Frequency of pressure ulcers in patients with spinal cord injury

Objectives: To determine the frequency of pressure ulcers in patients with spinal cord injury. To compare frequency of pressure ulcers in complete and incomplete spinal cord injury using ASIA impairment scale

Study Design: Cross sectional study

Place and Duration of Study: Departments of Armed Forces Institute of Rehabilitation Medicine Rawalpindi, from Jun 2013 to Jan 2014

Material and Methods: After permission from the hospital ethical committee and informed consent, spinal cord injury [SCI] patients were included from the outdoor and the indoor departments of Armed Forces Institute of Rehabilitation Medicine Rawalpindi from June 2013 to January 2014. Patients were divided in two groups of complete SCI and incomplete SCI on the basis of American Spinal Injury Association [ASIA] impairment scale. SPSS version 17 was used for data analysis

Results: Total 62 SCI patients were included. Mean age of patients was 36 +/- 0.93 SD. Males were more in number 79% [49]. On ASIA scoring 51.6% [32] were in ASIA 'A' followed by 19.4% [12], 17.7% [11] and 11.3% [7] patients in ASIA 'B', 'C and 'D' respectively. SCI was complete in 51.6% [32] and incomplete in 48.4% [30]. PU were present in 32.3% [20] patients. PU were in stage 4 in 30% [6] patients. PU were more frequent in ASIA [A] injuries followed by [B], [C] and "D" involving 43.8%, 25%,18.2% and 14.3% of patients respectively. Pressure ulcers [PU] were common in complete injuries involving 43.8% [14] than in incomplete injuries 20% [6] [p=0.041]

Conclusions: Pressure ulsers were more common complication detected after spinal cord injury with more frequency in complete spinal cord injury

Role of pulsed electromagnetic therapy in the management of backache: a study conducted at armed forces institute of rehabilitation medicine, Rawalpindi

To determine the role of pulsed electromagnetic therapy in providing pain relief for backache. This was a quasi experimental study. This study was conducted at Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan from Jan 2012 to June 2012. This study included 65 consecutive patients with backache. The pain was assessed on 11 points [0-10] Numeric Rating Scale [NRS] and patients with score >1 were included in the study. Detailed history was obtained and examination was performed. All patients were subjected to pulsed electromagnetic therapy. The pain was assessed at first week, 2nd week, third week and six week after start of the pulsed electromagnetic therapy. Data was compiled and analysed using SPSS version 17. A p-value < 0.05 was considered as significant. There was marked reduction in pain of patients with backache after treatment with pulsed electromagnetic therapy. Reduction in pain as calculated by the NRS [numeric rating scale] value after 1[st] week was 25.35% [p=0.002], after 2[nd] week was 43.66% [p=0.001], after 3[rd] week was 50.7% [p=0.001] and after 6 weeks was 71.83%[p=0.001]. Pulsed electromagnetic therapy is very effective in relieving pain in patients with backache

Electrophysiological evaluation of foot drop

Foot drop can be a presentation of many causes. Most of them initially present with same signs and symptoms, e.g. foot drop, numbness over lateral aspect of the leg and dorsum of the foot especially peroneal nerve lesions, sciatic nerve lesions, L5 radiculopathy. It poses a lot of diagnostic problems .No study has been published in local literature to highlight this very important subject .Aim and objective of this study is to highlight the importance of electrodiagnostic studies in predicting prognosis, localizing lesions, pathophysiological changes and monitoring recovery. Cohort and observational study. This study was carried out at Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi from July 2001 to June 2002. Nerve conduction studies were performed with MS-6 [MEDLEC] using surface electrodes. Concentric needle electromyography was done using Neuropack electromyographic model MEM-7102K. On the basis of electrophysiological studies out of fifty, thirty patients had axonal while 20 patients had demyelinating lesions. Patients were divided into two groups on the basis of axonal and demyelinating lesions. In group A out of 30, [n=30] there were 14 [46.64%] and group B out of 20, [n=20] 7 patients [35%] of foot drop were due to peroneal nerve lesions, rest of the patients had L5 radiculopathy, Sciatic nerve lesions, Polyneuropathy and other abnormalities. Electrodiagnostic studies serves as an important tool in localizing the lesion and assessing its severity in different causes of foot drop

Occurrence of deep vein thrombosis in spinal cord injured patients

The aim of this descriptive study was to describe the occurrence of Deep Vein Thrombosis [DVT] in spinal cord injured patients. 50 patients of both sexes [43 men and 7 women] with less then 90 days duration of injury and without other risk factors of DVT were studied over a period of two years. Most of the patients were in 20-39 years age group. They were evaluated for DVT on development of clinical signs or completion of 90 days of injury by Duplex Ultrasound Scan. DVT was found in 6 subjects [12%], all were male. One patient had bilateral, two had right sided and three had left sided involvement. None of the patients with incomplete spinal cord injury developed DVT. DVT is not a rare complication as is considered commonly and therefore requires adequate prophylactic measures in patients with concomitant various risk factors

Frequency of carpal tunnel syndrome [CTS] after conservatively managed Colles' fracture

In this study, 56 adult patients of both sexes treated conservatively for Colles' fracture for at least six months, were evaluated both clinically and electrodiagnostically for evidence of CTS. Those found to have CTS electrodiagnostically were divided into 3 categories on the basis of distal motor latency [DML] in median nerve across wrist. A rate of 28.57% of CTS after conservatively managed Colles' fracture was found in this study. This is much higher than that reported in developed countries. Malunion was present in 93.75% of these patients. Main anatomical derangements responsible for malunion were radial shortening more than 2 mm and dorsal angulations more than 10 degrees. Electrodiagnostic studies were not found to be more sensitive than history and physical examination, but they definitely helped in objective confirmation of diagnosis and in assessing the severity of compression thus guiding in devising management strategies