scholarly journals APPROACH TOWARDS SACROCOCCYGEAL FISTULA: A PROSPECTIVE CLINICAL AND COMPETITIVE INTERPRETATION

AYUSHDHARA ◽  
2021 ◽  
pp. 3091-3097
Author(s):  
Gupta Sudesh ◽  
Prasher Aarushi ◽  
Sharma Kumar Arun ◽  
Sharma Sakshi ◽  
Manhas Raman
Keyword(s):  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Fatty Tissue ◽  
Entire Treatment Period ◽  
Natal Cleft ◽  
Average Unit ◽  
Life Threatening ◽  
Anti Fungal

Background: Sacrococcygeal fistula, also known as Pilonidal sinus is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal cleft. The condition, though not life threatening, is socially embarrassing and adversely affects the quality of life of patients. In Ayurvedic literature Sacrococcygeal fistula is better correlated and treated as Nadi Vrana. Acharya Sushruta had explained Para-surgical procedure with the intervention of medicated Seton (Kshara Sutra) as one of the treatment modalities. The ideal method of treatment of Sacrococcygeal fistula should be effective with a low recurrence rate, short hospital stay and economical. Aim: This study is an attempt to evaluate the efficacy of Arka Ksharasutra in the management of Sacrococcygeal fistula. Methodology: A total no. of 10 patients having signs and symptoms of Sacrococcygeal fistula were selected for Arka Ksharasutra ligation under local anesthesia and the Seton was changed every week during the entire treatment period. Results: In this study all the patients i.e.,100% were males with age between 25-35 years. The length of initial track was 3.6 to 5.5 cm and average Unit Cutting Time was 7.23 days/cm in previously non-operated cases and 11.26 days/cm in previously operated cases, average being 8.2days/cm. There was no post-operative complication and recurrence even after 3 months of follow-up. Conclusion: Arka Ksharasutra is laced with anti-bacterial, anti-fungal, bactericidal and anti- inflammatory properties which minimizes the use of antibiotics and also demolished the recurrence of symptoms.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

scholarly journals TO EVALUATE THE EFFECT OF UPANAHA SWEDA IN JANUSANDHIGATA VATA WITH VACHADI AND KOLADI YOGAS A COMPARATIVE CLINICAL STUDY

2021 ◽  
Vol 9 (8) ◽  
pp. 1675-1682
Author(s):  
Desai Sucheta ◽  
Desai Ananta ◽  
Borannavar Shaila
Keyword(s):  
Clinical Study ◽  
Elderly Population ◽  
Functional Disability ◽  
Signs And Symptoms ◽  
Walking Distance ◽  
Treatment Modalities ◽  
Age Factor ◽  
Comparative Clinical Study ◽  
Group A

The present scenario of lifestyle is prone to cause many lives deteriorating conditions. Sandhigatavata is one among the Vatavyadhi and the commonest articular disorder affecting the middle-aged, obese, and elderly population. The advancement in working pattern, lifestyle & age-factor, all together have become a prime cause for aggravation of Vata, which accelerates Dhatukshaya (depletion of tissues). Sandhigatavata can be correlated with osteoarthritis (OA) which is one such chronic, degenerative, inflammatory disease that has a great impact on the quality of the life of an individual. OA poses a huge hindrance in the day-to-day activities of the sufferer like walking, dressing, bathing etc. As per Ayurveda, it is caused due to localized accumulation of aggravated Vata in joints, which leads to Shula, Sotha, Vatapoornadritisparsha and functional disability of affected Sandhis. If not treated in time, the disease makes man disable. According to epidemiology the prevalence of osteoarthritis in India is 22-39%. Different treatment modalities like Snehana, Swedana, Lepa, Bandhana, Agni Karma and Raktamokshana are emphasized in Ayurveda to provide better relief from the pain and swelling and restore mobility; for the management of these symptoms, Swedana is the most convenient & best procedure. So, the present study was aimed to assess clinically the effect of Upanaha Swedas in the management of Janusandhigatavata. Objectives: To evaluate and compare the efficacy of Vachadi Upanaha Sweda and Koladi Upanaha Sweda in the management of Janusandhigatavata. Materials and Methods: It was a randomized comparative clinical study; total 40 patients were divided into 2 groups as 20 in each. In Group A, patients were treated with only Vachadi Upanaha Sweda and other group patients were treated with Koladi Upanaha Sweda. Results: Statistical analysis revealed that both the interventions wereeffective in reducing all the signs and symptoms of Janusandhigatavata, however in parameters Shotha, tenderness and walking distance, Koladi Upanaha Sweda showed better response than Vachadi Upanaha Sweda. Conclusion: There is a significant effect of Koladi Upanaha Sweda over Vachadi Upanaha Sweda in Janusandhigatavata both clinically and statistically. Keywords: Janusandhigatavata, knee osteoarthritis, Koladi Upanaha, Vachadi Upanaha, Swedana.

Quality of Life and its Determinants in Patients With Treated Acromegaly: A Cross-Sectional Nationwide Study in China

2020 ◽  
Vol 106 (1) ◽  
pp. 211-225
Author(s):  
Xiaopeng Guo ◽  
Kailu Wang ◽  
Siyue Yu ◽  
Lu Gao ◽  
Zihao Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Short Form ◽  
Somatostatin Analogs ◽  
Chinese Patients ◽  
Treatment Modalities ◽  
Biochemical Control ◽  
Cross Sectional

Abstract Context Quality of life (QoL) continues to be impaired in acromegaly after treatment. Objective We conducted the first nationwide survey assessing QoL status among Chinese patients with treated acromegaly and explored correlations with clinical parameters, treatment modalities, and outcomes. Design Cross-sectional study. Setting Survey via Chinese Association of Patients with Acromegaly (CAPA) online platform. Patients Treated patients from CAPA. Main Outcome Measures QoL was assessed using acromegaly QoL questionnaire (AcroQoL), 5-level EuroQoL five-dimensional questionnaire (EQ-5D-5L), and 12-item short-form health survey questionnaire (SF-12). Results Complete, valid questionnaires from 327 patients (mean age: 39.2 years, 61.5% females) at a mean of 10 years after treatment were included. Biochemical control was satisfied in 52.9% of these patients. The controlled patients had significantly better QoL than the uncontrolled patients in all AcroQoL dimensions, most SF-12 dimensions, and pain/discomfort and anxiety/depression dimensions of the EQ-5D-5L. Patients with either controlled or uncontrolled acromegaly had significantly worse QoL than the age- and sex-adjusted population reference in most SF-12 dimensions except for physical functioning. More acromegaly-associated symptoms and comorbidities at follow-up were independent risk factors for decreased QoL across all questionnaires. Medical treatment, especially with somatostatin analogs (SSAs), and radiotherapy were predictors of worse QoL. Female patients had lower scores of physical-related QoL than male patients. Conclusions Our study suggests that biochemical control improved but did not normalize QoL in acromegaly. Numbers of symptoms and comorbidities at follow-up, sex, radiotherapy, and medical treatment with SSAs were factors determining QoL of patients with treated acromegaly.

Quality of life following treatment for PTSD: Comparison of videoconferencing and in-person modalities

2017 ◽  
Vol 25 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Lisa H Glassman ◽  
Margaret-Anne Mackintosh ◽  
Alexander Talkovsky ◽  
Stephanie Y Wells ◽  
Kristen H Walter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Processing ◽  
Treatment Modality ◽  
Treatment Modalities ◽  
Cognitive Processing Therapy ◽  
Modality Effect ◽  
Evidence Based ◽  
Over Time

Introduction Quality of life (QOL) is significantly impaired among individuals with post-traumatic stress disorder (PTSD); however, few treatment outcome studies examine QOL following treatment. Furthermore, the use of videoconferencing to deliver evidence-based treatments for PTSD is increasing dramatically. Although videoconferencing has demonstrated non-inferiority to in-person treatment modalities for improving PTSD symptom severity, no studies to date have directly compared QOL outcomes of an evidence-based intervention delivered via videoconferencing to one delivered in-person. Methods This study presents a secondary data analysis of two randomized controlled trials comparing cognitive processing therapy (CPT) delivered via videoconferencing or a traditional in-person modality. The Men’s study delivered group CPT to 125 male veterans with PTSD, whereas the Women’s study delivered individuals CPT to 126 female civilians and veterans. Multigroup latent growth curve models were used to model changes in QOL Inventory (QOLI) scores over time. Results There was no effect of treatment modality on changes in QOLI scores over time (modality effect on slope estimate = 0.004 (–0.60, 0.61) and on quadratic estimate = 0.001 (–0.18, 0.20); all ps > 0.33). Model fit was the same for both genders (Δ χ2 (2) = 2.28, p = 0.32) and for the gender × treatment modality interaction (Δ χ2 (2) = 2.87, p = 0.24). QOLI scores improved at post-treatment and three-month follow-up assessments, but declined at the six-month follow-up assessment. Discussion This secondary analysis extends the findings of the parent studies by establishing the efficacy of the videoconferencing platform in improving QOL. Clinical implications of findings are discussed.

scholarly journals Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER): Protocol for a Longitudinal Observational Study

10.2196/31647 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e31647
Author(s):  
Tamara W van Hal ◽  
Juul MPA Van den Reek ◽  
Hans MM Groenewoud ◽  
Marcel C Pasch ◽  
Frank HJ Van den Hoogen ◽  
...  
Keyword(s):  
Observational Study ◽  
Validation Cohort ◽  
Joint Damage ◽  
Internal Validity ◽  
Signs And Symptoms ◽  
Outpatient Setting ◽  
Prospective Data ◽  
Longitudinal Observational Study

Background One in three patients with psoriasis will develop psoriatic arthritis (PsA). If left untreated, this can lead to pain, impaired function, and irreversible joint damage. Timely recognition and referral to a rheumatologist are therefore key. However, current methods used to screen patients with psoriasis for those who might benefit from referral to a rheumatologist are not performing well enough. Objective The Discovery of Arthritis in Psoriasis Patients for Early Rheumatological Referral (DAPPER) study is designed to determine the prevalence of PsA in a psoriasis population and to find parameters that can be used to develop a new or enhance an existing instrument for a rheumatological referral. Methods DAPPER is a longitudinal observational study with a 1-year follow-up. Patients with psoriasis (N=300) who are treated at an outpatient dermatological clinic will be screened extensively for signs and symptoms of PsA by a trained rheumatologist. If there is clinical suspicion of PsA and the patient is not yet treated by a rheumatologist, referral to the Department of Rheumatology will follow for confirmation of the diagnosis and further care. After 1 year, data on changes in quality of life and PsA and psoriasis disease activity will be collected from the referred patients. The screening visit will be used to gather demographical and medical data, which can later be used to develop the aforementioned screening instrument. Results Inclusion started in June 2019 and finished in June 2021. Follow-up with newly discovered patients with PsA is ongoing. Conclusions The DAPPER study is specifically designed to improve the detection of existing PsA in a dermatologic outpatient setting. Although internal validity will be tested, external validity will have to be checked using a second validation cohort. To predict the development of PsA in the future, longitudinal/prospective data collection is required and will be performed in a follow-up study (DAPPER-i). Trial Registration Dutch Trial Register NTR7604; https://www.trialregister.nl/trial/7397 International Registered Report Identifier (IRRID) DERR1-10.2196/31647

scholarly journals Stoma Complications

Acta Medica ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 47-52
Author(s):  
Timuçin Erol
Keyword(s):  
Treatment Options ◽  
Early Postoperative Period ◽  
Stoma Creation ◽  
Quick Recovery ◽  
Stoma Complications ◽  
Post Operative Period ◽  
Life Threatening ◽  
The Ideal

An improper stoma creation can cause many complications, varying from minor to life-threatening ones. Conversely, a good functioning stoma, at the ideal site improves patient’s quality of life. Most of the stoma complications occur in the early postoperative period and all clinicians must be familiar to these complications. All measures before and during operation must be taken to avoid these complications. Careful follow up after post operative period can help early diagnosis, proper treatment quick recovery of the patient. This review focus on common complications and treatment options of stoma creation.  

scholarly journals Zdravljenje glavkoma in suho oko

2016 ◽  
Vol 85 (4) ◽  
Author(s):  
Barbara Cvenkel
Keyword(s):  
Ocular Surface ◽  
Clinical Signs ◽  
Tear Film ◽  
Signs And Symptoms ◽  
Surface Damage ◽  
Eye Drops ◽  
Film Instability ◽  
Asymptomatic Patients

Patients with glaucoma have increased prevalence of dry eye (DE) compared to age-matched population without glaucoma. Clinical presentation of DE varies among individuals and may significantly reduce quality of life. The onset and deterioration of DE is caused by the toxic-inflammatory effects of preservatives in eye drops, active substance itself, and added, pharmacologically inactive substances or excipients. Ocular surface changes most frequently include superficial punctate keratitis, tear film instability, and allergic reactions. Despite the lack of symptoms, clinical signs may indicate ocular surface damage. Discordance between signs and symptoms is partly caused by decreased corneal sensitivity induced by neurotoxicity of the preservative benzalkonium chloride (BAK). Therefore, it is important to evaluate ocular surface before initiating glaucoma therapy and during follow-up also in asymptomatic patients. Preservative-free and/or BAK-free therapy is indicated in patients with severe DE and allergy to preservatives, and recommended in patients with DE of moderate severity, blepharitis, in symptomatic patients, before filtering surgery to reduce preoperative inflammation, in those with moderate fluorescein staining of grade 2 on Oxford scheme, and reduced tear film break-up time.

Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up

2015 ◽  
Vol 25 (6) ◽  
pp. 1527-1536 ◽  
Author(s):  
Kadir Çeviker ◽  
Şahin Şahinalp ◽  
Erdinç Çiçek ◽  
Deniz Demir ◽  
Dinçer Uysal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Venous Disease

scholarly journals The autologous fascia pubovaginal sling for complicated female

2013 ◽  
Vol 6 (1) ◽  
pp. 36 ◽  
Author(s):  
Blayne K. Welk ◽  
Sender Herschorn
Keyword(s):  
Quality Of Life ◽  
Retrospective Review ◽  
Midurethral Sling ◽  
Mesh Erosion ◽  
Intermittent Catheterization ◽  
Treatment Modalities ◽  
Mesh Removal ◽  
Urogenital Distress Inventory

Introduction: The purpose of this study is to review our contemporary experience with autologous fascia pubovaginal slings (AF-PVS) in the era of the midurethral sling.Methods: A retrospective review was completed to identify allpatients who underwent an AF-PVS between 2002 and 2009. Across-sectional questionnaire was used to assess postoperative urinary- specific quality of life (consisting of the Urogenital Distress Inventory [UDI-6] and the Incontinence Impact Questionnaires [IIQ-7]).Results: We identified 33 patients. They had failed a median oftwo previous incontinence treatments. Of these patients, 16 (48%) had failed a previous midurethral sling, and of these half had experienced a significant mesh erosion necessitating mesh removal. Preoperative median incontinence pad usage was 5/day. After a median follow-up of 16 months from the time of AF-PVS, the median pad usage had decreased to 1/day (p = 0.003). A third of the patients had postoperative urgency, and only 1 patient continues to use intermittent catheterization. The median IIQ-7 score was 19/100, and the median UDI-6 score was 44/100. Overall quality of life was mixed-to-delighted in 62% of patients.Conclusions: The AF-PVS has reasonable outcomes in a diversepopulation of patients, despite failure of other treatment modalities.

Subglottic haemangioma in children: experience with open surgical excision

2006 ◽  
Vol 120 (12) ◽  
pp. 1033-1037 ◽  
Author(s):  
Y Bajaj ◽  
B E J Hartley ◽  
M E Wyatt ◽  
D M Albert ◽  
C M Bailey
Keyword(s):  
Surgical Excision ◽  
Treatment Modalities ◽  
Direct Result ◽  
Tertiary Referral Centre ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Stop ◽  
Open Excision ◽  
Subglottic Haemangioma

Subglottic haemangioma is a potentially life-threatening condition for which various treatment modalities are available. The objective of this study was to evaluate our results for open excision of subglottic haemangioma. The study assessed 18 patients who had been treated at a paediatric tertiary referral centre. Most of these patients (83.3 per cent) had undergone open surgical excision without post-operative tracheostomy and had been intubated for several days post-operatively (single-stage procedure). In most of these patients (66.7 per cent), an anterior cartilage graft had been used for reconstruction. The average follow up in this study was 25 months. All the patients in this series had achieved an adequate airway after the procedure. One patient had developed a recurrence of haemangioma in the trachea at a later date. The results of open surgical excision in this study were very encouraging. Seventeen out of 18 (94.4 per cent) patients had avoided tracheostomy or had been decannulated as a direct result of surgery. One of these 18 patients (5.6 per cent) had required a temporary post-operative tracheostomy for 13 months as the subglottis cleared; this was classed as a partial success. Our experience is that open excision is a highly successful ‘one stop’ treatment for subglottic haemangioma, which avoids prolonged use of steroids and multiple endoscopic procedures. No patient in this series developed subglottic stenosis, which can be a significant complication of laser application.

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