Despite the advancements in diagnostic techniques and therapeutic interventions, medical science has failed to keep the incidence of congenital malformations under control. Ayurveda, the ancient Indian medical system has given due emphasis on this and postulated various measures to minimize the risks. These measures start well before conception. According to Ayurvedic principles, proper preparation of the parents is an essential prerequisite for a healthy progeny. Pre-conception care is a set of interventions that identifies biomedical behavioral and social risks to the health of the mother and the baby. It includes both-prevention and management, emphasizing health issues that require action before conception, very early in pregnancy, for maximal impact. For meeting the objective of healthy progeny, Ayurveda scholars felt the importance of six procreative factors (Shadgarbhkarabhavas) such as Matrija, Pitrija, Aatmaja, Rasaja, Satmyaja, and Sattvaja. The conglomeration of these procreative factors is must for healthy progeny. The physical, mental, social, and spiritual well-being of the person, proper nutrition of the mother during pregnancy, and practice of a wholesome regimen, play a prime role in achieving a healthy offspring, thus structuring a healthy family, society, and nation. Negligence toward any of these factors becomes a cause for unhealthy and defective child birth. The present literary / conceptual study, thus focuses mainly on interpreting these observations, on the basis of modern scientific knowledge.
BackgroundTraditional Indian Medicine Ayurveda is used to treat knee osteoarthritis (OA) despite limited evidence.ObjectivesWe aimed to evaluate the effectiveness of complex Ayurvedic treatment compared to complex conventional care in knee OA patients.MethodsAccording to ACR criteria patients with knee OA were included in a multicenter randomized, controlled trial and treated in 2 hospital outpatient clinics and 2 private outpatient clinics in Germany with 5 physicians and 20 therapists participating. Patients received either Ayurvedic treatment (n=77) or conventional care (n=74) with 15 treatments over 12 weeks. Primary outcome was the change on the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index after 12 weeks (validated German version). Secondary outcomes included the WOMAC subscales; a pain disability index, numeric rating scales for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood index, rescue medication use, and safety issues.ResultsA total of 151 patients (Ayurveda n=77, conventional care n=74) were included. Changes of the WOMAC Index from baseline to 12 weeks were more pronounced in the Ayurveda group (mean difference 61.0 [95% CI 52.4;69.6]) than in the conventional group (32.0 [95% CI 21.4;42.6]) resulting in a significant difference between groups (p<0.001) and a clinically relevant effect size (Cohen's d 0.68 [95% CI 0.35;1.01]). Similar tendencies were observed for all secondary outcomes at week 12. Effects were sustainable at follow-ups after 6 and 12 months.ConclusionsThe results suggest that a complex Ayurvedic treatment might be clinically superior to a complex conventional intervention in the treatment of OA of the knee.Disclosure of InterestNone declared
IntroductionBarrett’s oesophagus (BE) is the only identifiable pre-cursor condition for oesophageal adenocarcinoma. Endoscopic surveillance is performed in BE to detect dysplasia as it likely to be amenable to curative therapy.There is data to suggest that a diagnosis of BE has a negative impact on the quality of life of patients. To our knowledge, no guidance exists on the counselling of patients entered into endoscopic surveillance for BE.The aim of this study was to check patient understanding of their diagnosis of BE and associated anxiety levels at a district general hospital.MethodAn in-house database was used to identify patients with BE over a 10 year period (2006–17). A simple, 14-point based questionnaire was devised and answers obtained via a telephone consultation (Table 1).Results163 patients with BE were identified. In total, 104 patients (70 male, 34 female) were recruited (13 deceased, 38 did not answer, 8 declined). 2 patients had previously undergone therapy for BE (1 RFA, 1 fundoplication).Results are displayed in Table 1. Less than a third of patients remembered meeting a clinician to discuss their diagnosis and the rationale for follow-up. Consequently, only 41% of patients understood their diagnosis and 44% the rationale for surveillance. Although almost all patients (92%) were on a regular proton pump inhibitor, less than half (48%) understood why. Only 11% of patients were aware of the overall cancer progression risk and even fewer (7%) of the treatment options that are currently available.Interestingly, half of all patients admitted feeling anxious about their diagnosis with the majority (82%) admitting that further counselling would benefit in this regard.Abstract PWE-115 Figure 1ConclusionWe have demonstrated that patients with BE have a relatively poor understanding of their diagnosis and the treatment options that are available to them. Further efforts need to be made to address this and help empower a group of patients who are understandably anxious about their diagnosis.Disclosure of InterestNone Declared
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