Comparative Study of Fluoroscopy vs Ultrasound Guided Stellate Ganglion Block

Introduction: Stellate ganglion block (SGB) is used for thetreatment of many vascular disorders and sympatheticallymediated pain including pain of head, neck, cancer, phantom,postherpetic neuralgia, cardiac arrythmia, orofacial pain, andvascular headache. Various modalities to localize stellateganglion use of fluoroscopy, computerized tomography,magnetic resonance imaging, and radionucleotide tracers.Ultrasound imaging is a best tool for SGB due to its clarity,low cost, lack of radiation and portability. In this study weaimed to compare the efficacy of fluoroscopy vs ultrasoundguided stellate ganglion block in lowering the pain usingnumeric rating scale (NRS).Material and Methods: Study was perform in 40 patientssuffering from upper limb and head and neck, neuropathicpain. The first group (Group I) received stellate ganglion blockunder ultrasound guidance while the second group (Group II)received stellate ganglion block under fluoroscopy guidance.The t-test and Man Whitney test were perform to analyses thedata.Results: The requirement of different analgesia werecomparable in both group I and group II patients. Change inpain score was maximum at immediate post-block, 1 h postblock, 6 h post block (65.84% of baseline) while change wasminimum at 48 h post-block (48.45% of baseline). The painwas significantly lower in group I from baseline as comparedto group II at all periods. Range of Ease rating score were alsolower in group I. Block was statistically achieved earlier inGroup I (4.55±0.69 min) as compared to Group II (12.60±2.56min).Conclusion: USG and fluoroscopy are both good techniquesfor stellate ganglion block, but due to less complication, earlyblocking effect time, more precise placement of medicationultrasound guided block is preferred over fluoroscopy method.

Weighted mean: A possible method to express overall Dhatu Sarata.

Several questions are being raised regarding the accuracy of the methods of diagnosis and reporting of various clinical parameters according to Ayurveda in recent times. Uniformity in reporting, issues related to inter‑rater variability, uniformity in applying statistical tests, reliability, consistency, and validation of various tools, ‑ are some of the major concerns that are being voiced. Dhatu Sarata is one such domain where no substantial work has been carried out to address these issues. The Sanskrit term “Dhatu” roughly translates as a “tissue.” Sarata stands for the status of Dhatu in a given individual, i.e., it describes whether the status is excellent, moderate, or poor. In the available research literature, there are several gaps while dealing with and reporting the clinical assessment of Dhatu. Most of the workers group an individual into any one of the categories of Dhatu Sarata, and this approach neglects the contribution of other Dhatus to the overall Sarata in that individual. In this communication, we propose the usefulness of “weighted mean” in expressing the overall Sarata in an individual. This gives the researcher a freedom of not classifying an individual into any one group of Sarata, while also simultaneously allowing him/her to retain the focus on the status of an individual Dhatu.

Ayurveda education: Evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology)

Background: ‘What is the ideal way of teaching Ayurveda?’ – has been a debated question since long. The present graduate level curriculum lists out the topics from ‘contemporary medical science’ and ‘Ayurveda’ discretely, placing no emphasis on integration. Most of the textbooks, too, follow the same pattern. This makes learning not only diffi cult, but also leads to cognitive dissonance. Objectives: To develop and evaluate the effectiveness of a few integrative teaching methods. Materials and Methods: We introduced three different interventions in the subject Kriya Sharira with special reference to ‘cardiovascular physiology’. The instructional methods that we evaluated were: 1. Integrative module on cardiovascular physiology (IMCP), 2. case-stimulated learning (CSL), and 3. classroom small group discussion (CSGD). In the fi rst two experiments, we subjected the experimental group of graduate students to the integrative instructional methods. The control group of students received the instructions in a conventional, didactic, teacher-centric way. After the experiments were over, the learning outcome was assessed and compared on the basis of the test scores. The groups were crossed over thereafter and the instructional methods were interchanged. Finally, feedback was obtained on different questionnaires. In the third experiment, only student feedback was taken as we could not have a control group. Results: The test results in the fi rst experiment showed that the integrative method is comparable with the conventional method. In the second experiment, the test results showed that the integrative method is better than the conventional method. The student feedback showed that all the three methods were perceived to be more interesting than the conventional one. Conclusion: The study shows that the development of testable integrative teaching methods is possible in the context of Ayurveda education. It also shows that students fi nd integrative approaches more interesting than the conventional method.