Background: Arthrogryposis multiplex congenita (AMC) refers to the development of multiple joint contractures affecting two or more areas of the body prior to birth. A contracture occurs when a joint becomes permanently fixed in a bent or straightened position which can impact the function and range of motion of the joint and may lead to muscle atrophy. Rehabilitation of a case of AMC is still a challenge owing to its multiple system involvement. Case Report: The patient presented at the age of 14 years with multiple joint contractures, dependent in most of the ADLs-eating, bathing, toileting and dressing upper garment, independent in transfer, bed mobility and dressing lower garment (FIM score=99). She walked on knees leading to skin hypertrophy though she could stand on one limb. Conclusion: Multidisciplinary approach consisting of a physiatrist, occupational therapist, prosthetist and orthotist, psychotherapist, physical therapist, art therapist, and vocational counselor is essential for the treatment. With extensive comprehensive multidisciplinary rehabilitation program the patient could walk 100 metres with orthoprosthesis, independent in most of the ADLs (FIM score improved from 99 to 115). She expressed great satisfaction on being able to walk upright for the first time in her life.
Objective: To compare the effectiveness of ultrasound-guided suprascapular nerve block (SSNB) and extracorporeal shockwave therapy (ESWT) in the management of adhesive capsulitis of the shoulder. Study design: Randomized controlled trial.
Background: Lateral epicondylitis also known as the tennis elbow is a painful condition of the elbow caused by overuse. The disease imparts significant disability to those affected in terms of the quantity and quality of work done.Methods: A randomised controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal for a period of 1 year from February 2017 to January 2018. Eighty-four patients with resistant lateral epicondylitis recruited were divided into 2 groups- group A received Prolozone injection while group B underwent Extracorporeal Shockwave Therapy (ESWT).Results: Assessments of VAS (Visual Analog Scale) and PRTEE (Patient Rated Tennis Elbow Evaluation) were done at 8 weeks and 24 weeks. The mean VAS score in Prolozone group improved from 7.22±0.89 to 4.04±1.01 at 8 weeks to 1.67±0.70 at end of 24 weeks. In ESWT group, mean VAS score improved to 3.91±0.72 at 8 weeks and reduced to 2.3±0.68 at end of 24 weeks. PRTEE improved significantly in both the groups, from 85.33±3.29 to 24.87±2.10 in Prolozone group, and from 85.17±2.83 to 41.89±3.17 in ESWT group.Conclusions: The improvement in pain and disability is better in prolozone group than ESWT (p<0.05) in chronic lateral epicondylitis.
Background: Ankle sprain is the most common injury in the world of sports and anterior talofibular ligament (ATFL) is most commonly affected. It is often underestimated, mismanaged and often result in delayed treatment, prolonged recovery times and long-term sequela. PRP may have enhancing effect on healing of partial tear of ATFL. Thus, the purpose of this study is to determine the role of PRP on partial tear of ATFL.
Methods: A randomized controlled trail was done among athletes with partial tear of ATFL who visited Department of Sports Medicine, RIMS, Imphal during January 2021 – June 2022. Patients with MRI diagnosed partial tear of ATFL (N=48) randomized into PRP injection plus rehabilitation, (n=24) and rehabilitation alone, (n=24) groups. The outcomes were compared using Foot and Ankle Disability Index (FADI) score for function and Visual analogue scale for pain at baseline, 2nd, 6th, 12th and 24th weeks respectively.
Results: Baseline characteristics were not statistically significant. There was statistically significant improvement seen in within the group comparison from baseline to 2nd, 6th, 12th and 24th weeks in both FADI and VAS in both the groups. There were statistically significant difference in mean changes of VAS and FADI score between the two groups from baseline to 2nd (p=0.007);(p=0.012), 6th (p=0.018);(p=0.009) and 12th (p=0.004); (p=0.001) follow-ups respectively with PRP group having more improvement however no significant difference at 24th weeks.
Conclusion: Ultrasound guided PRP injection along with standard rehabilitation program might be a treatment of choice for partial ATFL tear.
Keywords: ATFL tear, PRP, FADI, VAS, USG-guided.
Introduction: Osteoporosis has become a major public health problem affecting more than 100 million people worldwide. Standard diagnosis depends on measuring bone mineral density (BMD) using a dual energy X-ray absorptiometry (DEXA). Bone turnover markers are metabolic products that mediate bone metabolism and can provide information regarding bone formation or resorption before the structural changes of bone occur. BMD and bone markers complement each other, and provide comprehensive information about a patient's bone status and bone activity. Aim: To find the correlation between selected urinary bone turnover markers and bone mineral density measured by DEXA scan. Materials and Methods: A cross sectional study was conducted among 2700 pre and post-menopausal women with intact ovaries aged between 21 to 70 years in three districts of Manipur. Performance of three urinary markers of bone turnover, i.e., Deoxypyridinoline (DPD), N-telopeptide (NTx) and C-telopeptide (CTx) were assessed and correlated with the bone mineral density (T-score) measured by DEXA scan. Results: Significant correlation was found between DEXA T-score and NTx (r=0.070, p=<0.010), but not for DPD and CTx.
Conclusion:It can be concluded that there is significant correlation between DEXA T-score and NTx, but not for DPD and CTx. Clinical Significance: In the management of osteoporosis, bone markers can be used for determining the response to antiresorptive treatment, amongnst which NTx of collagen-I may be suggested to assess bone resorption for Manipuri women.
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