Comparison of neural mobilization and conservative treatment on pain, range of motion, and disability in cervical radiculopathy: A randomized controlled trial.

OBJECTIVE: The objective of the study was to compare the effectiveness of neural mobilization technique with conservative treatment on pain intensity, cervical range of motion, and disability. METHODS: It was a randomized clinical trial; data was collected from Mayo Hospital, Lahore. Eighty-eight patients fulfilling the sample selection criteria were randomly assigned into group 1 (neural mobilization) and group 2 (conventional treatment). Pain intensity was measured on a numeric pain rating scale, range of motion with an inclinometer, and functional status with neck disability index (NDI). Data were analyzed using SPSS, repeated measure ANOVA for cervical ranges and the Friedman test for NPRS and NDI were used for within-group analysis. Independent samples t-test for cervical ranges and Mann-Whitney U test for NPRS and NDI were used for between-group comparisons. RESULTS: There was a significant improvement in pain, disability, and cervical range of motion after the treatment in both groups compared to the pre-treatment status (p < 0.001), and when both groups were compared neural mobilization was more effective than conventional treatment in reducing pain and neck disability (p < 0.001), but there was no significant difference present in the mean score of cervical range of motion between both groups. (p>0.05). CONCLUSIONS: The present study concluded that both neural mobilization and conservative treatment were effective as an exercise program for patients with cervical radiculopathy, however, neural mobilization was more effective in reducing pain and neck disability in cervical radiculopathy. TRIAL REGISTRATION: RCT20190325043109N1.

Effects of Neurodynamic Mobilization on Health-Related Quality of Life and Cervical Deep Flexors Endurance in Patients of Cervical Radiculopathy: A Randomized Trial.

Purpose: Cervical radiculopathy is disorder of cervical spinal nerve root affecting large number of population. Previously many studies are conducted to design suitable protocol for management of this disorder, but they lack in quality. The purpose of this study was to compare the effects of neural mobilization and cervical isometrics on health-related quality of life and deep flexors endurance in cervical radiculopathy. Methods: A double-blinded randomized clinical trial was conducted at Mayo Hospital, Lahore, Pakistan. Eighty-eight patients within the age range of 35-50 years were included in the study after taking their consent. In the experimental group (n = 44), median nerve mobilization was applied along with cervical isometric exercises. The control group (n = 44) performed cervical isometric exercises alone. Muscle endurance was measured by craniocervical flexion test and quality of life on 36 items short form health survey SF-36 scale. Measurements were taken at baseline, at 2nd week, and at 4th week. For missing data, intention-to-treat analysis was used. Results: Within-group comparison with Friedman test showed a significant difference between pre, mid, and posttreatment scores on craniocervical flexion test and in all domains of SF 36 in both groups. While between-group comparison with Mann-Whitney U test showed all variables were similar at baseline but after 4 weeks there was a statistically significant improvement in craniocervical flexion test scores and all domains of SF 36 in the experimental group. But domain of pain showed mean rank of 49.43 after 4 weeks in the experimental group and 39.57 in the control group with p = 0.065 and d = 0.579, while for all the other 7 domains values were p < .05 and d > 0.25. Conclusion: Neural mobilization combined with cervical isometrics shows significant effects in improving quality of life and deep flexors endurance in patients with cervical radiculopathy than cervical isometrics alone.

Association of Inflammatory Markers/Cytokines with Cardiovascular Risk Manifestation in Patients with Endometriosis.

This study is aimed at determining the association of inflammatory markers and proinflammatory cytokines with cardiovascular risk manifestation in women with endometriosis as compared to healthy controls. A total of 181 females of reproductive age with the absence of other inflammatory or autoimmune disorders and a lack of hormonal therapy for at least 6 months voluntarily participated in this investigation. Patients were 81 females, laparoscopically diagnosed with endometriosis, while the control group comprised 80 healthy females without any pelvic pathology. All subjects were 20-40 years of age. Exclusion criteria were diabetes, obesity, hypertension, metabolic diseases, cardiovascular, and renal disorders. C-reactive protein, fibrinogen, homocysteine, interleukin-17, and interleukin-33 were analyzed using commercially available ELISA kits. For statistical interpretation, the unpaired Student "t" test was used. All inflammatory markers and cytokines demonstrated elevated levels (P < 0.001) in endometriosis patients as compared to healthy controls. The results of the study revealed that the patients with endometriosis demonstrate a hypercoagulable status due to inflammation, which initiates atherosclerosis and associated complications. Hence, endometriosis can cause a risk of cardiovascular disorders in these patients.

Evaluation of diabetes awareness among general population of Bahawalpur, Pakistan.

AIMS: To evaluate diabetes awareness among general population of Bahawalpur, Pakistan. METHODS: A questionnaire based descriptive cross sectional study was performed during 2014. Descriptive and inferential statistics were applied using the IBM Statistical Package for Social Sciences version 20. RESULTS: Total 383 respondents participated in this study giving a response rate of about 88%. Mean age of the participants was 33±13.3 years and the majority of the participants were females (50.4%). Mean scores of the participants were 20.77±6.65 out of 34 and only one participant scored 34/34 marks. Kruskal-Wallis and Mann-Whitney U test revealed that females scored significantly higher diabetes awareness score than males (p<0.05). Moreover, urban residential status, better education and higher socioeconomic status were significantly associated with higher diabetes awareness. CONCLUSIONS: Majority of our study population had adequate awareness regarding diabetes. However, lack of awareness was observed among illiterate, poor and rural participants that indicated the immediate need of diabetes awareness programs for these participants.