooking and heating purposes, whereas clean fuels like biogas were minimal. However, high-income, educated, elderly, well-structured houses (Pucca), and hierarchically more advanced families were observed to cook with biogas fuel. Further, the present study also used spatial HAP mapping and land use mapping models to analyze exposure load patterns and sources of solid fuel availability, respectively. The clean fuel biogas burning showed the lowest HAP concentration compared to traditional fuels, except for NO2 (1.14 ± 0.05 ppm), which is also represented in the case of health risk estimation. The biogas users also observed the lowest COHb% (0.008 ± 0.01) than conventional fuels. The health risks associated with SO2 and NO2 for biogas users were revealed to be lowest in both acute and chronic instances. Monte-Carlo probabilistic model observed that coal cake may pose high health risks among traditional fuels when considering PM2.5, SO2, and NO2, but in the case of COHb% %, cow dung users showed the highest health risk (0.39 ± 0.02). These findings have significant implications for public health, suggesting that promoting the use of cleaner cooking fuels, particularly biogas, which is less affected by muscular pain and eye irritation than biomass users, could lead to substantial health benefits for rural populations. This finding also indicates that government intervention should be required to enhance the utilization of cleaner cooking fuels in rural India for women’s safety.

Diagnosis of Cardiac Transplant Rejection Using Point-of-Care Ultrasound.

Silent killer strikes during Eid-Ul-Adha: Crimean-Congo hemorrhagic fever outbreak in Khyber Pakhtunkhwa, Pakistan, 2023.

Beyond muscle pain: A case of Paget-Schroetter syndrome in a young athlete

INTRODUCTION Postoperative fatigue is a major complication after surgery. It is one of the most distressing problems reported by patients and also thought to be the main contributor to delayed recovery after surgery. This is especially important for older patients who are often suffering from frailty characterised by a decreased physiological reserve. Surgical stress and the associated acute inflammatory response may be the driver of this fatigue by inducing acquired postoperative muscle weakness leading to impaired functional recovery. Corticosteroids are known to dampen this peri-operative stress response. Therefore, this study will investigate whether muscle weakness and, consequently, fatigue and delayed recovery after surgery can be ameliorated by administering methylprednisolone. METHODS AND ANALYSIS The CORTERAS trial is a large monocentric, parallel-group, double-blind, randomised controlled trial comparing the administration of 250 mg of methylprednisolone or a placebo in adults 60 years or older and scheduled for major elective surgery. In on-pump cardiac surgical procedures, a repeat dose of 250 mg will be given on initiation of cardiac bypass to correct for dilution. The primary outcome is the percentage change of handgrip strength on day 1 after surgery. Secondary outcomes encompass peripheral limb muscle strength, normalised peripheral limb muscle strength, fatigue, early quality of recovery, respiratory muscle strength, pain scores, postoperative nausea and vomiting (PONV), quality of life and markers of inflammation. The sample size has been calculated as a total of 674 patients receiving the study intervention and reaching the primary endpoint. Randomisation is performed at the patient level using computer-generated block assignments. Stratification is based on type of surgery, sex (male or female), age (60 to 70 years or older than 70 years) and BMI (≤30 or &gt;30 kg m−2). Patients and outcome assessors are blinded to the intervention assignment. Assessments are conducted pre-operatively, immediately postoperatively, during the hospital stay (postoperative days 1, 3 and 5), and on day 28 postoperatively. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Independent Ethics Committee at Ziekenhuis Oost-Limburg in Genk, under protocol version 2.0 (1 November 2021), reference number Z-202170. The study has been registered at ClinicalTrials.gov (NCT05220319) on 31 January 2022 and the first patient was included on 6 February 2022. Trial results will be presented at national and international academic conferences, and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT05220319

Effects of hydrotherapy kinetic chain exercises on muscle coactivation, pain management, and quality of life in men with chronic low back pain. Randomized clinical trial.

Rhabdomyolysis is a serious condition caused by skeletal muscle breakdown and can present with severe generalised pain, elevated creatine kinase and myoglobinuria. We report a rare case of rhabdomyolysis likely induced by chronic pregabalin abuse (15-year history of non-prescribed use) in a physically active man in his 20s. Despite the absence of trauma, infection or other known causes, he presented with typical symptoms and laboratory findings of rhabdomyolysis. He improved significantly with supportive care, including intravenous fluids and analgesia, and was discharged after stabilisation. This case highlights the importance of considering pregabalin as a potential myotoxic agent-even without overdose-particularly in young patients with unexplained muscle pain. Careful monitoring of drug history and early recognition are essential to prevent complications such as acute kidney injury and to ensure full recovery.

Introduction: Low back pain (LBP) is one of the most common musculoskeletal disorders in the modern population, representing a significant health, social, and economic issue. Physiotherapy is a fundamental component of conservative treatment for this condition. Objective: The aim of this study was to evaluate the effect of physiotherapeutic intervention on improving trunk muscle strength, lumbar spine mobility, and pain intensity in patients with nonspecific LBP. Methods: Fifty patients with non-specific low back pain were enrolled in the study. Each patient completed an individualized physiotherapy program composed of selected kinesiotherapy methods (spiral stabilization, spinal exercises, Pilates, stretching, and soft tissue techniques). Therapy was conducted three times per week, in 60-minute sessions, for a total of 10 sessions. Muscle strength was assessed using Janda’s test; spinal mobility was evaluated through Schober’s and Stibor’s tests and lateral flexion measurements. Subjective pain and disability were assessed using the Oswestry Disability Index (ODI). Results: Following physiotherapy intervention, statistically significant improvements were observed in all monitored parameters. Trunk muscle strength improved by an average of 0.61–0.95 points (p &lt; 0.001), spinal mobility increased by 1.66–4.72 cm (p &lt; 0.001). The ODI score decreased from a mean of 2.98 to 1.57 points (p &lt; 0.001), indicating a significant reduction in perceived pain and functional limitation. Conclusion: The results confirm that a targeted physiotherapy program leads to improved muscle function, increased spinal mobility, and reduced pain in patients with nonspecific low back pain. Physiotherapy remains an essential element in the management of this condition.

Background: Myogenous temporomandibular disorders (TMDs) typically present with pain but without obvious restriction of mandibular motion, making subtle dysfunctions difficult to detect clinically. In this study, we evaluated mandibular kinematics in myogenous TMDs using an electronic axiography system (Cadiax Diagnostic). The specific objective of this study was to evaluate whether patients with myogenous temporomandibular disorders exhibit qualitative abnormalities in mandibular movements that are not detectable using conventional clinical examination. Methods: Twenty-six patients with myogenous TMD (muscle pain without intra-articular disorders, diagnosed per DC/TMD) and 26 matched controls were examined. Clinical assessment (DC/TMD Axis I) measured mandibular range of motion and deviations. Instrumental recordings of maximal opening, protrusion, and laterotrusion were obtained with Cadiax 4. Quantitative (excursion ranges) and qualitative (movement symmetry and sagittal deviations) parameters were analyzed. Condylar position changes between the reference position and maximum intercuspation were evaluated (Condyle Position Measurement, CPM). Exact χ2 or Fisher tests were applied with effect sizes (φ) and 95% confidence intervals (CI). Results: Maximal opening, lateral excursions, and protrusion ranges were statistically similar between groups (mean opening: 47.96 ± 6.5 mm in TMDs vs. 49.46 ± 5.4 mm in controls, p = 0.40; 95% CI of difference −1.8 to 4.8 mm). However, qualitative deviations were more frequent in TMD. Of note, 12/26 (46.2%) patients vs. 6/26 (23.1%) controls showed a ΔY deflection during protrusion (χ2 = 3.06, p = 0.08; φ ≈ 0.24; difference = 23.1%, 95% CI −2.0–48.2%). Identical proportions (46.2% vs. 23.1%) showed a ΔY deflection upon opening (χ2 = 3.06, p = 0.08). Inferior condylar shifts (distractions) on closing into intercuspation occurred only in the mTMD group: 5/26 (19.2%) left condyles vs. 0% (p ≈ 0.05; 95% CI diff 4.1–34.4%) and 2/26 (7.7%) right vs. 0% (p ≈ 0.49; 95% CI −2.5–17.9%). Condylar compressions (superior shifts) were similar between groups. In summary, roughly half of TMD patients exhibited lateral jaw deflections (ΔY) and exclusive condylar “distraction” on closure; upon comparison, these conditions were rare in controls. Conclusions: Despite normal mandibular range of motion, patients with myogenous TMDs exhibited qualitative abnormalities in jaw kinematics, including movement deflections, condylar asymmetries, and centric–intercuspal discrepancies. Axiographic analysis with Cadiax enabled detection of subtle functional changes not identifiable in routine examinations, underscoring its diagnostic value in early dysfunction and potential therapeutic planning. The detection of kinematic abnormalities could influence early diagnosis or treatment planning for myogenous TMDs.

Background: Pain disorders in the upper trapezius muscle are often experienced by students due to non-ergonomic postures and excessive duration of device use. Interventions such as spinal manipulation and stretching exercises are non-invasive interventions often used to reduce pain and improve muscle function. Objectives: This study compares the effectiveness of two interventions in reducing trapezius muscle pain among university students. Methods: This randomized controlled trial involved 40 physiotherapy students divided equally into two intervention groups. Group I received thoracic spinal manipulation, and Group II received passive stretching. Each intervention was administered in a single 15-minute session. Pain intensity was measured using the Numeric Rating Scale (NRS) before and immediately after treatment. Data were analyzed using the Wilcoxon Signed-Rank test for within-group comparisons and the Mann–Whitney U test for between-group analysis, with an alpha level of 0.05. Results: The Wilcoxon test revealed a significant decrease in pain within both groups (Group I: median pre 4.5 [3.63–5] to post 2.5 [1.50–3.38], p = 0.000, r = 0.879; Group II: median pre 4.25 [3–5] to post 1 [0.13–3], p = 0.000, r = 0.84), indicating a significant effect of both interventions. The Mann–Whitney U test showed no statistically significant difference in pain reduction between the two groups (median pain difference = 2 [1–3] for both, U = 186.5, Z = –0.375, p = 0.707, r = 0.06). Conclusions: Both thoracic spinal manipulation and passive stretching were effective in reducing upper trapezius pain immediately after a single session, but no significant difference was found between the two interventions. These findings suggest that both approaches provide comparable short-term benefits; however, further research with larger samples, multiple sessions, and more extended follow-up periods is needed to confirm their long-term efficacy.