The effectiveness of manual versus algometer pressure release techniques for treating active myofascial trigger points of the upper trapezius.

Manual pressure release (MPR) is a popular treatment of trigger points. Yet, treatment response may be influenced by inconsistent application of pressure. Further, it may contribute to increased risk of work-related musculoskeletal disorders of the wrist and hand in therapists. Therefore, this study aimed at introducing a novel method to apply pressure using the algometer and to compare its effectiveness to MPR. Forty-five volunteers with active trigger points of the upper trapezius received algometer pressure release (APR), MPR, or sham ultrasound (US). Pain pressure threshold (PPT) and contralateral active and passive neck side-bending ranges were assessed at baseline and immediately after a single session. Results showed no significant differences in post-treatment PPT between the study groups (p > 0.05). The APR group showed a significant increase in passive side-bending range compared with the two other groups, whereas active range improved in the APR compared with the US group (p < 0.05). Our results show that using algometer to apply pressure release to upper trapezius trigger points is more effective compared with manual release and sham US.

Diagnosis of Trichomonous vaginalis by microscopy, latex agglutination, diamond's media, and PCR in symptomatic women, Khartoum, Sudan.

BACKGROUND: Trichomoniasis is the most common sexually transmitted disease. However, limited data are available on an effective technique for the diagnosis of Trichomonas vaginalis. METHODS: A cross-sectional study was conducted to evaluate the accuracy of wet mount microscopy, latex agglutination, Diamond's media, and polymerase chain reaction (PCR) for detection of T. vaginalis among symptomatic women who attended the gynecological clinic at Khartoum, Sudan. RESULTS: Of the 297 women studied, 252 (84.8%) were positive for T. vaginalis by wet mount microscopy, 257 (86.5%) by latex agglutination, 253 (85.2%) by Diamond's media, and 253 (85.2%) by PCR. The sensitivity and specificity of wet mount microscopy were 99.2% and 97.7%, respectively, compared with PCR. The sensitivity and specificity of latex agglutination and Diamond's media were 99.6% and 88.6%, and 100.0% and 86.4%, respectively, compared with PCR. CONCLUSIONS: In this study, wet mount microscopy, latex agglutination, and Diamond's media were found to be highly sensitive and specific. However, the availability and cost effectiveness might limit the use of Diamond's media and PCR in routine practice. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7859723851211496.

Stent thrombosis is a major concern in clinical practice: A single Saudi center experience.

BACKGROUND: Drug-eluting stents (DES) are used in the majority of patients who undergo percutaneous coronary intervention (PCI), and have reduced the rate of in-stent restenosis and repeated revascularization in comparison to bare metal stents. However, stent thrombosis (ST) is an uncommon but serious complication of coronary artery stents that is mostly fatal or presents as a large non-fatal myocardial infarction (MI), usually with ST elevation. OBJECTIVE: To study the incidence of stent thrombosis in Middle Eastern Saudi patients who underwent PCI using both drug-eluting stents (DES) and bare metal stents (BMS). ST can occur acutely (within 24 h), sub acutely (within 30 days), or as late as one year (late) or even more than one year (very late). METHODS: In an observational, single center study in catheterization (cath) lab a total of 1386 patients underwent PCI between January 2008 and September 2010. The study included all patients in that period who had acute coronary syndrome and stable coronary artery disease (CAD). RESULTS: A total of 1386 patients had PCI and stent deployments; 19 (1.3%) patients had stent thrombosis, four patients (21%) received BMS and 15 patients (79%) received DES. Four patients had acute ST; five had subacute ST; eight patients had late ST; while two patients had very late ST. Nine patients (47%) had DM and eight patients (42%) had hypertension. CONCLUSION: The incidence of ST in Saudi patients who received DES at our center is similar to internationally reported numbers. Almost half of ST patients are diabetics and there is increasing concern that the risk for late stent thrombosis is slightly higher with DES than BMS.