Bhamra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. The classic features of fetal hydantoin syndrome include craniofacial anomalies, prenatal and postnatal growth deficiencies, underdeveloped nails of the fingers and toes, and mental retardation. Less frequently observed anomalies include cleft lip and palate, microcephaly, ocular defects, cardiovascular anomalies, hypospadias, umbilical and inguinal hernias, and significant developmental delays. Anaesthesia for incidental surgery in such a patient poses unique challenges for the anesthesiologist. We report the successful management of a 4-year-old male child with fetal hydantoin syndrome, cleft palate, spina bifida, atrial septal defect, and dextrocardia for tibialis anterior lengthening under subarachnoid block.

Introduction Physiotherapeutic rehabilitation are used to optimize functional recovery following a distal radial fracture (DRF). Being most common upper limb fracture in all age groups, the DRF peaks in young men and in post-menopausal women with incidence ratio of 1:4. Leap motion control based rehabilitation of patients with DRF is limited. This research aims to assess the efficacy of leap motion control based rehabilitation in patients with DRF. Methods In an randomized parallel group trial, subjects (n = 40) with DRF will be recruited. The participants will be enrolled into either experimental or control group with 1:1 allocation ratio. Following the primary assessment and allocation, the participants in experimental group will receive both leap motion control and conventional therapy over a period of six weeks. Participants in conventional group would undergo only conventional therapy. The primary outcome measures will be Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and Universal goniometer however the grip strength and Visual Analog Scale (VAS) will be used as secondary outcome measures. Purpose of the study The findings of this trial will examine the impact of leap motion control in DRF patients with conventional therapy on improving the functional activity, range of motion (ROM), grip strength and pain. Expected clinical implications To conclude, this research seeks to examine the rapid and long term effects of leap motion control in DRF patients. The study findings would help prospective patients with DRF, which may include a newly designed approach of rehabilitation.

A 22-years-old lady presented with obstructed labor with a probable preoperative diagnosis of bladder/urethral injury. When a laparotomy was performed there was a complete urethral disruption at the vesicourethral junction with a big anterior forniceal tear in the vagina with intact uterus and cervix. The fetus had pushed itself through the upper vagina and bladder neck into the extraperitoneal space leading to complete urethrovesical disruption as a result of prolonged pressure on the vesicourethral junction against pubic symphysis for which an end to end anastomosis was performed. Although trauma has been mentioned as a cause of such urethral disruption in the literature, no such case has been reported so far following obstructed labor. A brief discussion of various surgical options for such cases is discussed.

Introduction: Physiotherapeutic rehabilitation is used to optimize functional recovery following a distal radial fracture. Being the most common upper limb fracture in all age groups, the DRF peaks in young men and in post-menopausal women with an incidence ratio of 1:4. To date, however, work on leap motion control based rehabilitation of patients with distal radius fracture is limited. This research aims to assess the efficacy of immersive virtual reality in patients with DRF. Methods: In an experimental study, subjects (n = 40) with DRF will be recruited. The participants will be enrolled into either an experimental or control group with 1:1 allocation ratio. Following the primary assessment and allocation, the participants in the experimental group will receive both leap motion control and conventional therapy over a period of 6-week. Participants in the conventional group would undergo only conventional therapy. Throughout the treatment duration and following 6 weeks, daily living activity performance, the hand function and mental status will be assessed in the form of questionnaires.Discussion: The goal of this experimental study is to examine the impact of leap motion control after DRF on improving the functional activity and in turn quality of life. Conclusion: To conclude, this research seeks to examine the rapid and long term effects of leap motion control in DRF patients. The study findings would help prospective patients with DRF, which may include a newly designed approach to rehabilitation.

Background: In upper cross syndrome (UCS), weaker neck flexors, anterior and middle serratus and lower trapezius along with rhomboids usually develop, and stiffness of the levator scapulae, pectoralis major as well as upper trapezius are biomechanically adapted. Muscle imbalance is the primary cause for the upper cross syndrome between the tonic and phasic muscles. Individuals with upper cross syndrome may also exhibit any of the following issues text neck syndrome, round upper back, reduced thoracic spine mobility, winged scapulae. Active Release Technique (ART) helps to reduce discomfort and improve the range of movement. Also, Active Release Technique (ART) is a manual procedure which is also being used for other soft tissue rehabilitation as well as for the management of the scar tissues. UCS and neck pain is common with uncomfortable job postures as well as in stress and anxiety, due to which muscle dysfunction starts which can further followed by altered posture around the neck. Active Release Technique was also used earlier for muscle dysfunction and for scar tissue mobilization. Changes in musculature structure may exhibit chronic headaches among the patients of upper cross syndrome also unbalanced soft tissue near the neck may create barriers for the head’s range of motion (ROM). Patients complaints were pain, decreased job efficiency for which he was later diagnosed as a case of upper cross syndrome. The patient showed great co-operation during the treatment and now the patient is able to perform his job-related tasks without discomfort

Premature birth is the most common cause for a stay in the neonatal intensive care unit (NICU) among neonates. Premature birth leads to prematurity, which is associated with complications such as respiratory distress syndrome (RDS), hyperbilirubinemia, gastroesophageal reflux (GERD), intraventricular hemorrhage (periventricular leukomalacia), retinopathy of prematurity (ROP), and so on. These secondary complications are of great concern and need to be handled with care to prevent the further deterioration of the quality of life of the baby as he grows. So, the early physiotherapeutic interventional approach comes into light and plays an important role in neonatal care. This case study demonstrates an infant boy of seven months chronological age, who had a preterm birth history with a poor APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score and NICU stay during the first three months of life. He approached the physiotherapy outpatient department with a complaint of delayed motor milestones like an absence of head holding, rolling, opening of hand, as well as delayed social-emotional development, Ryles tube (RT) in situ, with frequent episodes of GERD, neck rotated to the left side, high irritability, tactile defensiveness of both hands, and difficulty in regulating his sensory systems. Outcome measures used were gross motor function measure (GMFM), sensory profile, and rotating chair test. Early interventional physiotherapy was given including neurodevelopmental techniques (NDT), oromotor stimulation, sensory integration, passive stretching, and myofascial release for six days per week with each session of 45 minutes. The results demonstrated the achievement of motor milestones till sitting independently, reduced episodes of GERD, discontinued RT in situ, improved mobility of neck on both sides, reduced irritability, and started reaching, grasping along with bimanual tasks.

Introduction: "Goniometry" is derived from two Greek words: Gonia, which means "angle," and Metron, which means "measure." The focus of the research is to see if a smartphone-based goniometer application for knee flexion range of motion was reliable. The technology of smartphones is one of the most often used alternatives. A literature evaluation of 12 studies showed that smartphone applications are sufficiently trustworthy to be employed in research and clinical practice. As ROM angulation is widely employed in treatment policy decisions, new measures have to be thoroughly tested before use in clinical practice. The study design used will be an observational study. The participants will be recruited using a simple random sampling method. The total number of participants will be 100 in the age group between 20-60. With Universal Goniometer and Goniometer records, three certified physiotherapists measured maximum active knee flexion in a supine position. Data will be collected and analyzed using SPSS (version: 20) and the Bland Altman Test.Discussion: The goal of this observational study is to examine the reliability of smartphone applications for computing knee joint range of motion.Conclusion: To conclude, this research seeks to examine the reliability of smartphone applications for computing knee joint range of motion in a healthy population. The study findings would help in developing a novel approach for computing and documenting the knee range of motion.