Introduction: Road traffic accidents (RTA) have remained an ongoing endemic problem over the years and a serious economic and medical-social burden for many countries around the world. Among the most complex and frequent fractures inside the joint is tibial plateau fractures. Such fractures are linked to adverse results, because of reasons such as the damage of cartilage but also soft tissue envelopes, complications like compartment syndrome, postoperative infection, knee dysfunction or rigidity, or even post-traumatic osteoarthritis. Case Description: An 18-year-old young girl complaining of pain and inability to perform activities of daily living was referred to physiotherapy after being operated with external fixator (LCP) and skin grafting. Locking compressive plate was placed at lateral side of leg with 2 nails near head of fibula and 2 nails near lateral malleolus. Grafted skin was seen at anterior aspect of knee and anterior to medial aspect to leg. Patient was mostly suffering from pain in right leg and knee with intensity 7/10 at rest and 9/10 slight movement and swelling over right lower limb and patient complained of limited mobility and unable to walk. Discussion: The significance of early mobilisation and range of knee joint motion exercises has been apparent in literature in the past 40 years. From low-intensity activities to progressive strengthening and partial to complete weight with walkers, recovery objectives were devised. Good grafting rates can be achieved with fast ambulation leading low extremity skin grafting operations, which runs counter to conventional lessons in post-operative skin grafting after lower extremity
Kinesiophobia is an irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. According to the concept of avoidance of fear, pain is interpreted as threatening, which can trigger pain-related fears and anxiety leading to avoidance behavior. Avoidance action involves a process/period characterized by a person stepping back from undertaking daily tasks like exercise, socializing, and work, which increases the intensity of the painful experience. In hospital settings, kinesiophobia needs to be resolved to ensure a positive result in rehabilitation interventions. The femur is the lower extremity's primary weight-bearing bone. Early fracture fixation in the shaft of the femur allows for early mobilization, thereby reducing the risk of hip and knee stiffness as well as quadriceps and hamstring wasting. In this report, we present the case of a 16-year-old girl with an alleged history of fall who was admitted to Acharya Vinobha Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Deemed To Be University (DU), Wardha, India, with primary complaints of pain and swelling over the left thigh. She was diagnosed with a left midshaft femur fracture. An open reduction internal fixation (ORIF) femur interlock nailing was performed to stabilize the fracture, and she was referred to physiotherapy after surgery for further management. The comprehensive rehabilitation program was helpful in alleviating the severe kinesiophobia in the patient, and she was able to resume her activities of daily living (ADLs) independently.
Introduction: Bipolar affective disorder a chronic, and highly disabling psychiatric disorder is one of the leading causes of disability and is estimated to affect more than 1% of the global population irrespective of origin, ethnicity, nationality or socioeconomic status. The effectiveness of lithium in mania and psychotic excitement was proven first proven in 1960 and since then lithium is considered to be a gold standard treatment for bipolar disorder. Material and Method: A total of one hundred thirty five patients with bipolar disorder were enrolled in a prospective study to analyze the serum lithium levels on maintenance dose of lithium. After ethical clearance data was collected from patients attending BG Hospital and Research Centre from July 2013 to July 2019. The patients who were on maintenance treatment with different doses of lithium only were included. These patients were tested for serum lithium concentration as per lithium monitoring guidelines. Serum Lithium, serum electrolytes, height and weight of the patients were recorded. The psychiatric diagnosis was made according to the ICD-10 criteria. Data were computed and analyzed by using SPSS version 21. Parametric and non-parametric statistical technique was applied wherever appropriate. Results: The minimum efficacious serum lithium level in the long-term treatment of bipolar disorder was found at 0.16 mmol/l and maximum serum levels was 1.51 mmol/l. The mean serum lithium level was 0.596 mmol/l with standard deviation of 0.237 mmol/l. Conclusion: There is substantial variation in between the serum lithium levels of patients in remission on long term treatment. The uncertainty about the most efficacious serum lithium level for the long-term treatment of bipolar disorder leads to the suggestion of the treatment of individual patients to be based on clinical response rather than on serum lithium levels.
Background: A persistent infection triggered by Mycobacterium leprae is also known as leprosy or Hansen's disease, transmitting by tiny droplets of the nose and mouth to the skin and peripheral nerves, producing disability. Leprosy therapy is based on the combination of the rifampicin, dispone and clofazimine (MDT) three-drug regimen. In patients who undergo hormone therapy, avascular femoral necrosis (ANFH) or femoral head osteonecrosis (ONFH) may occur, causing steroid-induced femoral head avascular necrosis (SANFH) Core decompression (CD) reduces bone pressure, opens the hardening area, prevents osteonecrosis repair, promotes blood vessel development through the tunnel for decompression, increases bone replacement and delays osteonecrosis. Patient information, diagnosis and therapeutic interventions: In this case, we found a 20 years old girl known case of leprosy, was on corticosteroids for two and half years. After an increase in dosage of corticosteroids she began difficult for her walk and do her activities of daily living. She visited Acharya Vinoba Bhave Rural Hospital (AVBRH), DMIMS (DU) Sawangi Meghe, Wardha, Maharashtra, India where she got to know about necrosis of head of femur of both lower limbs. She underwent core decompression surgery of bilateral femoral head. For further management she was referred to Physiotherapy Department. Outcomes and Conclusion: this case, we found that a patient who is young who had Midshaft femur fracture with interlock nailing and sever kinesiophobia, affecting rehabilitation, was able to resume her ADLs independently.
Fear is an uncomfortable feeling, which results from the proximity of actual threat or pain. A strong correlation exists between fear and pain. Kinesiophobia is the phobia of activity and physical movement, which results from a sensation of sensitivity to painful injury or reinjury. Low back pain (LBP) is among the frequent disorders of the musculoskeletal system. LBP is mainly due to bad postures and poor organisational ergonomics. Kinesiophobia has adverse effects on rehabilitation outcomes. So the systematic application of graded exposure to movements is recommended in patients with Kinesiophobia to prevent pain-related anxiety. We compared Kinesiophobia's impact on patients with both acute and chronic LBP. We aimed to find out the role of Kinesiophobia in patients having LBP. The survey-based research using Tampa scale of Kinesiophobia was conducted with cross-sectional design. It included participants of both genders,in the age group of 18-65 who were diagnosed with acute and chronic low back pain. Tampa Scale for Kinesiophobia, Evaluation Performa, NPRS and Goniometer were used as outcome measures for the study. The patients were thoroughly examined, and they were evaluated using the Tampa Scale. Scoring to 17-items Tampa Scale was performedin4-point Likert scale varying from “strongly disagree” to “strongly agree.” After the inversion of items 4, 8, 12, 16, the final score was determined. The total score ranges from a minimum of 17 to a maximum of 68. It was concluded that Kinesiophobia plays a crucial role in LBP, especially chronic LBP.
Introduction: Active Release Technique (ART), works by releasing adhesions and repairing the integrity of soft tissue, thereby extending and restoring functional flexibility entirely. Core stabilization workout (CSE) aims to treat back pain by boosting your muscular strength and stamina, strengthening muscle motor patterns to relieve low-back pain. Aim: Aim of the study was to evaluate impact of active release technique and core strengthening on pain, mobility and quality of life on non-specific low-back pain. Study Design: Simple random convenient sampling, envelope method Place and Duration: A study of 40 people with non-specific low back pain and aging between 18 and 25 years was conducted at Musculoskeletal OPD, Ravi Nair Physiotherapy College, DMIMS(DU), Sawangi (Meghe), and Wardha in the duration of one year. Procedure: In this experimental investigation, the influence of active released and impacting non-specific low back pain on suffering, muscular soreness, hardness, strength, ODI, and quality of life was determined. Both groups received hot fomentation and core strengthening, but only the ART group was actively released. The findings have been obtained from NPRS to algometer, durometer, press biofeedback, ODI, and EQ-5D-5L in pre-treatment, post-treatment, and after four weeks of data to analysed impacts. Results: in this study both the groups showed reduction in pain, muscle tenderness, muscle hardness as well as increase in core strength and quality of life. When compared ART group shows significant improvement with p value of 0.001. Conclusion: In this study we find that the pain threshold, muscular hardness, muscle tenderness, deficiency and quality of life of both groups improved. The ART group was proven to be more effective than the Hpk group when the two groups were compared. In the two groups, the core strength did not change greatly, perhaps after four weeks, from pre- treatment to post- treatment to 4 weeks after.
Non-specific low back pain (NLBP) or "simple backache" is characterized as an LBP not due to any identifiable disease such as nerve root pain and severe spinal pathologies such as infection, tumour, osteoporosis, rheumatoid arthritis, fracture or inflammation. Myofascial Trigger Points in skeletal muscles, identified with a hypersensitive palpable nodule or "knot" in the middle of the muscle belly, are described as hyperirritable. Active Release Technique (ART) is a non- invasive soft tissue restoration procedure that includes reducing the scar tissue that would induce discomfort, stiffness, muscle weakness and unusual pain like mechanical dysfunction of the myofascial and soft tissue. A 23 years old inert, after assisting in a lot surgery started with a low back pain which increased gradually. Activities like bending forward as well as backward, standing for long time, and unsupported sitting for long time which relieved on rest. She took paracetamol as the pain started, which relived her pain. In this case report, a 23 years old intern, who had non-specific low back pain was successfully rehabilitated and was able to resume her activities withing a few days which was followed for a month which was painless as well. ART proved helpful along with hot fomentation and core strengthening exercises to reduce her pain. In this case report, a 23 years old intern, who had non-specific low back pain was successfully rehabilitated and was able to resume her activities withing a few days which was followed for a month which was painless as well. ART proved helpful along with hot fomentation and core strengthening exercises to reduce her pain.
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