Pricking Pain Research Articles

Ayurveda management of Savrana Shukla (superficial punctate keratitis): a case study

Abstract Savrana Shukla is one of the Krishnagata Rogas (corneal pathologies) mentioned in Ayurvedic texts. The Lakshanas of Savrana Shukla can be correlated with the clinical features of superficial punctate keratitis. Superficial punctate corneal keratitis is characterized by multiple, spotty lesions in the outermost layer of the cornea. A 30-year-old male approached the Shalakya Tantra outpatient department with complaints of foreign body sensation, mild pricking pain, redness, and watering of the left eye for 4 days. On history taking and slit lamp examination, it was revealed that the patient had superficial punctate keratitis due to trichiasis. Seka (pouring medicine on the closed eyes) and Vidalaka (application of medicated paste on the outer part of the eyes) were given as treatment for 5 days and epilation was done considering the cause (trichiasis). The subject had significant improvement for both subjective and objective parameters. The clinical features in this subject correspond to Prathama Patala Savrana Shukla Lakshanas (epithelium and Bowman’s membrane involvement) and are Sadhya (curable) according to Acharya Vagbhata. This case report highlights the efficacy of Kriyakalpa treatments in managing Savrana Shukla.

Comparative Clinical Evaluation of Kolakulatthadi Churna Upanaha and Eranda Taila Pana in Plantar Fasciitis (Vatakantaka)

Pada (foot) being one of the Karmendriya, most of the activities of day today life depends on this any problems of foot adversely affect the routine of an individual. Plantar fasciitis is the most common cause of heel pain.There is very less references available regarding Padagata vyadhi in Samhitas but amongest Vatavyadhi , Vatakantaka is one condition which affects the foot of a person. Vatakantaka is a Vata Pradhana Vyadhi particularly caused by walking on uneven surfaces or by Atishrama, which produces pain in Khuduka Pradesha (Paarshni or Padajanghasandhi). Except Charaka Acharya, all Bhruhatrayee’s and Laghutrayee’s accepted Vatakantaka as Vata Nanatmaja Vyadhi. Patients suffering with Vatakantaka experience severe pricking (Kantakavath) pain in Padatalapradesha. With this pathology and clinical presentation Vatakantaka can be effectively paralled with plantar fasciitis. Pathology reveals chronic inflammation of plantar fascia and degeneration of fibrous tissue with or without fibroblast proliferation. Thus, with the intention of identifying and creating an alternative, safer, effective and long-lasting therapy, the study titled “A Comparative clinical study to evaluate the efficacy of Kolakulatthadi Churna Upanaha and Eranda Taila Pana in Vatakantaka (Plantar fasciitis)” was carried out on 40 patients. They were divided randomly into two groups of 20 patients each. The treatments were successfully completed by 18 patients in Group A (Kolkulatthadi Churna Upanaha) and 19 patients in Group B (Eranda Taila Pana).

Ayurvedic management of acute calcaneal spur with Viddhakarma and Siravedha: A case report

The feet are a highly dependent yet most neglected part of the body. The negligence may result in various levels of discomforts and associated heel pain. Abnormal pressure over foot muscles and ligaments may lead to chronic plantar heel pain and further development of calcaneal spur, which are the most encountered orthopedic problems. Various modern treatment options are available for the management of calcaneal spur, but either they involve longer duration or are expensive. Hence, there is a need to opt treatment approaches that may provide satisfactory results with minimum adversities. Viddhakarma (~therapeutic needle-piercing) and Siravedha (~therapeutic bloodletting) are the therapies of Ayurveda origin, with proven efficacy in pain management and can be used in conditions such as calcaneal spur. A 42-year-old female patient presented to the outdoor patient department in the hospital on August 17, 2022, complaining of sharp pricking pain with heat sensation in the right heel, morning stiffness in bilateral heels, and difficulty in walking for four days. On assessment, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), and Foot Function Index Scale for the right foot of the patient were scored 47, 9 and 127, respectively. The X-ray of the bilateral foot (anterio-posterior and lateral view) showed an inferior bony spur projecting forward from calcaneal tuberosity more on the right side than on the left. The patient was treated with Viddhakarma, Siravedha of the right foot, along with oral Ayurvedic medicines. On completion of the treatment, the WOMAC and VAS scores were reduced significantly to 37 and 6, respectively. Further, there was a significant reduction in the Foot Function Index scale score to 96 within ten days of the treatment. Based on the clinical observations, it may be inferred that a combination of Viddhakarma, Siravedha, and oral Ayurvedic medicines can be safe, convenient, and effective in managing patients suffering from calcaneal spur. Both of these procedures can be performed by trained health-care professionals on an outpatient basis, thus convenient to the sufferers too.

Comparative study to evaluate the efficacy of Madhutailik Basti in comparison to Lekhana Basti in the management of Sthaulya (Obesity)

Obesity is a chronic disease, increasing globally and is characterised by excess body fat. As a preventable cause of death, obesity is second only to smoking. Obesity is a potent co-morbid risk factor for mortality and morbidity, if it remains untreated. It emerges as an important health problem in India. It is estimated that 31.6 million Indians are obese, specially abdominally obese. Obesity is the primary driver of non-communicable diseases, like diabetes, cardiovascular diseases, disabilities like osteoarthritis and even cancer. In Ayurvedic texts, Sthaulya is categorized as Santarpanjanya Roga. Lekhana Basti is a well-known treatment for Sthaulya in Ayurveda and lot of research work has done in the past but it is not suitable for all Sthula Purusha because of its Tikshana nature. Many complications like abdominal pain or pricking pain in anal region, bleeding per rectum were observed practically. In the present study, Lekhana Basti and Madhutailik Basti were selected for Sthaulya. Sthaulya is Kapha-Meda Pradhana Vyadhi with Medavritta Vata. The drugs of Madhutailik Basti have Ushna Virya and Kapha Vatahara property. So, it regulates the Samana Vayu and restores the “Jatharagni” to normal, while also activating the Vyana Vayu to break the Srotosanga and synergize the activity of Madhutailik Basti at the cellular level. Thus, it helps to break the pathogenesis of the disease. Considering the above facts case study was planned to evaluate the comparative effectiveness of Madhutailik Basti with Lekhana Basti in the management of Sthaulya (obesity) in 60 clinically diagnosed and confirmed cases of Sthaulya from OPD of Ch. Brahm Prakash Ayurved Charak Sansthan, Khera Dabar, Delhi.

Extraluminal migration of fish bone to the thyroid gland

Extraluminal migration of a foreign body in the oesophagus is rare. It can result in life-threatening complications as it can migrate anywhere causing injury to vital vessels and structures in the neck region. The patient’s outcome depends on prompt diagnosis and early intervention. We present a case of a 52-year-old female with a complaint of sharp pricking pain in her throat with a history of fish bone ingestion one-day prior. Direct laryngoscopy and oesophagoscopy failed to localise the foreign body and the symptoms persisted for 3 days. Computed tomography scan confirmed a foreign body located between the right carotid sheath and the right thyroid gland. We proceeded with neck exploration and successfully removed the foreign body. Multiple difficulties were encountered in localising the foreign body as its location differed from the one in the initial computed tomography scan.

Management of Pilonidal Sinus Disease with Homoeopathy: An Evidence- Based Case Report

Abstract: Pilonidal disease is an infection that occurs beneath the skin in the gluteal cleft just above the anus. It affects 7% of the population. In conventional mode of treatment there are several surgical or non-surgical treatments available but with high recurrence rate and post-surgical complications. Owing to the limited therapeutic efficacy of conventional treatment for PSD, an alternative approach is warranted. In this case, A 25years male patient attended OPD with pricking pain and oozing of foul-smelling discharge from three orifices above anus at sacral region since last 1 year. He had occasional reddish rash in sinus tract region. Based on his clinical symptoms and physical examination we diagnosed the case as Pilonoidal Sinus Disease. After thorough case taking, evaluation and analysis of the case the patient was prescribed Graphites and a marked improvement was noticed. Complain resolved within 1 and a half month and the patient was followed-up for one year with no recurrence. As this is a type of disease condition, where patient suffer due to pain and discomfort affecting his daily life leading, outcome-related to impact on daily living (ORIDL) Scale was used to evaluate the improvement. The MONARCH was used to assess the possible causal attribution.

Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China.

Self-monitoring of blood glucose (SMBG) plays a vital role in the maintenance of blood glucose with type 2 diabetes mellitus(T2DM) and pre-diabetes patients. The study was intended to describe the current status of SMBG with T2DM and pre-diabetes patients in grassroots communities, explore the relationship between SMBG frequency and blood glucose level and apply information-motivation-behavior(IMB) model to analyze the potential influencing factors of SMBG compliance based on electronic questionnaires. A cross-sectional study was conducted with 1388 T2DM and pre-diabetes patients who completed electronic questionnaires composed of demographics and IMB model content. Chi-square test, Mann-Whitney U test and multivariable logistic regression model analysis were utilized to explore deeply causes of SMBG compliance. The results of this study showed that among 1388 T2DM patients, only 26.2% (363/1388) patients reached SMBG standard, indicating low compliance with SMBG. Given that SMBG is one of the individual predictors of type 2 risk in prediabetes patients, this result suggests that the SMBG compliance rate needs to be improved. Patients with fixed occupation (OR=1.989, P=0.035), BMI in normal range (OR=1.336, P=0.049), smoking habit(OR=1.492, P=0.019), understanding SMBG frequency (OR=1.825, P<0.001), understanding control goal of blood glucose (OR=1.414, P<0.001), knowing all the functions of the blood glucose meter (OR=1.923, P<0.001), buying a blood glucose meter/test paper conveniently(OR=2.329, P=0.047), taking supplementary measurement when forgetting blood glucose test(OR=2.044, P=0.005), rotating all the fingers when measuring blood glucose (OR=1.616, P<0.001) and less pain at the needling site(OR=2.114, P<0.001)were independently promoting factors of adherence to SMBG. However, the lack of accessibility and convenience of blood glucose meter or heavy financial burden were blocking factors ofadherence to SMBG. Moreover, there were still bottlenecks such as lack of health care knowledge and needle pricking pain. This study verified the practicability of applying IMB model to SMBG with T2DM and pre-diabetes patients. Adherence to SMBG still remained to improved, and putting more emphasis in improvement of individual information, motivation and behavioral skills with patients might be beneficial to maintain better adherence to SMBG in long-term routine of diabetes self-management.

A randomized placebo-compared study on the efficacy of classical ayurvedic pharmaceutical form versus aqueous alcoholic extracts of Phyllanthus niruri Linn. Plus Sida cordifolia Linn. in patients of diabetic sensory polyneuropathy

BackgroundIn routine, Ayurveda practitioners prefer classical pharmaceutical form of herbal medicines in compare to modern extracts. ObjectiveTo explore the difference of efficiency between whole drug powder of Phyllanthus niruri plus root decoction of Sida cordifolia and modern extracts of the same in compared to placebo in patients of diabetic poly-neuropathy. Material and methodsA randomized, partly-double-blinded, placebo-controlled trial evaluated the efficacy of two different pharmaceutical forms of herbal medicines over placebo in 90 patients (30 in each group) of diabetic sensory polyneuropathy for first three weeks period. After three weeks, active herbal medication groups were continued with their assigned medicaments for next 5 weeks period and all placebo-patients were randomized again into 2 groups of active medication and treated for next 8 weeks. Patients were assessed with Neuropathy Total Symptom Score 6 and sensation thresholds. ResultsSignificant effect of both form of herbal medicines over placebo was found in aching pain [F (2, 49) = 6.79, p = 0.002], allodynia [F (2, 59) = 6.74, p = 0.002], burning pain [F (2, 82) = 14.66, p < 0.0001], numbness [F (2, 77) = 16.37, p < 0.0001] and pricking pain [F (2, 50) = 14.23, p < 0.0001]. After the 8 weeks period, no significant difference was identified between the effect of both the herbal treatment on aching pain (U = 220, p = 0.03), allodynia (U = 421.5, p = 0.29), burning pain (U = 881.5, p = 0.846), numbness (U = 778, p = 0.92) and pricking pain (U = 260, p = 0.15). ConclusionBoth herbal groups have significant effect to reduce NTSS-6 score in compare to placebo. No significant difference found between the effect of two different pharmaceutical forms of Phyllanthus niruri and S. cordifolia.

Ayurveda treatment as black box design in the management of Visarpa- Retrospective case study

Visarpa is one of skin disease explained by most of the Acharyas. A 24-years old female came to Panchakarma OPD of Dhanvantari Ayurveda College Hospital and Research Centre, Siddapur, Uttara Kannada. With the complaints of blisters on the right-side of neck, severe burning sensation, itching, severe pricking pain, redness, pus formation for 3 days. She was successfully treated with external applications and internal medications with Tikta (bitter), Kashaya (astrigent) and Sheeta (cool) drugs. This case study demonstrates that acute condition of Visarpa can be managed well in short duration with Ayurvedic medicines.

MANAGEMENT OF ARDHAVABHEDAKA (MIGRAINE) WITH ANUTAILA NASYA: A CASE STUDY

Ardhvabhedaka (migraine without aura) is characterized by severe tearing, pricking and piercing pain in one half of the head and giddiness which develops suddenly after ten days or a fortnight. Based on signs and symptoms it may correlate with migraine characterized by half sided headache associated with nausea, vomiting, photophobia and Phonophobia. The current line of management for migraine advocates the use of analgesics and antiemetic’s, vasoconstrictors, sumatriptan, topiramate, flunarizine, Propranolol. Ayurveda emphasizes various treatment modalities of Ardhvabhedaka, includes both Shodhana and Shamana. Nasya is one among them. In this study, A 45 year old female patient visited our OPD complaining of left half side headache associated with Phonophobia, vomiting and photophobia since 2 years. She was treated with local and oral analgesic medicine for which she did not get relief. We treated this case with anutaila Nasya and patyadikhada orally for 7 days along with Patya- Apathy. Patient was happy with the treatment.

A COMPARATIVE CLINICAL STUDY OF ISHTIKA SWEDA AND NADI SWEDA ALONG WITH RASNADI GUGGULU IN THE MANAGEMENT OF VATAKANTAKA

Vatakantaka is one of the Vata Vyadhi which gives pricking pain in the heels and causes discomfort in the day-to- day activities. It can be co-related with Calcaneal Spur. It is caused due to wearing high heels and walking with bare feet. Among the various treatment modalities, Abhyanga and Sweda is the best treatment for Vata vyadhi. Hence the present study brings to light the role of Swedana along with Rasnadi Guggulu in the management of Vatakantaka. To evaluate the effect of Istika sweda over Nadi Sweda along with Rasnadi guggulu in management of Vatakantaka. In the present study, 40 patients of vatakantaka were selected incidentally and placed randomly into two groups A and B, with 20 subjects in each group. Group A was treated with Istika Sweda, and Group B were treated with Nadi Sweda along with Rasanadi Guggulu as shamanoushadi for both groups. The effects of treatment provided to the subjects of both groups were significant. Both the treatment methods of Ishtika Sweda and Nadi Sweda showed equally significant effects in the subjects involved in a clinical study. Keywords: Vatakantaka, Calcaneal Spur, Ishtika sweda, Nadi sweda, Rasnadi guggulu.

Comparative study between medial canthus episcleral block versus peribulbar block in intracapsular cataract surgery

BackgroundOphthalmic regional anesthesia is now the most common anesthetic technique used for eye surgeries. There are various modes of needle-based ophthalmic anesthesia which are retrobulbar, peribulbar, and episcleral. The sub-Tenon episcleral anesthesia technique became a potential alternative to the retrobulbar and peribulbar anesthesia in most of the anterior and posterior segment eye surgeries; this is due to its better safety profile and tolerability than the other blocks. The aim of this study was to compare between medial episcleral block and peribulbar block in intracapsular cataract surgery as regards anesthesia and akinesia of the eye, the need of supplementation of local anesthetic, and finally the safety profile of each block. This was a prospective, comparative, randomized, double-blinded clinical study. It was carried out on 60 patients that were scheduled for intracapsular cataract surgery in ophthalmic surgery unit. The patients were randomly allocated into two equal groups; group A received medial canthus episcleral block technique and group B received peribulbar block technique.ResultsResults of this prospective, comparative, randomized, double-blinded study showed no statistical difference between the two groups as regards demographic and vital data. As regards Akinesia score, the ESA group had better akinesia score at 1, 5, and 10 min and at the end of surgery than PBA group (P value, 0.001). No patient in the ESA group received supplemental injection via inferotemporal peribulbar block technique, while 66.7% of PBA group was in need of supplementation. Regarding time to onset of acceptable akinesia score; ESA group had a faster onset with high statistical significance (P value, 0.001). Numeric pain scale was better in ESA group than PBA group with high statistical significance. There were chemosis after injection in two of the ESA group (6.6%). On the other hand, slight pricking pain at the end pf surgery developed in two cases in the PBA group.ConclusionMedial canthal episcleral technique proved to be superior in motor akinesia score, time to onset of acceptable akinesia score, and numeric pain scale in comparison to peribulbar anesthesia with high statistical significance between the two groups. Both techniques proved to be safe with no incidence of major complications.

Effect of pre-cooling agent on intensity of pricking pain at intraoral injection site in adults: An experimental study.

To determine the effect of pre-cooling agent on the intensity of pricking pain at the intraoral injection site in adult patients. The in-vivo interventional study was conducted at the Department of Operative Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from September 2018 to August 2019, and comprised adult patients of either gender. The pricking pain perception during needle administration was assessed using split-mouth technique. Topical anaesthesia benzocaine gel was applied on the left side, which was treated as controls, for 1 min, while on the right side, which was treated as the experimental side, refrigerated cartridge was placed for 2 min. Infiltration anaesthesia was then administered on both sides. Pain perception ratings were measured through visual analogue scale. After profound anaesthesia was achieved, restorative treatment was performed under rubber dam isolation. Data was analysed using SPSS 24. Of the 152 subjects, 77(50.65%) were females and 75(49.34%) were males. The overall mean age was 35.97±8.669 years (range: 21-50 years). The effect of refrigerated cartridge was significant on the intensity of pricking pain at the intraoral injection site in patients aged 41-50 years, and in female patients aged 21-30 years (p<0.05), whereas its effect was non-significant in males aged 21-30 years and patients aged 31-40 years (p>0.05). Pre-cooling agent was found to be effective in decreasing pricking pain felt by patients.

Comparative evaluation of the effectiveness of the two herbal desensitizing toothpastes in the relief of dentinal hypersensitivity

Background: Dentinal hypersensitivity is a sharp pricking pain occurring on exposure of the dentinal surface to the external stimuli such as hot, cold, air, tactile, and chemical. This study was conducted to compare the effectiveness of two herbal desensitizing pastes in the relief of dentinal hypersensitivity at different time intervals. Materials and Methods: Forty subjects (with two teeth per patient) were considered for this study and randomly divided into two groups: Group 1: Hiora K, herbal desensitizing toothpaste and Group 2: Dant Kanti medicated desensitizing toothpaste. Using tactile stimulus and air stimulus, the sensitivity scores were recorded on visual analog scale immediately, then at 2 weeks, and then at the end of 4 weeks and compared. Results: There was no significant difference in the distribution of tactile sensitivity score and air blast sensitivity score at baseline, immediately after application, after 2 weeks, and after 4 weeks between Groups 1 and 2. Statistical Analysis: Chi-square test was used for statistical analysis. Conclusion: Desensitizing pastes can be used as a safe, economical, and effective option in the management of dentinal hypersensitivity.

A STUDY ON LITERATURE REVIEW OF DRY EYE SYNDROME IN AYURVEDA W.R.T. SHUSHKAKSHIPAKA

Dry eye is a common ocular disease with a wide variety of symptoms due to multifactoral and elusive etiology. With a global prevalence ranging from 20 to 50%, dry eye disease (DED) is a significantly growing health problem worldwide. When symptoms of dry eye are analyzed, the disease that have striking similarity to dry eye, is Shuskakshipaka described by Acharyas Vagbhata and Sushruta in Sarvagat Netraroga. The commonest ocular symptoms are feeling of dryness, grittiness, foreign body sensation, itching, redness, photophobia, burning and pricking pain which gradually worsen over the course of day. Stringy discharge, transient blurring vision and crusting of lids are also common. Eventually symptoms worsen the condition of ocular surface and causes erosion and inflammation of lids, conjunctiva and cornea. Symptoms are timely relieved with the help of lubricating eye drops. In Ayurveda local treatment therapies like Ashchyotan, Parishek, Tarpan etc are performed. If not treated timely, there may be vision threatening complications, epithelial breakdown, ulceration, bacterial keratitis, trichiasis, keratinization, symblepheron, corneal perforation and melting. In recent times focus on treating the underlying cause of dry eye instead of conventional local treatments for symptomatic relief is highly considered by researchers studying xero-dacryology. In light of above knowledge, the present article focuses on evaluation of risk factors contributing to dry eye, pathophysiology and management of dry eye syndrome in terms of ayurveda.

AN OPEN LABELLED CLINICAL CONTROL STUDY TO EVALUATE THE EFFICA-CY OF VIDANGADI ARKA NASYA IN THE MANAGEMENT OF ARDHAVABHEDA-KA (MIGRAINE WITHOUT AURA)

Background and Objective: Ardhavabhedaka (migraine without aura) is characterized by severe tearing, pricking and piercing pain in one half of the head and giddiness which develops suddenly after ten days or a fortnight. Based on signs and symptoms it may correlate with migraine characterized by half sided head-ache associated with nausea, vomiting, photophobia and phonophobia. The current line of management for migraine advocates the use of analgesics and antiemetics, vasoconstrictors, sumatriptan, topiramate, flunar-izine, Propranolol. Ayurveda emphasizes various treatment modalities of Ardhavabhedaka, includes both Shodhana and Shamana. Vidangadi avapeedana Nasya and Vidangadi arka (distillate) Nasya have been mentioned for ardhavabhedaka chikitsa. Arka is the essence of the drug; possesses laghu, ushna, kaphavatahara, increased potency, more shelf life, easy absorption and act fast. Materials and Methods: 20 patients of Group A were treated with Vidangadi Arka Nasya and Group B 20 patients were treated with Vidangadi Avapeedana Nasya (each nostril 6 drops for 7 days). Results: The data of both the groups were collected according to the objective and subjective Parameters and analyzed using repeated measures of ANOVA, Bonferroni test, and Mann- Whitney U Test. The efficacy was statistically highly significant with-in the group at P &lt;0.001and statistically insignificant between the group at P &gt;0.05 among all the parame-ters. Interpretation and Conclusion: Study can be concluded that patients treated with Vidangadi Arka and Avapeedana Nasya showed not much difference in the results statistically, clinically group A showed better results than group B.

Quantitative Analysis of Cardamon and Fennel Combination

A Cardanon and Fennel combination is a traditional Chinese herbal formula for treating chi and blood - associated pricking pain. The formula is composed of Cinnamomi Ramus, Amomi Semen, Corydalis Tuber, Alpiniae Officinari Rhizoma, Ostreae Testa, Glycyrrhizae Radix, and Foeniculi Fructus. With the aid of high - performance liquid chromatography, we used cinnamaldehyde, coumarin, cinnamic acid (from the imperial component herb Cinnamomi Ramus), and glycyrrhizin (form the servant component herb Glycyrrhizae Radix) as the indicative constituents for the assessment of the quality of Chinese herb preparations and also for investigating the influences of different herb combinations, different doses, and different processed samples to the whole formula. Experimental data showed that when boiled in water, the formula yielded very little essential oil extract which, after concentration, this resulted in loss of more oil. Extractives of coumarin and cinnamaldehyde from Cardamon and Fennel combination which contains Cinnamomi Ramus were higher than from Cinnamomi Ramus decocted alone. The addition of Cinnamomi Cortex produced a contrary effect. Both preparations gave rise to greatly different results. The addition of Ostreae Testa changed the solution's pH value and promoted the extraction yields of cinnamic acid and glycyrrhizin. Absence of Gly cyrrhizae Radix or Cinnamomi Ramus caused reduction in the individual indicative constituents. Whereas, subtracting Foeniculi Fructus from the formula resulted in a marked increase in the extractives of the various constituents, and the addition of processed Cinnamomi Ramus produced a comprehensive influence of the chemical constituents. Differences in the drug materials selected, component combinations, and manufacturing processes produced marked differences in the constituent yields. Hence, there is a great difference found between commercial herbal products and laboratory-made counterparts.

The Benefits of Radical Laparoscopic Surgery and a Modified Endometriosis Health Profile-36 (EHP-36) on Quality of Life

Objective: This study investigates the outcomes for women up to 2 years after radical laparoscopic excision of endometriosis, and its effect on quality of life (QoL) and wellbeing using a modified Endometriosis Health Profile-36 questionnaire (EHP-36). Design: A prospective cohort clinical study. Setting: Robert Karoly Hospital, Budapest, Hungary, Endoscopic Unit. Population: Eighty-seven patients with proven investigative signs, symptoms and complaints of invasive endometriosis undergoing hysterolaparoscopic surgery in the hospital between 1 January 2017 and 31 December 2018. Method: This study proscribes the use of questionnaires on patient’s quality of life and wellbeing with postoperative follow-up (for 6, 12 and 24 months). Result: All 87 patients completed the questionnaires (response rate was 100%). Mean age was 34.2 ± 5.9 years; the average age of onset of endometriosis was 24.5 ± 5.710 years (15–37). The majority of patients (n = 65, 74.7%) were in stages III and IV. A total of 72 patients (82.76%) frequently described their pain as a pricking pain. The NRS-11 pain score reduced from 94.8% with moderate to severe pain preoperatively to 18.4% with mild pain postoperatively. There was a significant improvement in the QoL in this regard (p <0.001). The VAS pain score decreased from 8 ± 2.11 (86.0%) moderate to severe pain preoperatively to 0.47 ± 1.24 (93.1%) negligible to no pain postoperatively (p <0.001). 58.45% (32/61) of women with infertility, became pregnant, live birth was 77.4% (24/61). Perception of QoL before surgery as very bad in 89.6% (78/87) of women and the perception of QoL significantly improved in 93.1% (81/87) of women after surgery. General wellbeing was rated very low by 93.1% (81/87) of women before surgery. Postoperative general wellbeing rated very well or good in 94.2% (82/87) of women. Significant improvements observed in sexual life with 77.85% (75/87) and 74.7% (65/87) of women rating it as good or very good (p <0.001), respectively. Conclusion: Meticulous individualized radical laparoscopic surgical intervention showed tremendous improvement in patient wellbeing and QoL.

Comparative evaluation of a novel herbal anesthetic gel and 2% lignocaine gel as an intraoral topical anesthetic agent in children: Bilateral split-mouth, single-blind, crossover in vivo study

Topical anesthetics have an intrinsic part to reduce pricking pain sensation due to needle stick before injection in children. The present study aimed to determine the effectiveness of a novel herbal anesthetic gel used as a topical anesthetic before an inferior alveolar nerve block. This was a bilateral split-mouth, single blind, crossoverin vivo study. Atotal number of 30 children were selected for this study design. After the application of the topical anesthesia, a 26-gauge needle was inserted in the mucobuccal fold and local anesthetic solution was deposited. Assessment of pain perception was done before the procedure and at the time of needle penetration using hemodynamic parameters such as blood pressure and heart rate. The objective and subjective pain assessment was recoded through sound eye motor scale and Faces Pain Scale-Revised (FPS-R). As the data followed a normal distribution, parametric tests were used to analyze these data. The independent sample t-test and paired sample t-test were used to check the mean differences. The data showed no statistically significant differences in the objective and subjective pain assessment values of the novel herbal anesthetic gel compared to the 2% lignocaine gel. However, the intragroup comparisons of the before and during treatment results showed statistically significant results (P < 0.05). The novel herbal anesthetic gel was effective and safe in reducing the pain from needle insertion. Thus, setting up scientific evidence for the therapeutic usage of herbal products can, therefore, assist to develop a more efficient and alternative topical anesthetic.

Efficacy of Pathyaksha Dhatryadi Kashayam Tablet and Godanthi Bhashma on Ardhavabhedaka with special reference to Migraine

As per the classical texts of Ayurveda, Ardhavabhedaka is a one of Shirakshoola caused by all the three Doshas causing severe tearing and pricking pain in half of the head, with nausea, vomiting and piercing pain suddenly after a fortnight. Migraine is a kind of powerful headache that usually presents with nausea, vomiting and sensitivity to light. Most people start having migraine headache between ages 10 and 40.They generally lasts between 4 to 72 hours. .A 30-year-old female patient presented with 5 years history of migraine was treated with Pathyaksha Dhatryadi Kashayam tablet and Godanthi Bhashma for 4 weeks and follow up 7 months. The clinical presentation of patient was recurrent attack of headache, nausea, vomiting, difficult to engaging of day to day work and photophobia. She has taken abortive and preventive treatment in regular basis but no improvement was reported. The patient was treated for one month with these medicines. Terminalia chebula, Terminalia bellirica, and Embilika officinalis have properties of Kapha and Pitta balancing and also Vata Anulomana. Andrographis paniculata, Azadirachta indica, and Tinospora cordifolia have Pitta Nashaka property. Curcuma longa is an excellent anti-inflammatory drug. Godanthi Bhashma has coolant properties and preferred in the treatment of Pitta imbalance disorders. Progress of the treatment was recorded and therapeutic effects were evaluated through symptomatic relief using ICHD (International Classification of Headache Disorder). It can be concluded that these regimen is effective in treating Ardhavabhedaka (Migraine) by reducing symptoms and reducing the recurrence of the disease.