Introduction: Osteoarthritis (OA) of knee is one of the most common musculoskeletal disorders affecting the elderly population in Asia-Pacific region. Array of diverse treatment options exist including analgesics, Non Steroidal Anti-Inflammatory Drugs (NSAIDs), opioids, physical therapy, orthotic devices, structure modifying drugs, Intra-articular viscosupplementation, corticosteroids or Platelet Rich Plasma (PRP) and surgery. Viscosupplementation {Hyaluronic acid (HA)} is said to exert an anti-inflammatory effect and has remained a modality under investigation for a longtime. Aim: To see the change in aceclofenac usage pattern in knee OA following viscosupplementation as a surrogate for efficacy of viscosupplementation related pain relief. Materials and Methods: This study was a prospective interventional study on 60 subjects over duration of 18 months (October 2015 to March 2017). The subjects who were prescribed viscosupplementation (single dose of Intra-articular Hyaluronic Acid (IAHA) High Molecular Weight (HMW) 90 mg/3 mL in the affected knee) were included after satisfying inclusion and exclusion criteria. All the patients were assessed at the baseline, 4, 8 and 12 weeks in terms of Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quantity of aceclofenac intake post viscosupplementation. Data were entered and analysed in SPSS version 21. Categorical variables were presented in number and percentage while continuous variables were presented as mean±SD and compared using paired t-test across follow-ups. A p-value of ≤0.05 was considered statistically significant. Results: After viscosupplementation there was significant reduction in aceclofenac intake from 3.88±1.46 gm to 1.72±0.75 gm and p-value was <0.0001. There was also improvement in pain as VAS decreased from 6.88±0.98 to 3.97±0.86 (p-value <0.0001) over 12 weeks. Similarly there was functional improvement as WOMAC total score reduced from 46.2±8.45 to 27.53±5.67 after 12 weeks. The p-value was <0.0001 at all the follow-ups. Conclusion: Aceclofenac requirement is decreased and there is improvement in pain and function after viscosupplementation. Viscosupplementation reduces NSAIDs (aceclofenac) usage in OA knee while at the same time reducing pain and improving function.

Background – Stroke can lead to impaired mobility and disability. There are chances of decreased exposure to sunlight and decreased Vitamin D levels after stroke. This study was done to assess the vitamin D status in stroke survivors and its correlation with duration and ambulatory status of stroke. Methods – This cross sectional study included 100 patients of stroke. Patients were assessed after history and examination for their Serum Vitamin D levels, ambulatory status by Modified Rankin Scale (MRS). MRS grade 1-3 were considered ambulatory and MRS grade 4 and 5 were considered non ambulatory. Statistical analysis was done using chi square test for qualitative variables, unpaired t test for quantitative variables, and pearson correlation. P value < 0.05 was taken significant. Results –72 patients had Vitamin D levels less than 30ng/ml (20.42 ± 5.89 ng/ml). Significant negative correlation was observed between duration of stroke and Serum Vitamin D levels. Out of 41 non ambulatory patients, 38 were Vitamin D deficient (P<0.05). negative Correlation was present in Modified Rankin Scale and Serum Vitamin D levels. Conclusion –Vitamin D Deficiency is present in chronic non ambulatory stroke patients.