A Comparative Study Between Different Pain Rating Scales in Patients of Osteoarthritis.

Study was conducted to assess the sensitivity and simplicity of various pain rating scales in patients of osteoarthritis with chronic pain so that most appropriate scale can be identified. Scales included were Wong- Baker Faces Pain Rating Scale (WBS), Numerical Rating Scale (NRS), Faces Pain Scale- Revised (FPS-R), Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Patients were asked to indicate their pain on these scales and comment about the simplicity of scales. Median mark for WBS, NRS, FPS-R, VAS and VRS was 10, 10, 10, 9.1 and 10 respectively. P value between WBS, NRS, FPS-R, VAS and VRS was insignificant. Most simple, easy to answer scale (83%) was WBS followed by FPS-R (17%). We conclude that all the scales are sensitive for assessment of the chronic osteoarthritis pain and are not different from each others. The most simple and preferred pain rating scale is WBS for the regional population.

Role of proximal catheter ileostomy in typhoid enteric perforation

Addition of loop ileostomy with surgical repair of typhoid enteric perforation has recently reduced mortality rates but ileostomy itself is associated with high complication rates of 25-40%. This study was done to assess the effectiveness of proximal catheter ileostomy in these patients. Prospective study. J N Medical College Hospital, Aligarh Muslim University, Aligarh, India. Patients with typhoid enteric perforation who were treated surgically from November 2006 to November 2009. Proximal catheter ileostomy constructed along with primary surgical repair of typhoid enteric perforations when proximal defunctioning of bowel was considered advisable. Feasibility as well as outcome in terms of morbidity and mortality. Catheter ileostomy was performed in eight patients with typhoid enteric perforations treated by surgical repair. Patients' age ranged from 17 to 45 years [average 25.75 years] with a male to female ratio of 1:1. In the immediate postoperative period, two patients died of septicemia unrelated to catheter ileostomy. Catheter ileostomy started functioning within 48 hours of the operation and twice-daily irrigation was found sufficient. One patient developed mild peritubal leak that cleared within two days. Laparotomy wounds got infected in two patients. Ileostomy wounds closed spontaneously in all patients within 7-14 days after catheter removal. Mean hospital stay was 13.4 days. Follow-up was from 6- 36 months [average 24 months]. Catheler ileostomy is effective and safe in protecting primary repair of typhoid enteric perforations with minimal morbidity

Cauterization in unani system of medicine a review

In Unani system of medicine, treatment of a patient is performed by administering medicines [Ilaj bil-Dawa], by adopting suitable technique of interference in six-essentials of life [Regimental therapy] and by using manual art and surgical instruments [Ilaj bil-Yad/Ilaj bil-Hadid]. Since ancient time Ilaj bil-Yad consists of treatment of fractured bones, reduction of dislocated bones, incision of body tissues, amputation and excision of diseased body parts, cauterization of diseased body parts and stitching of incised and damaged tissues. In Arabic literature, Ilaj bil-Yad is also termed as Ilaj bil-Hadid [treatment by surgical instrument] or Sana'at ul-Yad [Manual Art or Operative Procedure]. Cauterization is reckoned in the category of manual treatment and it is performed either by fire [Hot metal] or by strong corrosive medicine. Now it is being realized that if cauterization is performed/applied as a common surgical procedure in the contemporary medical practise, it may provide successful treatment for a large number of diseases