Study design: Prospective observational study. Objectives: To assess the prevalence of symptomatic deep vein thrombosis (DVT) in earthquake survivors with spinal cord injury (SCI). Settings: Rawalpindi, Pakistan, in the months after the October 2005 earthquake. Methods: Earthquake survivors (n ¼ 187) with acute SCI were enrolled after verbal informed consent. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a detailed clinical and radiological assessment was performed. They were followed for 10 weeks for clinical signs and symptoms suggestive of DVT. Case with clinical suspicion of a DVT underwent a duplex scan of both legs to confirm the diagnosis. The influence of age, gender, American Spinal Injury Association (ASIA) grade and lower limb fractures on occurrence of DVT was determined. Results: There were 80 men and 107 women with a mean age of 28.3 ± 12.4 years. Seventeen patients were clinically suspected to have a DVT and ultrasound was positive in nine (4.8%). There was no influence of age (P ¼ 0.4), gender (P ¼ 0.4), ASIA grade (P ¼ 0.1) or presence of a lower limb fracture (P ¼ 0.6) on the occurrence of a DVT. Conclusion: This study adds further evidence to support the belief that the incidence of DVT in Southeast Asian patients with an SCI is lower than the reported incidence in the West. It may not be necessary to apply the recommendations for DVT prophylaxis in Caucasians with SCI to other groups, including Southeast Asians.

Objectives: To find out effectiveness of steroid injection for early management of lateral epicondylitis. Data Source: One hundred and twenty Patients of both genders presenting with unilateral lateral epicondylitis of less than two weeks duration reporting at Outpatient Department at Armed Forces Institute of Rehabilitation Medicine, Rawalpindi. Design of Study: Quasi experimental study. Setting: Out patient department of Armed Forces Institute of Rehabilitation Medicine, which is the largest rehabilitation facility in the country at present offering a multidisciplinary approach in the management of disability and musculoskeletal disorders17. Period: 01 yrs. Results: Both groups had sixty cases each with a mean age of 35.1 ± 6.22 and 36.08 ± 5.98 respectively. There were 54(45 %) males and 66(55%) females. At four weeks and three months follow up assessments there was significant improvement in pain relief and pain free grip strength in the Group A(steroids) as compared to Group B (NSAIDs). Conclusions: Local steroid injection is an effective treatment with an advantage over nonsteroidal anti-inflammatory drugs (Diclofenac). It results in a rapid and better relief of symptoms, which is sustained over a period of three months.

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Objective: To determine the etiology of ulnar nerve compression acrossthe elbow.Design: Retrospective and descriptive. Setting: At AFIRM Rawalpindi. Period: From Jan 2000 to Jan 2004.Material & Methods: 267 cases of Ulnar Nerve Compression at elbow diagnosed after electro-physiological studieswere selected. Most of the patients with a variety of complaints were referred to Rehabilitation Medical Department,Rawalpindi (AFIRM) for diagnostic evaluation (NCS/EMG) and management. Results: Out of 267 patients 210(78.65%)were males and 57(21%) were females. The mean age was 35 yrs (Range 9-67yrs). Most of the patients 180(67.41%)had left sided Ulnar nerve compression at elbow where as 87(32.59%) suffered on Right side. The most commonmode of presentation were paraesthesia 234(88%), pain 166(44%) and weakness of intrinsic hand muscles 104(27%).Electro-physiological evaluation shows prevalence of occupational 121(45%) and traumatic 51(21%) causes.Conclusion: Management of Ulnar never compression must include a comprehensive rehabilitation program thatshould focus on postural correction and workstation modification along with pharmacological and surgical advice

Objective: This study aimed to observe functional outcomes post coronavirus disease (COVID) rehabilitation in COVID-19 patients with postintensive care syndrome (PICS). Methods: We present 13 cases of severe COVID-19 pneumonia who required prolonged intensive care unit (ICU) stay, and were later admitted to our rehabilitation institute with features of PICS and functional disability, during the months of July and August 2020. All these patients underwent a multidisciplinary rehabilitation program and are the first group of patients successfully discharged to the community. Results: Among 13 patients presented, 11 were male patients and 2 were female, in the age range 34–64 years. Ten out of 13 patients had at least one chronic illness such as diabetes mellitus, systemic hypertension, dyslipidemia, obstructive airway disease, and coronary artery disease, and seven among them had more than one illness. None of them had any known neuropsychiatric illnesses. All of them had severe pneumonia which required mechanical ventilation from 12 to 30 days and an average length of ICU stay of 36 days (Range 21–54 days). The most common impairments on rehabilitation admission were impaired exercise tolerance with poor scores in Modified Medical Research Council (mMRC) dyspnea scale and desaturation on 40-step walking test, as well as significant ICU acquired weakness with a Medical Research Council (MRC) sum score in the range of 30–46 out of 60. Eight out of 13 patients had critical illness myopathy and/or neuropathy diagnosed with neuro-electrodiagnostic testing. The average length of stay for the patients in rehabilitation was 36 days, with a range of 18–65 days. Conclusion: Early multidisciplinary rehabilitation has got a potential benefit in the functional outcome of COVID-19 survivors. More studies are required in this area to further evaluate the benefits of different rehabilitation interventions, their intensity, duration, long-term benefits, and to create guidelines for addressing similar situations in the future.