Orthopedics Case No 1. Frozen Shoulder-1

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Orthopedics Case No 1. Frozen Shoulder-1

পানি জমে বরফ হয়ে যাওয়া হচ্ছে frozen, তখন কি হয়?

পানি শক্ত হয়ে গেলো, প্রবাহ বন্ধ,

shoulder joint এর আশে পাশে কিছু লিগামেন্ট ক্যাপসুল রয়েছে,

এই গুলি যদি কোনো কারণে thickend হয়ে joint কে লক করে দেয়, shoulder joint এর movement যদি বন্ধ হয়ে যায়, বিশেষ করে External rotation,

তখন এই অবস্থাকে frozen shoulder বলে—-

যাদের ডায়াবেটিস রয়েছে, তাদের প্রতি ১০০ জনের মধ্যে ২০ জনের ফ্রোজেন শোল্ডার হতে পারে !!

২ টা পেইজ থাকে—

frozen phase, adhesive phases

frozen phase টা হবে অনেক ব্যাথা, shoulder নাড়া ছাড়া করতে পারবেনা,

২ সপ্তাহ থেকে ২৬ সপ্তাহ পর্যন্ত এই phase থাকবে.

এর পরে শুরু হবে Adhesive phase.

তখন কিছুটা improve হবে, তবে পেইন থাকবে, এই phase থাকবে ৫ মাস থেকে ৯ মাস, কারো ক্ষেত্রে ২-৩ বছর।

কারণ কি?

1-2 % Unknown aetiology

বাকিদের ডায়াবেটিস /থাইরয়েড সমস্যা থাকতে পারে, পারকিনসন থাকলেও হবে।

চিকিৎসা কি–

1.. Counselling

2..Counselling

3… Counselling

1.. Exercise

2… Exercise

3… Exercise

4.. Pain control by NSAID প্রয়োজন হলে Intra-articular steroid

Tablet 1:-Sulidac 200 mg 1+0+1 for 7 days. AS A Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Drugs used in Gout, Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Indications Of Tablet:Sulidac 200 mg:-

Sulidac is indicated for the symptomatic treatment of-

Rheumatoid arthritis
Osteoarthritis
Ankylosing spondylitis
Periarticular inflammatory disorders
Acute painful shoulder
Acute gouty arthritis
Diabetic neuropathy
Diabetic retinopathy

Pharmacology Of tablet Sulidac 200mg:-

Sulindac is a non-steroidal antirheumatic agent possessing anti-inflammatory, analgesic and anti-pyretic properties. Prostaglandin synthetase inhibition is probably the basis of the mechanism of action of non-steroidal anti-inflammatory agents. Following absorption, Sulindac undergoes two major transformations. It is oxidised to the sulphone and then reversibly reduced to the sulphide. The sulphide metabolite is the biologically active form which is an inhibitor of prostaglandin synthesis.

Side Effects Of tablet Sulidac 200mg:-

Gastrointestinal side effects are the most common and consist of abdominal pain, nausea and constipation. Gastrointestinal ulceration and bleeding may also occur. The most frequently reported central nervous system side effects are drowsiness, dizziness, headache and nervousness. Other adverse effects include depression, tinnitus, confusion, light-headedness, insomnia, psychiatric disturbances, syncope, convulsions, coma, peripheral neuropathy, blurred vision and other ocular effects, oedema and mass gain, hypertension, hematuria, skin rashes, pruritus, urticaria, stomatitis, alopecia and hypersensitivity reactions. A hypersensitivity syndrome consisting of fever and chills, skin rashes or other cutaneous manifestations, hepatotoxicity, renal toxicity (including renal failure), leukopenia, thrombocytopenia, eosinophilia, inflammed glands or lymph nodes, and arthralgia have been reported. Leucopenia, purpura, thrombocytopenia, aplastic anaemia, haemolytic anaemia, agranulocytosis, epitaxis, hyperglycaemia, hyperkalaemia and vaginal bleeding have been reported. There have also been reports of hepatitis and jaundice or renal failure.

Tablet 2:-Syalox Plus 300MG 1+0+1 for 7 days As a Hyaluronic Acid As a Hyaluronic acid content N-Acetyl Glucosamine and Glucuronic which is a natural polymer. These are the important functions in articular cartilage and synovial fluid which can help in cases of stiffness and mild knee, shoulder, hip, knee, and to improve their mobility. This tablet also consists of AKBA, 3-O-Acetil-11-Keto-β-Boswellico of Boswellia Serrata. It is a powerful anti-inflammatory which helps to reduce the swelling of the joints and improve the joint mobility.

Indications Of tablet Syalox plus 300mg:-

This is indicated in-

Relieve symptoms of knee osteoarthritis (OA)
Reduces Joint pain
Improves joint mobility
Reduces inflammation and swelling

Pharmacology Of tablet Syalox plus 300mg:-

Hyaluronic Acid (HA) is a natural organic compound synthesized by fibroblasts and is composed of repeating disaccharide units formed by Glucuronic acid and N-acetylglucosamine acid. The main function of HA, in most biological processes, is to maintain the structural and functional characteristics of tissues. The biosynthesis of HA decreases with age and traumas. Boswellia (containing AKBA at 10%) is useful for the joint function.

This tablet has patented triple-coating technology with two different molecular weights of Hyaluronic acid. The purpose of the different molecular weight is to allow the higher molecular weight to be broken down by the stomach acids and the lower molecular weight to be absorbed through the synovial fluids so to ensures the ingredients will reach the joints unchanged and will not break into the stomach by the acids that are there.

This is made from Hyaluronic acid extracted from Fermented vegetables which is a 100% Vegetarian product. It has all-natural ingredients. This is a new technology. Hyaluronic acid content N-Acetyl Glucosamine and Glucuronic which is a natural polymer. These are the important functions in articular cartilage and synovial fluid which can help in cases of stiffness and mild knee, shoulder, hip, knee, and to improve their mobility. This tablet also consists of AKBA, 3-O-Acetil-11-Keto-β-Boswellico of Boswellia Serrata. It is a powerful anti-inflammatory which helps to reduce the swelling of the joints and improve the joint mobility.

This modified-release triple-layer tablet, based on high molecular weight Hyaluronic Acid and Boswellia containing AKBA at 10%, is developed with a patented process to improve the stability and bioavailability of the Formulation.

Side Effects Of tablet Syalox plus 300mg:-

There have been no known side effects reported so far. But if you have any specific allergies, we recommend you to consult with your doctor before taking this supplement.

3.Intra Articular Injection:-

Injection :-Hyalgun 20mg/2ml As a Sodium Hyaluronate As a Drugs for Osteoarthritis As a Intra Articular Injection Steroid .

Indications Of Injection Hyalgun :-Hyalgun 20mg/2ml As a Sodium Hyaluronate As a Drugs for Osteoarthritis As a Intra Articular Injection Steroid .

Hyalgun is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpharmacologic therapy and to simple analgesics, e.g., acetaminophen. It may also be used as adjuvant in orthopaedic surgery.

Pharmacology Of Hyalgun Injection :-Hyalgun 20mg/2ml As a Sodium Hyaluronate As a Drugs for Osteoarthritis As a Intra Articular Injection Steroid .

Sodium Hyaluronate is a viscous solution consisting of a high molecular weight fraction of purified natural sodium hyaluronate in buffered physiological sodium phosphate. It has a pH of 6.8-7.5. Hyaluronic acid is an important component of the body’s extracellular matrix and is present in a particularly high concentration in cartilage and synovial fluid. Endogenous hyaluronic acid provides viscosity and elasticity to synovial fluid, which is fundamental for its lubricating and shock absorbing properties. It is essential for the correct structure of proteoglycans in articular cartilage. In osteoarthritis there is an insufficient amount and a change in the quality of hyaluronic acid in synovial fluid and cartilage. The intra-articular administration of hyaluronic acid into arthritic joints improves joint functions.

Side Effects Hyalgun Injection:-

Local reactions such as pain, swelling/effusion and warmth or redness at the injection site have been reported. Usually such symptoms are transient and disappear spontaneously within a few days by resting the affected joint and applying ice only.

5…ফিজিওথেরাপি

কি কাউন্সেলিং করবেন–

রোগের ন্যাচার টা বুঝিয়ে দিবেন,

যে এখানে জয়েন্ট পেশি সমূহ মিলে জয়েন্ট শক্ত হয়ে গেছে, খুলতে ৪ মাস থেকে ৯ মাস কিংবা ২ বছর সময় লাগতে পারে, এই সময় আপনি পৃথিবীর যেখানেই যান, চিকিৎসা এইটাই, ধৈর্য ধরেন, আর শেখানো পদ্ধতিতে ব্যায়াম করবেন, আর ফিজিওথেরাপি নিবেন যদি সম্ভব হয়।

Raiyyan Tahsan Date:21-12-2024 Saturday Time:2.02.27 Pm.

Raiyyan Tahsan

Raiyyan Tahsan