Comparison of suprascapular nerve block and intra-articular injection in the treatment of frozen shoulder

The objective of this study was to compare the effect of supra scapular nerve block and intra articular injection to relieve pain and reduce disability in the patients of frozen shoulder. It was a quasi experimental study. The study was conducted at the department of Orthopedics, Pakistan Railway Hospital, Rawalpindi, fromAugust 2011 toSeptember 2012. Patients diagnosed as the cases of frozen shoulder in outpatient department of Orthopedics irrespective of their gender were included in the study. Forty patients and 50 shoulders were divided into two groups by randomization, one group received single suprascapular nerve block and second group received single intra-articular steroid injection. Both groups were advised for physiotherapy after injection. Patients' pain levels and ranges of movement were assessed over a period of twelve weeks. The study included 40 patients and 50 shoulders to a single suprascapular nerve block and intra articular steroid injection. The mean age of the patients was 49.4 + 9.97 and the range was 40-60 years. There were 16 females and 24 male patients. Post injection assessment of patients was done at two, six, eight and twelve weeks. There was a significant decrease in pain and marked improvement in range of movement with supra scapular nerve block than with intra articular injection. Patients' pain levels and ranges of movement were assessed over a twelve week period. Suprascapular nerve block produced a faster and more complete resolution of pain and restoration of range of movement than intra articular injection

Treatment of colle's fracture with wrist immobilization in palmar flexed and dorsiflexed position

To evaluate and compare the radiological and functional results of immobilization of Colle's fracture treated conservatively in two different positions of wrist i.e. palmarflexion [PF] and dorsiflexion [DF]. A Descriptive Cross Sectional Study. Sixty patients with closed Colle's fracture who were treated conservatively by close reduction and below elbow cast application were included in this study. The study was conducted at Department of Orthopedics, Railway Hospital, Westridge, Rawalpindi from November 2008 to May 2011. The patients were alternately allocated to dorsal or palmar flexed immobilized position of wrist. Patients were followed up for a minimum six-month period. The radial tilt, palmar tilt and ulnar variance were measured at 6 month follow up. The results were scored by Demerit Scoring System of Saito. All fractures were united. Individual movement of dorsiflexion, palmar flexion, supination, and radial-ulnar deviation [except pronation] were all significantly better in the dorsiflexed-immobilized group as compared with the palmar flexed immobilized group. Grip strength recovery with subjective assessment was better in the dorsiflexed group as compared to the PF group. Radiological parameters were markedly better in the dorsiflexed group. 100% of patients in the dorsiflexed group had overall excellent results as compared to 23.3% in the palmar flexed group in terms of radiological and functional outcome. Functional and radiological results of Colle's fractures are superior if the fractures after reduction are immobilized in dorsiflexion of wrist ratherthan in conventional palmarflexion position

Universal HIV testing for TB patient; is it really applicable universally?

Background: Universal HIV testing for all TB patients regardless of their individual risk factors is being recommended by most of the authorities including WHO in recent guidelines

Objective: To determine the prevalence of HIV infection among Pulmonary TB patients presenting at Department of Pulmonology, Rahim Yar Khan, Pakistan

Patients and Methods: In this cross sectional study, one hundred consecutive newly registered smear positive pulmonary TB patients presented at Department of Pulmonology, Sheikh Zayed Medical College, Rahim Yar Khan from 1[st] April to 31[st] December 2010 were included in this study. Interviews were conducted to record the sociodemographic data and various HIV related risk factors for all patients. Consent was taken from the patients to be included in this study and for HIV testing. Test was done by ICT method at department of pathology of this institute. The data was entered and analyzed in SPSS version 15

Results: Out of 100 TB patients in this study, 56 were male and 44 were female. Majority [51%] of the patients were uneducated. Only 24% were earning more than ten thousands rupees per month. Sixty six percent patients were aged between 15-49 years. All the patients gave their consent for HIV testing. Only 4 of the 100 subjects had travelled abroad, 8 had history of blood transfusion and none of the patients admitted any history of drug abuse. None of the 100 patients in this study was positive for HIV infection

Conclusion: Despite the presence of risk factors in considerable number of participants of this study, HIV infection was not detected in any of the Pulmonary TB patient. This finding put a question mark over universal recommendation of HIV testing in all TB patients worldwide. However, larger study including all TB patients, both Pulmonary as well as Extra Pulmonary is required to confirm this finding