Introduction: Somatoform disorder (SD)is group of psychiatric disorders that disrupt multiple physical symptoms, accompanied by disturbance in thoughts, impairing activities of daily living due to muscle and joint pain, low back pain, headache, chronic tiredness, palpitation, stomach upset, dizziness and sleeplessness which may cause occupational and social dysfunction.
Objective: Evaluation of patients by Numeric Pain Rating Scale (NPRS), Pain Disability Scale (PDS) and complications duloxetine medication during treating of patients with somatoform disorder at Koshi Zonal Hospital.
Methodology: A total of 50 patients with first time diagnosis of SD were selected by in this cross sectional study on the basis of diagnostic and statistical manual (DSM-5), pain and other symptoms, were treated with Duloxetine medication in early stage of Somatoform Disorder and results were evaluated at 2nd week, 6th week and 12th week. The study was conducted from March 2016 to July 2017 at Koshi Zonal Hospital.
Results: Out of 50 early SD patients, total mean age was 41.38 years (range 20-60), 21 patients recovered at 6th week and 22 patients recovered at 12th week but 7 patients needed other medications after 12 weeks. Duloxetine was well tolerated with nausea and headache being the most common complaint following use of duloxeting.
Conclusion: Duloxetine can be both effective and well tolerated in the treatment of early stage of somatoform disorder.
Introduction: Idiopathic frozen shoulder (IFS) is a common chronic and disabling condition of shoulder pain characterized by progressive loss of active and passive range of motion (ROM) with unclear pathogenesis. The ideal treatment protocol is still controversial but commonly used treatment includes single agent or combination of oral non-steroid anti- inflammatory drugs (NSAIDS), oral steroids, intra-articular steroid injection and physiotherapy.
Objective: The objective of this study was to evaluate the effectiveness of intra-articular methylprednisolone injection for pain and ROM in patients suffering from idiopathic frozen shoulder who did not respond to oral NSAIDS with or without oral steroid.
Methodology: A total of 70 patients suffering from IFS were enrolled in this cross sectional study from May 2017–October 2018 from outpatient department of orthopaedic and physiotherapy of Koshi Zonal Hospital. All the patients underwent treatment protocol that comprised of Intra-articular steroid injection followed by five days of oral NSAIDS along with five days regime of physical therapy at the physiotherapy centre, followed by home exercise program. Each patient was followed up at every two weeks interval from intra-articular injection till 6th week. Each patient was evaluated for range of motion (ROM), Numerical Pain Rating Scale (NPRS) and Shoulder Pain and Disability Index (SPADI) before the treatment protocol and at every follow up visit. Data was analyzed using Microsoft Excel Program.
Results: All patients enrolled for the study had satisfactory response. The mean age of the patient was 51.8 years (range 40-65 years). The mean age of the 26 male patients was 54 years (range 45-65), whereas the mean age of 44 female patients was 50.5 years (range 45-60). Mean duration of illness was 26.5 weeks (range 18-32 weeks), SPADI before medication was 83.14, at 2nd week was 50.92, at 4th week was 38.63 and at 6th week was 27.22.
Conclusion: Combination of intra-articular methylprednisolone injection, physiotherapy and home exercise program is effective in IFS for rapid improvement in pain and ROM.
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