Satisfactory Relief Research Articles

A ROLE OF AYURVEDIC MANAEGEMENT IN INSULIN DEPENDENT DIABETES MELLITUS: A CASE STUDY

Diabetes Mellitus is one of the of the most common non communicable or lifestyle disease globally. In Ayurveda this condition can be correlate with Madhumeha. It is one type of Prameha where the patient passes honey like urine. Prevalence of diabetes mellitus is rapidly rising throughout the world, where India leads with largest num- ber of diabetes. In Ayurveda Madhumeha is explained as Asadhya but also gives treatment for it. Ayurveda can be useful in the treatment of diabetes and associated complications. Sodhan and Shaman both are useful in the treat- ment of Madhumeha. A 64 years old male patient known case of Insulin dependent diabetes mellitus was visited in OPD of P. D. Patel Ayurveda Hospital, Nadiad. He had complaints of weakness, pain in both knee joint and shoulder joint with back pain since 10 years. Patient was on regular allopathic medicine for 10 year but he did not got any satisfactory relief in the sign and symptoms. His blood glucose level also not under control. He was treated for 28 days in I.P.D. treatment then after O.P.D. treatment also given. After treatment a significant improvement was noted in patient’s signs and symptoms. His blood glucose level also under control even after insulin therapy and hypoglycemic drugs were stopped. There was 80% relief after I.P.D. and O.P.D. treatment. Keywords: Diabetes, Madhumeha, Sodhan, Shamana, Blood glucose.

Endoscopic ultrasound-guided gastroenterostomy using an oroenteric catheter-assisted technique: a retrospective analysis

BACKGROUND : This study evaluated an oroenteric catheter (OEC)-assisted technique to distend the enteric loop for endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in patients with gastric outlet obstruction (GOO). METHODS : Patient outcomes were reviewed. Proximal enteric loops were filled with water via an OEC (7 Fr or 8 Fr), providing a target for EUS-GE using a lumen-apposing metal stent (15-mm caliber). Clinical success was defined as toleration of a non-liquid diet by Day 3. RESULTS : 42 patients (mean age 73.1 [SEM 2.8] years; 23 male) underwent EUS-GE for malignant (n = 37) and benign (n = 5) duodenal strictures. EUS-GE creation was successful in 41/42 (98 %), with mean procedure time of 36 (SEM 3) minutes and no serious complications. Clinical success was achieved in 39/42 (93 %) at 5.7 (SEM 2.6) months' follow-up. Of 14 patients who died, 13 (93 %) maintained oral intake until death. EUS-GE provided good symptom relief in all 28 surviving patients until follow-up. CONCLUSIONS : OEC-assisted EUS-GE provided satisfactory relief of GOO symptoms, with high technical success (98 %) and no serious complications.

Crop insurance in India: Status of PMFBY against different crop insurance schemes

Crop insurance has been implemented in the country since 1972, yet it has been beset with several problems such as delayed payment of claims, high premium, lack of transparency and delay in conducting crop cutting experiments etc. From these schemes none of them has been able to make a significant impact on farming system; as just 23.50 per cent of farmers were insured in kharif 2016. The existing relief and compensation criteria for farmers against crop loss was adhoc, messy and politicized and was ineffective to bring well-timed and satisfactory relief to affected farmers. This research article examines the cumulative performance of different crop insurance schemes implemented time to time. The claim premium ratio in First Individual Approach Scheme was 8.34, indicating that for every one rupee of premium collected; the scheme paid Rs 8.34 in claims. It shows high out go in the scheme. The benefits of CCIS were highly twisted towards few states and many more failures found in these schemes. Under PMFBY from kharif 2016 to kharif 2017, there has been a significant increase in the number of gross premiums (21 %), claims paid (64 %) and farmers benefitted (29%), respectively. The difference between gross premium and claim paid in the Kharif season has abridged and indicated a divergence in the data on the payout of claims and the profits made by private insurance companies. The new scheme revealed that overall area insured and farmers covered were decreased over the years from Kharif 2016 to Kharif 2018. On the other hand, there has been a significant increase in the number of gross premiums as 45 per cent. The PMFBY has therefore failed to achieve the targets, i.e. increasing the area and the number of farmers insured. The exclusion under the scheme are-risks and losses arising out of war and nuclear risks, malicious damage, theft, grazed and destroyed by domestic and wild animals.

Management of Palmo-Plantar Psoriasis by Classical Shodhan and Shaman Chikitsa- A Case Report

Background: Palmo-plantar psoriasis in a non-inflammatory skin condition in which it is capable to produce functional disability. It is the type of psoriasis which occurs in palms and soles together with features like scaling, erythema and itching, pustules cracked & pain, and is limited. Palmo-plantar is the disease which does not have a specific line of treatment, but can be assessed and treated with classical line of Ayurvedic management. This Palmo-plantar not only affects physically but also disturbs the mental health of patient In Ayurveda all the skin diseases are described under single topic; Kushtha (Skin disorders). As Palmo-Plantar psoriasis is compared with Vipadika Kshudra Kushta (cracked bilateral soles & palms) in Ayurveda, the predominant Dosha’s (fundamental bodily bio-elements) are Vata (governs movement of body & mind) & Kapha (controls immune system) in which Vaman Karma (Emesis) is useful. Aim: To evaluate the role of Ayurveda treatment modalities in Vipadika Kshudra Kushta. Materials & Methods: A case report of 56 year old male patient suffering from scaling of both palms and soles with severe pain since 16 years is presented in this article where the patient got satisfactory relief by adopting Shodhan Karma (purification treatment) followed by Shaman Chikitsa (pacifying treatment) with dietary and behavioral lifestyle modification. The symptoms were reduced by Vaman procedure. Result: Patient got about 80% relief after the treatment by which one can say that the palmo-plantar psoriasis can be treated by Ayurveda Medicine.

Clinical study of dienogest in the treatment of refractory endometriosis-associated pain

Objective: To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP). Methods: In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA125, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results: The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm (P<0.01), and CA125 level was significantly reduced from (95±139) kU/L to (38±45) kU/L (P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm (P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions: DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.

Long-term symptom severity in people with irritable bowel syndrome following dietetic treatment in primary care: A service evaluation.

Evidence suggests that dietary interventions can improve symptoms in people with irritable bowel syndrome (IBS), although most data explore the short-term (immediate) impact. Data on long-term (>6months) impact are limited, especially from primary care settings. The present study aimed to investigate the long-term effect of dietetic-led interventions for IBS delivered in primary care. A service evaluation of a dietetic-led IBS clinic was completed, analysing data on symptom severity, stool frequency and consistency, and healthcare input. Data were collected before and immediately after dietary intervention as part of patients' routine clinical appointments. Long-term data were collected via a postal questionnaire at least 11months later. In total, 211 patients responded to the long-term follow-up questionnaire at a median of 13months (interquartile range 12-16months) post follow-up appointment. Of these, 84% had been advised to follow a low FODMAP (i.e., fermentable oligosaccharides, disaccharides, monosaccharides and polyols carbohydrates) diet. All symptoms were reported significantly less frequently short term, and all except heartburn and acid regurgitation remained so over the long term. The four most commonly reported bowel symptoms reduced in frequency were abdominal pain (62%), bloating (50%), increased wind (48%) and urgency to open bowels (49%) (p<0.001). The percentage of patients reporting satisfactory relief of gut symptoms was 10% at baseline and 55% at long-term follow-up (p<0.001). Visits to a general practitioner were reduced (from 96% to 34%; p<0.001), as were those to the gastroenterologist (from 37% to 12%; p=0.002), during the year prior to long-term follow-up compared to the year prior to dietary intervention. Patients with IBS who received dietetic-led interventions in primary care reported long-term symptoms improvements that may result in reduced healthcare usage.

Comparison of Interface Pressures and Subjective Comfort of Pressure-Relieving Overlays on the Operating Table for Healthy Volunteers.

(1) Background: Pressure ulcers in the hospital setting occurring within 72 h after surgery are called perioperative pressure injuries. The aim of this study was to provide data for the prevention of perioperative pressure injuries following the use of pressure-relieving overlays by measuring the interface pressures and subjective comfort. (2) Methods: This study is based on a repeated measures design. The subjects included 30 healthy volunteers aged 18 to 57 years. Interface pressures of the sacrum and both heels were measured in the supine position, and the subjective comfort was evaluated with visual analog scale after applying polyurethane foam, gel pad, and egg crate foam for relief. (3) Results: The pressures in the sacrum and both heels were the lowest with polyurethane foam, and the subjective comfort was the highest. (4) Conclusions: Inexpensive polyurethane foam with satisfactory pressure relief is recommended as an overlay for surgical patients.

Laparoscopic approach for intermittent hydronephrosis caused by primary ureteral fibroepithelial polyps in children

ObjectiveTo summarize the diagnosis and treatment experience of children with intermittent hydronephrosis caused by ureteral fibroepithelial polyp (UFP).MethodsFrom 2017 to 2020, cases of hydronephrosis caused by ureteral polyp in Anhui...

Sex-Gender Differences in the Effectiveness of Treatment of Irritable Bowel Syndrome: A Systematic Review.

BackgroundIn recent years, research on sex-gender differences in health care has increasingly recognized that men and women differ in the way symptoms occur, in risk factors for certain conditions and in the way they respond to the same treatment. A disease that is known to often present differently in women and men is irritable bowel syndrome (IBS). Given the difference in prevalence, predominant symptoms and possible other pathophysiology, it is conceivable that a difference in treatment effectiveness in men and women is a discovery waiting to be found.PurposeTo determine whether there are differences in treatment effectiveness between men and women with irritable bowel syndrome.Materials and MethodsWe searched on PubMed and EMBASE, selecting randomized controlled trials comparing IBS treatment in men and women over 18 years old. One researcher performed the inclusion process, and two researchers independently performed a quality assessment. A descriptive analysis was conducted.ResultsTwelve studies, randomizing 1847 men and 3562 women, were included in this review. Treatment with serotonin antagonist alosetron, treatment with ibodutant and crofelemer and adding cognitive behavioral therapy to medical treatment found significant differences between men and women in favor of effectiveness towards women in either satisfactory relief of overall IBS symptoms or percentage of pain-free days.ConclusionSex-gender can be a determining factor in the effectiveness of IBS treatment. Due to the limited number of studies per treatment option, no recommendations can be made on the choice of a specific treatment. It is clear, however, that so as not to miss beneficial treatment options for either sex, the inclusion, analysis and description of data on the basis of sex is of the utmost importance.

EFFECTIVENESS OF MUSTA-TAKRA BASTI IN THE MANAGEMENT OF ULCERATIVE COLITIS (PITTAJA GRAHANI) – A CASE REPORT

Ulcerative colitis is an idiopathic inflammatory bowel disease causing inflammation and ulcers in the rectum and colon. Ulcerative colitis affects approximately 5,00,000 individuals in US with an incidence of 8-12 per 1,00,000 population per year. It is manifested as ano-rectal bleeding with increased frequency of bowel evacuation, general debility. In the contemporary science treatment is Corticosteroids, 5-Aminosalicylates, Anti-TNF therapy which results in other complications and the disease may even relapse after a period of time. A 62 years old female Patient attended OPD with diffuse abdominal pain, loose stools 10-15 times a day with blood, debility and weight loss. Patient was known case of ulcerative colitis since 6 years receiving treatment from contemporary science but she was not getting any satisfactory relief. Patient was treated with the concept of Pittaja Grahani in Ayurveda. Objective: To improve the signs and symptoms of the ulcerative colitis, to prevent from all possible intestinal and extra-intestinal complications related to ulcerative colitis finally to cure the disease. Method: Musta-Takra Basti was administered for 16 days along with other Ayurvedic drugs and signs and symptoms were evaluated daily. Result: Patient responded well with much improvement in her general condition. Frequency of defecation is decreased, no bleeding per rectum and other signs and symptoms were relieved. Conclusion: This study can be useful for reducing the need of steroids and surgical procedures in the patient of ulcerative colitis Hence Ayurveda treatment can be a promising alternative, safe and convenient treatment in the management of Ulcerative colitis.

Identification Of Strn-Ntrk2 Rearrangement In A High Grade Sarcoma, With Good Clinical Response To Firstline Larotrectinib Therapy

Abstract Casestudy Gene fusions involving tropomyosin receptor kinase genes, NTRK (NTRK1-3), are important in tumorigenesis. Larotrectinib, a selective NTRK inhibitor, is recently approved to treat NTRK fusion positive solid tumors. We herein report a case of soft tissue sarcoma harboring two STRN-NTRK2 gene fusions, with good clinical response to firstline larotrectinib treatment. Results A 35 year-old female presented with pain in the right gluteal region, and a large solid mass without overlying erythema, edema and induration was identified. Initial MRI study showed a heterogenous, vascular and partially necrotic mass (16.5 x 12.9 x 10.4 cm) centered in the right gluteus medius and maximus muscles. A core biopsy of the mass showed a cellular mesenchymal neoplasm with round/ovoid cells, high mitosis (21 per 10 HPFs) and focal staghorn type vessels, reminiscent of solitary fibrous tumor. However, STAT6 immunostaining was negative. Additional immunostains show no specific lineage. Our in-house NGS fusion panel showed two in-frame STRN- NTRK2 fusions, containing the same 5’ partner sequence (exon 1-3) of STRN, with the 3’ fusion partner starting from either the exon 15 or the exon 16 of NTRK2. Due to the large size and location of the tumor, larotrectinib was initiated as firstline therapy. The patient noticed a quick amelioration of tumor related pain, and a significant shrinkage of the size of tumor following the initial 7-day treatment. On post-treatment day 52, MRI showed the tumor significantly decreased in size to 7.7 x 7.4 x 6.6 cm with satisfactory symptomatic relief. Conclusion NTRK2 fusions are relatively rare when compared with NTRK1 and NTRK3, especially in sarcoma. Of note, the only other report in the literature of NRTK2 fusion- positive sarcoma also showed SFT-like morphology, and the patient responded well to larotrectinib as second line therapy.

Identification Of Strn-Ntrk2 Rearrangement In A High Grade Sarcoma, With Good Clinical Response To Firstline Larotrectinib Therapy

Abstract Casestudy Gene fusions involving tropomyosin receptor kinase genes, NTRK (NTRK1-3), are important in tumorigenesis. Larotrectinib, a selective NTRK inhibitor, is recently approved to treat NTRK fusion positive solid tumors. We herein report a case of soft tissue sarcoma harboring two STRN-NTRK2 gene fusions, with good clinical response to firstline larotrectinib treatment. Results A 35 year-old female presented with pain in the right gluteal region, and a large solid mass without overlying erythema, edema and induration was identified. Initial MRI study showed a heterogenous, vascular and partially necrotic mass (16.5 x 12.9 x 10.4 cm) centered in the right gluteus medius and maximus muscles. A core biopsy of the mass showed a cellular mesenchymal neoplasm with round/ovoid cells, high mitosis (21 per 10 HPFs) and focal staghorn type vessels, reminiscent of solitary fibrous tumor. However, STAT6 immunostaining was negative. Additional immunostains show no specific lineage. Our in-house NGS fusion panel showed two in-frame STRNNTRK2 fusions, containing the same 5’ partner sequence (exon 1-3) of STRN, with the 3’ fusion partner starting from either the exon 15 or the exon 16 of NTRK2. Due to the large size and location of the tumor, larotrectinib was initiated as firstline therapy. The patient noticed a quick amelioration of tumor related pain, and a significant shrinkage of the size of tumor following the initial 7-day treatment. On post-treatment day 52, MRI showed the tumor significantly decreased in size to 7.7 x 7.4 x 6.6 cm with satisfactory symptomatic relief. Conclusion NTRK2 fusions are relatively rare when compared with NTRK1 and NTRK3, especially in sarcoma. Of note, the only other report in the literature of NRTK2 fusion- positive sarcoma also showed SFT-like morphology, and the patient responded well to larotrectinib as second line therapy.

Role of Panchatikta Panchaprasutik Niruha Vasti in Prediabetes A case report

Background: Prediabetes is an intermediate state of hyperglycemia with glycaemic parameters above normal but below the diabetes threshold. In Ayurveda, it is correlated with Prameha Poovaroopavastha. The risk of developing diabetes remains high with an annual conversion rate 5-10%. Many other studies have shown that the efficacy of lifestyle intervention in diabetes prevention with a relative risk reduction of 40-70% in prediabetes adults. If we treat this disease in early stage then it checks the further pathogenesis of disease. Aim and objectives: The aim of this study was to observe the efficacy of Panchatikta Panchaprasutik Niruha Vasti enema including Palliative treatment in prediabetes. Methods: It is a single case study of 55 years old male patient who was diagnosed with prediabetes correlated as Prameha Poorvaroopa from 1 year approached to Ayurvedic hospital and was treated Panchatikta Panchaprasutik Niruha Vasti. The treatment was continued for consecutive 15 days. Results: After 15days changes were observed in symptoms as well as reduction was seen in blood and urine sugar level and overall quality of life of patient was improved. Conclusion: Patient got satisfactory relief in symptoms as well as objective parameters after 15 days.

Hydroxytyrosol alleviates Parkinsonism in Caenorhabditis elegans and C57BL/6 mice

Background and Objective: Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease. The pathological hallmark of PD involves the death of dopaminergic neurons and aggregation of α-synuclein (α-syn). Nowadays therapeutics for PD provides satisfactory symptom relief but not a cure. New drugs that will prevent or arrest the progressive course of PD by correcting disease-specific pathogenic process are of great interest. Hydroxytyrosol (HT) is a natural polyphenol present in extra virgin olive oil and is well known for its antioxidant properties. The aim of the present study was to evaluate the potential for HT to ameliorate PD features in Caenorhabditis elegans (C. elegans) and MPTP PD model in C57BL/6 mice.

CHEMODNERVATION FOR CERVICAL DYSTONIA: A CLINICAL REVIEW

Cervical dystonia (CD) is a focal dystonia characterized by involuntary contractions of neck muscles that result in patterned movements and abnormal postures of the head and neck that have a directional quality. CD is the most common form of dystonia presenting to the movement disorders clinic. Botulinum toxin is an effective treatment for cervical dystonia. It has become the first-line treatment for cervical dystonia with a satisfactory relief of symptoms reported in more than 80% of the cases. Multiple small and large scale studies proven that fact and provided Class-A evidence for the benefit. However, 20% of the patients discontinue treatment due to adverse effects, treatment failure and other reasons. With the proper knowledge of toxins and the anatomy of the neck, much better results can be achieved with fewer and self-limiting adverse effects as compared to other modalities. However, the expert consensus recommendations are lacking to guide clinicians for optimal use of botulinum toxin for cervical dystonias. This paper discusses the different available treatments, botulinum injection techniques and the adverse effects involved with the procedure.

MANAGEMENT OF ASCITES (JALODARA) THROUGH ANCIENT SYSTEM OF MEDICINE- A CASE REPORT

Ascites is a pathologic condition and accumulation of free fluid where fluid accumulates in the peritoneal cavity commonly observed in decompensated cirrhotic states. Symptoms may include increased abdominal size, increased weight, abdominal discomfort and shortness of breath. There is no specific treatment where ascetic pathology will cure completely. By contemporary science where patient gets temporary relief and symptomatic relief from their complaints. But after Paracentesis again fluid gets collected in the peritoneal cavity. In such cases, Ayurvedic treatment gives satisfactory relief from complaints along with hidden pathology. In this present article above mentioned ascites i.e., nothing but one among the liver pathology attempted to correlate with Jalodara which is very well mentioned in classics. A 45 years old male patient came to our Medicine outpatient department having complaints of Kshudhamandya (Loss of appetite), Annanabhilasha (Anorexia), Ubhaya Paada Shotha (Oedema), Netra Pitata (Icterus), Udara Vriddhi (fullness in flanks). Subject had treated thirteen days by Shodhana Aushadhis, Shamana Aushadhis also by diet restriction.

Performing laparoscopic adenomyomectomy with the four-petal method

To demonstrate an innovative idea for a four-petal method for performing laparoscopic adenomyomectomy on a patient with focal-type adenomyosis. A step-by-step explanation of the technique with narrated video footage. University hospital. A 38-year-old female with a 7 × 4 cm adenomyoma at the anterior uterine wall. Laparoscopic adenomyomectomy began with a cruciate incision to turn the adenomyoma into the shape of a blooming four-petal flower to fully expose the tumor and maximize the removal of adenomyotic tissue. During excision of the lesion, around a 1 cm thickness of the myometrium was preserved at the subendometrial region and around a 0.5 cm thickness of the serosa flap was also left in each "petal." Suture repair in the method introduced is different from closing the wound by approximation of myometrium to myometrium as in traditional myomectomy; instead, herein we repaired the adenomyomectomy wound by anchoring the serosal flap to the subendometrial tissue, with care taken to avoid dead space. Subjective clinical symptoms as well as serial ultrasonographic measurement of the uterine size, shape, and wall thickness. The specimen removed was 92 g in weight. The symptoms have dramatically decreased since the procedure and dysmenorrhea improved from visual analog scale 8 to 1 postoperatively. Besides achieving satisfactory symptomatic relief, the ultrasonographic measurement of the myometrium was of adequate thickness (2.3 cm) after the operation and did not increase in a serial follow-up of 33 months. The four-petal method of adenomyomectomy with cruciate incision offers full exposure to the localized adenomyosis. It greatly facilitates a balance between the maximized resection of the lesions and tailored reserves of myometrium. Subsequent repair by anchoring the serosal flap to the subendometrial tissue ensures adequate thickness of the uterine wall after the operation.

71. Can the novel lumboiliac triangle technique based on biplane oblique fluoroscopy facilitate transforaminal percutaneous endoscopic lumbar discectomy for patients with L5-S1 disc herniation combined with high iliac crest? A case-control study of 100 patients

BACKGROUND CONTEXT Percutaneous endoscopic lumbar discectomy (PELD) via the transforaminal approach is difficult at L5-S1 in patients presenting with high iliac crests (HIC). The conventional wisdom is that measurement using lumbar radiography, CT or MRI is necessary. PURPOSE To introduce a lumbo-iliac triangular (LI-Tri) technique based on biplane oblique fluoroscopy and verify whether it facilitates transforaminal PELD for patients with L5-S1 LDH combined with HIC. STUDY DESIGN/SETTING Retrospective case-control study. PATIENT SAMPLE The definition of HIC is derived from Choi's degree system, classifying the relationship between the location of the highest point of the iliac crest and the adjacent bony structures such as the L5 pedicle, and the L4 inferior and S1 superior endplates. In our patient selection, the highest point of the iliac crest above the mid-point of the L5 pedicle (Type>5) was regarded as ‘HIC.’ Between January 2016 and December 2016, 100 patients with LDH combined with HIC were treated with PELD via a unilateral transforaminal approach in two tertiary spine centers. Inclusion criteria were as follows: (1) clinical symptoms and signs of unilateral neurological deficit including radiculopathy, paresthesia, motor weakness that did not respond to conservative treatments including medication, physiotherapy, and nerve root blocks for 6 weeks; (2) symptoms corresponding to preoperative MRI and/or CT scans. Exclusion criteria were as follows: (1) definite segmental instability (anterior or posterior displacement>3 mm or the angle change of the endplate>15 ° on the dynamic radiography); (2) severe central canal stenosis (less than 10 mm) on preoperative MRI or CT; (3) cauda equina syndrome; (4) highly migrated nucleus pulposus beyond the low rims of adjacent pedicles; and (5) suspected infection or malignant diseases. OUTCOME MEASURES Besides the mean operative duration, clinical outcome evaluation included the Oswestry Disability Index (ODI) score and visual analog scale (VAS) score without the usage of analgesic to truly reflect the intensity of back and leg pain. Relevant complications, including intraoperative conversion from conventional puncture to LI-Tri technique, postoperative dysthesias and motor weakness were also recorded. METHODS The LI-Tri technique was used in the first 50 patients (applied group) with L5-S1 disc herniation. The other 50 patients were classified as non-applied group, in which the conventional puncture process was performed. The puncture location was considered unsatisfactory after 20 puncture attempts, regarded as a difficult puncture. If this occurred in the non-applied group, the LI-Tri technique was introduced into the puncture process, as with the applied group. Three senior surgeons with experience of over 500 transforaminal PELD cases performed the surgeries. The intervals of follow-up were scheduled at 1 day, 1, 3, 6, 12 and 24 months after surgery. Postoperative MRI or CT examinations were recommended, especially for patients without satisfactory symptom relief. RESULTS No significant difference was observed with respect to demographic information (P .05, respectively). With the exception of the back pain VAS and ODI at 1 day postoperatively, no significant difference was observed in the three parameters at other time-points postoperatively between two groups (P>.05, respectively). CONCLUSIONS For patients with L5-S1 LDH combined with HIC treated by transforaminal PELD, the LI-Tri technique is simple and effective in preoperative evaluations, locating the skin entry point and guiding the puncture trajectory. Compared to the conventional technique, it shows advantages in terms of reducing intraoperative surgical duration and promoting fast postoperative recovery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Ayurveda Treatment Protocol in the Management of Galagraha (Pharyngitis)- A Case Study

Pharyngitis is inflammation of the pharynx, which affects in back of the throat. It is most often referred to simply as sore throat; it is one of the most common reasons for doctor visit. The condition is the usual phenomenon in paediatric population due to intake of cold drinks, junk food etc. This disease is more recurrent now a days than earlier As per ayurvedic classics the condition has close similarity with the disease Galagraha. Aim: In this article management of pharyngitis with ayurvedic modalities were discussed. Material &amp; Method: A 32 years male patient visited ENT OPD of Shalakya Tantra, I.P.G.T&amp;R.A Hospital on 16/12/2019 with complaints of pain and foreign body sensation of throat, Recurrent moderate cough, mild fever and head ache, difficulty in swallowing along with congestion in posterior pharyngeal wall aggravate since 10 days. He consulted a local hospital near his house but didn’t get a satisfactory relief. History reveals the reccurents of disease since 3 years. We started Triphala + Darvi kwatha kawala thrice/Day, Haritaki Kwatha pana Twice BD with honey (20 ml Before food), Khadiradi vati (2 Tab -4 times/ day) for Chushanartha, Sitopaladi churna -3gm +Yastimadhu 1 gm, Naradiya Lakshmi vilasa rasa-125 mg-2 times a day for 14 days Followed by Virechana and Nasya. Marked relief was found in signs and symptoms within 7 days and cured completly within 21 days of treatment. Conclusion: Study concluded that the above Ayurvedic treatment can prove to be an effective alternate management in Chronic Catarrhal Pharyngitis with proper diet and regimen.

REVISIÓN DE TEMA: PAPEL DE LA ACTIVIDAD FÍSICA EN EL MANEJO NO FARMACOLÓGICO DEL SÍNDROME DE INTESTINO IRRITABLE

El síndrome de intestino irritable (SII) es el diagnóstico gastroenterológico más común, con una elevada prevalencia global que oscila entre el 5% al 21%. Esta enfermedad de curso recurrente crónico se caracteriza por su traslape con otros trastornos funcionales y su afectación en la calidad de vida de los pacientes. Actualmente son pocos los tratamientos que ofrecen un alivio sintomático satisfactorio, por lo que en el manejo efectivo del SII se ha dado importancia a la consejería sobre cambios en el estilo de vida, actividad física, dieta, entre otros. Este enfoque de esfuerzo personal por parte del paciente se sustenta en la relación del estado de estrés crónico con la exacerbación de los síntomas de SII. Las interacciones cerebro-intestino pueden jugar un rol en la asociación entre la actividad física y los síntomas en el SII. La mayoría de estudios concuerdan que las intervenciones que propician el aumento de la actividad física mejoran los síntomas gastrointestinales del SII; así como diferentes aspectos de la calidad de vida, fatiga, depresión y ansiedad a largo plazo.