Prevalence of shoulder pain disability among assistive device users with paraplegia

Objective: To identify the prevalence of shoulder pain disability in paraplegic patients using assistive devices following Spinal Cord Injury. Methods: This was a cross-sectional study done among 53 SCI paraplegia patients having shoulder pain after use of assistive devices. Pre-test was done among 5 subjects. The association among different variables with shoulder was tested by using chi-square test. SPSS version 16 was applied to find the result. Results: The study showed that almost 98.11% of the respondents had shoulder pain with the assistive device users. Among them all of the participants were using wheelchair as the assistive devices and 86.3% had mild disability, 11.8% moderate disability and 2% sever disability. Among them, 72% of the patients had stayed in the hospital for less than six months. Shoulder pain was dependent on age, gender, duration of assistive devices used, type of assistive devices used and level of injury Conclusion: Shoulder pain is common and has a high prevalence rate in both traumatic as well as non-traumatic spinal cord injury. Wheelchair user have more shoulder pain then other assistive devices users. Shoulder pain has a negative effect on activities of daily living and is a potential cause of activity limitations. Keywords: shoulder pain, paraplegia, spinal cord injury, assistive device

Cause, pattern and outcome of fractures occurring in the pediatric population of rural tertiary health care center of Nepal.

Introduction: Pediatric trauma is a significant burden to health care worldwide. In Karnali province, most of the cases present late. The aim of this study is to determine demographic characteristics, cause, pattern, treatment and outcome of pediatric fractures in tertiary health care center in Jumla. Method: This is a retrospective study done in patients younger than 16 years who presented to our hospital between January 2016 to December 2017. We analyzed demographic data, injury characteristics, fracture pattern, time of presentation, treatment modalities and outcome. Results: There were total of 1028 patients out of which 60% were males. Mean duration of presentation to hospital was 4.8 days. Most common mechanism of injury was fall from height. 85.60 % were managed conservatively and 14.40% were managed operatively. Postoperative outcome was good in 71 % of the cases, fair in 28% and poor in 1% cases. Forearm fracture was the most common presentation, accounting for 358 cases (34.82%) followed by Supracondylar humerus fracture accounting 23.34%. Conclusion: Pediatric fractures constitute a huge proportion of cases in our hospital. As pediatric bones unite readily, the treatment outcome is good in most of the cases even after conservative management and after delayed presentation. Keywords: pediatric fractures, conservative management, supracondylar fractures, delayed presentation