DR-TB is increasing in Mumbai, India. Based on the DST results, individualised therapy would be recommended.

INTRODUCTION Increased reliance on bulbospinal motor systems has been implicated in individuals with chronic stroke during maximum voluntary arm joint torque generation. METHODS Maximum isometric single-joint and multi-joint arm strength were observed in two body orientations (sitting & supine) while maintaining identical head/neck/trunk/extremity joint configurations in order to identify bulbospinal contributions to maximum joint torque generation in 11 individuals with stroke and 10 individuals without stroke. RESULTS During sitting, shoulder flexion was greater for both groups, while shoulder extension and elbow flexion, part of the “flexion synergy,” were greater only in individuals with stroke. CONCLUSIONS The results demonstrate that body orientation influences isometric arm strength, notably the constituents of flexion synergy in individuals with stroke, suggesting bulbospinal motor pathway involvement. From a practical perspective, clinical evaluation of single joint strength in the supine position may underestimate strength available during activities of daily living that are performed in an upright orientation.

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The hand and wrist are rare sites for tuberculosis (TB) and account for < 1% of all skeletal TB. Though rare, TB of the wrist is a cause of major morbidity. A common feature in the available reports on wrist TB is a delay in diagnosis causing residual stiffness and pain after treatment. Although TB of the wrist has a varied presentation, the majority of lesions respond to conservative treatment. We report a 12-year–old girl who presented with wrist swelling, having intercarpal, carpometacarpal, and radiocarpal joint involvement which turned out to be tuberculous and it healed with residual deformity.

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