RESUMO
An abnormal buildup of pleural fluid, known as a pleural effusion, results from an imbalance between excessive formation and absorption. Despite the wide range of pleural effusion causes, including pneumonia, congestive heart failure, and cancer, the majority of cases are attributed to pleural fluid buildup. Acute pancreatitis also leads to complications such as systemic inflammatory response syndrome. A complex pathophysiologic reaction to a range of wounds, including trauma and infections, burns, and pancreatitis, is known as systemic inflammatory response syndrome. It was recognized that a variety of injuries exhibited a similar inflammatory response, making them prime candidates for new anti-inflammatory molecules designed to stop the spread of inflammation or provide targeted therapy. Localized inflammation, a protective response that the body regulates at the site of the injury, can, if lost or overly activated, result in a heightened systemic response known as systemic inflammatory response syndrome. The patient is a 19-year-old female who arrived at Acharya Vinoba Bhave Rural Hospital with complaints of abdominal pain for eight days, abdominal distension for three to four days, breathing difficulty for three to four days, and fever. According to the patient's condition, she was unable to perform normal activities of daily living for eight days. She had breathlessness for eight days, which worsened four days ago. She was diagnosed with pleural effusion, acute pancreatitis, and systemic inflammatory response syndrome. This case is unique as the patient is very young and she has multiple health issues such as severe pancreatitis, ischemic heart disease, systemic inflammatory response syndrome, pulmonary consolidation, and pleural effusion at the same time which makes this condition critical. This study aimed to identify the improvement in this patient after getting physiotherapy treatment. Physiotherapy treatment included lifestyle modifications to reduce weight, performing exercise on a daily basis, breathing exercises airway clearance technique, volumetric incentive spirometer segmental expansion, inspiratory muscle training, chest mobilization, chest proprioceptive neuromuscular facilitation (PNF), and graded mobilization to improve patient condition. When added to standard care, a physiotherapy program improves radiological results, spirometric parameters, and hospital stays in pleural effusion patients.
RESUMO
A carpal injury called a lunate fracture can cause severe carpal instability if treatment is not received. After the scaphoid, triquetrum, and trapezium, the lunate is the fourth most frequently fractured carpal bone. Due to lunate fracture, the functional prognosis is uncertain, and conservative treatment frequently results in surgery. Lunate fracture may be caused by anatomical features such as ulnar and radial variation, although necrosis is not commonly one of them. Vascularization in the lunate is unstable and dependent on the capsular arterioles. High shear stresses are frequently applied to the lunate, which rubs against the triangular fibrocartilage complex and the radius. This could lead to a fracture. Intraosseous compartment syndrome is most likely caused by the inflammatory condition Kienböck's disease. In order to protect the lunate against shear and compression loads, surgery entails decompressing the lunate. The consequences of current osteotomy techniques on biomechanics will be discussed. While some osteotomies may lessen the stresses conveyed to the lunate, they may also put too much strain on the ulnar side of the lunate. Techniques for treating wrist degeneration comprise extra-articular methods that keep the mid-carpal joint's architecture and vascularization intact. Bone grafting or repair may be indicated if lunate destruction is extensive. In the last phases, palliative methods are employed. For Kienböck's disease, there are currently no efficient biological therapies. The lunate is prevented from collapsing by decompression osteotomies, giving time for natural healing. The patient came to Acharya Vinoba Bhave Rural Hospital Outpatient Department of Orthopedics with a complaint of pain in her right wrist. At a private hospital in Amravati, the patient had gone through a proximal row carpectomy on the right side. After undergoing post-operative physiotherapy, the patient showed good improvement in her functional activities and quality of life. Physiotherapy helps in gaining back the functional activities for the post-operated lunate fracture patient.