Heat stroke is the most dangerous heat-related illness, and it can be fatal.Two characteristics define heat stroke: a core body temperature greater than 104°F (40°C) and neurological signs such as confusion, seizures, or loss of consciousness.Some of the first cells in the body to be affected are in the brain. These cells are sensitive to temperature changes. The heart also must work harder to push blood to the skin. As a person's temperature gets closer to the air temperature, the rate of heat transferred to the skin decreases. Evaporation of sweat also decreases with higher humidity. Sweating leads to further dehydration and loss of electrolytes and minerals vital for muscle and nerve cell function. As the body is no longer able to cool itself by sweating, heart rate and breathing increase to compensate. This can be aggravated by medications that alter heart function or by chronic diseases.Classic heat stroke is seen in people who are exposed to a hot environment, especially in young and elderly persons. Those with chronic diseases such as Parkinson disease, heart failure, or diabetes or who take medications can have a decreased response to dehydration. Exertional heat stroke is seen in healthy people who undergo strenuous activity in hot weather, such as marathon runners, military trainees, and football players.

Objective: Measurement of range of motion is used to measure the joint Position Sense (JPS). The objective of this study was to give an easy and less costly method of measuring JPS. Methods: The study conducted at Tehran University of Medical Sciences, in Iran in May 2017. In this study researcher used the system of digital photographs, non-reflective markers and software for measuring the accuracy and reliability. The fixed arm of the goniometer was horizontal. The moveable arm was positioned at the 15° initially and then selected it at different degrees (30, 45, 60 and 75) randomly. 5 reference angles were selected from 15° to 75°. By using moving arm three photos were taken from each angle. Reliability and validity of measurement for each angle was disclosed by utilizing T-test, correlation (reliability test) and R square of regression (validity test). Also relative and absolute error is used to evaluate the accuracy of this method. Results: Results showed that mean (R^2) for validity is 0.99, T-test p-value for reliability is 0.41 it means there is no significant difference between these methods and for correlation (reliability) mean value was 0.97 and averages of absolute error and relative error were (-0.44 and 0.62) respectively. Conclusion: It was disclosed that method comprising of digital photography non-reflective markers showed similar results as compared to goniometer in terms of reliability, validity and accuracy of this method. In conclusion, it was a novel approach to measure JPS with salient features of user friendly, fast, less expensive, accurate and reliable.

Background: Chronic obstructive pulmonary disease (COPD) is associated with prolonged respiratory problems and compromised airflow. Eventually, routine activities become troublesome. Pulmonary rehabilitation program and specific training of inspiratory muscles can do management of such patients. Aim: To find out the effects of Inspiratory Muscle Trainer on dyspnea in moderate COPD patients during Pulmonary Rehabilitation in terms of improvement of pulmonary lung function and Multidimensional Dyspnea profile. Study Design: Randomized controlled trial. Methodology: Two groups were designed; in one group Pulmonary Rehabilitation Program was applied in other group both PRP and IMT was given. Patients were recruited into two groups by simple random technique. Pre-treatment measurements were taken and then Sessions of 4 weeks with 5 days per week were given and post treatment assessment was done. Data was evaluated by using SPSS version 24. Independent sample t-test was applied to determine any significant difference between Pre-treatment and Post-treatment Functional pulmonary assessment between two groups. Results: Findings revealed that differences between two groups were statistically significant (p <0.05) and also statistically significant difference were observed within group analysis (p< 0.05) with respect to dyspnea , fatigue , quality of life. Practical Implication: This study considered moderate COPD patients for Inspiratory Muscle training (IMT) along with Multi-Disciplinary Approach in slowing down the worsening of disease and in this way prevented the future complications. Conclusion: It was concluded that inspiratory muscle trainer group was more effective as compare to standard rehabilitation in improving pulmonary function testing and reducing dyspnea among COPD patients. Keywords: Dyspnea, Inspiratory Muscle Training and Pulmonary Rehabilitation Programme.

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