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Background: Osteoarthritis (OA) is a significant contributor to chronic pain, mainly affecting lower extremity joints like the knee and hip, and causing considerable impairment in elderly individuals. OA treatment focuses on easing discomfort and enhancing mobility. Despite their adverse unfavorable effects, non-steroidal anti-inflammatory medications (NSAIDs) are frequently used for symptom alleviation. However, there is still a need for secure and efficient alternative therapies that could provide OA patients with both symptomatic relief and disease-modifying benefits. Despite the indisputable fact that the disease has a substantial socioeconomic impact on patients, there is not much research available to reflect on the medicine prescription pattern in OA. Aim and Objectives: The objectives of this study were to assess the prescription pattern and their rationality in patients with OA in a tertiary care hospital. Materials and Methods: A cross-sectional, prospective, and observational study conducted in the orthopedics department for all newly diagnosed and old treated patients with OA. Around 350 patients were taken into the study and their prescriptions were scrutinized. Descriptive statistics were used to analyze the data and present it as percentages. Results: Over 61.7% of females were affected compared to 38.3% of males with OA. The knee joint (76.2%) followed by the hip joint (13.7%) were the most common joints involved. Aceclofenac and diclofenac were the most common NSAIDs used in the patients, whereas piroxicam was the least prescribed drug. Gastroprotective agents, calcium supplements, and SYSDOA were the commonest adjuvants used in the treatment of OA patients. Conclusions: Even though NSAIDs are favored, SYSDOA and non-pharmacological treatments such as lifestyle changes, and frequent mild exercise have changed the treatment plan for OA
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Clinical Summary: An 18-year-old male presented with progressive breathlessness and cough of two months duration. He also complained of generalised body pains, low grade intermittent fever, anorexia and weight loss. He was started on empiric daily anti-tuberculosis treatment with rifampicin, isoniazid, pyrazianmide and ethambutol from elsewhere for right-sided pleural effusion one month ago. He presented to us as he did not experience improvement in his condition. There was no other significant medical history. Physical examination showed a 10cm x 8cm, non-tender hard bony mass with ill-defined margins over the upper third of left arm. There was no evidence of digital clubbing or peripheral lymphadenopathy. Respiratory system examination showed features of a right-sided pleural effusion.
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Middle ear surgeries can be performed under local anesthesia and sedation and can be well tolerated by the patient with minimal discomfort. This study was undertaken to compare two techniques of conscious sedation, intravenous midazolam, and propofol infusion for tympanoplasty. Forty patients scheduled for right or left tympanoplasty. American Society of Anesthesiologists I or II in age group 18-75 years were included in the study. The patients were randomly allocated into one of the two groups to receive either propofol [group I] or midazolam [group II]. The mean duration of anesthesia was 116.00 +/- 33.94 min in group I, while 97.50 +/- 30.76 min in group II [P = 0.07]. The modified Ramsay sedation scale was not statistically significant in both the groups. In group I, 70% of the patients and 95% of the patients in group II had amnesia during the surgery [P = 0.091]. The mean visual analog scale [VAS] score for surgeons and patients was not statistically significant in both the groups. In group I there was a positive correlation between the total dose of fentanyl and VAS score for surgeons [P = 0.02]. There was also a positive correlation between the total dose of propofol and VAS score for surgeons [P = 0.034] and patients [P = 0.039] in group I. Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better. Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery