RESUMO
Objective: To compare the effectiveness of steroid therapy with and without physiotherapy for the management of lateral epicondylitis (tennis elbow). Methodology: Patients, who fulfil the inclusion criteria of selection were admitted to study in the Department of Physiotherapy PSRD, Lahore. Each patient received an informed consent. Demographic data including name, age, sex, height and weight were noted. Participating individuals were randomly allocated into two groups by lottery method. Patients of group A were treated by steroidal therapy without physiotherapy manoeuvres and the individuals of group B were treated by combination of steroidal therapy and physiotherapy. The follow-up was carried out for up to 4 weeks.All the information has been collected with pre-defined preforms.Data was interpreted and analysed through SPSS version 22.0. Results: The overall mean age of cases was 38.90±6.97 years and 42.07±7.03 years. There were 38(63.33%) male and 22(36.67%) female in this study. Before treatment the mean pain of participating individuals of group-A and in group-B was 7.40±1.45 and 7.63±1.27 with insignificant difference. After treatment the mean pain in group-A and group-B was 3.40±1.73 and 2.53±1.57 with significantly lower pain in group-B, p-value < 0.05. When we compared mean pain before and after injection was significantly improved in both groups but the improvement was higher in group-B. The mean pain difference in group-A and group-B was 3.77±2.18 and 4.90±1.83 with higher improvement in group-A, p-value < 0.05. Conclusion: Results of study concludesteroid injection with addition to physiotherapy was more effective in reducing pain.We must encourage orthopedic and physiotherapist teamwork to treat tennis elbow.
RESUMO
Background and Aims: Wilson disease (WD) is autosomal recessive disorder of copper metabolism. Wilson disease patients usually suffer from hepatic or neuropsychiatric complications. The symptoms appear between ages five to 35 but it can vary from two years to 72 years. Materials and Methods : Study was carried out from June 2008 to November 2010. This study included nine families with eleven cases of WD to determine clinical presentation, diagnostic findings (including laboratory results) and liver histology. It included 11 patients who presented with hepatic manifestations and/or Neuropsychiatric manifestations and/or family history suggesting features of WD. Patients with hepatitis B and C and those with history of taking antipsychotic drugs were excluded from the study. Patient's data was included in a well designed performa. Liver function test, serum ceruloplasmin, serum copper, 24 hour urinary copper, blood complete picture were analyzed. Quantitative data such as age, hemoglobin etc were expressed as mean with ± SD and quantitative variables such as sex, movement disorders, hepatic involvement etc were expressed as frequency and percentage. Results: There were five male and six female patients with evidence of various manifestations here (i) hepatic in which they had only liver dysfunction (ii) hepatic and neurological (iii) neurological. The mean age of presentation was 8.7±3.92 years (range 4-19 years) and 45% were male patients. Decreased serum ceruloplasmin, enhanced 24-h urinary copper excretion and signs of chronic liver damage were confirmed in all patients and Kayser-Fleischer rings (KF rings) in 72% of patients. In severe WD patients, serum prothrombin activity was less than 50%, serum ceruloplasmin were low and serum copper levels were high than those in non-severe WD patients. High degree of suspicion leads to early treatment with good outcome. Conclusions: The WD is rare but important cause of chronic liver disease. Clinical and biochemical analysis in cases of patients with unexplained liver disease with high degree of suspicion can lead to early treatment with good outcome.