1.A cluster of co-occurring cases of leptospirosis and brucellosis in a pastoral community of dairy farmers, India, 2023–2024: an epidemiological investigation
Farida Khatoon ; Srividya K Vedachalam ; Sushma Choudhary ; Subodh Kumar Joshi ; Pankaj Kumar Jain ; Yogesh Bahurupi ; Fareedduzzafar . ; Meenu Singh ; Pankaj Kumar Singh
Western Pacific Surveillance and Response 2026;17(2):50-56
Objective: A cluster of leptospirosis and brucellosis cases in a semi-nomadic, pastoral community was reported in October 2023 from Village A, Uttarakhand State, India. This cluster was investigated to describe the epidemiology and potential exposures.
Methods: Suspected cases were residents with sudden-onset fever or myalgia occurring from 1 August 2023 to 7 January 2024; confirmed cases were suspected cases with laboratory confirmation. Suspected cases were identified through a house-to-house case search and were interviewed regarding sociodemographic variables, symptoms and exposures. Those who consented were tested. Data were cleaned and analysed in Microsoft Excel.
Results: Fifty suspected cases were identified among a total of 300 residents across 85 households. Among these, 27 agreed to be tested, and 25 were confirmed (13 with leptospirosis, 7 with brucellosis and 5 with both leptospirosis and brucellosis). The cases began in September 2023 following flooding and continued until January 2024, with no deaths. The median age (range) of cases was 30 (17–82) years for leptospirosis, 39 (25–56) years for brucellosis and 39 (22–50) years for coinfection. Altogether, females accounted for 92% (12/13) of leptospirosis cases, 57% (4/7) of brucellosis cases and 80% (4/5) of coinfections. Symptoms included fever, myalgia and arthralgia. All cases reported contact with floodwater and animal abortus.
Discussion: This was a laboratory-confirmed co-occurring cluster of leptospirosis and brucellosis, including five cases of coinfection, following flooding, predominantly affecting female Van Gujjar dairy farmers. Education was provided to the community about the hygienic disposal of animal waste.
3.Ultrasound-guided pulsed radiofrequency ablation of stellate ganglion in upper-extremity phantom limb pain: a case series
Ajit KUMAR ; Manasa KANTHA ; Sonal GOYAL ; Pradeep ATTER
Anesthesia and Pain Medicine 2024;19(4):349-352
Background:
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.Case Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Conclusions
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
4.Ultrasound-guided pulsed radiofrequency ablation of stellate ganglion in upper-extremity phantom limb pain: a case series
Ajit KUMAR ; Manasa KANTHA ; Sonal GOYAL ; Pradeep ATTER
Anesthesia and Pain Medicine 2024;19(4):349-352
Background:
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.Case Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Conclusions
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
5.Ultrasound-guided pulsed radiofrequency ablation of stellate ganglion in upper-extremity phantom limb pain: a case series
Ajit KUMAR ; Manasa KANTHA ; Sonal GOYAL ; Pradeep ATTER
Anesthesia and Pain Medicine 2024;19(4):349-352
Background:
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.Case Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Conclusions
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
6.Ultrasound-guided pulsed radiofrequency ablation of stellate ganglion in upper-extremity phantom limb pain: a case series
Ajit KUMAR ; Manasa KANTHA ; Sonal GOYAL ; Pradeep ATTER
Anesthesia and Pain Medicine 2024;19(4):349-352
Background:
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.Case Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Conclusions
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
7.Epidemiology of Traumatic Spinal Cord Injury in the Himalayan Range and Sub-Himalayan region: A Retrospective Hospital Data-Based Study
Osama NEYAZ ; Vinay KANAUJIA ; Raj Kumar YADAV ; Bhaskar SARKAR ; Md. Quamar AZAM ; Pankaj KANDWAL
Annals of Rehabilitation Medicine 2024;48(1):86-93
Objective:
To compile epidemiological characteristics of traumatic spinal cord injury (TSCI) in the Northern Indian Himalayan regions and Sub-Himalayan planes.
Methods:
The present study is a retrospective, cross-sectional descriptive analysis based on hospital data conducted at the Department of Physical Medicine and Rehabilitation and Spine Unit of Trauma Centre in a tertiary care hospital in Uttarakhand, India. People hospitalized at the tertiary care center between August 2018 and November 2021 are included in the study sample. A prestructured proforma was employed for the evaluation, including demographic and epidemiological characteristics.
Results:
TSCI was found in 167 out of 3,120 trauma patients. The mean age of people with TSCI was 33.5±13.3, with a male-to-female ratio of 2.4:1. Eighty-three participants (49.7%) were from the plains, while the hilly region accounts for 50.3%. People from the plains had a 2.9:1 rural-to-urban ratio, whereas the hilly region had a 6:1 ratio. The overall most prevalent cause was Falls (59.3%), followed by road traffic accidents (RTAs) (35.9%). RTAs (57.2%) were the most common cause of TSCI in the plains’ urban regions, while Falls (58.1%) were more common in rural plains. In both urban (66.6%) and rural (65.3%) parts of the hilly region, falls were the most common cause.
Conclusion
TSCI is more common in young males, especially in rural hilly areas. Falls rather than RTAs are the major cause.
8.Ultrasound-guided pulsed radiofrequency ablation of stellate ganglion in upper-extremity phantom limb pain: a case series
Ajit KUMAR ; Manasa KANTHA ; Sonal GOYAL ; Pradeep ATTER
Anesthesia and Pain Medicine 2024;19(4):349-352
Background:
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.Case Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Conclusions
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
10.Efficacy of interventional treatment strategies for managing patients with cervicogenic headache: a systematic review
Sonal GOYAL ; Ajit KUMAR ; Priyanka MISHRA ; Divakar GOYAL
Korean Journal of Anesthesiology 2022;75(1):12-24
Cervicogenic headache (CeH) is caused by the disorder of the cervical spine and its anatomical structures. Patients who fail to respond to conservative therapies can undergo interventional treatment. The purpose of this review is to describe the various interventions and compare their relative efficacies. Although a few reviews have been published focusing on individual interventions, reviewing studies on other available treatments and establishing the most efficacious approach is still necessary. We performed a systematic review of studies available on the various interventions for CeH. The PubMed, Embase, and Cochrane databases were searched for literature published between January 2001 and March 2021. Based on the inclusion criteria, 23 articles were included. Two reviewers independently extracted the data from the studies and summarized them in a table. Eleven of twenty-three studies evaluated the effect of radiofrequency ablation (RFA), 5 evaluated occipital nerve blocks, 2 each for facet joint injections and deep cervical plexus blocks, and 1 study each evaluated atlantoaxial (AA) joint injections, cervical epidural injection, and cryoneurolysis. Most of the studies reported pain reduction except 2 studies on RFA. In conclusion, based on the available literature, occipital nerve blocks, cervical facet joint injection, AA joint injection, deep cervical plexus block, cervical epidural injection may be reasonable options in refractory cases of CeH. RFA was found to have favorable long-term outcomes, while better safety has been reported with pulsed therapy. However, our review revealed only limited evidence, and more randomized controlled trials are needed to provide more conclusive evidence.


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