Correlation of self-reported pain severity and healthcare expenditures in older United States adults

Objectives Healthcare expenditures of older United States (US) adults with different pain severity levels are important to investigate given the increasing prevalence of pain in this population. This study assessed the correlation of healthcare expenditures among older US adults with different pain severities, hypothesizing that expenditures would increase as pain severity increased. Methods This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey (MEPS) data and included US adults aged ≥50 with self-reported pain in the past four weeks and positive healthcare costs. Adjusted linear regression models with logarithmically transformed expenditure data compared differences in: total; office-based; outpatient; emergency room; inpatient; other; and prescription medication expenditures, between those with little, moderate, quite a bit, and extreme pain. Analyses were weighted to account for the complex MEPS design and to obtain nationally representative estimates. The a priori alpha level was 0.05. Results The eligible sample of 5,123 individuals produced a weighted study population of 57,134,711 US adults aged ≥50 with pain (little = 53.1%, moderate = 21.6%, quite-a-bit = 18.5%, extreme = 6.8%). In adjusted linear regression models, compared to little pain, extreme pain had the greatest level of costs, followed by quite a bit pain and moderate pain, for total, office-based, and prescription medication costs. For instance, compared to little pain, total healthcare costs were 78% greater for those with extreme pain, 51% greater for quite a bit pain, and 37% greater for moderate pain. However, this pattern was not observed for outpatient, emergency room, inpatient, and other costs, where ≥1 comparison for each cost category was not statistically significant. Conclusions This study found total healthcare costs increased as pain severity increased, yet this was not always the case when analyzing subcategories of healthcare costs. Further research is needed to investigate why some types of healthcare costs are greater with increasing pain severity, yet others are not.

EFFECTIVE MANAGEMENT OF VATALA YONIVYAPDA W.S.R ENDOMETRIOSIS BY AYURVEDA: A CASE REPORT

Background: A married Hindu female patient of 44 years of age visited OPD of National Institute of Ayurveda, deemed to be university, Jaipur on 30 December 2020. She was having chief complaint of extreme and unbearable pain starting 2-3 days before menstruation and continuing in her menstruation also. Methodology: On reviewing her laboratory investigations (USG) she was diagnosed with Endometriosis. On de- tailed history, Dosha assessment was done based on the clinical features and mainly Vata Dosha was found to be vitiated in the present patient. Considering this, she was diagnosed with Vatala Yonivyapada, and treatment was given to her based on the line of treatment explained for Vatala Yonivyapada in classics. Result: Patients showed complete relief in extreme pain during menstruation in the very 1st first cycle following treatment and she is having complete relief in pain to date. Keywords: Vatala Yonivyapada, Endometriosis, Dysmenorrhea

EFFECT OF KSHEERBALA TAILA NASYA IN MIGRAINE WITH SPECIAL REFERENCE ARDHAVABHEDAK: A LITERARY REVIEW

Migraine is a neurological disorder that is frequently characterized by intense and debilitating headaches. According to the records, Migraine tends to affect people aged 15 to 55 years and the extreme pain or headache can last for hours or even days. Migraine is the third most prevalant and 7thleading cause of disability worldwide. There is no direct reference of Migraine in Ayurveda, but signs and symptoms of migraine can be co-related with Shiroroga, one of which is Ardhavabhedak. In Ayurveda, Nasyakarma plays a very important role in the management of Urdhvajatrugat Vikara. Thus an attempt has been made to evaluate the probable efficacy of polyherbal formulation Ksheerbala Taila in Ardhavabhedak.

CLINICAL ASSESSMENT OF A LOCAL APPLICATION OF KASISADI GHRITAIN PARIKARTIKA (FISSURE-IN-ANO)

Parikartika is charecterised by sharp cutting pain in the anal region. In parikartika teevrashoola, bleeding is observed, equally extreme pain slimy blood discharge are seen in fissure-in-ano. To test the efficacy of thelocal application of kasisadi ghruta in managing. Classical signs and symptoms of parikartika (fissure in ano) age groups of 20 to 60 years have been recruited for the research. The trial group obtained treatment with kasisadi ghruta local application for 28 days, twice a day. Average relief observed was observed 62.5% for most symptoms shothahara, vedanasthapana, and ropana are in kasisadi ghruta. Properties because of which it helps in healing the ano fissure.

Pain experience in an aging adult population during a 10-year follow-up

Objectives This 10-year follow-up study aimed to examine the persistence of SF-36 pain intensity and pain-related interference and to identify baseline factors that may relate to pain experience among community-dwelling aging adults. Methods Questionnaire and clinical data on a total of 1,954 participants (mean age at baseline 63 years) were collected in 2002, 2005, 2008, and 2012. Based on pain reports, four pain intensity, pain interference (PIPI) groups were formed at each time point: PIPI group I: none to mild pain intensity and interference; II: moderate to extreme pain intensity, none to mild pain-related interference; III: None to mild pain intensity, moderate to extreme pain-related interference, IV: Moderate to extreme pain intensity and interference. Results Participants with the most pain at baseline improved their pain situation the most during the follow-up. Higher BMI was associated with pain interference, and metabolic syndrome (MetS) and musculoskeletal diseases with both pain intensity and interference (p<0.05, statistically significant interaction between pain intensity and pain interference) at baseline. According to multivariate logistic regression analysis the following baseline characteristics were associated with remaining in PIPI group I throughout the follow-up: presence of musculoskeletal disease (OR 0.22 [95% CI 0.16–0.30]), high BMI (OR 0.93 [95% CI 0.90–0.97]), high household income (OR 1.46 [95% CI 1.07–1.98]), good childhood home environment (OR 1.03 [95% CI 1.00–1.05]). Conclusions Multiple factors may affect pain persistence in late adulthood with varying effect on pain intensity and pain-related interference. Pain situation of even those with most pain may be improved.

Non-uremic calciphylaxis in a woman without end-stage renal disease

A woman in her 60s with a history of lower extremity vascular disease presented with extreme pain and wounds in her legs which had kept her from walking for several weeks. The patient’s pain became intolerable throughout her hospital stay despite multiple surgical revascularisations. Biopsy of the patient’s calf wounds revealed evidence of calciphylaxis, a diagnosis which corresponds with this patient’s extreme pain. Our patient had no history of end-stage renal disease.

Effectiveness of Light Pressure Stroking Massage with Sesame Oil in Alleviating Acute Knee Joint Pain among Elderly Adults

Osteoarthritis (Acute knee joint pain) is a major health problem in the world. This investigation to assess the impact of lightweight stroking knead with effective sesame oil on torment seriousness of patients with knee joint agony. The main aim to determine the effectiveness of light pressure stroking massage with sesame oil on alleviating acute knee joint pain among elderly adults. (Age, Sex, Religion, Marital status, Educational status, Diet habit, Exercise, Body mass index). A pre-test was conducted to assess the WOMAC scale was managed to evaluate the level of pain. A back rub with sesame oil was applied 3weeks period. A post-test was led to evaluate the adequacy of the intercession. The knee pain level was surveyed by Western Ontario MAC Master Scale. The discoveries were most of the older grown-up individuals 46.7% had moderate pain, 10% had moderate pain, 31.7% had serious pain, 11.6% had extreme pain. After the back rub with sesame oil the knee pain level was diminished to 26.7% had mild pain, 40% had moderate pain, 25% had serious pain, 3% had extreme pain. The finding of the examination uncovered that knead with sesame oil for Knee joint pain was compelling in a huge decrease of the knee joint pain level at the degree of p<0.05 in the trial gathering. Thusly, because of ease, simple use and absence of unfriendly impact, it is proposed to utilize this oil on integral medication for relief from discomfort.

The Influence of Pain on Frailty among the Elderly: Based on Korea Health Panel

Background: Interests between pain and frailty have been increasing in aging or aged societies. This study aimed to identify the prevalence of pain and frailty and to find the influence of pain on frailty. Methods: Subjects were selected with aged 65 yr or older among pooled Korea Health Panel data from 2009 to 2013. The prevalence of pain was determined by combining some pain and extreme pain and also, frailty was defined when subjects had at least one of the following 6-domain frailty: physical inactivity, mobility reduction, dependence of daily life, depression, multimorbidity, and disability. Results: The prevalence of pain and frailty was 56.1% and 59.8%. It was significantly higher in female (66.1% and 65.2%) and the oldest-old (69.4% and 71.8%). After adjusting for gender, age group, spouse, illiteracy, and economic activity, odds ratios of frailty for some pain and extreme pain were 2.8 (95% CI 2.6-3.0) and 10.5 (95% CI 8.0-13.8) in total subjects. The odds ratios of each 6-domain frailty for some and extreme pain were also significant. Among them, mobility reduction was 5.1 (95% CI 4.5-5.8) and 16.5 (95% CI 13.6-20.1), and dependence of daily life was 3.9 (95% CI 3.5-4.5) and 12.4 (95% CI 10.2-15.1). Conclusion: Among the elderly, prevalence of frailty (59.8%) was somewhat higher than that of pain (56.1%). Female and oldest-old had higher prevalence of pain and frailty. In addition, some pain and extreme pain had a decisive influence on frailty and each 6-domain frailty. Therefore, pain control is essential to prevent or manage frailty.

A Case Report of Urusthambha Vyadhi

Ayurved is the science of good long health and vitality. All possible vyadhis (disease) and their treatments classified under vata, pitta and kapha (tridosha) types. There have been mentioned 80 types of vata vyadhis (type of diseases) as per classical texts of ayurved. Uruthambha vyadhi (disease) is the type of vata vyadhi explained by acharya charak separately in Charak samhita other than mentioned 80 types. Urusthambha is caused due to avrodh (obstruction) of vata (type of dosha) by aama (indigested food) and meda dhatu (fat). It obstructs the natural karya (function) of vata in urupradesh (femoral region) due to which the patient has restricted or no movements of thighs. Hence it’s the avran (covering) of aama & meda dhatu to prakruta vata (normal vata)which produces difficulty in walking along with symptom as sthambha (stiffness) in uru Pradesh (thigh region) and hence known as urusthambha. Urustambha cases are very uncommonly seen and diagnosed in routine clinical practice and hence we thought to present the case which diagnosed & successfully treated with only ayurveda. A male patient aged 39 yrs was reported for OPD by us at Shree gajanan ayurvedic chikitsalay and panchakarma centre, panvel, navi mumbai, Maharashtra (Registration no- 2166) with complaints of difficulty in walking with extreme pain and stiffness in uru pradesh (thigh region).We diagnosed and treated for urusthambha with classical treatment mentioned as per charak samhita (ayurvedic text) and was recovered completely after the regular treatment. Patient showed progressive improvement with complete cure in the period of 1 year & 2 months with abhyantara (internal) and bahya chikitsa (external treatment).