RESUMEN
Objective: adhesive capsulitis is a common condition in which the shoulder capsule swells and stiffens, restricting its mobility. It is a common cause of shoulder pain and disability, estimated to affect 25% of the general population. The objective of the study was to compare the mean decrease of pain scores [according to ULCA shoulder rating scale] with intra-articular nonsteroidal anti-inflammatory [NSAID] injection versus steroid injection for the management of adhesive capsulitis of the shoulder
Material and Methods: a randomized controlled trial was carried out in Department of Orthopedic Surgery at Services Hospital Lahore from September 2012 to March 2013. A total of 150 patients with adhesive capsulitis of the shoulder were included in the study and were assigned into two groups using random number table. Group A patients received intra-articular NSAID [Ketorolac] and Group B patients were treated with intra-articular steroid [Triamcinolone] injection for the treatment of adhesive capsulitis. The pain scores were recorded before and four weeks after the intra-articular injections using ULCA shoulder rating scale
Results: the age distribution of the 150 patients shows that majority of the patients i.e. 37.33% [n=28] in Group A and 33.33% [n=25] in Group B were between 51 -60 years, mean and SD was calculated as 53.55+/-5.11 and 55.21+/-5.76 years respectively. In Group-A45.33% [n=34] and in Group-B 48% [n=36] were males whereas 54.67% [n=41] and 52% [n=39] were females. The pre-treatment pain score in both groups was recorded as 4.43+/-1.76 in Group A and 5.92+/-1.31 in Group B. The post-treatment pain score was 7.95+/-0.32 in Group A and 6.7620.63 in Group B [p=0.01], showing significant difference in both groups
Conclusion: the intra-articular NSAIDs injection is a more effective treatment option compared to intra-articular steroid injection for the management of adhesive capsulitis of the shoulder
RESUMEN
Background: Microscopic colitis [MC] which includes two distinct but probably related entities namely collagenous colitis [CC] and lymphocytic colitis [LC] is characterized by chronic watery/secretary diarrhea and normal/near normal endoscopic and radiological appearance of colon. The purpose of this study was to determine the rate of MC in our patients who seek medical advice because of chronic watery diarrhea and found to have either normal colonic mucosa on endoscopy or show minimal non specific changes
Material and Methods: A retrospective study of 100 consecutive colonic biopsies coming to Indus Lab, Lahore for analysis
Results: We reviewed one hundred colonic biopsies and found seven cases of MC, four showed features of LC and three had CC. The two out of four cases of LC were associated with celiac disease. The age distribution was 24 to 65 years. Out of four patients of LC three were female and one male whilst CC was found in one female and two male patients. The two patients of MC associated with celiac disease also complained of failure to thrive/weight loss. One patient with CC had mild abdominal discomfort in addition to chronic watery diarrhea. There was no history of long term use of non steroidal anti-inflammatory drugs [NSAIDs] in any of our patients
Conclusion: MC is a relatively rare but important cause of chronic watery diarrhea and all patients should have multiple endoscopic biopsies taken from different parts of "normal" looking colon to rule out the possibility of MC
RESUMEN
Since the Start of chemotherapy there has been a search for more specific anti-cancer agents which should selectively act against the tumor cells and spare the normal cells. We know that conventional anti-cancer drugs act against all dividing cells in our body and because of the fact that most of the tumor cells have high proliferative index they are at the selective disadvantage. There are two important considerations in this regard, firstly some tumor grow slowly rendering them less sensitive to these agents and paradoxically some normal cells divide very rapidly such as bone marrow, gut lining epithelium and hair follicle resulting in some of the well known side effects of chemotherapy such as myelosuppression, gastrointestinal disturbances and alopecia. With our better understanding of the molecular biology of cancer, new exploitable differences between normal and tumor cells have been discovered against which we can apply more specific agents. Majority of these molecular targets are protein products of oncogenes and oncosuppressor genes including growth factor receptors and their enzymatic intracytoplasmic domains. Various monoclonal antibodies directed against these proteins or small molecule inhibitors of their enzymatic intracytoplasmic domains are increasingly being used in cancer therapy such as imatinib mesylate, trastuzumab, cetuximab and gefitinib. This article reviews the molecular biology of these agents and the new and promising role of histopathologist in selecting these therapies for individual patients, known by various names such as targeted/customized/individualized or personalized therapy