Comparison of the mean decrease of score with intra articular nsaid injection versus steroid injection for the management of adhesive capsulitis

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

Resolution of a large left ventricular thrombus with anticoagulation alone

Dilated cardiomyopathy and the resultant left ventricular dysfunction are risk factors for thrombus formation in the heart, reflecting the intimate relationship between structure and function in this vital organ. Once formed, depending on size, location, and mobility, left ventricular thrombi have the tendency to embolize, sometimes with dire consequences. Proper management of these thrombi is still controversial. We present a case of an unusual large thrombus, which resolved with anticoagulation therapy alone, giving hope that more invasive intervention can safely be circumvented

Subarachnoid haemorrhage; evaluation by CT scanning

25 patients of Subarachnoid Haemorrhage between the ages of 39 to 70 years were studied over a period of 3 years [Jan, 1998 to Dec, 2001] out of which 92% patients had classical Subarachnoid Haemorrhage on CT and 8% did not show any definite SAH. CT scan is quite helpful in Subarachnoid Haemorrhage diagnosis and there after the proper management of the disease.

Colour doppler ultrasound; A useful diagnostic tool for venous imaging

The incidence and prevalence of venous thrombosis can only be estimated as most episodes go undetected clinically. Venous Thromboembolism [VTE] is a major source of emboli in 95% cases of pulmonary embolism [P.E], which in tuner is one of the leading causes of death in patients dying undetected. This study was carried out in the Department of Radiology and Ultrasound at Allied Hospital, PMC Faisalabad for a period of 8 months and total number of cases are 100. The objective was to evaluate the case of VTE and their squealae by using Colour Doppler studies. The result was that colour doppler sonography and colour enhanced technique has improved the sensitivity of blood flow detection