Objective: To compare the effectiveness of ultrasound-guided suprascapular nerve block (SSNB) and extracorporeal shockwave therapy (ESWT) in the management of adhesive capsulitis of the shoulder. Study design: Randomized controlled trial. Materials and methods: A total of 88 patients from September 2016 to August 2018 were recruited from outpatient of the Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences, Imphal. While the ESWT group received radial shock waves on average 2,000 impulses once weekly for 4 weeks, the SSNB group got ultrasound-guided single SSNB with 10 mL bupivacaine (0.5%). Range of motion (ROM) and shoulder pain and disability index (SPADI) were measured at week 1, week 4, and week 12. Results: Both groups showed significant improvement in the mean score of ROM and SPADI (p < 0.05). Although SSNB was found to be significantly more effective than ESWT in the reduction of pain and disability in both short term and long term (p < 0.05). Conclusion: The effectiveness of SSNB specifically in short-term pain control and ease of application under ultrasound guidance makes it preferable in the management of adhesive capsulitis of the shoulder. While ESWT also seems to be a promising therapy and a viable alternative to steroids for adhesive capsulitis in case of patients with diabetes.

Introduction: Pes planus is one of the commonest foot deformities during childhood. By measuring the talo-first metatarsal (TFM) angle radiologically, the condition can be classified as mild, moderate, and severe. This study is our humble attempt to put some light to assess the role of nonsurgical treatment approaches in cases of congenital pes planus with respect to the measurement of improvement in TFM angle. Materials and methods: This prospective randomized open label control trial was conducted in the Department of Physical Medicine and Rehabilitation, Sambhu Nath Pandit Hospital, Lala Lajpat Rai Sarani, Kolkata, West Bengal, India, between December 2009 and November 2011, after obtaining clearance from the Institutional Ethical Committee clearance. Proper consent was taken from the legal guardian of the patient. Confirmed cases of congenital pes planus (flat foot) between 6 years and 18 years were included according to the inclusion and exclusion criteria and were being randomly subdivided into two groups. One group (group I) of patients received exercise (Ex) therapy, shoe modification (SM), and acetaminophen (paracetamol) SOS; and the other group of patients (group II) received Ex therapy, SM, electrical stimulation in the form of faradic foot bath (FFB), and acetaminophen (paracetamol) SOS; and after initial visit, these patients were followed up on 6th, 12th, 24th week, every time with respect to measurement of improvement in TFM angle. Results: Statistically significant improvement (with p value less than 0.05) was observed in group I, and similar type of observation was also found while analyzing the improvement in TFM angle among group II patients. But unfortunately, the comparative analysis by Student's unpaired t test of the numerical variables of groups I and II failed to show any statistically significant improvement pattern of TFM angle due to FFB itself. Conclusion: The TFM angle radiologically is a good assessment scale for measuring the outcome of conservative management in case congenital pes planus (flat foot).

Objectives: To demonstrate the effect of autologous platelet-rich plasma (PRP) injections on pain and functional activities in patients with osteoarthritis (OA) knee. Study design: Prospective interventional study. Materials and methods: A detailed demographic data were collected, and each patient was examined clinically and radiographically. Complete blood counts, prothrombin time (PT)/international normalized ratio (INR), and X-rays of bilateral knees were taken. Radiological grading was done on Kellgren–Lawrence (KL grading) OA scale. Each individual was explained and informed consent was taken before the procedure. Three injections of PRP were given at an interval of 2 weeks. Detailed clinical examination was done at the end of 1 month and 6 months postinjection. Pain assessment was done on visual analog scale (VAS) and Western Ontario McMaster (WOMAC) OA index was used for comprehensive documentation of pain, stiffness, and overall disability experienced by the individual suffering from OA knee. Results: The mean VAS score for pain was 6.53, 4.24, and 3.76 before treatment, 1 month posttreatment, and 6 months postinjection, respectively, in KL grades I and II individuals. On WOMAC scale, mean pain scores were 17.15, 7.90, and 7.39 before treatment, 1 month posttreatment, and 6 months postinjection, respectively. Mean stiffness scores were 5.56, 3.15, and 2.56 39 before treatment, 1 month posttreatment, and 6 months postinjection, respectively. Mean functional capacity scores were 46.49, 27.78, and 23.51 before treatment, 1 month posttreatment, and 6 months postinjection, respectively. Conclusion: An overall reduction in pain and improvement in functional status were observed in all individuals suffering from OA knee of any grade. In the light of other studies, it can be concluded that the use of PRP injection has proven to be a promising treatment modality for OA.

Introduction: Excess fat accumulation in body, known as obesity, has many adverse health effects. Yoga has been proved to have both curative and preventive value. Objective: To find out whether regular practice of yoga has any role in control of weight reduction and waist-to-hip ratio. Materials and methods: Eighty subjects with 40 males and 40 females were included with body mass index (BMI) >30 and waist-hip-ratio (WHR) >0.85. Same were assessed after 12 weeks of yoga training comprising of various asanas. Results: Body mass index of the male subjects decreased from 30.07±1.84 to 26.03±1.51 while of female subjects decreased from 30.29 ± 1.86 to 26.03 ± 1.51 while WHR of males decreased from 0.95 ± 0.02 to 0.89 ± 0.02 and of females decreased from 0.87 ± 0.01 to 0.83 ± 0.01 respectively after 12 weeks of yoga training. Conclusion: Regular practice of yoga can be used as a therapeutic regimen for weight control and reduction.

Klippel–Feil syndrome (KFS) is a congenital segmentation anomaly of cervical vertebra leading to vertebral fusion, often accompanied by other systemic anatomical and functional anomalies. Benign hypermobile joint syndrome (BHJS) is a frequently overlooked cause of chronic musculoskeletal pain. Early identification and management of both conditions are essential to prevent long-term damage and suffering due to chronic pain and impaired activities of daily living (ADLs). The authors present this rare case report of KFS with BHJS in a young Indian female.