Aim: To examine the effectiveness and clinical significance of lumbar spine MRI in chronic lower-back ache patients and its relevant radiculopathies. Study design: Cross-sectional descriptive study Place and duration of dtudy: Department of Radiology, Sir Syed College of Medical Sciences for Girls Karachi from 1stJune 2020 to 30thNovember 2020. Methodology: Ninety patients of both males and females, between the ages of 20-75 years with a history of bilateral or unilateral lower limbs radiculopathy, lower back numbness and pain were included. The patients with a history of vascular malformation, metastasis, tumour, infection, and trauma were excluded. Lumbar spine MRI was performed by MRI scanner. At the following levels, the scan was taken: L5-S1, L4-L5, L3-L4, L2- L3. Results: The mean age was 44.64±15.67 years. Eighty percent of patients showed osteophytes formation and disc desiccation signs, 53.5% of patients showed signs of numbness, and 36.7% of patients has bilateral lower-limbs radiculopathies complaints, whereas 91.1% had shown signs of diffuse disc bulge on spinal level of L5-S1. In 100 percent of patients, neural foramina were compromised at level L4-L5 to which in 98.9% of patients there was a “nerve root compression” at this level. Mostly it has been seen that level L2-L3 is spared. At level, L2-L3 hundred percent of patients did not reveal any important ligamentumflavum hypertrophy and 98.9 percent of people have no “facet joint hypertrophy”. Conclusion: The lower back pain frequency is higher in males as well as in females. In a patient who has lower back pain, the Disc desiccation was frequent. Because of spinal canal stenosis, foraminal canal and nerve root compressions the most general targeted sites were L5-S1 and L4-L5. Keywords: Lumbar spine, Magnetic resonance imaging, Lower backache
Aim: To compare wrist function by mean of DASH score at 12 weeks in distal radial fracture patients treated operatively (ORIF group) versus those treated non-operatively (CAST group). Methodology: The randomized controlled trial was conducted at The Indus Hospital Karachi, which is a tertiary care hospital from 1st January 2017 to 30th June 2017 and the 12 weeks follow up was taken after the recruitment of the last patient and 96 patients were enrolled. Patients in the operative group were treated with a volar locking plate. Reduction and stabilization of fracture were done with the application of 2.7mm volar locking titanium distal radius anatomically contoured implants. Non-operative Treatment Protocol was that All patients were complete a six weeks immobilization in a splint. One repeated manipulation if needed was accepted in the first 3 weeks. Passive and active finger motion from the starting was encouraged. Formal physiotherapy in this group was started 6 weeks after the removal of the cast. In the twelfth week, the functional assessment was examined by a physiotherapist or orthopaedic resident in both the Cast group and ORIF. Results: Thirty (31.3%) were in operative and 66(68.8%) were in non-operative group. No significant difference were found in age, height, weight, and BMI between both the groups (Mean: 42.7 vs 41.6 years, p=0.644; 156.5 vs 156.4 cm, p=0.962, 61.0 vs 59.5 kg, p=0.557, 24.9 vs 24.5, p=0.395 respectively). Moreover, distribution of gender, dominant hand, and injured hand was also similar in both the groups (p=0.427, p=0.587, and p= 0.673). DASH score were found to be significantly lower in operative group as compared to non-operative cast group (median 17.5 vs 28.8, p<0.0001, mean 16.6 vs 27.9, p<0.0001). Conclusion: At 12 weeks volar locking plates significantly produced better clinical and functional outcomes as compared with the treatment by Cast. The significantly anatomical reduction was more possible to be conserved in the operating group, but in the operative group, early mobilization achieved is the key to better achieving functional outcomes. Keywords: Distal radius extra-articular fractures, DASH score, Wrist function
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