Comparative study of ultrasound guided supra-scapular nerve block versus intra-articular steroid injection in frozen shoulder

Background: Frozen shoulder is one of the most common musculoskeletal problems seen in orthopaedics. Many treatment modes are available however, it is difficult to treat and data on the comparative efficacy of various interventions are limited. Intra-articular corticosteroid injection (IASI) is a commonly used to treat frozen shoulder pain. Supra-scapular nerve block (SSNB) is also effective method to treat pain in chronic diseases that affect the shoulder. The present study was done to compare efficacy of ultrasound guided SSNB and IASI in management of painful frozen shoulder.Methods: 60 patients with painful frozen shoulder were divided in two groups, Group A received ultra-sound guided SSNB with 6 ml 0.5% Bupivacaine; Group B received IASI using 40 mg Triamcinolone. Outcome measures were shoulder ranges mainly lateral rotation and abduction, shoulder pain and disability index and visual analogue scale (VAS). Patients were followed-up on 2nd day, at 1st, 3rd and 6th week.Results: All baseline parameters improved significantly in both groups; however, on comparison Group A showed significant improvement in passive lateral rotation on 2nd day and 1st week follow up (P =0.038 and 0.040 respectively). VAS score showed significance at all follow-up in Group A, whereas, in Group B significance was seen after 1 week. On inter group comparison Group A shows significance on 2nd day (P =0.050), 1st week (P =0.042) and 3rd week (P =0.036).Conclusions:Both SSNB and IASI have efficacy in management of frozen shoulder. But supra-scapular nerve block is better than intra-articular injection and should be considered prior to steroid as it has early onset pain relief, early improvement in ranges, potentially lesser contraindications and side effects.

Evaluation of Podoplanin in Oral Leukoplakia and Oral Squamous Cell Carcinoma

Background. Recent studies have demonstrated that podoplanin was expressed in some dysplastic lesions adjacent to primary oral cancers suggesting that podoplanin expression may occur in early oral tumorigenesis and lymphangiogenesis and therefore is related to tumor growth. The purpose of this study is to determine the role of podoplanin as a biomarker for cancer risk assessment in oral leukoplakia and correlation of podoplanin expression with grades of oral squamous cell carcinoma (OSCC). Materials and Methods. In the present retrospective study, podoplanin expression was investigated immunohistochemically in 40 patients each of oral leukoplakia and OSCC. The scores were analyzed statistically using one-way ANOVA test followed by Tukey HSD. Results. By applying one-way ANOVA test, there was a highly significant increase of the podoplanin expression from mild to severe dysplasia and from well to poorly differentiated OSCC ( < 0.01). Statistically highly significant difference was present between scores of mild to moderate dysplasia, moderate to severe dysplasia, well to poorly differentiated OSCC, and moderately to poorly differentiated OSCC (Tukey HSD test, < 0.01). Conclusion. Podoplanin can be used as a biomarker for early oral tumorigenesis and for malignant transformation risk assessment of premalignant lesions and as a tumor progression biomarker for advanced grades of OSCC

Soil biological properties as influenced by long-term manuring and fertilization under sorghum (Sorghum bicolor) -wheat (Triticum aestivum) sequence in Vertisols

The effect of long-term manuring and fertilization on soil biological properties was studied under the long term fertilizer experiment on sorghum [Sorghum bicolor (L.) Moench] -wheat (Triticum aestivum L.) sequence conducted on Vertisols. The treatments comprised 50% RDF, 100% RDF, 150% RDF,100% RDF (-S), 100% RDF + 2.5 kg Zn/ ha to wheat crop only, 100% RD of NP, 100% RD of N, 100% RDF + FYM @ 10 tonnes/ha, 100% RDF + S @ 37.5 kg/ ha, FYM @ 10 tonnes/ha, 75% RDF and control. The assessment of soil biological properties at 40 and 70 days after sowing revealed that, significantly highest CO2 evolution was recorded at 70 DAS of sorghum under 100% RDF + FYM @ 10 tonnes/ ha ( 66.82 mg/ 100 kg). Soil microbial biomass carbon was also influenced significantly with the combined application of NPK+FYM (278.9 mg/ kg). The soil enzyme activity, viz. dehydrogenase (55.01 µg TPF/g/24 hr), urease (47.9 mg NH4/kg/ 24 hr) and cellulase (52.23 µg glucose/g/24 hr) were significantly influenced with the application of 100% RDF + FYM @ 10 tonnes/ha. Similarly, the application of 100% RDF + FYM @ 10 tonnes/ha recorded significantly higher grain yield of sorghum

Lichen sclerosus of soft palate: A rare case report

Lichen sclerosus (LS) is a rare disease affecting the skin and the mucous membrane, and it is chronic inflammatory in nature. It occurs in both males and females, but mainly affects females in the fifth or sixth decade of life. It mainly involves the genital and perianal areas but can affect any part of the body and the involvement of the oral mucosa is exceptionally rare, but sometimes it affects only the oral mucosa. It requires differentiating from other lesions of the oral cavity which looks similar to this lesion. In considering the rarity of the reported cases, the present article reports one more case of LS affecting the soft palate in an edentulous 66 year-old male patient

LOCAL INJECTION OF PLATELET-RICH PLASMA VERSUS STEROID INJECTION IN PLANTAR FASCIITIS: A COMPARATIVE STUDY

Objectives: The aim of the study was to compare the effect of local steroid injection and injection of platelet rich plasma in patients with plantar fasciitis. Methods: Eighty patients diagnosed to be having plantar fasciitis were included in this study on the basis of a predefined inclusion and exclusion criteria. The study was conducted in PIOS Medilinks Pvt limited jaysingpur Kolhapur India. The duration of study was 1 year from January 2022 to January 2023. Institutional ethical committee approved the study. Patients were assigned to two equal, parallel groups of 40 patients each. Patients in one group were given local steroid injection (Group S) whereas patient in other group was given local injection of platelet rich plasma (Group P). The patients were followed up for 12 weeks. Visual analog score (VAS) Score and American orthopedic foot and ankle society (AOFAS) score were compared at each follow-up visit. For statistical purposes, p<0.05 was taken as statistically significant. Results: The M: F ratio in Group P and Group S was found to be 1:1.85 and 1:1.50, respectively. Overall, most commonly affected age group was 41–50 years (32.50% and 37.50%) followed by 51–60 years (25% and 27.50%). The analysis of body mass index (BMI) in patients of Group S showed that among 40 patients 12 (36.67%) patients were obese (BMI ≥30) and 15 (30%) patients were overweight (BMI ≥25 but <30). In Group P, 22 (73.33%) patients were either obese or overweight (BMI ≥25). IN our study from time of presentation till 4 weeks the reduction in VAS score was found to be comparable in both the groups. However, at the time of 8-week and 12-week follow-up, mean VAS score in Group P was less as compared to group S and the difference was found to be statistically significant (p<0.05). At the time of follow-up at 12 weeks, better AOFAS score was seen in Group P (90.12±14.26) as compared to group S (82.08±8.68) and the difference was found to be statistically significant (p=0.0032). Conclusion: Injection of platelet rich plasma is found to have better outcomes as compared to steroid injection in plantar fasciitis treatment over the course of 12 weeks as assessed by improvement in VAS and AOFAS scores