Effects of Subcapsularis Neuro Muscular Reduction (NMR) in Adhesive Capsulitis

Background: To determine the effects of Subscapularis Neuromuscular Reduction (NMR) in Adhesive Capsulitis patients on pain, Range of Motion (ROM) and Quality of life. Methods: In this randomized controlled trail patients with freezing and frozen stage of Adhesive capsulitis and limited range of movement were included. Patients were randomly divided into control (Group A) and experimental group (Group B). The patients of Group A were treated with conventional physical therapy treatment protocol and patients of group B were treated with subscapularis neuromuscular reduction along with conventional physical therapy. The patient outcome measures were assessed using numeric pain rating scale (NPRS), SPADI (shoulder pain and disability index) and ranges via goniometry. Data was analyzed by SPSS 21. Results: Both group showed significant improvement, but the end value comparison showed significant difference. NMR (Neuromuscular Reduction) on Subscapularis muscles improved the pain, ROM and Patient functional status more as compared to the conventional physical therapy group. The NPRS mean value for control group was 2.90±1.09 and mean value for experimental group was 2.05±1.10with p value of 0.021 while the mean value of SPADI for control group was33.52±9.96 and for experimental group was 26.72±8.00 with p value of 0.026. Conclusion: Treatment groups showed improvement by reducing pain, improving range of motion and functional status but neuromuscular reduction of subscapularis muscles was found to be more effective

Repercussion of Academic Stress on Vital Parameters among Medical Students of Ayub Medical College Abbottabad

OBJECTIVES: An increased stress is a common cause of mental fatigue and physical consumption among medical students. Therefore, the purpose of this study was to assess the effect of stress on vital parameters during students’ examination and to highlight the importance of personal well being among medical students. METHODOLOGY: The major aim of this study was to assess the effect of academic stress on vital parameters in medical students. This study was carried out in Ayub Medical College, Abbottabad in September to October 2018. The subjects selected for the study were final year MBBS students. Data was collected before and during the examinations. After taking their due consent, physical parameters such as blood pressure (both systolic and diastolic), heart rate were measured and psychological parameters like perceived stress and total mood disturbance were evaluated. Data was analyzed by using SPSS-22. RESULTS: Parameters like blood pressure (both systolic and diastolic) and total mood disturbance score   with a p-value of <.01 showed significant difference during examination. However other variables like age, height, weight, BMI, heart rate, and perceived stress score showed no significant difference. CONCLUSION: The study concludes that students during examinations were under pressure which resulted in anxiety and stress. Total Mood Disturbance is considered a more reliable and prominent factor in interpretation of a student's stressed and disturbed state. It is more closely related to the stress state of students than any other. &nbsp

LAPAROSCOPIC OR CONVENTIONAL CHOLECYSTECTOMY FOR SYMPTOMATIC CHOLELITHIASIS

Objective: In this research study we compare the result of conventional open to laparoscopic cholecystectomy on the basis of duration and positive result on patient after surgery. Methodology: This research study is done in five years from January 2014 to December 2018 four hundred cholelithiasis patient participate in this study 200 patients treated with open and 200 patients was treated with Laparoscopic cholecystectomy. During surgery we noted the duration and positive parameters of both surgery and also determine advantages & disadvantages of both procedures. All 400 patients were equally divided in 2 groups one OC for open cholecystectomy & 2nd LC for laparoscopic cholecystectomy. Results: The surgery time of LC was shorter than OC patients the duration of surgery in OC was 54.16±11.94 minutes & in LC was 46.89±14.83 minutes’ p values are greater than 0.001. The OC group surgery was fifty point five percent complicated as compared to LC it was thirty-seven percent as well as all negligible and extensive problems with joined morbidity of forty-three point seventy-five percent p value is greater than 0.001. The hospital stay was also longer in OC group with respect to LC group i.e. 5.56±9.8 (range 4-10) days vs. 3.02±1.75 (range 1-5) days respectively. OC patient take longer time to return it routine work with respect to LC i.e. 31.61±7.6 days (range three-six weeks) & 18.06±5.16 days (range one-four weeks) respectively p<0.001. Conclusions: The LC is more admirable & good to OC due to short operational duration, early unrest & fast return, decrease the duration of pain & less complicated, decrease in bed rest & patients able to return it routine work in short time. KEY WORDS: Morbidity, Biliary Pathology, Cardiopulmonary, Perusal Parameters, Gallstones

Comparison of instrument-assisted soft tissue mobilization and proprioceptive neuromuscular stretching on hamstring flexibility in patients with knee osteoarthritis

Background The association between hamstring tightness and knee osteoarthritis (KOA) is significant because tight hamstrings can put more strain on the knee joint, reduce its range of motion, and cause compensatory movements that worsen the KOA. Objective To compare the effects of instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular (PNF) on hamstring flexibility in patients with KOA. Methods Data for the randomized controlled trial (NCT05110326) was collected from n = 60 participants randomly divided into group A received IASTM and group B received PNF stretching. In group A, the therapist made 30 strokes gentle strokes with the tool from the origin to the insertion while holding the plane at a 45-degree angle over the treatment area. In group B, PNF stretching was done with three repetitions and 10 seconds rest between each, after isometric contraction of the hamstring muscle using approximately 50% of their maximum strength, holding it for 8 seconds, and then releasing it. A 30-minute session was given to each patient three times per week and was given for 6 weeks. Outcome measures were the visual analog scale (VAS) for pain intensity, the active knee extension test (AKET) for hamstring flexibility, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for the health status of KOA patients. Results The study found a significant interaction (p < 0.001) between interventions and time across several measurements. After 6 weeks, both interventions resulted in significant improvements (p < 0.001) across all dependent variables, with group A (IASTM) showing more significant improvement in hamstring flexibility, pain reduction, and health status (p < 0.001) compared to group B (PNF). Conclusions Both the IASTM technique and PNF stretching resulted in increased hamstring flexibility, decreased pain, and enhanced general health. The IASTM technique, however, showed potential benefits over PNF stretching in terms of flexibility, pain relief, and public health enhancement. Physical therapists and manual therapists may prioritize the usage of the IASTM technique for patients who want to make significant changes in these areas