ABSTRACT
The poetic medical philosophies of Siddha were presented in palm scripts cannot be easily interpreted by common man. According to this system, the disease classification is based on the concepts of Tridosha pathology (Vatham, Pitham and Kabham). The Siddha concept of tri-humoural theory seems poles apart from those of the International Classification of Diseases (ICD) when viewed afar. This review article is an attempt to correlate clinically, the symptoms of “Net?ic?laivatam”, a disease given in the Siddha text Y?ki vaittiya cint?ma?i - 800 with that of the common ailment Sinusitis mentioned in contemporary science. Through meticulous interpretation and parallel analysis of the condition it can be concluded that the signs and symptoms of ‘Net?ic?laivatam’ can be correlated well with that of Sinusitis. This parallel analysis would further pave way for better perceptive, diagnosis and management of the disease ‘Net?ic?laivatam’ as mentioned in Siddha literature
ABSTRACT
Background: In the earlier periods analgesia was restricted to surgical and immediate postoperative period. However, this was associated with a lot of morbidities to the patient in terms of surgical stress and increased requirements for analgesia as the pain persisted. Patient’s attitude and concern about postoperative pain need to be addressed preoperatively. Early interventions are essential for better long-term outcomes. Because of the multiplicity of mechanisms involved in postoperative pain, a multimodal analgesia regimen, with a combination of opioid and non-opioid analgesic drugs is often used to enhance analgesic efficacy, reduce opioid requirements and its side effects. Aim of the study: To compare the efficacy of ketorolac in the management of postoperative pain when administered intravenously or intramuscularly, to assess the efficacy of ketorolac by two routes of administration namely Intravenous (IV) and Intramuscular (IM). Materials and methods: This comparative study was done in 2015 in Pondicherry Institute of Medical Sciences, Pondicherry. Totally 60 patients undergoing elective surgeries under ASA I/II was selected and they were divided into two groups of 30 patients each. Postoperatively the patients were examined at half hourly intervals for the first 6 hours for pain and it was graded using Visual Analogue Scale (VAS). If VAS score was > 3, inj. Tramadol 1mg/kg IV was given as rescue analgesic and the time was noted. Any adverse effect such as dizziness, vomiting, nausea was also Maria Varun Raj, R. Ahila, Sangiev Koshy George. Comparative study on efficacy of Ketorolac in the management of postoperative pain when administered intravenously or intramuscularly. IAIM, 2019; 6(3): 164-169. Page 165 noted at half hourly interval for the first six hours following surgery. Total dosage and frequency of rescue analgesic tramadol in the 24 hour period were also calculated. Use of anti-emetics was noted. Results: Postoperative VAS score between the two groups was comparable at zero hours and after the first hour. However, at the 4th and 5th hour, there was a statistically significant difference in the scores between the two groups showing a better analgesic effect with the intramuscular route of administration of ketorolac. The mean VAS score at the end of the 5 th hour showed a statistical difference between the two groups (p=0.001). Postoperative VAS score between the two groups was comparable. However, at the 4th and 5th hour, there was a statistically significant difference in the score between the two groups. The mean duration of analgesia produced by intramuscular routes was found to be high when compared with that of the intravenous route and is statistically significant (p=0.001). The mean duration of analgesia produced by intramuscular routes was found to be high when compared with that of the intravenous route and is statistically significant. (p=0.001). Conclusion: We conclude that ketorolac can be used for postoperative analgesia in place of opioids in patients where opioid has to be avoided. Intramuscular administration provided more effective and prolonged pain relief when compared to intravenous administration.
ABSTRACT
Aim & Objectives: This cross sectional study was conducted to bring out a better understanding of the link between somatic symptoms and underlying psychiatric conditions in geriatric population of Mangalore city. Material and methods: 200 subjects with the age above 50 years in the outpatient department of hospitals, except the psychiatry wards, and consist of a face to face interview using the standard HADS scale. Result: A total of 105 males and 95 females were interviewed during the study period. The HAD scores of the patients were noted. It was found that in the anxiety sub-scale of the HADS scale 79(39.50%) patients scored less than 8 ('normal') 29(14.50%) scored between 8 and 11 ('borderline abnormal') and 92(46%) patients scored more than 11 ( 'abnormal'). In the depression sub-scale of the HADS scale 79(39.50%) scored less than 8('normal') and 34(17%) scored between 8 and 11('borderline abnormal') and 87(43.50%) scored more than 11('abnormal').In the combined score,71(35.5%) scored less than 8('normal') 54(27%) scored between 16 to 22('borderline abnormal') 75(37.50%) scored more than 22('abnormal'). Among those who were borderline abnormal and abnormal on the HADS scale, it was found that somatic manifestations of underlying depression was found in 64.21% women and 63.81% men. The chief complaints of these patients mostly included dizziness(10.85%), GI symptoms (10.85%), headache(18.60%), menopausal symptoms(17.05%), sleep disturbances (18.60%), general malaise(14.73%) others(9.30%). Conclusion: The present study suggested that somatic symptoms could be due to an underlying psychiatric condition(depression). The patients might present with complain of dizziness, GI symptoms, headache, menopausal symptoms, sleep disturbances, general malaise. While examining a patient, the psychological well-being of the patient should be assessed too. Ageing is another important aspect, and aging patients are more prone to somatisation. This should be kept in consideration while examining a patient.