ABSTRACT
Musculoskeletal pain is a common and debilitating symptom in older adults. However, its importance is often underestimated. In this review article, we discuss its proper evaluation and management. Pain evaluation includes detailed history taking, physical examination, imaging, and laboratory investigations. Management of musculoskeletal pain requires a multidomain approach including nonpharmacological, pharmacological, and surgical modalities. A step-wise approach recommended by the World Health Organization can be used for pain management. Common musculoskeletal conditions causing pain are osteoarthritis, low?back pain, gout, pseudogout, rheumatoid arthritis, polymyalgia rheumatica, and fibromyalgia.
ABSTRACT
Orthostatic hypotension (OH) is defined as a drop of >20 mm Hg of systolic or >10 mm Hg of diastolic blood pressure (BP) within 3 min of standing from lying position. It is a common geriatric syndrome caused by impaired orthostatic response of BP. Its clinical manifestation can range from dizziness to syncope. It is a common cause of recurrent falls and fracture in older adults. Its etiology ranges from neurological causes such as Parkinson and diabetes to hypovolemia. Drugs, especially cardiovascular drugs are also frequently identified as the cause of OH. The management of OH is primarily nonpharmacological including medication review, dietary, and lifestyle modifications. However, in partially responsive or resistant cases, medications such as fludrocortisone, midodrine, droxidopa, etc., are also used.
ABSTRACT
Background: To ascertain the prevalence of Hepatitis C infection among patients visiting a tertiary care center in Jaipur, Rajasthan.Methods: An observation analytic study was done at a tertiary care center affiliated to Medical College with retrospective analysis of the hospital data of two calendar years. During this period HCV infection screening (anti-HCV) was offered to every suspected patient admitted in hospital and every pregnant women visiting antenatal care clinic.Results: The study prevalence of HCV infection was 0.05% (13/25311). The prevalence was more in female (0.03%) than male (0.02%). The study prevalence of anti-HCV among pregnant female was 0.02% (3/16224). Maximum positive cases (4/13, 30.77% positive cases) were in the age group of 21-30 years (sexually active group) and >50 years age group while minimum positivity was found in children (00 case, 0-20 years age).Conclusions: In this study, prevalence of HCV infection was 0.05%. The study prevalence of HCV among pregnant females was 0.02%. Maximum positive cases (4/13, 30.77% positive cases) were in the age group of >50 years and 21-30 years. This study aids in view to strengthen proper screening for HCV infection to reduce HCV related morbidity and mortality
ABSTRACT
Background: To ascertain the prevalence of HBV among HIV-infected, treatment- naïve patients visiting a tertiary care centre in Jaipur, Rajasthan, India.Methods: An observation analytic study was done at a tertiary care centre affiliated to medical college with retrospective analysis of the hospital data of 30 calendar months. During this period routine diagnostic screening of HIV infection and HBV infection was offered to every suspected patient admitted in hospital and every pregnant woman visiting antenatal care clinic. Patients with documentary evidence of HIV infection and history of Hepatitis B vaccination in last 30 days are not screened for these infections at our centre. The HIV screening was done as per NACO guidelines. The HBV screening was done using commercially available enzyme linked immunosorbent assay kits (ELISA) for detection of surface antigen (HBsAg).Results: The study prevalence of HIV infection was 0.11% (40/35289). The prevalence was more in male (0.45%) than females (0.06%). HBV was not detected in any of the HIV positive patient in this study. The study prevalence of HIV among pregnant females was 0.05% (10/22026).Conclusions: In this study, prevalence of HIV infection was 0.11%. The study prevalence of HIV among pregnant females was 0.05%. Other than pregnant women, maximum positive cases (13/30, 43.33% positive cases) were in the age group of 25-34 years (sexually active group). No patient had HIV and HBV co-infection.