Adhesive capsulitis is frequently recognized as ‘Frozen Shoulder’, which is characterized by primarily painful joint range of motions and later progressively restricted range of motion of the glenohumeral joint. Other common names used for adhesive capsulitis includes ‘Periarthritis and Painful stiff shoulder’ and ‘Shoulder arthrofibrosis’. Objective: To compare the effects of scapular proprioceptive neuromuscular facilitation and Myofascial release techniques on pain and function in scapular dyskinesia associated with adhesive capsulitis. Methods: Quasi Experimental study was conducted on 34 patients of Scapular dyskinesia associated with Adhesive Capsulitis. Subjects were allocated to either to PNF technique group and Myofascial release technique groups. Both were treated for 12 sessions in 6 weeks. NPRS and SPADI scale were used to evaluate the treatment effects at baseline, 2 weeks, 4 weeks and 6 weeks. Results: The mean age of Group A was 43.12± 5.25. The mean age of Group B was 43.0±5.95. There was a significant difference between the mean value of baseline, 2 weeks, 4 week and 6-week NPRS score and baseline, 2-week, 4 week and 6-week SPADI score with P value <0.05 in both study groups. There was more significant mean difference of 6.23 between baseline and week 6 NPRS in Group A but there was less significant mean difference of 4.00 between baseline and week 6 NPRS in Group B. There was more significant mean difference of 70.70 between baseline and week 6 SPADI in Group A but there was less significant mean difference of 46.17 between baseline and week 6 SPADI in Group B. Conclusions: The study concluded that PNF technique and Myofascial release techniques were led to significant difference in NPRS and SPADI score, but PNF technique had shown more significant results than myofascial release technique to improve pain and function in scapular dyskinesia associated with Adhesive capsulitis.
Objective: To compare the mean healing time in patients undergoing ultrasound guided needle aspirations versus incision and drainage for lactational breast abscess. Study Design: Randomized Controlled Trail. Setting: Department of Surgery, Holy Family Hospital, Rawalpindi. Period: 1st March 2019 to 31st August 2019. Material & Methods: After endorsement from the ethical committee, an informed consent was taken from the patients in order to obtain their data for assessment with the affirmation of privacy of their record. After taking complete history from each patient, their breasts were palpated bilaterally for any lump. The diagnosis was established by the sonomammogram. Patients were randomized by lottery method prospectively to ultrasound guided aspiration group, and incision and drainage group for lactational breast abscess. Both groups were compared in terms of mean healing time. Results: In this study, total 70 patients having lactational breast abscess were included. There were 35 patients in Group-A i.e patients undergoing ultrasound guided needle aspirations and 35 in Group-B i.e patients undergoing incision and drainage. Mean healing time in patients undergoing ultrasound guided needle aspirations versus incision and drainage for lactational breast abscess shows 21.0+1.97 days in Group-A and 44.23+3.15 days in Group-B, p value was 0.0001. Conclusion: We concluded that the mean healing time in patients undergoing ultrasound guided needle aspirations was significantly lower when compared to those with incision and drainage for lactational breast abscess.
Background: Modified radical mastectomy (MRM) is one of the surgical procedures for breast cancer management. Many complications are associated with wound healing, like hematoma, dehiscence, infection, chronic seroma and skin necrosis. The objective of this study was to compare the mean blood loss in drain output of topical versus intravenous tranexamic acid (TXA) use among patients undergoing modified radical mastectomy.Methods: This randomized controlled trial was conducted at department of surgery, Holy Family hospital, Rawalpindi from November 2019 to November 2020. 130 patients were randomly divided into two groups. Group A patients received tranexamic acid topically while group B patients received intravenous tranexamic acid during modified radical mastectomy. Drain output and blood loss was recorded after twenty-four hours of the surgery.Results: Mean age was 51.15±10.33 in group A, while it was 50.58±10.59 in group B. Mean duration of breast cancer among the patients was 11.45±8.70 months. Mean blood loss, 24 hours after MRM was 40.68±20.79 ml in the topical group, while it was 50.83±26.38 ml in the intravenous group (p=0.016).Conclusions: Topical tranexamic acid showed significantly better control on blood loss as compared to intravenous TXA.
Introduction. A huge literature is available regarding the efficacy of various physiotherapy techniques for neck pain (NP), however, comparative study is still in scarcity. Therefore, this study aimed to compare effectiveness of stretching exercises versus manual mobilization techniques in the management of NP. Material and method. A randomized controlled trial parallel-group design study was conducted on the patients suffering from NP. Participants with the history of NP, aged between 19 to 60 years, NP without radiculopathy, and no history of trauma were included in the study. Two outcome measures were used i.e., Numeric pain rating scale (NPRS) and neck pain disability index (NDI) questionnaire. Two groups were equally divided had twenty-five patients each. Group A received cervical stretching with strengthening exercises as home-treatment program and group B received manual mobilization with strengthening exercises as home-treatment program. Six sessions were given on alternate basis and assessed pre- and post-treatment information of all patients. Results and discussions. Independent sample t-test was run to compare the post difference between stretching exercises and manual mobilization at 95% confidence interval (p<0.05). The Post NPRS difference between the groups shows no significant improvement (p=0.32). Similarly no significant difference was found in post NDI Disability (p=0.57). Therefore, both the treatment strategies are equally effective in improving NP and disability. Conclusions. This clinical trial concluded that stretching or manual mobilization is equally effective to reduce pain and disability. Hence, improve the quality of life in neck pain survivors. Keywords: Manual Mobilization Technique, Neck Pain, , Neck Pain Disability Index Questionnaire, Numeric Pain Rating Scale, Range of Motion, Stretching Exercises,
Background: Although a huge literature is available regarding the efficacy of various physiotherapy techniques for neck pain. This study was to compare effectiveness of stretching exercises versus manual mobilization techniques in management of neck pain along withhome exercises program.Methodology: A randomized controlled trial parallel group design study was conducted on the patients suffering from neck pain. Participants with the history of NP and aged between 19 to 60 years, Neck pain without radiculopathy, no history of trauma was included in the study. Two outcomes measures were used. NPRS and neck pain disability questionnaire. Two groups were equally divided had twentyfive patients each. Group A received treatment cervical stretching with strengthening exercises as hometreatment program and group B received manual mobilization with strengthening exercises as hometreatment program. Six sessions were given on alternate basis and assessed pre-and post-treatment information of all patients. Result:The results of the study is that NPRS outcomes in two treatment groups, in stretching exercises before treatment 68% samples found with moderate pain, whereas in manual mobilization techniques 52% samples found with severe pain, after treatment, in stretching exercises 76% samples converted to mild pain, and in manual mobilization techniques 88% samples converted to mild pain, however p-value of Mann Whitney U-test suggested that, both treatment performing similar on average in all patients. Conclusion:The conclusion of the study is that both the treatment therapies are effective in Np and patient condition is improving as such there were not any significant differences in these treatment groups. Patient's quality of life is improving with the both therapies.
Objective: In this study we evaluated the two most commonly used methods for pain relief in acute pancreatitis i.e. epidural analgesia and I/V analgesia and compared the results. Study Design: Randomized Controlled Clinical Trial. Setting: Surgical Unit-1 of Holy Family Hospital, Rawalpindi. Period: June 2019 to June 2020. Material & Methods: Patients presenting with acute pancreatitis with moderate severity were divided into groups A and B. In group A patients, epidural catheter was passed at T9-T10 level epidural space and they received 0.125% Bupivacaine injection every 4 hours, while group B patients received combination analgesia in the form of IV tramadol 100mg TDS and IV Toradol 30mg BD. Pain was assessed by using visual analog scale (VAS) at 12 hour intervals. Rescue analgesia, in the form of IV paracetamol 1g given in the case of >7 VAS score was also recorded. Results: Total 100 patients were included according to the inclusion criteria of the study. Patients were randomly divided into two groups; Group A (Epidural) and group B (intravenous). Mean age (years) in the study was 42.39+11.21 whereas there were 37 male and 63 female patients who were included in the study. In our study, mean pain score in group A was 3.16+1.23 which was significantly lower than group B (5.42+1.01), p-value < 0.0001. There was a single mortality in the study. 6 patient’s required ventilatory support due to respiratory complications, 5 in group B and 1 in group A. Conclusion: Epidural analgesia is superior to I/V analgesics in pain management of moderately severe pancreatitis and it also reduces respiratory morbidity in these patients.
Depending on the cause, neck pain can persist anywhere from a few days to several years; Osteoarthritis, spinal stenosis, ruptured disc, pinched nerves, emotional and physical stress, strain, bad posture, tumor, and other disorders are among the most common causes acupressure on local and distal acupuncture sites may provide drowsiness and relaxation, which may help to relieve chronic neck discomfort. Objective: To compare the effects of therapeutic massage and acupressure on neck pain. Methods: ISRA University Hospital Karachi conducted a randomized clinical trial. A total of n=30 individuals were between the ages of 20 and 35, with neck discomfort ranging from 3-6 on the VAS scale. The n=30 participants were separated into two groups: therapeutic massage (n=14) and acupressure (n=15). The data was analyzed using the SPSS version 22.0. Results: Mean age of study participants was 24.34± 4.3 years. A total of n=12 were female, and the remaining n=18 were male. The analysis showed that pain and neck disability significantly improved in both groups (p<0.05). When compared in both groups, the intensity of pain was not significantly different in both groups, but neck disability was significantly improved in the acupressure group as compared to the massage group after six weeks of intervention. Conclusion: The study concluded that both techniques benefit neck pain and disability and found significant results. But results show that acupressure was found to be more beneficial and significant than the therapeutic massage.
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