Effect Of Whole Body Vibration On Lower Body Strength And Balance In Osteoarthritis Knee

Background: Knee osteoarthritis causes pain, functional limitation, and disability in the elderly. Whole-body vibration has gained a lot of attention in recent years. It is currently used in alleviating pain and improve physical function along with strength and balance. Methods: 34 individuals aged between 50-70 years fulfilling the inclusion criteria were selected and randomized into two groups. Baseline assessment was done using the VAS scale, WOMAC scale, Berg Balance Scale, and 30seconds chair stand test. Group A received whole-body vibration, and knee strengthening exercises, and group B received only strengthening exercises. The treatment was given thrice in a week for four weeks. The assessment was done by the end of the 2nd and 4th weeks. Results: Whole body vibration had shown greater improvement of VAS on rest (p<0.05) compared to VAS on activity. Also, the WOMAC score was statistically improved between and within the group with p<0.05. Conclusion: Whole body vibration, along with strengthening exercises, showed superior effects in reducing pain, stiffness, physical function, balance, and lower limb strength in osteoarthritis knee patients.

Empyema Thoracis- Our Ten Years Experience.

Empyema still remains one of the serious problems and challenge for a thoracic surgeon , despite the wide spread use of antibiotics and other surgical modalities its treatment is controversial with or without bornchpleural fistulae. Our experience in 200 patients of empyema with or without bronchopleural fistula was retrospectively reviewed. The causes of empyema were as follows. Parapneumonic (n=140), post tubercular empyema (n=20), following trauma (n=16), Post surgical (n=10), subdiaphragmatic pathology (n=2), oesophageal rupture (N=5) and underdetermined + 17. Broncho- pleural fisyula was found to be present in 20 % of these patients. Therapeutic thoracentesis was carried out successfully in 22 patients and closed tube thoracostomy in 178 patients and success was obtained in 89 patients (50 %) decortication alone in 60 patients (30 %). Thoracoplsty with muscle with muscle flap interposition in n=13, open drainage with rib resection (Eloesser flap) in ten patients , six patients refused any surgical intervention .

Kimura’s Disease.

A rare case of Kimura’s disease alongwith AV Malformation around left pinna in a 26 year old male is being described. AV Malformation had two feeders from superficial temporal artery and occipital artery. The lesion was excised along with ligation of feeders. Post operatively patient was put on systemic corticosteroid therapy with some benefits.

Pleurocutaneous flap: how useful it is in management of chronic empyema.

BACKGROUND: Definitive surgical treatment of chronic empyema is associated with considerable morbidity and mortality. Methods. Retrospective study of 50 patients with chronic empyema who underwent pleurocutaneous flap procedure during the period 1994 to 2003. RESULTS: Their age ranged from 14 to 70 years; there were 32 males. Thirty-seven (74%) patients were on intercostal tube drainage; nine (18%) presented with bronchopleural fistula; and four (8%) had past-pneumonectomy empyema. Following pleurocutaneous flap procedure, 28 (56%) responded with re-expansion of the lung; 15 (30%) had persistence of pus discharge and air-leak suggestive of bronchopleural fistula. Definitive surgery could be undertaken in nine of the 15 patients. CONCLUSIONS: Pleurocutaneous flap procedure renders the patient ambulatory, facilitates re-expansion of the lung and helps as a tide-over procedure before definitive surgery in patients with chronic empyema.

Pulmonary Resections - Jammu Experience

Ten year registry of patients who underwent pulmonary resections at CTVS section of Govt Medical College Jammu is being presented. The cohort consisted of 94 patients operated between1994-2004. Males outnumbered females in this series Most number (30/94) of patients presented in the 4th decade. Etiology wise, Infective lung diseases were the leading causes leading to pulmonary resections, this included bronchiectasts with 32/94, chronic empyema in6/94 and middle lobe syndrome in one patient. Lung tumors were the causative factors in 20 and post tuberculosis destroyed lung in 17 cases. Two patients presented with intralobar lung sequestrations and one each with pulmonary blastoma and teratoma. The spectrum of resections included right pneumonectomy in19/94 followed by right and left lower lobectomies in 18 each. Thirteen patients underwent left pneumonectomy, 7 bilobectomy and 4 lingulectomy respectively. The mortality in our series was 6/94,20 patients had wound infection, 9 had bronchopleural fistula and 3 postoperative space infections.3 patients were reexplored because of hemorrhage in immediate postoperative period. Diagnostic video assisted thoracoscopy has been started and was employed in 6 patients.

Malignant Melanoma of Gastroesophageal Junction

A rare case of malignant melanoma arising from the gastroesophageal junction is being reported. Since part of the tumor was adherent with hiatus, palliative procedure in form of Mousseau Barbin tube insertion was necessitated. Postoperatively patient was subjected to radiotherapy. Malignant melanoma of gastroesophageal junction is rare accounting for only 0.1% of the lesions of this region. Surgical treatment requires a far greater margin of excision than the usual squamous cell carcinoma. Intracavitary radiotherapy has been recommended.

Angiosarcoma of Manubrium Sterni

A rare case of angiosarcoma affecting the manubrium sterni is being reported.Angiosarcoma is a very rare tumour affecting the bones with incidence as less as O.13%and its incidence involving the manubrium sternii is extremely rare.