randomized controlled trial of intermittent cervical traction in sitting Vs. supine position for the management of cervical radiculopathy

Objective: To compare the effectiveness of intermittent cervical Traction in sitting vs. supine position for the management of cervical radiculopathy

Methods: A randomized clinical trial was done to compare pain and disability modification of cervical radiculopathy patients by using cervical traction in sitting and supine positions. Forty patients [males and females aged between 18-60 years with chronic cervical radiculopathy] were recruited for the trial. Participants were randomized into two homogeneous groups by dice method. The Group-A [n=20] received 3-weeks of intermittent cervical traction in sitting position along with Transcutaneous Electric Nerve Stimulation [TENS] and hot pack. The Group-B [n=20] received the same treatment except the intermittent cervical traction that was applied in supine position. Participants were assessed two times: at baseline [week 0] and at the termination of rehabilitation [week 3]. Neck disability index was used to collect the data before and after the treatment

Results: The mean age of the patients was 43.15+/-8.99 vs. 48.80+/-6.89 years in Group-A vs. Group-B respectively. Mean [+/-S.D.] weight of the patients was 74.75+/-12.11 vs. 74.60+/-11.24 kg in Group-A vs. Group-B respectively. Mean Neck Disability Index score at start of treatment was 30.30+/-7.46 vs. 30.75+/-7.85 in Group-A and Group-B respectively. There was a significant difference in Group-A and Group-B regarding aggregate NDI score at the end of treatment [19.45+/-7.12 vs. 11.05+/-4.40; p<0.0001]

Conclusion: Supine position is better choice for applying cervical traction as compared to sitting position for the management of cervical radiculopathy comparing post interventional NDI score

Assessment of human health risk associated with the presence of pesticides in chicken eggs

The presence of pesticides in the environment is highly toxic to environment and human health. Aim of the study was determination, quantification and assessment of associated health risk due to presence of pesticide residues in chicken eggs using high pressure liquid chromatography. HPLC method was successfully employed and validated. From collected samples pesticides were extracted in presence of petroleum ether and acetonitrile. Bifenthrin and Difenoconazole residues were found in all samples with different concentration exceeding maximum residue limits (MRL) of Codex Alimentarius Commission. However imidacloprid was not detected in any sample. Concentration of bifenthrin in house egg samples ranged from 0.256206 to 4.112387 mg/kg while in poultry farm samples it varied from 1.5862 to 5.80796 mg/kg. Difenoconazole was found in concentration of 0.02835 mg/kg, 1.7668 mg/kg, 3.7205 mg/kg, 21.8937 mg/kg 21.9835 mg/kg, 19.26407 mg/kg in samples collected from houses while and in poultry farm samples its detected concentration was 10.939 mg/kg, 12.3296 mg/kg, 29.3617 mg/kg, 18.6116 mg/kg, 40.0523 mg/kg and 19.2335 mg/kg. Concentrations of both pesticides Bifenthrin and Difenoconazole exceeded the MRLs (0.05 mg/kg). Health risk index surpassed 1 (the cut off value) for Difenoconazole in seven samples while for Bifenthrin values were less than 1, indicating the possibility of potential medium to long term health risk associated with ingestion of contaminated eggs.(AU)

Frequency of neck and shoulder pain and use of adjustable computer workstation among bankers

Background and Objective: Neck and shoulder are the most susceptible areas for developing musculoskeletal symptoms among computer users. The modifiable risk factors for these work related musculoskeletal disorders include physical office environment and psychosocial work related factors. Computer workstation layout had been shown to be an important physical aspect of work environment that influences the upper quadrant symptoms. Our objective was to find the frequency of neck and shoulder pain and use of adjustable computer workstation among bankers of Islamabad/Rawalpindi/Multan

Methods: A cross sectional study was conducted and 120 participants were questioned. Purposive sampling technique was used in this study. Maastricht Upper Extremity Questionnaire [MUEQ] was remodeled and important questions were extracted from its detailed version. The tool was then validated by taking expert opinion. Frequencies and percentages were calculated for categorical variables

Results: Pain in the neck during working hours was experienced by 71.67% of the respondents and 48.33% of the participants had experienced shoulder pain during working hours. Adjustable keyboards were used by 16.67% of respondents. Back care material was used by 40% bankers. Adjustable chairs were used by 95.83% of the participants. Only 3% of the bankers did not have chairs with adjustable heights. Chairs with adjustable armrests were used by 25% bankers

Conclusion: Neck and shoulder pain are common occurrences among bankers. Most of the components of workstations of bankers were adjustable but some of them still need attention

To evaluate the efficacy of mobilization techniques in post-traumatic stiff ankle with and without paraffin wax bath

Mobilization techniques are frequently used by physiotherapists to reduce pain, improve joint movement and facilitate return to activities after injury. The objective of this study was to explore differences in the efficacy of Mobilization Techniques in Post-Traumatic stiff ankle with and without Paraffin Wax Bath. Thirty seven patients of Post Traumatic stiff ankle were recruited for the study at Sajid Physiotherapy and Rehabilitation center, Multan from March 2011 to February 2013. It was a randomized controlled trial and the patients with equal grades of seventy were placed in control and study groups. Group A had nineteen patients and Group B had 18 patients. The inclusion criteria were age range from 20-60 years, pain, loss of ROM, with history of trauma and fracture of ankle. The patients with similar complaints but with surgical treatment were excluded. Group A was given mobilization techniques with paraffin wax bath while group B was treated without paraffin wax bath. Improvement was observed by EscolaPaulista de Medicina Range of Motion [EPM-ROM] scale and visual analogue scale [VAS]. After ten weeks of treatment, the patients were re-evaluated by an orthopedic surgeon and a Physiotherapist for their symptoms and ROM. t-test was applied to compare outcome between two groups and p < 0.05 was considered to be statistically significant. Group A had nineteen patients and Group B had 18 patients and both were treated for ten weeks. There were 12 male and 7 female patients in group A and 10 male and 8 female in group B. At the start of treatment the basic characteristic were similar in both the groups. Deficits in dorsiflexion, planterflexion, inversion, eversion pain and stiffness were measured before and after the treatment period. Pain relief was found better in both groups which were considered statistically significant with p=0.001, group A [1.135 +/- 0.359] vs. group B [1.135 +/- 0.359]. ROM in pre and post treatment degrees showed that dorsiflexion was significantly increased in group A [1.135 +/- 0.359] vs. group B [1.135 +/- 0.0359] and planterflexion was in group A [1.337 +/- 0.422] vs. group B [0.841 +/- 0.264]. Functional movement showed improvement in inversion in group A [0.875 +/- 0.276] vs. group B [0.966 +/- 0.305]and in eversion in group A [0.948 +/- 0.300] vs. group B [0.674 +/- 0.213]. Mobilization Techniques followed by wax bath resulted in significant improvements of range of motion [ROM], clinical and functional changes. Wax bath alone had no significant effect. After ten weeks intervention treatment, t-test was applied to compare outcome between the two groups and p=0.001to 0.004 in group A and p= 0.104 to 0.168 in group B, [p < 0.05] was obtained which shows statistical significance. Joint mobilization and wax bath therapy is an effective and beneficial tool to improve the symptoms and quality of life in post traumatic stiff ankle patients. Joint mobilization techniques combined with wax bath are more effective in the management of post-traumatic stiff ankle as compared to wax therapy alone

Efficacy of transcutaneous electric nerve stimulation [TENS] therapy in overactive non-neurogenic neurogenic bladder [Hinman's Syndrome]

To compare the outcome of the patients of overactive non-neurogenic neurogenic Bladder Syndrome with traditional treatment alone and traditional treatment plus Transcutaneous electrical nerve stimulation [TENS] therapy. Twenty eight patients of Hinmans syndrome [all below 12 years] were recruited for the study at The Children's Hospital and The Institute of Child Health Multan, from August 2008 to November 2010. It was a randomized controlled trial and individual patients were categorized as having mild moderate or severe disease, on the basis of Overactive Non-neurogenic neurogenic bladder symptom score [OABSS] scoring system. The patients with equal grades of severity were placed in control and study groups each comprising 14 patients. Group A was given traditional treatment while group B was treated with TENS therapy in addition to traditional treatment. Improvement was observed by OABSS and voiding diaries. After 12 weeks of treatment, the patients were re-evaluated for their symptoms and grade of severity of disease, t-test was applied to compare outcome between two groups and p < 0.05 was considered to be statistically significant. At the start of treatment, dribbling and increased frequency was observed in all 28 patients and urgency was noted in 22 patients [11 patients in each group]. At the completion of treatment after 12 weeks, dribbling was observed in 11[78.51%] vs. 3[21.4%] children in group A and B respectively. Frequency was reduced to 8[57.14%] in group A and 5[35.7%] in group B patients. Urgency was also reduced to 8[72.7%] in group A while 3[27.3%] in group B patients. No marked side affect were noted, except local skin irritation in some patients. Transcutaneous electrical nerve stimulation [TENS] Therapy is an effective and safe tool to improve the symptoms and quality of life of the patients with Hinman syndrome but still large scale studies with longer follow up are required