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A 52-year-old patient with early diffuse scleroderma (Scl) developed scleroderma renal crisis (SRC) following exposure to topical steroid cream. She had applied a larger-than-prescribed quantity of triamcinolone acetonide 0.1% cream all over her body for 3 months, the absorption of the cream being the equivalent of 7.5 mg of oral prednisone per day. Her SRC was subsequently managed successfully with aggressive antihypertensive therapy and hemodialysis, and she was discharged home. High-dose corticosteroids (CS) have long been implicated in the development of SRC, but topical and low-dose CS until now have not. In our opinion, low-dose CS and a predisposing clinical setting appeared sufficient to provoke SRC and may broaden the proscription against CS in Scl.

The aim of this research was to ascertain the effect of constraint-induced movement therapy on individuals with Parkinson's disease's hand and arm functions. Methods: It was a randomized controlled experiment that ran from December 28, 2020, to March 3, 2021, at the physical therapy departments of the University of Lahore Teaching Hospital, Lahore General Hospital and Mayo Hospital. Between the ages of 50 and 80, 40 male and female Parkinson's disease patients were divided evenly into two groups. Patients in the experimental group (n = 20) received both routine physical treatment and constraint-induced movement therapy, while patients in the control group (n = 20) received just normal physical therapy. Six hours a day, for a total of four weeks, were spent treating the patients. Frenchay Arm Test was used to evaluate patients (FAT). The data were examined using IBM's Statistical Package for Social Sciences (SPSS) version 25. Results: Data for 40 individuals were evaluated, with 17 (42.5%) men and 23 (57.50%) women, and a mean age SD of 65.28 7.28 with a minimum age of 50 and a maximum age of 78. Patients improved in both groups; the mean difference between pre- and post-test results in the experimental group was 2.060.66 (p=0.000), whereas it was -0.940.64 (p=0.000) in the control group. Contrary to conventional physical therapy alone, however, patients reported greater improvement following treatment with constraint-induced movement therapy (p=0.003). Conclusion: According to this study, constraint-induced mobility therapy helped Parkinson's disease patients' hands and arms operate better

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