Journal Of The Indian Medical Association[JOURNAL]
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200 papers
Comparative study of heart rate responses to laryngoscopic endotracheal intubation and to endotracheal intubation using intubating laryngeal mask airway under general anaesthesia in patients with pure mitral stenosis for closed mitral commissurotomy.
Das S, Gupta SD, Goswampi A … +1 more , Kundu KK
J Indian Med Assoc · 2013 Apr · PMID 24475554
The various drugs and methods studied in an attempt to curb the haemodynamic stress response associated with conventional laryngoscopic endotracheal intubation have not been found to be ompletely satisfactory. The rise i...
The various drugs and methods studied in an attempt to curb the haemodynamic stress response associated with conventional laryngoscopic endotracheal intubation have not been found to be ompletely satisfactory. The rise in heart rate can be detrimental to patients with mitral stenosis. This study was aimed to compare the heart rate responses to endotracheal intubation using conventional laryngoscope and with the help of intubating laryngeal mask airway (ILMA) in patients with isolated mitral stenosis. Thirty-four adult patients of either sex, aged between 18 and 40 years with isolated mitral stenosis to undergo closed mitral commissurotomy were randomly allocated into two groups : Group A (n=17)- To be intubated using laryngoscopy. Group B (n=17)- To be intubated with the help of ILMA. The heart rate was recorded immediately preinduction, just prior to introducing the intubating device and postintubation every minute up to first 5 minutes. On applying statistical tests, it was found that the median heart rate values in group A at 2, 3, 4 and 5 minutes postintubation were significantly higher than in group B (p<0.05). Although use of both laryngosope and ILMA for endotracheal intubation was associated with rise in heart rate, the rise was less with ILMA compared to laryngoscope. Hence, it can be concluded that use of ILMA may be a preferable device for endotracheal intubation laryngoscopy in patients with isolated mitral stenosis.
Herpes simplex virus 2 : a boon to develop other sexually transmitted infections.
Chopra S, Devi P, Devi B
J Indian Med Assoc · 2013 Apr · PMID 24475553
Genital herpes is one of the most common sexually transmitted infections. Though, mostly asymptomatic, it acts as a potential risk factor for acquisition of other sexually transmitted infections (STIs). The present study...
Genital herpes is one of the most common sexually transmitted infections. Though, mostly asymptomatic, it acts as a potential risk factor for acquisition of other sexually transmitted infections (STIs). The present study was undertaken to know sero-prevalence of herpes simplex virus 2 (HSV2), syphilis and HIV among STI clinic attendees and to detect the diagnostic utility of HSV2 IgM antibodies. The study group included 170 individuals attending STI clinic irrespective of their presenting complaints. Their sera were subjected to enzyme-linked immunosorbent assay for detection of HSV2 IgM antibodies. The samples were also screened for HIV and syphilis. Twenty-seven (15.88%) out of 170 persons were found to be seropositive for HSV2 IgM antibodies. Syphilis was detected in 13 individuals (7.65%). Twelve individuals (7.06%) were found to be reactive for anti HIV I antibodies. Ten of the genital herpes patients (37.04%), did not have any complaint of genital ulcer. Eight HSV2 patients (29.63%) had coinfection with HIV I, 6 (22.22%) with syphilis and 2 (07.41%) had co-infection with both HIV and syphilis. A significant proportion of the patients with genital herpes presented without the history of genital ulcers. Thus, its detection and treatment among asymptomatic patients is significant so as to reduce its transmission and other STIs.
Study of adverse events following immunisation with universal and newer vaccines in the Serampore IMA Child Clinic over a period of 7 years.
Das PK
J Indian Med Assoc · 2013 Apr · PMID 24475552
Immunisation is an important part of childcare practice. It is one of the most beneficial and cost effective measures for the prevention of diseases. From the previous retrospective studies, it was evident that smallpox...
Immunisation is an important part of childcare practice. It is one of the most beneficial and cost effective measures for the prevention of diseases. From the previous retrospective studies, it was evident that smallpox has been completely eradicated throughout now-a-days with the wholehearted and sincere efforts of healthcare providers by applying efficient and safe vaccine against smallpox, same is true also to polio which is now close to worldwide eradication and measles and rubella are no longer endemic in certain parts of the world. Not only has that with the introduction of safer and more efficient newer vaccines, the incidence of most other vaccine preventable disease of childhood also reduced considerably. The aim of the present study is to estimate the incidence and clinical presentation of adverse events following immunisation with universal and newer vaccines for a period of seven years using prospective active surveillance. Children under the age of 7 years were taken for universal and newer scheduled vaccinations given in the Serampore IMA Child Clinic under the supervision of the clinicians maintaining strictly the guidelines of Expanded Programme of Immunisation (Government of India). This study of adverse events following immunisation in the Serampore IMA Child Clinic confirms that the adverse events such as fever (0.37%), pain and swelling at the site of injection (0.32%0, urticarial rash (0.02%), anaphylactic shock (0.003%) are negligible. There were only two reports of anaphylaxis following preschool and infant schedule vaccines, including measles, mumps and rubella (MMR), Haemophilus influenzae type B vaccines and typhoid vaccines in approximately 52,000 infants received over a period of 7 years starting from 1st April, 2005 to 31st March, 2012 and there were no deaths or longterm effects reported during the post follow-up period in the Serampore IMA Child Clinic.
Hypertensive leucocytosis.
Rajkumari R, Laishram D, Thiyam J … +1 more , Javan N
J Indian Med Assoc · 2013 Apr · PMID 24475551
There are studies showing association of high WBC count with the higher incidence of hypertension though a few are done in the Indian population. The present study was conducted with the view to find any significant incr...
There are studies showing association of high WBC count with the higher incidence of hypertension though a few are done in the Indian population. The present study was conducted with the view to find any significant increase in total leucocyte count and differential leucocyte count in hypertensive patient Twenty-seven hypertensives with 12 males and 15 females and 27 age and sex matched control subjects (normotensive) were studied. Hypertension was defined when the systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or history of taking antihypertensive medicine. Three blood pressure recordings at an interval of 2 minutes were taken after the patient was made to sit for 30 minutes with a standard mercury sphygmomanometer in the left arm. The disappearance of sound was used for diastolic blood pressure. Blood was drawn into EDTA containing vials. Two separate counts were performed: First for total leucocyte count (TLC) and second for determination of percentage of polymorphonuclear cells. For the TLC, 0.5 part of blood mixed with 10 part of Turk's fluid followed by counting of leucocyte in a counting chamber under light microscope. The percentage of polymorphonuclear leucocyte was performed on a slide after making the slide and staining it with Leishman's stain. The erythrocyte sedimentation rate (ESR) was performed using Wintrobe's methods. The first 1 hour reading on the Wintrobe's tube was taken for analysis. The total leucocyte count (TLC) for the study group as compared to the controls were 7413.70 +/- 735.45 cells/cmm and 5236.30 +/- 528.77 cells/ cmm which was statistically significant. The mean percentage neutrophils were 62.04 +/- 4.99 for study group and 53.00 +/- 3.44 for the controls; the mean percentage lymphocytes for the study group and the controls were 34.37 +/- 4.55 and 39.11 +/- 4.40 respectively. Both the mean percentage neutrophils and lymphocytes showed significant differences. The mean erythrocyte sedimentation rate (ESR) also showed statistically significant when the study group (29.63 +/- 3.76 mm in first hour) was compared to the controls (21.15 +/- 6.88 mm in first hour). In addition, when male and female hypertensive subjects were analysed separately, the TLC, neutrophil, lymphocyte and ESR levels showed significant differences as compared to their respective controls. The result has showed that there is a significant increase in inflammatory markers like TLC and neutrophils counts in hypertensive patients suggestive of hypertension as an inflammatory disease.
Rabindranath Tagore and his vision and thought in health perspectives.
Ghosh S
J Indian Med Assoc · 2013 Apr · PMID 24475550
Abstract loading — click title to view on PubMed.
Conjunctival malignant melanoma resembling a horn.
Gupta S, Das D
J Indian Med Assoc · 2014 Jan · PMID 25935957
Conjunctival melanoma is a rare ocular malignancy occurring most frequently in aged patients. It is a potentially life-threatening condition. This article presents history and management of a case of malignant melanoma o...
Conjunctival melanoma is a rare ocular malignancy occurring most frequently in aged patients. It is a potentially life-threatening condition. This article presents history and management of a case of malignant melanoma of conjunctiva resembling a horn.
Small cell carcinoma of the urinary bladder: a case report and review of the literature.
Roy C, Deb AR, Pal M … +3 more , Das D, Mandal A, Mukhopadhyay S
J Indian Med Assoc · 2014 Jan · PMID 25935956
Small cell carcinoma of the urinary bladder is extremely rare. In this report, a case of non-metastatic small cell carcinoma of the urinary bladder treated by systemic chemotherapy followed by adjuvant external radiother...
Small cell carcinoma of the urinary bladder is extremely rare. In this report, a case of non-metastatic small cell carcinoma of the urinary bladder treated by systemic chemotherapy followed by adjuvant external radiotherapy, with a brief review of the epidemiology, clinical features, diagnosis, pathological features, staging, treatment and prognosis about this neoplasm is reported. A 53 years old man attended with sign and symptoms suggestive of a bladder cancer. Computed tomography of the whole abdomen showed a large tumour at right lateral wall of the bladder. Transurethral resection and histopathological study of the bladder tumour established the diagnosis of a small cell carcinoma. The patient received six cycles of platinum based chemotherapy with adjuvant locoregional external radiotherapy. He had an invasive bladder recurrence thirteen months later and died shortly afterwards.
A very rare case of intussusception of small bowel due to metastasis from renal cell carcinoma.
Ekbote GR, Rajpal LB, Makam SD
J Indian Med Assoc · 2014 Jan · PMID 25935955
Bowel metastasis secondary to renal cell carcinoma causing intussusception is very rare condition. Here a case of a 52-year-old male, who presented with signs and symptoms of small bowel obstruction is reported. CT abdom...
Bowel metastasis secondary to renal cell carcinoma causing intussusception is very rare condition. Here a case of a 52-year-old male, who presented with signs and symptoms of small bowel obstruction is reported. CT abdomen showed small bowel obstruction due to ileo-ileal intussusception and left renal mass. On exploratory laparotomy Ileo-ileal intussusception was present. FNAC taken from left kidney at same sitting. Histology of resected specimen reported metastatic nodule in small bowel of renal cell carcinoma. FNAC confirmed primary renal cell carcinoma of left kidney. Although abdominal CT scanning provides the most reliable indications, it is laparotomy, that establishes the diagnosis of intussusception, and the histological examination that determines the cause.
Submental intubation: a new approach in panfacial trauma.
Gandhi M, Ved BK
J Indian Med Assoc · 2014 Jan · PMID 25935954
The submental route for endotracheal intubation is an alternative to nasal intubation or tracheo- stomy in the surgical management of patients with complex craniomaxillofacial injuries. The critical indication for submen...
The submental route for endotracheal intubation is an alternative to nasal intubation or tracheo- stomy in the surgical management of patients with complex craniomaxillofacial injuries. The critical indication for submental intubation is the requirement for intra-operative maxillomandibular fixation in the presence of injuries that preclude nasal intubation and in a situation where a tracheostomy is not otherwise required. Maxillomandibular fixation is essential to re-establish dental occlusion for a normal functional result in dentate patients with fractures involving alveolar segments of the jaws. However, maxillomandibular fixation precludes orotracheal intubation. Nasotracheal intubation is often used but is contra-indicated in the presence of skull base fractures and will interfere with the access to certain fracture types. A tracheostomy has a high potential complication rate and in many patients, an alternative to the oral airway is not required beyond the peri-operative period. Submental intuba- tion is a simple and useful technique with low morbidity in selected cases of craniomaxillofacial trauma.
Kikuchi's disease: an uncommon cause of cervical lymphadenopathy.
Murali A, Narasimhalu CR, Madhavan M … +1 more , Sujithkumar S
J Indian Med Assoc · 2014 Jan · PMID 25935953
Kikuchi Fujimoto's disease is a benign self limiting disorder presenting with localised cervical lymphadenopathy, fever, weight loss and night sweats. It is a rare disease with worldwide distribution but commonly reporte...
Kikuchi Fujimoto's disease is a benign self limiting disorder presenting with localised cervical lymphadenopathy, fever, weight loss and night sweats. It is a rare disease with worldwide distribution but commonly reported from Asia. It is diagnosed by excision biopsy of the lymph nodes. Clinical features suggest a viral aetiology though not proven. It is often misdiagnosed as either systemic lupus erythematosus or malignant lymphoma. Better understanding as well as high clinical suspicion would aid in the diagnosis of the disease. Treatment is mainly symptomatic, with non-steroidal analgesics and antipyretics. Corticosteroids are rarely indicated. Although patients show a spontaneous recovery in 1-4 months, a follow-up of several years would be required to study the development of SLE in these patients.
Hysterectomy: treatment for secondary infertility.
Wani R, Patra C, Dusane V
J Indian Med Assoc · 2014 Jan · PMID 25935952
Infertility is a distressing condition but extenuating circumstances sometimes make the choice of treatment seem paradoxical. Here is discussed a challenging case of a 30-year-old woman with no living child and secondary...
Infertility is a distressing condition but extenuating circumstances sometimes make the choice of treatment seem paradoxical. Here is discussed a challenging case of a 30-year-old woman with no living child and secondary infertility who presented with a large abdominal mass and severe abdominal pain, sequelae of previous obstructed labour. There was complex management dilemma. She was young, had no living child, had undergone vesicovaginal fistula (VVF) repair and vaginoplasty yet was wanting fertility; however she was distressed with the abdominal pain and desired a complete cure. Both she and her spouse were counselled about the high possibility of failure if repeat attempt at vaginoplasty was made, and possible damage to the VVF repair. Finally, decision of exploratory laparotomy with total abdominal hysterectomy was taken after counselling the couple about adoption as an option for childbearing.
Anaesthetic management of a child with large occipital meningomyelocele.
Niyogi S, Mitra P, Chakraborty J … +4 more , Santra S, Mitra T, Nandy S, Acharya A
J Indian Med Assoc · 2014 Jan · PMID 25935951
A meningomyelocele is herniation of meninges along with neural elements through a congenital defect in the cranium or vertebral column. Reported incidence of occipital meningomyelocele is 1 in 5000 live births. Children...
A meningomyelocele is herniation of meninges along with neural elements through a congenital defect in the cranium or vertebral column. Reported incidence of occipital meningomyelocele is 1 in 5000 live births. Children with meningomyelocele may have varying degrees of sensory and motor deficits and other important associated congenital defects with clinical features of brain stem compression. The major anaesthetic challenges associated with myelomeningocoele repair includes difficulty in securing airway, intra-operative prone positioning, accurate assessment of blood loss and prevention of hypothermia.
Squamous cell carcinoma arising in a chronic osteomyelitic sinus tract in the peri-anal region involving pelvis: a rare occurrence.
Karumbaiah KP, Shruthi MS, Ragavendran V … +1 more , Kariappa TM
J Indian Med Assoc · 2014 Jan · PMID 25935950
Squamous cell carcinoma is a rare, but well documented complication of chronic osteomyelitis. Squamous cell carcinoma arising in a sinus tract following chronic osteomyelitis of the pelvic bone is a very rare occurrence....
Squamous cell carcinoma is a rare, but well documented complication of chronic osteomyelitis. Squamous cell carcinoma arising in a sinus tract following chronic osteomyelitis of the pelvic bone is a very rare occurrence. The patient presented with multiple draining sinuses and an ulcerative growth at the mouth of one of the sinuses in the peri-anal region. X-ray findings and sinogram showed de- struction of part of pubic bone. Biopsy from the growth confirmed a well differentiated squamous cell carcinoma. Therefore it is imperative that these lesions be biopsied for accurate diagnosis, adequate therapy and follow-up.
Implementation of PC and PNDT Act in Gulbarga region.
Mudda V, Uzair SH
J Indian Med Assoc · 2014 Jan · PMID 25935949
Denial to a girl child of her right to live is one of the heinous violations of the right to life committed by the society. Gender bias and deep rooted prejudice and discrimination against girl child and preference of ma...
Denial to a girl child of her right to live is one of the heinous violations of the right to life committed by the society. Gender bias and deep rooted prejudice and discrimination against girl child and preference of male child have led to large scale female foeticide in the last decade. The declining sex ratio is a major concern for all. The census 2001 data indicates that female ratio is declining at an alarming rate and needs immediate action. In order to check the female foeticide, the Prenatal Diagnostic Techniques (regulation and prevention of misuse) Act 1994 was enacted and became operational from January, 1996. This article is an attempt to throw light on the successful implementatuion of PC and PNDT Act in the Gulbarga region and active participation of various organisations and people in proper implementation of the act.
Mifepristone: current knowledge and emerging prospects.
Kakade AS, Kulkarni YS
J Indian Med Assoc · 2014 Jan · PMID 25935948
The first clinically available antiprogestin, mifepristone has generated immense interest in the research community since its' discovery in 1980. Mifepristone is a synthetic orally active steroid with potent antiglucocor...
The first clinically available antiprogestin, mifepristone has generated immense interest in the research community since its' discovery in 1980. Mifepristone is a synthetic orally active steroid with potent antiglucocorticoid, antiprogestogen and a weak anti-androgen activity, used primarily for termination of pregnancy. It acts as a competitive receptor antagonist at the progesterone receptor in the presence of progesterone, and acts as a partial agonist in the absence of progesterone. Extensive research has been carried out regarding its' antiprogestogen activity for use in medical abortion. Lately other medical uses of mifepristone are being explored like for induction of labour in late preg- nancy, as oestrogen free oral contraceptive and for treatment of endometriosis, uterine fibroids, ovarian cancer, prostate cancer, meningiomas, Cushing's syndrome and major psychotic depression.
Xanthogranulomatous pyelonephritis: critical analysis of 18 cases from a rural tertiary care centre of India.
Datta B, Datta C, Pahari DK
J Indian Med Assoc · 2014 Jan · PMID 25935947
Xanthogranulomatous pyelonephritis is an uncommon disorder of the kidney that is characterised by chronic inflammation and extensive destruction of the involved kidney usually associated with renal calculus and obstructi...
Xanthogranulomatous pyelonephritis is an uncommon disorder of the kidney that is characterised by chronic inflammation and extensive destruction of the involved kidney usually associated with renal calculus and obstruction. It commonly involves the middle aged people with an increased incidence among females and diabetic population. Confirmed diagnosis can be done only after histopathological examination of the diseased nephrectomy specimen. So early suspicion and timely intervention is important to reduce the morbidity. In this retrospective study, we analysed the case records of all patients diagnosed with xanthogranulomatous pyelonephritis in our institute over a period of 11 years. A total 18 patients were treated and diagnosed with xanthogranulomatous pyelonephritis from January 2002 to December 2012. Among them 13 were female and 5 male. Most common clinical presentation was flank pain, fever, dysuria and weight loss. Left kidney was affected in 15 cases and right kidney in 3 cases. All patients were having urinary calculus causing obstruction to the pelvicalyceal system of the kidney. Only 2 patients were diabetic. Urine culture was sterile in all patients. All patients were treated with antibiotics, other supportive measures pre-operatively and ultimate nephrectomy having good recovery. Early suspicion and prompt treatment is necessary in minimising morbidity and mortality from the condition.
Plasma malondialdehyde (MDA) and anti-oxidant status in diabetic retinopathy.
Kumawat M, Kharb S, Singh V … +3 more , Singh N, Singh SK, Nada M
J Indian Med Assoc · 2014 Jan · PMID 25935946
Hyperglycaemia and dyslipidaemia in diabetes mellitus induce increased lipid peroxidation and peroxyl radical formation is an important mechanism in genesis of micro-angiopathy. We took up a study on oxidative stress as...
Hyperglycaemia and dyslipidaemia in diabetes mellitus induce increased lipid peroxidation and peroxyl radical formation is an important mechanism in genesis of micro-angiopathy. We took up a study on oxidative stress as measured by lipid peroxidation marker, malondialdehyde (MDA) and antioxidant enzyme status in type 2 diabetes mellitus patients with and without retinopathy and compared them with a control non-diabetic group. MDA was significantly elevated (p < 0.001) in both the diabetic groups whereas antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT) and reduced glutathione (GSH), etc, were significantly decreased (p < 0.001) which might be helpful in risk assessment of various complications of diabetes mellitus. The study included 100 subjects of age group 50-70 years, out of which 50 patients were non-insulin dependent diabetes mellitus (NIDDM) with retinopathy and rest 50 age and sex matched apparently healthy individuals (control group). The status of fasting blood sugar (FBS), postprandial blood sugar (PPBS), total cholesterol (TC), triglyceride (Tg), HDL-cholesterol, LDL-cholesterol, VLDL- cholesterol, GPx, GR, CAT, SOD, MDA were determined. The results showed significant increase (p < 0.001) in FBS, PPBS, TC, TG, LDL-C, VLDL-C, CAT, MDA while HDL-C, GSH, GPx, GR and SOD were found to be decreased significantly (p < 0.001). The data suggest that alteration in anti-oxidant status and MDA may help to predict the risk of diabetic retinopathy.
Retrospective observational study of penetrating keratoplasty in the management of non-responsive microbial keratitis.
Mondal A, Mukhopadhyay U, Mondal A … +4 more , Pattanayak U, Mukhopadhyay S, Ghosh S, Islam N
J Indian Med Assoc · 2014 Jan · PMID 25935945
Microbial keratitis tops the list of the diseases leading to corneal blindness. Corneal transplant, either partial or full thickness, is the most helpful technique for infective keratitis that remains non- responsive, ev...
Microbial keratitis tops the list of the diseases leading to corneal blindness. Corneal transplant, either partial or full thickness, is the most helpful technique for infective keratitis that remains non- responsive, even with the most suitable medical treatment. Aims of this study are to evaluate the success of therapeutic penetrating keratoplasty in non-responsive microbial keratitis in eradication of infection, restoration of anatomical integrity of the globe and prevention of complication that influence the visual prognosis in a positive way. Result of the retrospective study of 60 patients who underwent therapeutic penetrating keratoplasty, following infected keratitis showed restoration of anatomical integrity in 51 cases (85%). Success rate of penetrating keratoplasty was higher in non- perforated (92%) than in perforated group (74.28%) and in non-mycotic than in mycotic group. Penetrating keratoplasty in non-responsive infected keratitis is thus helpful.
Genito-urinary tuberculosis in 67 cases: experience from a tertiary core centre in India.
Datta B, Datta C, Halder B … +1 more , Pahari DK
J Indian Med Assoc · 2014 Jan · PMID 25935944
Tuberculosis is very much prevalent in developing countries like India. Genito-urinary tuberculosis usually occurs after 5 to 15 years of the primary lung infection. After lymph node involvement,it is the second common f...
Tuberculosis is very much prevalent in developing countries like India. Genito-urinary tuberculosis usually occurs after 5 to 15 years of the primary lung infection. After lymph node involvement,it is the second common form of extrapulmonary tuberculosis. In this retrospective study, case records of 67 patients diagnosed with genito-urinary tuberculosis in our institute were thoroughly reviewed regarding age, sex, the urogenital organ involved by tuberculosis,mode of diagnosis,and treatment given to the patients. Median age of the patients was 38.5 years, males were more commonly involved than females, kidney was the most common organ involved by tuberculosis followed by ureter and urinary bladder.HIV infection was present in a single patient who had developed tuberculous perinephric abscess. Most common mode of diagnosis was by histopathological examination of the organ involved. Hydronephrosis of the involved kidney with echogenic debris in the dilated pelvicalyceal system on ultrasonography and non-visualised kidney on intravenous urogram was the most common findings on imaging studies who underwent nephrectomy. One patient was seen with tuberculosis of the glans penis which is not much common. Surgical intervention was ablative in nature in most of the cases in the form of nephrectomy. Early diagnosis is important and can prevent the anatomical defor- mity and loss of function of the involved organ.
Clinicopharmacological comparative study of rizatriptan versus conventional therapy in migraine.
Kushwah A, Tomar A
J Indian Med Assoc · 2014 Jan · PMID 25935943
Migraine is a common neurological problem, which accounts for large morbidity and disability. Non-steroidal anti-inflammatory agents and triptans are mainly used to terminate the attack of moderate to severe migraine. Th...
Migraine is a common neurological problem, which accounts for large morbidity and disability. Non-steroidal anti-inflammatory agents and triptans are mainly used to terminate the attack of moderate to severe migraine. This study compared the safety, efficacy and pharmaco-economics of rizatriptan (5HT(IB/ID) agonist) versus conventional therapy (paracetamol 500 mg + metoclopramide 10 mg + flunarizine 10 mg + alprazolam 0.5 mg). In this study, drug combinations used in conventional therapy was indigenously designed by the neurologist. Rizatriptan was found more efficacious than conventional therapy in terminating an attack of migraine and its' associated symptoms but looking into the contra-indications, side-effects and cost of the former there has been limitation in its prescription as well as the use.
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