Introduction: Gout is a disorder of purine metabolism, affecting men 40-50 years of age resulting in recurrent bouts of arthritis and subcutaneous tophi in patients with long standing disease. We report a case of a 45-year-old male with symmetric, deforming polyarticular arthritis, affecting all the joints of hands, wrists and feet with diffuse subcutaneous nodules over his body. the radiographic findings of the patient were atypical. Following clinical evaluation and additional investigations, the patient received a diagnosis of chronic tophaceous gouty arthritis mimicking rheumatoid arthritis.
BACKGROUND: Bell's palsy is an acute weakness of seventh cranial nerve leading to loss of movement on one side of the face. It usually recovers of its own without treatment in most of the patients but not all. Physical therapy in the form of electrotherapy, massage and facial exercises is used as adjuvant to hasten recovery.
OBJECTIVES: To analyze the role of physiotherapy in the form of electrotherapy in patients with peripheral facial paralysis attending multispecialty hospital in Kashmir.
METHODS: A prospective study was carried out on 50 patients of facial nerve paralysis attending OPD between Jan 2009 and Jan 2010. All of the patients were subjected to medical treatment. The patients were put to Physical Therapy in the form of electrotherapy followed by facial exercises. All patients received electrotherapy to the paralyzed facial muscles for a period of 2 weeks but some were given extended doses for 4 weeks. 20 patients presented for the treatment in the first week, 12 in second week and 18 presented after three weeks or later.
RESULTS: Fifty patients (30 female, 20 male) of facial nerve paralysis were included. Time span between medical diagnosis and physical therapy was from 1 week to 4 weeks. Patients were assessed at 4 weeks, 2 months and 6 months after the treatment. Out of 20 patients who presented in 1st week and received steroids and electrotherapy 19(95%) had fully recovered except for one case that was irregular for treatment. Out of 12 Patients who presented in 2nd week of illness, 8(66.6%) patients had full recovery and partial recovery in rest of 4 (33.4%) patients. Eighteen patients (100%) who presented in third week onwards of illness had partial recovery.
CONCLUSION: Physiotherapy in the form of electrotherapy and facial exercises has a effective role in the early management of peripheral facial palarlysis. JMS 2012;15(2):145-48
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