03161nas a2200517   4500000000100000008004100001653000900042653001400051653001000065653002300075653002300098653001600121653002400137653000900161653001500170653002500185653002500210653001000235653001100245653001100256653002800267653002500295653002300320653002400343653001000367100001600377700001200393700001700405700001300422700001100435700001900446700001700465700001200482700001700494700001400511700001400525700001500539700001300554700001500567700001500582245019600597300001100793490000800804520181700812022001402629       2013                            d10aYoga10aSelf care10aRubia10aPower (Psychology)10aNeglected Diseases10aMiddle Aged10aMedicine, Ayurvedic10aMale10aLymphedema10aIntervention Studies10aIntegrative Medicine10aIndia10aHumans10aFemale10aElephantiasis, Filarial10aCompression Bandages10aCommunity Networks10aBreathing Exercises10aAdult1 aNarahari SR1 aBose KS1 aAggithaya MG1 aSwamy GK1 aRyan T1 aUnnikrishnan B1 aWashington R1 aRao BPS1 aRajagopala S1 aManjula K1 aVandana U1 aSreemol TA1 aRojith M1 aSalimani S1 aShefuvan M00aCommunity level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study.  a566-770 v1073 a<p><strong>BACKGROUND: </strong>Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting.</p>

<p><strong>METHODS: </strong>Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol.</p>

<p><strong>RESULTS: </strong>A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p &lt; 0.000. In AK inflammatory episodes at the three months interval reduced from 37.5% (127 patients) to 28.3% (96 patients) and in GK from 37.6% (147 patients) to 10.2% (40 patients), p &lt; 0.000. All patients had reduced bacterial entry points. There was an overall improvement in quality of life in all domains of LF specific quality of life questionnaire p &lt; 0.000.</p>

<p><strong>CONCLUSIONS: </strong>Self care and integrative treatment is possible in resource poor Indian village settings. Further work is needed to explore factors leading to better compliance by randomizing the interventions such as washing and emollient compression vs Ayurvedic and yoga interventions before integrative treatment is considered for national health programmes in developing countries.</p>
  a1878-3503