No abstract

Multinodular goiter is a condition in which the thyroid gland is swollen and has several distinct masses. A large multinodular goiter can lead to difficulty in swallowing and breathing. A large goiter hampers respiration and deglutition; therefore, a part of or the whole thyroid gland is removed. Total thyroidectomy is a surgical process which involves the removal of the whole thyroid gland. One of the adverse effects of a complete thyroidectomy is vocal cord paralysis. It occurs because of an injury to the recurrent laryngeal nerve. Vocal cord paralysis could be bilateral or unilateral. It is characterized by hoarseness of voice, breathing difficulties and voice pitch loss, and inability to talk loudly. This case report describes physiotherapy along with voice exercises in a 65-year-old female who suffered from unilateral vocal cord palsy following total thyroidectomy. The patient was successfully rehabilitated after four weeks, using a tailored physiotherapy program according to the difficulty faced by her. The rehabilitation exercises consisted of upper and lower limb mobility activities, breathing activities including thoracic expansion, and deep breathing exercises. Static hamstrings, static quadriceps exercise, heel slides and isometric exercise to neck muscles, and passive movements to the cervical spine were administered. Voice therapy exercises combined with breathing exercises were also administered.

Upper cross syndrome (UCS) refers to tightness of muscles such as pectoralis major, upper trapezius and levator scapulae and weakness of deep neck flexors, scalene, rhomboids, serratus anterior, middle and lower trapezius. Poor posture is associated with imbalance created in musculoskeletal system and common condition to be reported as upper cross syndrome. It is commonly seen in people with forward head posture, desk job workers, dentist, beauticians etc. The resulting clinical presentation is complaint of pain in neck and shoulder, cervicogenic headache, hunched upper-back and rounded shoulder. Children are not as proactive today and the rate of the UCS is on the rise. This deviated posture and sedentary lifestyle continues, where it progresses more as the age progresses in adulthood. To screen, detect, early treat as well as prevent upper cross syndrome in young individuals. Asymptomatic individual with 20-40 years of age group was explained about the procedure before commencement of the study. Posture was screened using REEDCO Posture Assessment Scale was used for evaluation. Assessment of muscle tightness and weakness was evaluated using muscle length tests and manual muscle testing. From the current study we conclude that prevalence of UCS is significantly less in asymptomatic individuals as compared to symptomatic. Although it is very important to practice good posture in daily routine in order prevent early signs of UCS. The parameters of outcome measures were analyzed by descriptive statistics only. Based on previous data we conclude that it is essential to screen asymptomatic individual to looks for signs of UCS for early detection, prevention and treatment. Keywords: Upper Cross Syndrome, Manual Muscle Testing, Muscle Length Testing.

Colles' fracture specifically is defined as metaphyseal injury of cortico-cancellous junction of distal radius. The incidence has been shown to follow bimodal distribution; in general those most affected are in first and seventh decade of life. Distal radius fracture have high incidence among the aging population. Comminuted fracture of distal end of the radius are caused by severe trauma and presents as shear and impacted fracture of articular surface. The type of fracture and localization, degree of displacement, patient's age and magnitude of soft tissue injury are the factors to be considered for treatment options. A 19 year old female reported to casualty with pain, swelling, tenderness and deformity over right wrist. Patient had history of fall from stairs 2 months back and sustained trauma to her to her right wrist. She was unable to performher daily activities with right hand. X-ray findings confirmed displaced comminuted fracture of distal end of right radius Medicinal and therapeutic intervention was given. Therapeutic intervention included thermotherapy, range of motion exercises, joint mobilization and progressive resistive exercise. Functional improvement was observed after 12 weeks of physiotherapy. Early start of physiotherapy after fixation of fracture can improve forearm functioning and quality of life.