Journal of the Indian Medical Association
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Review
Is Parkinson's disease a homogeneous disorder--what is the burden of Parkinson's disease in India.
Movement disorders are common neurological illnesses among the elderly. These include essential tremor, Perkinsonian disorders and chorea of different aetiologies. Parkinsonian disorders can be divided into two major groups of disorders--classical idiopathic Parkinson's disease and Parkinson plus syndrome. ⋯ Incidence and prevalence of Parkinson's disease increase with increasing age. Some risk factors for Parkinson's disease have been narrated briefly. As the number of cases of Parkinsonism is likely to increase along with increasing population, the general practitioners or consultant physicans should have to play a greater role referring the cases to attend neurologists or movement disorder clinic early.
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To analyse the reasons for family refusal for donating the organs of their deceased relatives, 33 families were approached and interviewed as a part of the consent process. Thirty of these refused and their reasons for refusal were documented. ⋯ Superstitions relating to being reborn with a missing organ (that had been donated) in 40% or that tampering with the body would not free their dead relatives from the cycle of life-death-rebirth in 26% were next most frequently voiced. A delay in funeral (23%), lack of consensus within family members (17%), fear of social criticism (10%), dissatisfaction with the hospital staff (10%) and being unaware of their deceased relatives' wishes (6%) were the other reasons cited.
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Pott's paraplegia associated with pregnancy is a serious problem and is difficult to treat, as not much literature is available regarding its management. Such a case, where the multidisciplinary team approach gave good neonatal and maternal outcome, is reported here.
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Randomized Controlled Trial Clinical Trial
Role of parecoxib in pre-emptive analgesia: comparison of the efficacy and safety of pre- and postoperative parecoxib in patients undergoing general surgery.
Management of acute postoperative pain remains sub-optimal despite the availability of multiple analgesics and improved pain management strategies (with nearly 80 % of patients reporting moderate to extreme pain following surgery). To evaluate the role of parecoxib as a pre-emptive analgesic in patients undergoing general surgery, the present study was undertaken. Eighty patients of either sex, aged 18 to 70 years, requiring elective ambulatory general surgery like hernioplasty, appendicectomy, cholecystectomy, etc, were enrolled in this prospective, randomised, assessor-blind, parallel-group, comparative trial. ⋯ Present results suggested that pre-operative administration of parecoxib was more effective than a postoperative use in providing pain relief in postoperative period in patients undergoing elective general surgical procedures. Both the regimens were well tolerated. Based on the above data, it appears that pre-operative dose of parecoxib 40 mg IV/IM is a useful optionfor pre-emptive analgesia in general surgical practice.
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Performance of RNTCP involvement of medical colleges in implementing DOTS strategy, management of paediatric TB under RNTCP, TB/HIV co-ordination, external quality assurance, training of staff, strengthening of ICE, monitoring, supervision and collaboration with other sectors are briefly discussed with regard to DOTS expansion and implementation during the 4th quarter, 2003.