Intrasound therapy: an effective alternative to sodium diclofenac phonophoresis in the management of mechanical chronic cervical spine pain

The efficacy of Sodium Diclofenac Phonophoresis (SDP) as an effective adjunct in the management of inflammation and pain has been established though its application entails complicated choices of treatment parameters. Intrasound Therapy (IST), acclaimed for its simplicity of operation has been reported to promote healing though no studies have been done on its effect in Chronic cervical spine pain (CCSP). The aim of this study was to determine if IST could be an effective therapeutic option to SDP as an adjunct in the management of CCSP. Forty seven (47) participants with CCSP that had definite diagnoses were randomly assigned into 3 groups. All participants had exercises and massage while in addition, group 1 had SDP and group 2 IST for 10 minutes each. Participants were treated for 40 minutes twice a week for 4 weeks and were evaluated for pain, Quality of life (QoL), disability and range of motion (ROM) of the cervical spine. Paired sample t-test was used to compare the outcome parameters in each group and data presented as Mean ± SEM with significance at p<0.05. IST and SDP significantly (p˂0.05) improved the clinical parametres compared with the control group and there were no significant (p ˃0.05) differences in clinical outcome between the IST and SDP groups. IST was as effective as SDP and considering its relative simplicity of operation could be an alternative therapeutic adjunct in the management of chronic cervical pain

Relationship between selected anthropometric variables and prevalence of flatfoot among urban and rural school children in south west Nigeria.

BACKGROUND: Flat foot is a common reason for attendance at children's orthopaedic clinics. Its prevalence which varies from one population to the other has been reported to be influenced by various factors. OBJECTIVE: This study investigated the effect of nutritional status as indicated by factors such as height, weight and BMI on the prevalence of flatfoot in school age children in urban and rural areas in south-western Nigeria. MATERIALS AND METHODS: This study involved 560 children with age range 6 to 12 years. They were divided into two groups; rural and urban. The demographic and anthropometric data of all the subjects was taken. Each subject's static footprint was taken on a white duplicating paper after which the instep was measured and the footprint classified into high arch, normal, flat or severe flat. The body mass index and nutritional status of each subject was calculated from the anthropometric data. Epi Info statistical package programme version 3.5.1 (2008) was used to analyse the data. RESULTS: There was a statistically significant (p < 0.05) prevalence of flatfoot between the rural dwelling (18.2%) and the urban dwelling (32.9%) children. Anthropometric measurements were significantly higher in urban than in rural children. Nutritional status of urban children was also significantly higher than that of the rural children. CONCLUSION: Flatfoot is more prevalent in school age children in urban area than in the rural area; age and body mass index being the primary predictors for flatfoot.

Bromelain in the early phase of healing in acute crush Achilles tendon injury.

UNLABELLED: Bromelain, an enzyme extracted from the stem of the pineapple plant has been proposed as a treatment for reducing pain and swelling following acute muscle injuries but studies are yet to be done on its effect on tendon healing. This study therefore investigated the effects of bromelain on tenocyte proliferation and the tendon malondialdehyde (MDA) level in the early stage of healing in a crush injury to the Achilles tendon of Sprague-Dawley rats. Twenty four male rats were divided randomly into three groups; groups 2 and 3 had induced crush injury to the left Achilles tendon. Group 1; nil injury and nil treatment, Group 2; nil treatment, Group 3; oral bromelain treatment. Bromelain was given at a dosage of 7 mg/kg body weight daily over the first 14 days post-injury. On day 15 post injury, the animals were killed and the tendons excised and processed for histological study and MDA assay. The results showed a significant increase in the tenocyte population in the bromelain group; p < 0.05. There was, however, no significant difference in the MDA level. CONCLUSION: Based on this study, 600 GDU bromelain given once daily in acute tendon injury at a dosage of 7 mg/kg promoted healing by stimulating tenocyte proliferation.

Intrasound therapy in tendon healing: is intensity a factor?

OBJECTIVE: This study investigated the effects of low- and high-intensity intrasound therapy (LITR and HITR, respectively) given once daily and twice daily on the morphology and oxidative stress in healing tendon tissue following an acute injury. METHODS: Eighty-five male rats, randomized into six groups were further subdivided into groups A, B, and C, except for Group 1 which was subdivided into A and B only. Groups 2-6 underwent an induced crush injury. The six groups were allocated to: serve as controls (Group 1), receive no treatment (Group 2), HITR twice daily (Group 3), HITR once daily (Group 4), LITR twice daily (Group 5), and LITR once daily (Group 6). Intrasound therapy (ITR) was commenced 24 hours postinjury and was given once daily or twice daily over the first 14 days postinjury. The animals in subgroups A and B were sacrificed on day 15 postinjury, and those in subgroup C were sacrificed on day 31 postinjury. The tendons were excised, and processed for histology and malondialdehyde (MDA) assay. RESULTS: There was no significant difference in the tenocyte population between the HITR- and LITR-treated groups. However, twice-daily treatment in either the low- or high-intensity mode resulted in significant tenocyte proliferation compared with the once-daily treated groups, and also had the highest percentage of tenoblasts compared with the population of tenocytes in the proliferative phase of healing. All treatment protocols marginally lowered the MDA level. CONCLUSION: The role of IRT in tendon healing is influenced more by the frequency of treatment rather than the intensity of the delivered dosage.

The effects of varied intensities of intrasound therapy with indomethacin on the morphology of the healing tendon.

BACKGROUND: Patients undergoing intrasound therapy are often concurrently on NSAIDs. The effect of varied intensities of intrasound therapy with NSAIDs on tendon healing is yet to be determined. OBJECTIVE: The study investigated the effects of a concurrent admistration of low and high intensity intrasound therapy (LIRT&HIRT) with indomethacin (Indocid) on the morphology of the tendon in the early stage of healing. METHODS: Thirty five male rats were divided randomly into seven groups; groups 2-6 underwent an induced crush injury. Group 1, nil injury and nil treatment. Group 2: injury but nil treatment. Group 3: Indomethacin only. Group 4: LIRT only, Group 5: Indocidand LIRT, Group 6: HIRT, Group 7: Indocid and HIRT. Intrasound therapy (IRT) commenced 24 hours post-injury and was given alternate days for the first 10 days post injury. Indocid was given at a dosage of 0.4 mg/kg body weight daily. On the 11 day post injury, the animals were sacrificed and the tendons excised and processed for histological study. RESULTS: Indocid significantly (p < 0.05) reduced the tenocyte population when combined with LIRT but marginally increased it when combined with HIRT (p > 0.05). There was significant difference in the tenocyte population between the combined Indocid and LIRT and the combined Indocid and HIRT groups (p < 0.05). CONCLUSION: High intensity intrasound given concurrently with oral indomethacin resulted in tenoblast proliferation and promoted healing in the injured tendon.

The role of aqueous extract of pineapple fruit parts on the healing of acute crush tendon injury.

BACKGROUND: The Pineapple plant contains the enzyme bromelain which has been acclaimed to reduce pain and swellings following acute muscle injuries as well as carotenoids and polyphenols which are powerful antioxidants. It is yet to be determined if these constituents are distributed throughout the plant and what effect they have on the healing of acute tendon injuries. OBJECTIVE: This study therefore investigated the effects of the aqueous extract of different parts of the pineapple plant on tenoblast proliferation and the tendon Malondialdehyde (MDA) level in the early stage of healing in a crush injury to the achilles tendon of Sprague-Dawley rats. METHODS: Forty male rats were divided randomly into five groups; all had induced crush injury to the left Achilles tendon. Group 1; injury and nil treatment, Group 2; leaves extract, Group 3; fruit flesh extract, Group 4; bark extract, Group 5; core extract. The extract was given at a dosage of 30 mg/kg body weight daily over the first 14 days post-injury. On the 15th day post injury, the animals were sacrificed and the tendons excised and processed for histological study and MDA assay. RESULTS: The flesh and bark extract induced a proliferation of tenoblasts which however was not significantly different from that of the untreated tendon while the leaves and core extracts reduced the population of the tenocytes. The flesh extract significantly (p < 0.05) reduced the MDA level while the leaves and core extract significantly (p < 0.001) increased it. The bark extract had no significant impact on the MDA level compared with the untreated tendon. CONCLUSION: This study suggests that the anti-oxidant constituents of the pineapple plant are concentrated in the flesh while the bark and flesh extracts have the potential to promote healing by stimulating tenoblast proliferation.

The Effects of Varied Intensities of Intrasound Therapy with Indomethacin on the Morphology of the Healing Tendon

BACKGROUND: Patients undergoing intrasound therapy are often concurrently on NSAIDs. The effect of varied intensities of intrasound therapy with NSAIDs on tendon healing is yet to be determined. OBJECTIVE: The study investigated the effects of a concurrent admistration of low and high intensity intrasound therapy (LIRTetHIRT) with indomethacin (Indocid) on the morphology of the tendon in the early stage of healing. METHODS: Thirty five male rats were divided randomly into seven groups; groups 2-6 underwent an induced crush injury. Group 1; nil injury and nil treatment. Group 2: injury but nil treatment. Group 3: Indomethacin only. Group 4: LIRT only; Group 5: Indocidand LIRT; Group 6: HIRT; Group 7: Indocid and HIRT. Intrasound therapy (IRT) commenced 24 hours post-injury and was given alternate days for the first 10 days post injury. Indocid was given at a dosage of 0.4 mg/kg body weight daily. On the 11 day post injury; the animals were sacrificed and the tendons excised and processed for histological study. RESULTS: Indocid significantly (p 0.05) reduced the tenocyte population when combined with LIRT but marginally increased it when combined with HIRT (p 0.05). There was significant difference in the tenocyte population between the combined Indocid and LIRT and the combined Indocid and HIRT groups (p 0.05). CONCLUSION: High intensity intrasound given concurrently with oral indomethacin resulted in tenoblast proliferation and promoted healing in the injured tendon

Students' view of a learning method: opinions of first year medical and dental students in the School of Basic Medical Sciences of University of Lagos, Nigeria, about problem based learning.

BACKGROUND: Driven by a desire to improve basic medical science education, the department of Anatomy in the College of Medicine University of Lagos introduced the Problem Based Learning (PBL) programme into the Anatomy component of first year Basic medical science training of the College of Medicine, University of Lagos. OBJECTIVE: We conducted a students' assessment of the different aspects of this newly introduced PBL. METHODS: Structured questionnaires were circulated among first year Medical and Dental students in the School of Basic Medical Sciences of the University. Apart from relevant personal data that would not compromise identity of respondents, we sought to find out through relevant questions students' opinion about various aspects of the programme. The respondents had to grade their responses on a scale of 1 through 5 (representing strongly agree to strongly disagree) to indicate their level of agreement/ disagreement to simple statements designed as completions to a single stem statement. RESULTS: The class generally rated the use of PBL and the activity of the department in the programme high whilst also highlighting the areas of challenges where some major improvements needed to be observed. CONCLUSION: The established benefits of the PBL approach are reproducible even when implemented newly in a challenging and often times difficult environment in a developing country.