RESUMEN
The biceps is the supinator and secondary flexor muscle of the forearm. Injury to the long head of the biceps occurs in the middle aged and elderly; most commonly due to trauma and sudden eccentric contraction of the biceps whilst lifting a weight. It can be diagnosed clinically and further confirmed by sonography and Magnetic Resonance Imaging [MRI]. Treatment is conservative in the majority of cases and involves activity modification, pain relief, range of motion and strengthening exercises, physical therapy and weight lifting precautions. Surgical management, which includes tenodesis and tendon transfer, is reserved for individuals who are active, involved in sport and for those preferring cosmesis. Conservative management has good results with little loss in supination and flexion power, complete independence in activities of daily living and complete resolution of symptoms. Clinical suspicion, early clinical diagnosis and conservative management can prevent morbidity/complications and assist in early recovery
RESUMEN
Objective: To analyze the spectrum of medical issues during floods and to document the needs for medical rehabilitation expertise during floods in Pakistan
Methodology: A questionnaire based cross sectional survey was designed. Medical officers from Pakistan Army who provided services in the flood affected areas of Pakistan during 2010-14 were selected. Data recorded included the area, time since flood,number and types of patients seen per day, medical issues encountered and trauma cases seen. We also inquired about the need for rehabilitation medicine physicians during floods and if any rehabilitation interventions were needed or offered during rescue operations. Data was analyzed using SPSS version 20
Results: Forty self-administered questionnaires were distributed among physicians who had recently returned after performing duties in the flood hit areas. The response rate was 70% [28]. All the respondents were medical officers from Army Medical Corps. There were 15 males and 13 female respondents with an average of 1 year experience. They had reached the flood affected areas1-4 weeks post-floods and spent an average of 30 days in those areas. Majority of the doctors were in Rahimyar khan and surrounding areas. Average number of patients attended was 147 patients/physician/day. Gastrointestinal diseases, skin infections and conjunctivitis were the commonest issues seen, followed by respiratory illness and minor trauma [bruises and lacerations]. Only one case each of head injury and fracture were reported. None of the respondents considered early rehabilitation intervention mandatory in acute flood situation, however, weekly visits of medical, surgical, skin and eye specialist, gynaecologist and psychiatrist were recommended
Conclusion: Frequent medical consultations in floods involve gastrointestinal disorders, skin diseases, conjunctivitis and respiratory illnesses. General duty doctors trained in common flood related ailments are sufficient. However weekly visits by consultants is recommended. No specialized rehabilitation and other services are required in initial days of floods