Online ISSN: 2515-8260

Keywords : shoulder pain

High and low-pressure carbon dioxide in patients undergoing laparoscopic cholecystectomy

Dinesh Maheshwari, Avinash Maheshwari, Anjali Maheshwari, Kopal Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 231-236

Background:Laparoscopic cholecystectomy is considered the gold standard for gallbladder
removal and is the most common laparoscopic procedure worldwide. The present study was
conducted to compare high and low-pressure carbon dioxide in patients undergoing
laparoscopic cholecystectomy.
Materials & Methods:86 patients undergoing laparoscopic cholecystectomy of both
genders were classified into 2 groups of 43 each. Group I comprised of high-pressure
carbon dioxide and group II low pressure carbon dioxide. In both groups, abdominal pain,
nausea and vomiting were evaluated on the verbal rating scale (VRS) at 1, 3, 6, 12, and 24
Results: The mean nausea/vomiting score at 1 hour, 3 hours, 6 hours, 12 hours and 24
hours in group I and II was 5.6, 5.0, 4.5, 3.8 and 3.2 and 4.2, 3.4, 3.0, 2.6 and 2.0
respectively. The mean abdominal pain in group I was 7.5, 6.5, 6.0, 5.4 and 4.6 and in
group II was 6.8, 4.6, 5.2, 3.6 and 2.2 in group I. The mean shoulder tip pain was 6.2, 5.4,
4.6, 3.8 and 2.4 in group I and 6.0, 4.8, 4.4, 3.6 and 1.8 in group II respectively. The mean
pre- operative ALT level in group I was 20.5 and post- operative level was 40.5 and in
group II was 20.4 and 45.6. AST level found to be 21.4 and 38.2 and in group II was 20.4
and 45.3, ALP level was 185.4 and 170.5, BILLT level was 0.62 and 0.70 in group I and
0.61 and 0.69 in group II, BILLD level was 0.21 and 0.34 in group I and 0.23 and 0.35 in
group II respectively. The difference was significant (P< 0.05).
Conclusion: Low pressure group had less pain score and nausea and vomiting score as
compared to high pressure group. Hence, it can be considered as treatment of choice in
patients undergoing laparoscopic cholecystectomy.

Effect Of Modified Hand Position During Circuit Resistance Training On Improving Shoulder Kinematics In Paraplegic Patients

Osama M. Elmehrath; Eman S. Fayez; Islam M. El-Azab; Ibrahim E. AlAhmar; Walaa M. Ragab; Shereen M. S. Badawy

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 3499-3512

Background: Most paraplegic patients report shoulder pain due to considerable stress placed on the shoulder by wheelchair propulsion and other activities of daily living. Wheelchair-based circuit resistance training (CRT) should promote favourable shoulder kinematics to protect the shoulder from mechanical impingement following paraplegia. The purpose of the study was to investigate the effect of circuit resistance training with modified hand position on shoulder kinematics in paraplegic patients. Methods: Thirty patients from both gender, aged from 40 to 60 years, with shoulder pain due to paraplegia participated in this study. They were assigned randomly into two equal groups: (Study Group) performed CRT with modified hand position and (Control Group) performed CRT with traditional hand position. Both groups received conventional physiotherapy program (2 sessions per week for 2 months). The patients were evaluated by numeric rating scale (NRS) for assessment of pain intensity, electrical goniometer for assessment of shoulder joint range of motion (ROM) and 3- D ultrasonography for assessment of subacromial space. Results: There was a significant decrease in pain intensity and a significant increase in the shoulder ROM in both groups after treatment with the best results for study group. The study group showed significant improvement in subacromial joint space, whereas the control group showed no improvement. Conclusion: Hand position alters kinematics during CRT and should be selected to emphasize healthy shoulder mechanics