EFFECTIVE MANAGEMENT OF VATALA YONIVYAPDA W.S.R ENDOMETRIOSIS BY AYURVEDA: A CASE REPORT

Background: A married Hindu female patient of 44 years of age visited OPD of National Institute of Ayurveda, deemed to be university, Jaipur on 30 December 2020. She was having chief complaint of extreme and unbearable pain starting 2-3 days before menstruation and continuing in her menstruation also. Methodology: On reviewing her laboratory investigations (USG) she was diagnosed with Endometriosis. On de- tailed history, Dosha assessment was done based on the clinical features and mainly Vata Dosha was found to be vitiated in the present patient. Considering this, she was diagnosed with Vatala Yonivyapada, and treatment was given to her based on the line of treatment explained for Vatala Yonivyapada in classics. Result: Patients showed complete relief in extreme pain during menstruation in the very 1st first cycle following treatment and she is having complete relief in pain to date. Keywords: Vatala Yonivyapada, Endometriosis, Dysmenorrhea

Clinical case of multisystem inflammatory syndrome development in a child with new coronavirus infection

Objective: The article deals with a clinical case of new coronavirus infection in a 1 5-year-old child who was receiving treatment in an infectious diseases hospital of City Children's Clinical Hospital №3 during the period from 1 0 October to 1 December 2020.Materials and methods. The diagnosis was confirmed through nasal swabs examination for the presence of SARS-CoV-2 RNA using PCR and SARS-CoV-2 IgM detection through ELISA.Results. The main feature of the infection course in the present patient was multisystem inflammatory syndrome development with long-term fever, maculopapular rash and multisystemic lesions including bilateral pneumonia, acute carditis and polyserositis.

A case of traumatic isolated duodenal perforation due to blunt abdominal trauma

Isolated duodenal injury following blunt abdominal trauma is a rare clinical entity and is often unnoticed leading to delay in management thereby increasing morbidity and mortality. We report a case of isolated duodenal perforation following blunt abdominal trauma and highlight the challenges and decision-making dilemmas associated with its management. The present patient had two perforations, one on the anterior and the other on the posterior wall of the duodenum. Complete duodenal mobilization during laparotomy and a decision of performing pyloric exclusion aided momentously in the management.

Treating Tourette Together: An Agenda for Patient-Centered Research Focused on Comprehensive Behavior Therapy for Tics

Tourette Syndrome and other persistent tic disorders (TDs ) involve chronic, repetitive, unwanted movements and/or sounds (i.e., tics) that can cause substantial distress and disruption in everyday activities. Effective medications for treating TD exist, but, in many cases, they cause significant side effects that limit their usability. Comprehensive Behavioral Intervention for Tics (CBIT) is a therapy that teaches tic-management skills to reduce tic frequency and interference. Large, controlled research studies have shown that CBIT reduces tics in children and adults about as much as medications, but without significant side effects. However, at present, patient demand for CBIT exceeds availability, and many patients do not have access to a local CBIT provider. Also, a smaller percentage of patients perceive CBIT to be a poor fit for their specific situation. Researchers have been exploring options to make CBIT more available and to tailor it to different settings, but patient, family, and other stakeholder input is essential to understand how to do this most effectively. We established the “Treating Tourette Together” project to bring together patients, clinicians, researchers, and other stakeholders to develop an agenda for a new generation of patient-centered CBIT research. In this report, we describe the Treating Tourette Together project and the resulting research agenda.

Graves hyperthyroidism in pregnancy: a rare presentation

Hyperthyroidism in pregnancy is much less common occurring in 0.1-0.2% of women with Grave’s disease being the most common cause accounting for 90% of the cases. It is important to diagnose hyperthyroidism in pregnancy because fetal loss in untreated patients is high and may even be life threatening for the mother. We are presenting a case of 29 years old G3P2L1 who presented to our emergency with amenorrhea of 7 months and history of loose stools for the last 20 days. It was associated with generalized weakness. She also had history of palpitations, weight loss and sleep disturbances. She was a known case of hyperthyroidism for the past 1-2 years and was already taking anti-thyroid drugs. B/L exophthalmos was apparently present. Patient was severly anaemic with haemoglobin of 5.5gms/dl. Ultrasound showed fetal demise at 28weeks. Patient was given 3 units of blood transfusion and was induced with prostaglandins. She delivered a dead male baby weighing 1.2kgs. Her postpartum period was uneventful. Timely diagnosis of graves hyperthyroidism and its optimal treatment throughout pregnancy is vital in reducing maternal, fetal and neonatal complications.

A korkorrigált fejkvóta (kapitáció) a háziorvosi (alapellátási) finanszírozás alapja

The health care renumeration poses a great challenge for both politicians and policymakers. During the beginning of the 1990s, following the end of communism in Hungary, the reform of health care began with the introduction of the primary health care (PHC), specifically with general practitioner (GPP)/family medicine (FM) care. The basis of the renumeration was the age-adjusted capitation built upon the free choice of doctors, while social security renumeration was built on a mixed system. Several pros and cons have been highlighted, but the underlying principle has proved to be simple and effective. Comparison of the European and Hungarian characteristics, analysis of data in the present patient care report as well as in the years preceding the release of the aforementioned document, these confirm that the method of capitation-based remuneration is a fundamental, easy, and unmanipulable method. It places minimal weight on social security and comes with little costs. Orv Hetil. 2019; 160(27): 1057–1063.

Amiodarone Toxicity: A Case Report

Amiodarone is one of the commonly used drug in arrhythmias. It is first line of treatment for ventricular tachycardia particularly in treatment of supraventicular tachycardia like atrial fibrillation. Amiodarone has a wide range of adverse effects ranging from endocrine to cardiac system. A case of raised thyroid stimulating Hormone (TSH) with amiodarone was reported in our Adverse drug monitoring centre (AMC), in which several other adverse events such as raised raised billirubin and hyponatremia were present. Patient was treated with thyroxine while amiodarone along with atorvastatin and metoprolol were withdrawn. We present a case who developed subclinical hypothyroidism, electrolyte imbalance and liver dysfunction with amiodarone therapy.

Collision Tumor of Adenocarcinoma and Gastrointestinal Stromal Tumor in the Small Bowel

We report a very rare case of collision tumor composed of primary adenocarcinoma of the jejunum and gastrointestinal stromal tumor (GIST). The patient was a 63-year-old man who visited our hospital for epigastralgia and vomiting. Abdominal computed tomography revealed a mass in the upper jejunum, with gastric and duodenal dilatation. Endoscopy of the small bowel showed a circumferential tumor in the upper jejunum, which was diagnosed as primary adenocarcinoma by tissue biopsy. Thereafter, partial resection of the small bowel from the third part of the duodenum over the upper jejunum was performed. A tumor colliding with the primary adenocarcinoma was identified on the serosal side of the jejunum in the excised specimen and was histologically diagnosed as GIST. The annual incidence of primary adenocarcinoma of the small bowel (i.e., jejunum and ileum excluding the duodenum) has been reported to be 7 in 1 million people, and only 6 cases of collision tumor of the small bowel (i.e., duodenum: 5, ileum: 1) have been reported thus far. Although esophageal, gastric, and large intestinal collision tumors composed of primary cancer and GIST have been reported, to our knowledge, the present patient is the first case of the small bowel. The cause of or correlation between 2 tumors forming a collision tumor remains unclear. In the present patient, there was no pathological finding of infiltration between the 2 tumors. Although the collision of the 2 tumors was unclear, the findings indicate their independent development in closely located regions consistent with collision tumors.