Role of Ultrasonography in the Evaluation of Painful Shoulder

2018 ◽  
Vol 1 (01) ◽  
pp. 19-24
Author(s):  
Sindhu Sharma ◽  
Santosh Pant ◽  
Bibek Rajbhandari
Keyword(s):  
Shoulder Pain ◽  
Clinical Diagnosis ◽  
Clinical Examination ◽  
Frozen Shoulder ◽  
College Teaching ◽  
Cost Effective ◽  
Radiology Department ◽  
Medical College ◽  
Diagnostic Arthroscopy ◽  
Considerable Morbidity

Introduction: Shoulder pain is a common problem encountered in clinical practice. It is often disabling to the patient and results in considerable morbidity and unsatisfactory outcomes if therapy is not instituted effectively or delayed. Ultrasonography is a rapid, real time and cost effective alternative to MRI and diagnostic arthroscopy. Here, we compare sonographic diagnosis with clinical diagnosis in the diagnosis of the various causes of shoulder pain. Methods: This descriptive study was done in the radiology department of Nepalgunj Medical College Teaching Hospital, Kohalpur during a time period of 18 months. About 30 cases of shoulder pain that had been evaluated clinically by a single examiner in the orthopedics OPD were diagnosed with the help of sonography. Correlation between clinical diagnosis and USG diagnosis was done. Results: Clinically, most of these cases were provisionally diagnosed as Frozen shoulder 9 (30%) followed by Cuff tendinopathy 8 (26.66%) and Impingement syndrome 6 (20%). However, USG of the shoulder revealed rotator cuff tendinopathy and cuff tear (n=6 each) to be the main etiology behind shoulder pain. Supraspinatus calcific tendinopathy was found in 4 individuals. Hence, it was seen that the diagnosis of the causes of shoulder pain with clinical tests alone is unsatisfactory. Out of 30 cases, clinical examination could correctly diagnose only 20% of the time (n=6). 73% of the time (n=20), USG showed a different diagnosis compared to clinical examination whereas in 4 (7%) cases a more specific diagnosis was reached.Conclusions: We conclude that USG is more specific and frequently leads to increased diagnostic accuracy when compared to clinical examination.

scholarly journals Comparison Intra Articular Steroid vs. Hydraulic Distention for the Treatment of Frozen Shoulder

2013 ◽  
Vol 1 (1) ◽  
pp. 3-9 ◽  
Author(s):  
GP Singh
Keyword(s):  
Pain Relief ◽  
Teaching Hospital ◽  
Frozen Shoulder ◽  
College Teaching ◽  
Muscle Relaxants ◽  
Medical College ◽  
Group I ◽  
Normal Sleep ◽  
Group Ii

Background Frozen shoulder is a chronic fibrosing condition of the capsule of the shoulder joint. OBJECTIVE The objective of the study was to compare the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra articular steroid alone. Sample Size: 60 patients were taken in this study and were divided into two groups. Duration and Setting: The study was conducted in 2005-2006 treated in the department of orthopaedic, Janaki medical college Teaching Hospital, Janakpur. Materials and Methods: It was a prospective, observational, comparative and clinical study. Sixty patients were selected from Dhanusha District of Janakpur, Nepal. They were divided into two groups. Since January 2005 to January 2006 periods in the department of orthopedics surgery, Janaki Medical College & Teaching Hospital, Janakpur. The Group I was treated by hydraulic distention of glenohumeral joint with 50ml normal saline with steroid, oral medicines (analgesics and muscle relaxants) and exercises. Patients in group II were treated by intra-articular steroid followed by oral medicines (analgesics and muscle relaxants) and exercises. Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 23 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions: Hydraulic distension technique is quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. DOI: http://dx.doi.org/10.3126/jucms.v1i1.8415   Journal of Universal College of Medical Sciences Vol.1(1) 2013: 3-9

scholarly journals Assessment of Hand Hygiene Knowledge among Residents and Nursing staffs at Nobel Medical College Teaching Hospital, Biratnagar

2019 ◽  
Vol 38 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Sunil Kumar Yadav ◽  
Arun Giri
Keyword(s):  
Hand Hygiene ◽  
Disease Transmission ◽  
College Teaching ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Cross Transmission

Introduction: Hand hygiene is a very simple and cost-effective procedure to prevent cross-transmission of microorganisms. The compliance of residents and nursing staffs with hand hygiene guidelines seems to be vital in preventing disease transmission among patients. The objective of the study was to assess the knowledge of residents and nursing staffs with regard to hand hygiene. Material and Methods: This was an institution based descriptive cross-sectional study conducted among 55 respondents (29 nursing staffs and 26 resident doctors) of department of paediatrics, Nobel Medical College in Biratnagar, Nepal. Knowledge was assessed using WHO hand hygiene questionnaire for health care workers. Chi square test was used to compare the percentage of correct responses between resident doctors and nursing staffs. A p value of <0.05 was considered significant. Results: Among 26 resident doctors and 29 nursing staffs who participated in the study, 30.7% of resident doctors and 55.1% of nursing staffs had received formal training in hand hygiene in the last three years. Only 9% of participants (5 out of 55) had good knowledge regarding hand hygiene. Conclusions: The knowledge regarding hand hygiene is limited among the study population. The study recommends the need for emphasizing hand hygiene component in the preservice as well as in-service training programs of doctors and nurses.  

scholarly journals Spectrum of Exfoliative Cytology at Birat Medical College and Teaching Hospital

2019 ◽  
Vol 4 (2) ◽  
pp. 734-737
Author(s):  
Shilpi Shaukin ◽  
Satosh U Kafle ◽  
Mrinalini Singh
Keyword(s):  
Teaching Hospital ◽  
College Teaching ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Exfoliative Cytology ◽  
Cross Sectional ◽  
Medical College ◽  
Important Diagnostic Tool ◽  
Breast Fluid ◽  
Malignant Lesions

Introduction: Exfoliative cytological study of body fluids is easy, simple, rapid, cost effective and patient compliant investigation that helps in characterizing the disease into their varying subtypes. These presumptive and sometimes definitive diagnoses are in most cases the cornerstone which helps in staging and prognosis of the patient Objective: To determine the spectrum of malignant and non-malignant lesions in exfoliative cytology Methodology: This was a quantitative retrospective cross sectional study conducted at Birat Medical College Teaching Hospital from 24th December 2014 to 24th December 2018. All the exfoliative samples received at the lab were accepted in our study. Results: Of the 300 samples received, the maximum number were those of sputum followed by pleural fluid and ascitic fluid. Peritoneal fluid, Cerebrospinal fluid, synovial fluid, fluid from suspected abscess and breast fluid were also received. Malignancy was found in 1.67% of the samples studies. Conclusion: A study of different cytomorphological features of exfoliative cytology samples will help in establishing the role of cytology as an important diagnostic tool in improving the effectiveness of diagnosis , treatment & prognosis of the patient in the medical field.  

scholarly journals A prospective study of arthroscopic evaluation of patients with chronic shoulder pain

2017 ◽  
Vol 3 (5) ◽  
pp. 1015
Author(s):  
Pramod Bhor ◽  
Sachin Y. Kale ◽  
Shikhar D. Singh ◽  
Sanjay B. Dhar ◽  
Abhinav Garg ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Cost Effective ◽  
Diagnostic Modality ◽  
Medical College ◽  
Institutional Ethics ◽  
Single Centre Study ◽  
A Prospective Study ◽  
Radiological Methods ◽  
Chronic Shoulder Pain ◽  
Made In

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Shoulder pain is a common musculoskeletal complaint that may be due either to intrinsic disorders of the shoulder or referred pain. In this study, we aimed to find out the sensitivity and specificity of the clinical and radiological methods in diagnosing the chronic shoulder problems and to compare clinical and radiological diagnosis with arthroscopic diagnosis.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">After obtaining approval of the institutional ethics committee, we enrolled patients who presented with chronic shoulder pain in the outpatient clinic of Department of Orthopedics, DY Patil Medical College and Hospital, Navi Mumbai from August 2003 till August 2005. We obtained historical data of each patient in detail and made clinical, radiological and arthroscopic diagnosis. The findings from each diagnostic modality were compared and analysed</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">During the study period, 34 patients were enrolled in the study. Injury was traumatic in 32% of the patients and 50% of all patients were heavy workers by occupation. Half of all the patients had pain in shoulder for more than 6 months. Clinical diagnosis of biceps tendinitis was made in 44% of patients, but radiological and arthroscopic diagnosis of biceps tendinitis was made in 18% and 12% respectively. Impingement was diagnosed in 29% patients clinically, in 15% patients radiologically and in 21% patients arthroscopically. Rotator cuff injury was diagnosed in 26% patients clinically, in 41% patients radiologically and in 67% patients arthroscopically. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Findings from this single centre study suggest that arthroscopy can diagnose and treat conditions causing chronic shoulder pain, which is cost effective as well</span><span lang="EN-IN">.</span></p>

scholarly journals Evaluation of Prophylactic Antibiotic in Caesarean Section

2016 ◽  
Vol 12 (2) ◽  
pp. 40-41
Author(s):  
Nazmussaba Ansari ◽  
CR Das ◽  
Miraj Alam Ansari
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Prophylactic Antibiotic ◽  
College Teaching ◽  
Cost Effective ◽  
Dose Regime ◽  
Medical College ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Introduction: Caesarean section is one of the most rewarding surgeries when performed in time and indication. The number of C/S has been growing rapidly in the developing as well as developed world.Aims & Objectives: Evaluation of prophylactic antibiotic in caesarean section.Methodology: This study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from June 2014 to September 2014. Group A consisted of 100 patient who were randomly allocated & injection ceftriaxone 1gm. I/V stat was given at the time of induction of anesthesia (30 mins. before incision). Group B also consisted of 100 patients who were given 5 days antibiotics.Results: In post operative evaluation the infection rate were compared in both groups, group A wound infection 2% and group B 3% , Endometritis - group A 1% and group B 2%, UTI- group A 3% and group B 4%, Fever - group A 6% and group B 4%.Conclusion: Single dose prophylactic antibiotic is comparable to multi dose antibiotic in this study. Since the single dose antibiotic is as efficacious as multi dose regime, it is advocated that single dose prophylactic antibiotic can be given in caesarean section as it is cost effective and as efficient as multi dose regimen.JNGMC Vol. 12 No. 2 December 2014, Page: 40-41

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

The CSF p-tau181/Aβ42 Ratio Offers a Good Accuracy “In Vivo” in the Differential Diagnosis of Alzheimer’s Dementia

2019 ◽  
Vol 16 (7) ◽  
pp. 587-595 ◽  
Author(s):  
Roberto Santangelo ◽  
Alessandro Dell'Edera ◽  
Arianna Sala ◽  
Giordano Cecchetti ◽  
Federico Masserini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Diagnosis ◽  
Fdg Pet ◽  
Amyloid Β ◽  
Cost Effective ◽  
Daily Clinical Practice ◽  
Different Types ◽  
Experimental Trials ◽  
Csf Findings

Background: The incoming disease-modifying therapies against Alzheimer’s disease (AD) require reliable diagnostic markers to correctly enroll patients all over the world. CSF AD biomarkers, namely amyloid-β 42 (Aβ42), total tau (t-tau), and tau phosphorylated at threonine 181 (p-tau181), showed good diagnostic accuracy in detecting AD pathology, but their real usefulness in daily clinical practice is still a matter of debate. Therefore, further validation in complex clinical settings, that is patients with different types of dementia, is needed to uphold their future worldwide adoption. Methods: We measured CSF AD biomarkers’ concentrations in a sample of 526 patients with a clinical diagnosis of dementia (277 with AD and 249 with Other Type of Dementia, OTD). Brain FDG-PET was also considered in a subsample of 54 patients with a mismatch between the clinical diagnosis and the CSF findings. Results: A p-tau181/Aβ42 ratio higher than 0.13 showed the best diagnostic performance in differentiating AD from OTD (86% accuracy index, 74% sensitivity, 81% specificity). In cases with a mismatch between clinical diagnosis and CSF findings, brain FDG-PET partially agreed with the p-tau181/Aβ42 ratio, thus determining an increase in CSF accuracy. Conclusions: The p-tau181/Aβ42 ratio alone might reliably detect AD pathology in heterogeneous samples of patients suffering from different types of dementia. It might constitute a simple, cost-effective and reproducible in vivo proxy of AD suitable to be adopted worldwide not only in daily clinical practice but also in future experimental trials, to avoid the enrolment of misdiagnosed AD patients.

scholarly journals An Exonuclease I-Aided Turn-Off Fluorescent Strategy for Alkaline Phosphatase Assay Based on Terminal Protection and Copper Nanoparticles

Biosensors ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 139
Author(s):  
Yan Wang ◽  
Ying Yan ◽  
Xinfa Liu ◽  
Changbei Ma
Keyword(s):  
Alkaline Phosphatase ◽  
Human Serum ◽  
Clinical Diagnosis ◽  
Copper Nanoparticles ◽  
Cost Effective ◽  
Fast Method ◽  
Exonuclease I ◽  
Alkaline Phosphatase Assay ◽  
Phosphatase Assay ◽  
Phosphatase Alkaline

As an important DNA 3′-phosphatase, alkaline phosphatase can repair damaged DNA caused by replication and recombination. It is essential to measure the level of alkaline phosphatase to indicate some potential diseases, such as cancer, related to alkaline phosphatase. Here, we designed a simple and fast method to detect alkaline phosphatase quantitively. When alkaline phosphatase is present, the resulting poly T-DNA with a 3′-hydroxyl end was cleaved by exonuclease I, prohibiting the formation of fluorescent copper nanoparticles. However, the fluorescent copper nanoparticles can be monitored with the absence of alkaline phosphatase. Hence, we can detect alkaline phosphatase with this turn-off strategy. The proposed method is able to quantify the concentration of alkaline phosphatase with the LOD of 0.0098 U/L. Furthermore, we utilized this method to measure the effects of inhibitor Na3VO4 on alkaline phosphatase. In addition, it was successfully applied to quantify the level of alkaline phosphatase in human serum. The proposed strategy is sensitive, selective, cost effective, and timesaving, having a great potential to detect alkaline phosphatase quantitatively in clinical diagnosis.

An evaluation of a shoulder rehabilitation class in a UK hospital following evidence-based modifications

2021 ◽  
pp. 1-8
Author(s):  
Emily Kell ◽  
John A. Hammond ◽  
Sophie Andrews ◽  
Christina Germeni ◽  
Helen Hingston ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Shoulder Pain ◽  
Management Strategies ◽  
Cost Effective ◽  
Rehabilitation Programme ◽  
Patient Specific ◽  
Satisfaction Survey ◽  
Evidence Based ◽  
Patient Satisfaction Survey ◽  
Significant Difference

OBJECTIVES: Shoulder pain is a common musculoskeletal disorder, which carries a high cost to healthcare systems. Exercise is a common conservative management strategy for a range of shoulder conditions and can reduce shoulder pain and improve function. Exercise classes that integrate education and self-management strategies have been shown to be cost-effective, offer psycho-social benefits and promote self-efficacy. This study aimed to examine the effectiveness of an 8-week educational and exercise-based shoulder rehabilitation programme following the introduction of evidence-based modifications. METHODS: A retrospective evaluation of a shoulder rehabilitation programme at X Trust was conducted, comparing existing anonymised Shoulder Pain and Disability Index (SPADI) and Patient-Specific Functional Scale (PSFS) scores from two cohorts of class participants from 2017-18 and 2018-19 that were previously collected by the physiotherapy team. Data from the two cohorts were analysed separately, and in comparison, to assess class efficacy. Descriptive data were also analysed from a patient satisfaction survey from the 2018-19 cohort. RESULTS: A total of 47 patients completed the 8-week shoulder rehabilitation programme during the period of data collection (2018-2019). The 2018-19 cohort showed significant improvements in SPADI (p 0.001) and PSFS scores (p 0.001). No significant difference was found between the improvements seen in the 2017-18 cohort and the 2018-19 cohort. 96% of the 31 respondents who completed the patient satisfaction survey felt the class helped to achieve their goals. CONCLUSION: A group-based shoulder rehabilitation class, which included loaded exercises and patient education, led to improvements in pain, disability and function for patients with rotator cuff related shoulder pain (RCRSP) in this outpatient setting, but anticipated additional benefits based on evidence were not observed.

scholarly journals Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2019 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
B Parajuli ◽  
G Pun ◽  
S Ranabhat ◽  
S Poudel
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
College Teaching ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Partial Mole ◽  
Proliferative Endometrium ◽  
The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

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