In practice, among the patients with most common chronic headaches, the ones which annoy the practising doctors, are those who have chronic migraine or tension headaches or a combination of both.
With the combination of modern drugs, the treatment of frequent migraine headache has become easy, but the management of tension headache remains difficult.
I am writing this article to inform you, that if you came across a wealthy patient whose tension headaches are not responding to drugs, try Inj. Botulism toxin therapy. There are plenty of chances that you will succeed. Whether the patient will be relieved because of the drug or the cost of the drug, I do not know.
In very rich patients, one should advise Inj. Botulism Toxin, but majority of poor and middle class patients not responding to drugs, should be sent for acupuncture therapy. Among all alternative medicines, acupuncture treatment has been shown to be most effective for patients having tension headache. Alternative medicine could be tried only, if you or the patient believe in it.
BABIES OF HBsAg POSITIVE MOTHERS SHOULD BE IMMUNISED
Hepatitis B vaccine and immunoglobulin, solely or in combination, reduce hepatitis B occurrence in newborn infants of mother seropositive for hepatitis B surface antigen (HBsAg). In a meta-analysis of 29 randomised controlled trials on newborns with vaccination or immunoglobulin in their first month of life, Lee and colleagues found that immunisation against hepatitis B reduced the occurrence of infection. They found no significant differences between low dose and high dose vaccine nor recombinant and plasma derived vaccine, but vaccine plus immunoglobulin was superior to vaccine alone.
BMJ, 2006; 332 : 328. |
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