Ayurveda and medicalisation today: The loss of important knowledge and practice in health?

Ayurveda translates as ‘life science’. Its knowledge is not limited to medicine, cure or therapy and is forlaypersons, households, communities, as well as for physicians. Throughout its evolutionary history,Ayurveda and Local Health Traditions have reciprocally influenced each other. In modern times, theinfluence of biomedicine on Ayurveda is leading to its medicalisation. Over the past century, theintroduction and perspective of biomedicine into India has made the human being an object for positiveknowledge, a being who can be understood with scientific reason and can be governed and controlledthrough medical knowledge. This paper explores how this shift towards medicalisation is affecting theknowledge, teaching, and practice of Ayurveda. It examines the impact and contribution of processes likestandardisation, professionalisation, bio-medicalisation and pharmaceuticalisation on Ayurveda education, knowledge, practice and policies. To maintain health and wellbeing Ayurveda's ancient knowledgeand practice needs to be applied at individual, community and health care provider levels and not belimited to the medical system. The current over medicalisation of society is a potential threat to humanhealth and well-being. Ayurveda and LHT knowledge can provide essential teachings and practices tocounter-balance this current trend through encouraging a population's self-reliance in its health.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Comparative Effects of Single Agent Rectal Diclofenac versus a Combination of Rectal Diclofenac and Intramuscular Pentazocine, on Post Caesarean Section Pain Relief in a Tertiary Institution in Southern Nigeria

Background: Caesarean section commonly causes moderate to severe pain in the first 24 hours after surgery with associated discomfort, delayed ambulation, difficulty initiating breastfeeding and prolonged hospital stay. Receiving adequate analgesia after caesarean section is very important for the patient’s comfort, overall wellbeing and recovery.Objective:To compare the efficacy, time to rescue-analgesia and side effects of single agent rectal diclofenac versus its combination with intramuscular pentazocine for pain management after caesarean section in Rivers State University Teaching Hospital (RSUTH). Methodology:A randomized double-blind clinical trial was carried out at the RSUTH. A total of 120 patients scheduled for either elective or emergency caesarean section were recruited. Group ‘A’ received rectal diclofenac 100mg and intramuscular placebo (unimodal group) while group ‘B’ received rectal diclofenac 100mg and intramuscular pentazocine 30mg (multimodal group). Socio-demographic information was collected via structured proforma, while Visual Analog Scale (VAS) was used to assess the level of pain. Data were analyzed using SPSS version 20 and statistical significance was set at p< 0.05.Results:The mean ages of respondents in unimodal and multimodal groups were 31.7 ± 4.3 years and 31.3 ± 5.2 years respectively. The difference in the median pain score and range was significant only at 8 hours between the groups, there was no significant difference before and after 8 hours. Although the mean time (in minutes) to first rescue-analgesia was shorter in the unimodal (147.5 ± 60.1) as compared to the multimodal group (170.0), this difference was not statistically significant. There was no side effect noticed in either of the two groups.Conclusion: The combined agents (diclofenac and pentazocine) had a superior analgesic effect to the single agent (diclofenac alone) when given as used in the study.

"It's 100% for me": hospital practitioners' perspectives on mandatory HIV testing.

This article explores the thinking of medical practitioners working in nine hospitals spread across five cities in India, on a contested subject - mandatory HIV testing of patients prior to surgery. We used in-depth interviews with practitioners and an interpretive analytical approach to understand their decisions to conduct mandatory tests. While many in the public health community see mandatory testing as an unacceptable violation of patient autonomy, the practitioners widely regarded it as a valuable cost-saving innovation for obviating transmission of infection during surgery. These conceptions are rooted in the day-to-day logic of practice which defines practitioners’ actions - imperative of personal security, investment in core occupational roles and the importance of harmonious relations with co-workers. The experiences of hospitals with contrasting policies on mandatory HIV testing shows how an approach that balances patients’ needs with an appreciation of practitioners’ perspectives may result in more workable solutions for field-level ethical dilemmas.