ABSTRACT
Background: Shoulder pain is the third most common musculoskeletal condition has a lifetime prevalence of up to 70% and this seems to be increasing in incidence. The diagnosis of these disorders is based primarily upon results of clinical tests. The prevalence of shoulder pain in India has not been reported. The aim of present study is to study and report the prevalence of various disorders causing shoulder pain in patients reporting to a tertiary care hospital in North India. Methods: This is a prospective hospital based cross-sectional study carried in a tertiary care hospital and 130 patients satisfying inclusion criteria over a period of two year were included. Results: Age of patients ranged between 23-69 years (51.36 ± 11.86 years). A predominance of females was observed (Male-Female ratio: 0.81:1). The commonest cause of pain was periarthritis shoulder (43.1%), subacromial (SA) impingement (13.8%), acute rotator cuff injury (13.1%), GH arthritis (10.0%) and AC Arthritis (8.5%). The major risk factors were diabetes mellitus, excessive overhead lifting and trauma. Conclusion: Periarthritis and subacromial pain syndrome are two most common diagnoses reporting to a tertiary care centre. Periarthritis is the commonest diagnosis in both genders. AC arthritis is more common in females (P <0.001) and rotator cuff injury is more in males (P <0.001). Periarthritis, GH arthritis and AC arthritis is much more common in fifth and sixth decades and rotator cuff injury is seen in young adults.
ABSTRACT
Background: Osteoarthritis, a whole organ disease is diagnosed on clinical and radiological features, but plain radiographs show changes only in moderate to advanced stage of disease. Biochemical marker such as Hyaluronic Acid (HA) is used as a diagnostic tool in early stages. Hyaluronic acid level estimation has limited use in developing world due to cost and availability. Methods: A case-control study was done to correlate role of WOMAC score and serum Hyaluronic acid levels in knee osteoarthritis. All subjects were asked to fill the WOMAC questionnaire and were subjected to knee radiography. Blood samples of all subjects were tested for serum levels of Hyaluronic acid by Enzyme Linked Immuno-Sorbent Assay (ELISA). The assessment of severity was done by K-L grading of the radiographs. Results: The mean age in case group was 51.28 ± 7.93 years and in control group was 46.08 ± 4.81 years (P <0.001). A statistically significant difference in WOMAC score, HA levels and K-L grading of cases and controls was found (P <0.001). The results show a mild association of HA (r=0.421), moderate association of age (r=0.570), and strong association of K-L grade (r=0.910) with WOMAC scores and all these associations were highly significant (p<0.001). Multivariate analysis shows only WOMAC score >60 is independently associated with the outcome. Conclusion: WOMAC scores are significantly associated with knee osteoarthritis and can play a crucial role in identification, gradation and management of patients with knee osteoarthritis and can be used singly along with clinical features in situations where treatment cost and assessment of serum HA levels is of concern.
ABSTRACT
Background: Idiopathic Congenital Talipes Equino-Varus (CTEV) is a complex deformity of foot that is difficult to treat. The goal of treatment is to gain a functional, pain free, plantigrade foot, with good mobility and without callosities. Currently, the most accepted and popular method is the Ponseti method which allows correction of all components of CTEV by manipulation and serial casting without any major surgical intervention. This prospective study was done in a tertiary care centre to statistically assess the efficacy of Ponseti method. Methods: We treated 150 children (210 feet) with idiopathic clubfoot deformity, using Ponseti technique. The severity of foot deformities were assessed by Pirani scoring system and were also recorded clinically, radiologically and podographically. The changes in the mean Catterall-Pirani scores at different follow ups were evaluated statistically. Results: The mean number of casts that were applied to obtain correction was 7.86 (range 5 to 11 casts). Percutaneous tendoachilles tenotomy was done in 70% of feet. All children were given foot abduction orthosis after the correction. The results were graded according to Ponseti and Smoley criteria. Good results were obtained in 83% of feet, acceptable results in 7% of feet and poor results in 10% of cases. Statistically significant correction was achieved in manipulation and casting stage which was maintained during bracing phase. The recurrences of the deformity were primarily due to poor compliance in the use of orthosis in post correction phase. Conclusion: The Ponseti method of correction is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non-compliance with orthotics is the main factor causing relapse of the deformity.
ABSTRACT
Fibro-osseous pseudotumor of the digit is a very rare benign lesion however it may be a cause of concern as it forms differential diagnosis to aggressive bone forming tumors like extraskeletal osteosarcoma. Till date only a few cases have been reported in the literature. We came across a case of 7yr old female presented with complains of post traumatic progressively growing hard swelling present on the palmar surface of the hand at the hypothenar region for last 6 months. Investigations i.e. X-rays, MRI and CT scan were done along with other blood investigations to rule out other common diseases such as exostosis or myositis ossificance or extraskeletal osteosarcoma. Excisional biopsy of the lesion confirmed the diagnosis of fibro-osseous pseudotumor of the digit.
ABSTRACT
Background & objectives: Indoor residual spraying (IRS) is a proven tool to reduce visceral leishmaniasis vectors in endemic villages. In India IRS is being done with stirrup pumps, whereas Nepal, Bangladesh, and other countries use compression pumps. The present study was conducted with the objectives to compare the efficiency, cost and user friendliness of stirrup and compression pumps. Methods: The study was carried out in Gorigawan village of the Vaishali district in north Bihar and included a total population of 3259 inhabitants in 605 households. Spraying with 50 per cent DDT was done by two teams with 6 persons per team under the supervision of investigators over 5 days with each type of pump (10 days in total using 2 stirrup pumps and 3 compression pumps) by the same sprayers in an alternate way. The spraying technique was observed using an observation check list, the number of houses and room surfaces sprayed was recorded and an interview with sprayers on their satisfaction with the two types of pumps was conducted. Results: On average, 65 houses were covered per day with the compression pump and 56 houses were covered with the stirrup pump. The surface area sprayed per squad per day was higher for the compression pump (4636 m2) than for the stirrup pump (4102 m2). Observation showed that it was easy to maintain the spray swath with the compression pump but very difficult with the stirrup pump. The wastage of insecticide suspension was negligible for the compression pump but high for the stirrup pump. Interpretation & conclusions: The compression pump was found to be more user friendly due to its lower weight, easier to operate, lower operation cost, higher safety and better efficiency in terms of discharge rate and higher area coverage than the stirrup pump.