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Prevalence and clinical characteristics of headache in dental students of a tertiary care teaching dental hospital in Northern India  [cached]
Ruchika Nandha,Mahinder K. Chhabra
International Journal of Basic & Clinical Pharmacology , 2013, DOI: 10.5455/2319-2003.ijbcp20130110
Abstract: Background: Chronic headache is as much as a problem in India as elsewhere in the world with a rising trend in young adults which negatively affects the quality of life of the affected person. In current scenario of increasing prevalence of headache in students, most of them have been found to practice self medication leading to inappropriate management and sometimes analgesic overuse causing treatment refractoriness. Methods: A questionnaire based survey was done on undergraduate dental students at a tertiary care dental teaching hospital in Northern India. Severity of headache was assessed by Numeric Rating Scale. Data collected was analyzed to assess the prevalence, pattern & triggering factors of headache along with awareness of dental students regarding treatment. Prevalence and characteristics of migraine were also assessed along with the therapeutic strategies opted by students. Results: Our study (n=186) demonstrated headache prevalence of 63.9% which was higher in females (74.3%) as compared to males (32.6%). Headache experienced by majority of student population was bilateral (36.13%), sharp stabbing (38.65%) and of moderate intensity (57.98%). Common associated symptoms were nausea/ vomiting (24.36%) and scalp tenderness (22.68%). Stress (82.3%) &irregular sleep (81.5%) were the most common triggering factors. Prevalence of migraine was 13.44% with female preponderance (87.5%). Practice of self medication was reported by 88.2% of students. Most commonly used drugs were paracetamol (36.76%), aspirin (26.47%) and combination of ibuprofen and paracetamol (25%). Specific medication use in migraineurs was found to be low (25%) showing inadequate management of migraine headache in our study population. Conclusions: The results in this study demonstrate high headache prevalence in dental students with self medication being practiced by the majority. [Int J Basic Clin Pharmacol 2013; 2(1.000): 51-55]
Headache in an emergency room in Brazil
Bigal, Marcelo;Bordini, Carlos Alberto;Speciali, José Geraldo;
Sao Paulo Medical Journal , 2000, DOI: 10.1590/S1516-31802000000300002
Abstract: context: when experiencing a headache attack, brazilian patients usually look for a primary care service, where they are seen by general clinicians. in the town of ribeir?o preto, these clinicians routinely refer patients to the emergency room of the university hospital. objective: the objective of this study was to evaluate the quality of primary care by analyzing retrospectively the medical records of patients with a complaint of headache seen in this emergency room during the year of 1996. design: retrospective study. settiing: emergency room of the universital hospital, ribeir?o preto, s?o paulo, reference unit. participants:1254 patients. the patients who sought the emergency room (er) of the university hospital of ribeir?o preto, during the year of 1996 with a complaint of headache were studied retrospectively. main measurements: etiology, age, diagnosis, secondary cause, laboratory tests. results: of the 1254 patients seen (61% women), 1190 (94.9%) were discharged after the administration of parenteral analgesics before they had spent 12 hours in the room. only 64 (5.1%) patients remained for more than 12 hours. of the patients who spent less than 12 hours in the room, 71.5% had migraine or tension type headache and did not require subsidiary exams for diagnosis. of the patients who spent more than 12 hours in the room, 70.3% had secondary headaches. conclusions: we conclude the primary care for headache is unsatisfactory in the ribeir?o preto region. many patients with primary headache are referred to tertiary care services, indicating the need for the dissemination of the diagnostic criteria of the international headache society to general practitioners.
Prevalence of parafunctional habits and temporomandibular dysfunction symptoms in patients attending a tertiary headache clinic
Fragoso, Yára Dadalti;Alves, Heloísa Helena Carvalho;Garcia, Sidney Oliveira;Finkelsztejn, Alessandro;
Arquivos de Neuro-Psiquiatria , 2010, DOI: 10.1590/S0004-282X2010000300009
Abstract: objetive: to investigate the most prevalent forms of headache in a tertiary outpatient service, and to assess the frequency of associated parafunctional habits and temporomandibular dysfunction symptoms (tmd). method: all new patients referred to the headache outpatient service in unimes during 2008 were prospectively assessed by the neurologist and the dental surgeon. results: eighty new patients were assessed; chronic migraine and episodic migraine without aura were the most prevalent conditions, accounting for 66.3% of all cases. there was significantly higher use of analgesics/days for the chronic migraine patients. the prevalence of parafunctional habits was 47.5% and the prevalence of tmd symptoms was 35%. conclusion: the high prevalence of primary headaches, parafunctional habits and tmd symptoms and the inadequate use of analgesic drugs suggest that primary healthcare units need further training in the field of headache and orofacial pain.
Classification and Clinical Features of Headache Disorders in Pakistan: A Retrospective Review of Clinical Data  [PDF]
Muhammed Murtaza, Mehreen Kisat, Haroon Daniel, Aziz B. Sonawalla
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005827
Abstract: Background Morbidity associated with primary headache disorders is a major public health problem with an overall prevalence of 46%. Tension-type headache and migraine are the two most prevalent causes. However, headache has not been sufficiently studied as a cause of morbidity in the developing world. Literature on prevalence and classification of these disorders in South Asia is scarce. The aim of this study is to describe the classification and clinical features of headache patients who seek medical advice in Pakistan. Methods and Results Medical records of 255 consecutive patients who presented to a headache clinic at a tertiary care hospital were reviewed. Demographic details, onset and lifetime duration of illness, pattern of headache, associated features and family history were recorded. International Classification of Headache Disorders version 2 was applied. 66% of all patients were women and 81% of them were between 16 and 49 years of age. Migraine was the most common disorder (206 patients) followed by tension-type headache (58 patients), medication-overuse headache (6 patients) and cluster headache (4 patients). Chronic daily headache was seen in 99 patients. Patients with tension-type headache suffered from more frequent episodes of headache than patients with migraine (p<0.001). Duration of each headache episode was higher in women with menstrually related migraine (p = 0.015). Median age at presentation and at onset was lower in patients with migraine who reported a first-degree family history of the disease (p = 0.003 and p<0.001 respectively). Conclusions/Significance Patients who seek medical advice for headache in Pakistan are usually in their most productive ages. Migraine and tension-type headache are the most common clinical presentations of headache. Onset of migraine is earlier in patients with first-degree family history. Menstrually related migraine affects women with headache episodes of longer duration than other patients and it warrants special therapeutic consideration. Follow-up studies to describe epidemiology and burden of headache in Pakistan are needed.
Distribution of “Brazilian headache specialists” – Analyses of Brazilian Headache Society members
Marcelo Rodrigues Masruha,Jano Alves de Souza,Helio Barreiros,Elcio Juliato Piovesan
Einstein (S?o Paulo) , 2007,
Abstract: Objective: Two important barriers that hinder the adequate care ofpatients with headache are the inadequate learning of the disorder inMedical Schools and the relative lack of headache specialists. Herewe report the results of a survey on the distribution of headachespecialists in Brazil. Methods: The inclusion of specialists was donethrough visual inspection of the 2004-2005 Directory of the BrazilianSociety of Headache. Inclusion was determined based on societyaffiliation. Non-physician members were excluded from the analysis.The specialists were distributed by absolute and relative numbers(professionals/regional population ratio) for each Brazilian state, andwere aggregated in geopolitical regions. Results: Two hundred andforty-three headache specialists are distributed over 22 states. Thestate with the highest absolute number of headache specialists is SaoPaulo (n = 86); however, when the HS/population ratio was analyzed,Rio de Janeiro has the highest figure – 0.003/1000 inhabitants.Conclusions: This study provides the distribution of headachespecialists, with the higher densities of physicians with special interestin headache concentrated in the south and southeast regions. An idealdensity of such professionals is yet to be determined. A special effortshould be made towards a better density and distribution of headachespecialists in Brazil. Public policies should be taken in order to reducethe burden of headaches in the general population.
Types of Stratigraphic Traps in Tertiary Deposits of the Eastern Slovakia
Janoèko Juraj
Acta Montanistica Slovaca , 2004,
Abstract: Tertiary sediments of the Eastern Slovakia were deposited in the Eastern-Slovakian Basin, Inner-Carpathian Paleogene Basin and basins of the Outer Western Carpathians represented by Magura and Dukla Units. In the first basin shallow-water conditions prevailed during the deposition and the most common types of perspective hydrocarbon traps are represented by architectural elements of deltaic and shelfal environments. The second and third areas are typical by predominant deep-water sediments forming basic types of the most perspective traps: canyon fills, deep-water distributary channels and lobes comprising basic architectonical elements of turbidite depositional systems. Tapering fan-deltaic fronts on steeply inclined ramps are also valuable from the view point of hydrocarbon prospection.
The impact of headache and chronic musculoskeletal complaints on the risk of insomnia: longitudinal data from the Nord-Tr ndelag health study
Siv Steinsmo deg rd, Trond Sand, Morten Engstr m, John-Anker Zwart and Knut Hagen
The Journal of Headache and Pain , 2013, DOI: 10.1186/1129-2377-14-24
Abstract: In this prospective study headache and CMSCs were risk factors for insomnia 11 years later.
Using relative survival measures for cross-sectional and longitudinal benchmarks of countries, states, and districts: the BenchRelSurv- and BenchRelSurvPlot-macros
Christian O Jacke, Iris Reinhard, Ute S Albert
BMC Public Health , 2013, DOI: 10.1186/1471-2458-13-34
Abstract: Applications and extensions of algorithms can be used to link the information on disease phases with relative survival rates and to consolidate them in composite measures. The application of the developed SAS-macros will give results for benchmarking of health care quality. Data examples for breast cancer care are given.A reference scale (expected, E) must be defined at a time point at which all benchmark objects (observed, O) are measured. All indices are defined as O/E, whereby the extended standardized screening-index (eSSI), the standardized case-mix-index (SCI), the work-up-index (SWI), and the treatment-index (STI) address different health care aspects. The composite measures called overall-performance evaluation (OPE) and relative overall performance indices (ROPI) link the individual indices differently for cross-sectional or longitudinal analyses.Algorithms allow a time point and a time interval associated comparison of the benchmark objects in the indices eSSI, SCI, SWI, STI, OPE, and ROPI. Comparisons between countries, states and districts are possible. Exemplarily comparisons between two countries are made. The success of early detection and screening programs as well as clinical health care quality for breast cancer can be demonstrated while the population's background mortality is concerned.If external quality assurance programs and benchmark objects are based on population-based and corresponding demographic data, information of disease phase and relative survival rates can be combined to indices which offer approaches for comparative analyses between benchmark objects. Conclusions on screening programs and health care quality are possible. The macros can be transferred to other diseases if a disease-specific phase scale of prognostic value (e.g. stage) exists.
Bounds of the Pinsker and Fannes Types on the Tsallis Relative Entropy  [PDF]
Alexey E. Rastegin
Physics , 2011, DOI: 10.1007/s11040-013-9128-z
Abstract: Pinsker's and Fannes' type bounds on the Tsallis relative entropy are derived. The monotonicity property of the quantum $f$-divergence is used for its estimating from below. For order $\alpha\in(0,1)$, a family of lower bounds of Pinsker type is obtained. For $\alpha>1$ and the commutative case, upper continuity bounds on the relative entropy in terms of the minimal probability in its second argument are derived. Both the lower and upper bounds presented are reformulated for the case of R\'{e}nyi's entropies. The Fano inequality is extended to Tsallis' entropies for all $\alpha>0$. The deduced bounds on the Tsallis conditional entropy are used for obtaining inequalities of Fannes' type.
Relative types and extremal problems for plurisubharmonic functions  [PDF]
Alexander Rashkovskii
Mathematics , 2005,
Abstract: We study properties of relative types of plurisubharmonic functions with respect to maximal plurisubharmonic weights. It is shown that they give a general form for upper semicontinuous, tropically additive functionals on plurisubharmonic singularities. We consider some extremal problems whose solutions are Green-like functions that give best possible bounds on a plurisubharmonic function, given the values of its types relative to some of (or all) the weights. An analyticity theorem is proved for the upperlevel sets for the types with respect to exponentially H\"older continuous weights, which leads to a result on propagation of plurisubharmonic singularities.
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