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2.  Clinical Comparative Study: Efficacy and Tolerability of Tolperisone and Thiocolchicoside in Acute Low Back Pain and Spinal Muscle Spasticity 
Asian Spine Journal  2012;6(2):115-122.
Study Design
We performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days.
Purpose
To assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles.
Overview of Literature
No head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done.
Methods
The assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score.
Results
The improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001).
Conclusions
Tolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.
doi:10.4184/asj.2012.6.2.115
PMCID: PMC3372546  PMID: 22708015
Tolperisone; Thiocolchicoside; Skeletal muscle relaxant; Low back pain; Muscle; Spasm
3.  Bilateral multiligament injury of knee caused by entangled dupatta 
Indian Journal of Orthopaedics  2012;46(2):239-241.
We report a rare case of bilateral multiligament knee injury in an 18-year-old female employed in garment industry. Patient was wearing salwar kameez and dupatta while operating an electric laundry machine. In this case we discuss a peculiar mechanism of injury caused due to wearing dupatta near working site and suggest simple preventive measures.
doi:10.4103/0019-5413.93690
PMCID: PMC3308669  PMID: 22448066
Multiligament injury; mechanism of injury; dupatta
4.  Total knee arthroplasty: Limb length discrepancy and functional outcome 
Indian Journal of Orthopaedics  2010;44(3):300-307.
Background:
Limb length discrepancy and its effects on patient function have been discussed in depth in the literature with respect to hip arthroplasty but there are few studies that have examined the effect on function of limb length discrepency following total knee arthroplasty (TKA). The aim of this study was to determine whether limb length discrepancy after TKA in patients with bilateral osteoarthritis of knee with varus deformity affects functional outcome.
Materials and Methods:
Fifty-four patients with bilateral osteoarthritis of knee with varus deformity, who were operated for total knee arthroplasty from 1996 to 2008, were reviewed retrospectively. The patients were divided into two groups. Thirty patients (mean age 64 years) were operated for unilateral TKA and thirty patients (mean age 65.8 years) were operated for bilateral total knee arthroplasty. Six patients underwent staged surgery and were included in both groups as the time interval between the two surgeries was more than the minimum 6-month follow-up period specified for inclusion in the study. The limb length discrepancy was measured and statistically correlated with the functional component of the Knee Society Score.
Result:
In the unilateral group (n=30), the mean limb length discrepancy was 1.53 cm (range: 0-3 cm) and the mean functional score was 73 (range: 45-100). In the bilateral group (n=30), the mean limb length discrepancy was 0.5 cm (range: 0-2 cm) and the mean functional score was 80.67 (range: 0-100). A statistically significant negative correlation was found between limb length discrepancy and functional score in the unilateral group (Spearman correlation coefficient, r =−0.52, P=0.006), while no statistically significant correlation was found in the bilateral group (Spearman correlation coefficient, r = −0.141, P=0.458).
Conclusion:
Limb length discrepancy affects functional outcome after total knee arthroplasty, especially so in patients of bilateral osteoarthritis with varus deformity undergoing surgery of only one knee.
doi:10.4103/0019-5413.65159
PMCID: PMC2911931  PMID: 20697484
Limb length discrepancy; osteoarthritis knee; total knee arthroplasty

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