RESUMEN
Psychiatric disorders are common health problems in patients of all age groups, under-diagnosis and under-treatment of these disorders can result in disability and serious complications. With an objective of creating a comprehensive evidence-based consensus on common mental health disorders and their management in the Indian setting, 10 expert groups meetings involving 98 psychiatrists across India were conducted in the month of May 2020. Clinical insights related to burden, signs and symptoms, diagnosis and management were summarized based on the discussions during these meetings. Experts agreed that depressive disorders and anxiety disorders represent two important psychiatric disorders in India. Selective serotonin reuptake inhibitors (SSRIs) are commonlyused for the treatment of depression. Benzodiazepines are effective for the treatment of comorbid anxiety in patients with depression, but their long-term use causes adverse events such as dependence and withdrawal reaction. Obsessive compulsive disorder (OCD), bipolar disorder, substance use especially alcohol withdrawal syndrome, and sleep disorders are other common psychiatric disorders found among Indian patients. Lithium and valproate represent the commonly used and effective pharmacological treatments for bipolar disorder. SSRIs are preferred drugs in the treatment of OCD,whereas benzodiazepines such as chlordiazepoxide and diazepam represent important pharmacological treatment optionsfor alcohol withdrawal. Early identification and timely and effective treatment of psychiatric disorders is important for prevention of complications. Treatment should be individualized based on efficacy, tolerability profile of the medicine, risk of drug interactions, and cost. This consensus may be useful to psychiatrists and general practitioners treating common psychiatric conditions in Indian patients.
RESUMEN
Background: Fractures of the distal end radius represent the most common upper extremity fracture in elderly. The treatment problem includes not only achieving union in right anatomical position but also good functional results as far as joint mobility is concerned. Many types of external fixation devices are described to achieve reduction and fixation of the fragments without loss of position and acceptable functional results. The ligamentotaxis is the basic principle used by external fixation. The aim of the study was to assess the functional outcome in fractures of the lower end radius in elderly patients treated by static external fixator (Modified JESS). Materials and Methods: A total of 52 wrists in 51 patients (24 males and 27 females), aged more than 50 years with intra-articular distal end radius fracture were treated with Modified Joshi’s External Stabilization System from 2003 to 2016. The patients were followed up at 2 weeks, 3 weeks, between 6 and 8 weeks, 6 months, 1 year and at 2 years after the surgery. The assessment of pain, range of motion, grip strength and activity were assessed at 6th month, one year and two years follow- up and scored according to Green and O’Brien scoring system. Results: Result was excellent in 42 (80.76%), good in 6 (11.54%) and poor in 4 (7.69%) at 2 years post operatively. Conclusion: Ligamentotaxis using external fixator has been the traditional mode of treating unstable distal radius fractures and is still used by many as the preferred technique due to its acceptable results, easy application and cost-effective.