Role of Vitamin B Complex as an Add-on Therapy to Diclofenac in Patients with Primary Osteoarthritis of the Knee

Objective: This study was conducted with the aim to evaluate the efficacy and safety of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis (OA) of the knee. Materials and Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 130 patients of age >40 years with primary OA of knee attending orthopedics OPD were randomly allocated into two groups of 65 each, i.e., Group D and Group B. In Group D, patients received tablet diclofenac 75 mg and in Group B, patients received tablet Vitamin B complex along with diclofenac once daily for 4 weeks, respectively. Clinical assessment was done at baseline and at the end of 4 weeks and 8 weeks by the visual analog scale (VAS), WOMAC index, and Lequesne index. Results: During the intergroup comparison, it was found that Vitamin B complex as an add-on therapy to diclofenac produced statistically significant reduction in mean VAS pain score (P < 0.05). However, the difference in mean WOMAC index and Lequesne index was not statistically different at 4 and 8 weeks between the two groups (P > 0.05). Mild side effects were seen at 4 weeks, but no side effects persisted up to 8 weeks in both the groups. Conclusion: The present study suggested that Vitamin B complex as an add-on therapy was found to cause a significant reduction in pain score. It could be a promising drug in patients with OA to improve the analgesic effect, when combined can reduce the dose of diclofenac, thereby minimizing the side effects.

Solitary Osteochondroma: Rare Occurrence A Report of Two Cases.

Solitary Osteochondroma is the most common benign bone tumor, and occurs most frequently in the proximal humerus, tibia, and distal femur. It rarely affects proximal femur and talus. Therefore, we report two cases of solitary osteochondroma, which were found at these rare sites (one at lesser trochanter and another at talus) with a brief review of literature and discussion of clinical features and management..

Dyke-davidoff-masson syndrome- a rare cause of refractory epilepsy.

DDMS is a rare syndrome characterized by seizures, facial asymmetry, contralateral hemiplegia and mental retardation. The characteristic radiologic features are cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses. Dyke-Davidoff- Masson Syndrome (DDMS) is one among the syndromes associated with refractory epilepsy. We report a case of DDMS in an 18 year old female who presented with seizures, hemiparesis of the right side and mental retardation. Computed tomography on this patient assisted in making a diagnosis of DDMS.

Quality of life in Burn Injury Patients.

Objectives: The study was planned to assess quality of life and factors affecting it in patients with burn injury. Methods: This is hospital based cross sectional study which involves 70 burn patients hospitalized to the department of surgery and plastic surgery of Rajindra Hospital, Government. Medical College, Patiala between May 07 and Aug 08. Details of burns were taken on semi-structured proforma. All patients underwent detailed psychiatric assessment using International Classification of Disease-10 (ICD-10) and divided into two groups. Group A contains burn patients with psychiatric morbidity and remaining burn patients without psychiatric morbidity were included in Group B. Further, both groups were subjected to Quality Of Life Scale (QOL) to assess quality of life. Results: Quality of life was poor in burn injured patients and was affected by severity of burn injury. Psychiatric morbidity was found to be significant factor affecting quality of life in burn injury patients. Conclusion: The quality of life following burns must be assessed at every stage of their treatment for better adjustment.

Psychiatric Morbidity in Post Traumatic Orthopedically Handicapped Patients.

Objectives: Prevalence of comorbid psychiatric disorders in trauma is high and it increases the overall management difficulty. The current study attempts to find out the prevalence of psychiatric disorders and factors affecting these disorders in post traumatic orthopedically handicapped patients. Method: This is a hospital based cross-sectional study which involves 85 post traumatic orthopedically handicapped inpatients and outpatients of orthopedics, rehabilitation unit and psychiatry. They were screened for psychiatric symptoms by SCL-90R (Symptoms Check List-90 Revised). All patients underwent detailed psychiatric assessment using ICD-10 (International Classification of Disease-10) criteria and further subjected to MADRS (Montgomery Asberg Depression Rating Scale) and HARS (Hamilton Anxiety Rating Scale) to assess severity of the symptoms. Results: 67.6% patients had psychiatric symptoms. According to ICD-10, 38% had depressive disorder of which majority have mild to moderate depressive disorder. 26.8% patients had post traumatic stress disorder, 15.5% phobic anxiety disorder, 14% adjustment disorder, 12.7% somatoform disorder and 4.2% acute stress reaction. Conclusions: The psychiatric comorbidity was observed more in temporal association to traumatic injury, was higher in intensity and severity after more severe injury. The psychiatric co-morbidity following trauma needs to be addressed while we aim for holistic treatment of a patient.

Impact of Substance Dependence on Primary Caretaker in Rural Punjab.

Objectives: The study was planned to assess the impact of substance dependence and factors affecting it on PCT (Primary Care Taker) in rural area of Punjab. Methods: This is a systematic, randomized,cross sectional study which involves 83 PCT of patients with ICD-10 diagnosis of substance dependence in village Chhajli of Punjab. Details of substance useand sociodemographic attributes of dependence patients were taken on semi-structured proforma. All PCT underwent detailed assessment using Family Burden Interview Schedule. Results: Majority of PCT (77.5 percent) was found to have moderate burden especially in financial areas, disruption of routine activities, family leisure and family interaction. Higher proportion of burden was seen in PCT of illiterate patients of reproductive age group, of lower socioeconomic status, having multiple and longer duration of substance dependence and had relapsed many times. Conclusion:Burden on PCT was observed more in temporal association to the number of substance, type and duration of dependence. The impact of substance dependence on family members must be assessed at every stage of patient treatment for better quality of life.

Quality of life in post-traumatic orthopedically handicapped patients.

Objectives : The study was planned to assess quality of life (QOL) and factors affecting it in post-traumatic orthopedically handicapped patients. Materials and Methods: This is hospital-based cross-sectional study which involves 68 patients with traumatic orthopedic handicapped injury in the Department of Orthopaedeics, Rehabilitation center and Psychiatry, Government Medical College, Patiala between May 07 and Aug 08. Details of injury were taken on semistructured proforma. All patients underwent detailed psychiatric assessment using International Classification of Disease-10 (ICD-10) and divided into two groups. Group A contains handicapped patients with psychiatric morbidity and remaining patients without psychiatric morbidity were included in Group B. Further, both groups were subjected to Quality Of Life Scale (QOLS) to assess QOL. Results : QOL was poor in handicapped patients and was affected by severity of injury. Temporal association was seen between psychiatric morbidity and QOL in handicapped patients. Conclusion : The QOL must be assessed at every stage of treatment for better adjustment of handicapped patients.