Effect of Early Elbow Crutch Mobility on Patients with Post-Anterior Cruciate Ligament Repair.

Objective: Rehabilitation after anterior cruciate ligament (ACL) reconstruction has focused over the past decade on early mobility and exercises in the recent years, due to advancements in the surgical techniques, presumably less strain on the graft. Thus it was necessary to investigate the effect of early mobilization with the single elbow crutch with conventional methods and its outcome responses. Materials and Methods: Totally, 40 subjects of day 1 post-ACL oblique repair with mean age of 25 ± 5.3 years participated in the study. Subjects were divided into experimental and control groups for rehabilitation with single elbow crutch and walker, respectively, along with conventional exercises for 6 weeks. After 4 th week elbow crutch and walker were discarded for both groups. Interventional outcomes were assessed by static, dynamic stability, and knee functional score at 4 th and 6 th weeks post-operatively for both groups. Results: Both groups showed statistically significant difference in static and dynamic stability at 4 th and 6 th weeks. Whereas compared with experimental group, in control group Lysholm functional score was low in at 4 th and 6 th weeks. It was found that outcomes were improved within each group from 4 th to 6 th week. Conclusion: Study concluded that knee stability and Lysholm functional Knee Score were significantly improved by early mobilization although functional score was more significant in single elbow crutch group than walker and also recommended early weaning off walking aids for faster outcomes during rehabilitation of post-ACL repair.

Intrauterine contraceptive device position: a possible cause for intrauterine contraceptive device associated menorrhagia

Intrauterine contraceptive device [IUCD] is used by more than 100 million women around the world. Menorrhagia is the most common complication for many women using this method. To evaluate the relation between the position of intrauterine contraceptive device [IUCD] within the uterus and abnormal uterine bleeding in the form of menorrhagia. A cross sectional study. Out-patient gynecology clinics at Kasr El-Aini Hospital, Cairo University and National Research Centre. Fifty women with IUCD in place and menorrhagia [study group] were enrolled in the study and compared with thirty women with IUCD and normal menstrual flow [control group]. The distances between the top of the vertical arm of IUCD and the fundus [IUCD-F], the myometrium [IUCD-M], and the junction between the endometrium and uterine cavity [IUCD-E] were measured by the use of trans-vaginal ultrasound [TV U/S] scan. Also, the distance between the lower end of the vertical arm of IUCD and the internal Os as measured [IUCD-I]. 3D ultrasound transparent mode was used in frontal plane. All the measurements were longer among the study group compared to the control one, where the IUCD-F distance was 24.66 +/- 9.76 and 17.98 +/- 4.04mm respectively [p<0.001]. Also, the IUCD-M distance was 10.42 +/- 9.73 and 5.38 +/- 1.89mm respectively [p=0.006]. The IUCD-E distance was 6.76 +/- 8.40 and 1.83 +/- 1.47mm respectively [p=0.002]. Also, the IUCD-I distance was longer among the control group than the study group, 14.23 +/- 4.56 and 6.20 +/- 9.09mm respectively [p=0.0001]. There is a possible relationship between the IUCD position inside the uterine cavity and the IUD associated menorrhagia in IUCD users. Less incidence of menorrhagia due to IUCD use is seen in women with higher device in position. We recommend the simultaneous use of TV U/S scan with IUCD application, and for follow up, to ascertain its proper position in the uterus

Subclinical hyperthyroidism as a potential factor for dysfunctional uterine bleeding

To evaluate the functional status of thyroid gland in apparently euthyroid women with dysfunctional uterine bleeding. Forty apparently euthyroid women with menorrhagia and no pathologic lesion in the genital tract were compared to 20 women having normal menstrual cycle as control group. All women were subjected to hormonal assay: total and free T3, T4 and TSH, Serum PRL, P [progesterone], total and free testosterone. A statistically significant difference in the values of TSH, total T3, free T3 and total T4 in the menorrhagia group compared to the control group. Prolactin was decreased significantly in the menorrhagia group. Subclinical hyperthyroidism can be a potential risk factor for dysfunctional uterine bleeding. Other studies are needed to confirm our findings