A randomized, double-blind, parallel and placebo-controlled clinical study to evaluate the efficacy and safety of KaraCalm™: a dietary supplement to support sleep and manage stress

Background: KaraCalm™ is a novel polyherbal formulation obtained from the combination of Valeriana officinalis extract, Passiflora incarnata extract, Ocimum sanctum extract, Ziziphus jujuba extract, Rosmarinus officinalis extract, and Nigella sativa extract. The objective of the present investigation was to assess the efficacy and safety of KaraCalm™ to manage stress and improve sleep in healthy subjects in a randomized, double-blind, placebo-controlled clinical study. Methods: A total of 60 healthy volunteers were randomized into two groups, with 30 subjects in the KaraCalm™ group and 30 in the placebo group. Participants were asked to take KaraCalm™ 500 mg or placebo once daily for 56 days. As primary outcomes, sleep analysis was performed by using Actiwatch, while stress level was evaluated with the Perceived Stress Scale (PSS) scores from baseline to the end of the study period. Serum cortisol, and hs-CRP from baseline to the end of the study period were assessed as secondary endpoints. Results: An increase in overall sleep quality was observed in the KaraCalm™ group compared to the placebo as measured by total sleep time, onset latency, wake after sleep onset minutes, and number of awakenings. There was also a reduction in PSS scores in the KaraCalm™ group from baseline to the end of the study, indicating reduced stress levels. A significant reduction in Serum cortisol and hs-C-reactive protein (CRP) levels in the KaraCalm™ group from baseline to the end of the study further supported the effectiveness of KaraCalm™ in reducing stress. There was no significant change in the safety analyses of the patients in the intervention group when assessed from the start of the study to the end. Conclusions: KaraCalm™ can be considered a safe and effective dietary herbal Supplement to reduce stress and improve sleep quality.

Smartphone addiction: impact on health and well-being

This study explores the increasing prevalence and negative impacts of excessive smartphone use. It emphasizes the detrimental effects on academic performance, mental health, and physical well-being, highlighting the need for intervention strategies. The review aims to summarize evidence demonstrating the significant influence of smartphone addiction on dietary behavior and lifestyle, as well as the complex interplay between mobile phone usage patterns and mental health outcomes. The document suggests that mindfulness practices, self-reflection, and seeking professional help can be effective strategies to combat smartphone addiction. Through a systematic literature search using databases like Google Scholar, NIH, and PubMed, the review gathers information on smartphone addiction's effects on health, academics, and adolescence. The conclusion calls for longitudinal studies to track the long-term impact of smartphone usage on academic performance and overall well-being. It recommends identifying at-risk groups for intervention and promoting responsible smartphone usage to prevent adverse effects. Overall, the document underscores the importance of understanding the factors contributing to smartphone addiction and implementing measures to foster genuine human interactions, balance technology use, and mitigate the hazards of smartphone addiction among adolescents.

Histomorphological spectrum of meningeal tumours and its association with MIB-1 labelling index

Background: Meningiomas are extremely common, slow growing tumours originating from meningeal covering of brain and spinal cord. They are mostly encountered in middle or later adult life. Females are affected more commonly than males. Grading of meningiomas based on histological features has certain limitations in predicting exact biological behavior hence ancillary studies like immunohistochemistry can be used to predict the nature of the lesion. Methods: This prospective cross-sectional study was conducted in pathology department in our institute. Total 105 cases, diagnosed as meningioma between October 2019 to May 2021 were included in the study. Immuno-staining was performed using MIB-1 antibody against ki67 antigen. Various statistical test methods like chi square test, unpaired t test and spearman’s rho correlation were used to evaluate the significant value. Results: Among 105 patients analysed there were 78.09% females (mean LI 4.01±3.25%) and 21.91% males (mean LI 3.17±2.64%). Mean age of presentation was 53.14 years and most common subtype was transitional meningioma with 51.43% cases. Histological grading revealed 95.24% WHO grade 1 tumor (mean LI- 3.33±2.22%), 4.76% WHO grade 2 (mean LI- 13.80±2.28%) and no case of WHO grade 3. There was correlation between values of MIB-1 LI and histological grade. Some differences for MIB-1 labelling index were found among the subtypes of meningioma of same grade. Conclusions: The MIB-1 is one important tool in addition to routine histological evaluation. High MIB-1 LI indicates higher grade of meningioma.

Screening of type 2 diabetes mellitus patients for their macrovascular complications in tertiary care hospital

Background: Type2 diabetes is characterized by a long asymptomatic period commonly to be diagnosed when complications appear. The risk factors associated with diabetes are age, hypertension, dyslipidemia, smoking, alcohol, obesity & others. The role of early detection and adequate treatment of diabetes and related complications patients and health services is the basis for present study.Methods: The present study was conducted at S.N. Medical College, Agra, India on 86 consecutive newly diagnosed cases of type 2 diabetes. All individuals aged ≥ 20 years of age, who were not known diabetic, presenting to medicine department were included in the study for the targeted and opportunistic screening duration of January 2011 to June 2012.Results: The prevalence rates of vascular complications in this study group were analyzed statistically. The findings are the mean age was 54.27±9.27 years. 72.09% of newly diagnosed type 2 diabetes patients were aged above 50 years. Maximum number of patients were overweight (37.20%) followed by obese (32.55%). Hypertension was present in 30.23%, prevalence of CAD was 9.30%, and none had evidence of PVD and Cerebrovascular disease.Conclusions: Macrovascular complications were present in 9.30% of asymptomatic newly diagnosed type 2 diabetes patients. In the study present study found that there was a significant association of these risk factors were identified and treated as early as possible to decrease the progression of vascular complications.

Role of Serum Iron and Serum Calcium in Patients of Cholelithiasis

Gangetic plains are known to have a very high incidence of cholelithiasis, the eiopathogenesis of which cannot be ascertained. Aim: to conduct a study to find a correlation, if any between the incidence of gallstone disease and the serum Iron and serum Calcium levels of patients and compare it with controls. Methods: 50 patients and 50 controls were taken and serum Iron and serum Calcium of both were evaluated. The distribution of age, sex and gender were taken as factors. Results and conclusion: The number of female patients was higher than the males but no strong association could be proven in the study. Among the symptoms dyspepsia had the highest incidence but could not be taken as a reliable marker for the diagnosis of cholelithiasis clinically. Hence, ultrasonography remains a very important tool for the diagnosis of the diasease .The role of serum Iron and serum Calcium in the etiopathogenesis could not be established. There was however a strong correlation of previous surgery in the formation of new gallstones .The family history was a strong factor for the formation of new gallstone disease however, the association was not established in this study. Gallstone disease had stronger association with anaemia than with serum Serum Iron. Calcium levels were comparable between the cases and the controls.

Analysis of the Functional Outcome of Limb Length Discrepancy after Total Hip Replacement

Background: The Aim of the study was to analyze the functional outcome of limb length discrepancy after total hip replacement. . Methods: It is a Prospective study on 21 patients who underwent total hip replacement with different hip pathology between November 2015 and October 2017. Results: 13 males and 8 females patients with a mean age of 35.31±7.42 (21-50) were followed up for a time of 12months. Limb length discrepancy and hip function of 21 patients who underwent primary total hip arthroplasty were assessed before surgery and 1month, 3 month and 12 month after surgery. Limb length discrepancy was evaluated before and after surgery by clinical and radiological method, Functional outcome assessed by using the Oxford hip score (OHS) and Harris hip score(HHS). Preoperatively all patients had shorter limb length as compared to contra lateral side. Postoperatively in 42.9% (9/21) the limb operated on was longer, in 19 %( 4/21) of cases limb operated on was shorter and in 31 %( 8/21) postoperative limb length were equal. Postoperatively limb length discrepancy was present in 61.9 %( 13/21) & was perceived by 53.8 %( 7/13 of cases) when either shortening or lengthening exceeded 10mm. Oxford hip score (OHS) and Harris hip score (HHS) were significantly increased at subsequent follow up (at 1, 3 and 12 months). Functional scores (OHS and HHS) were excellent in patients with equal limb length as compared to those having shorter or longer limb length. Conclusion: Patient with limb length discrepancy had negative influence in relation to limping and pain. Patients should be counseled preoperatively about possible limb length differences and associated symptoms.

A prospective study of wound infection among post‑discharge patients at a level 1 trauma centre of India.

Background and Aim: To study the rate of wound infections in the post‑discharged patient population and to assess the usefulness of post‑discharge surveillance. Methods: A prospective surveillance of all the post‑discharged trauma patients was done during a period of 6 months. Discharge instructions were given to all the patients regarding identification of the signs and symptoms of wound infections. They were telephonically followed up after a week to enquire about the wound condition and followed up in the outpatient department (OPD). Microbiology culture samples of those showing any signs and symptoms of infections were sent and their antimicrobial therapy, any change in the treatment schedule and the length of their hospital stay were noted. Factors such as wound class, type of surgeries and readmissions were noted. Results: A total of 281 postdischarge patients were enrolled, of which 101 were completely followed up for wound infections. Males were predominant (89%). Of the 101 patients, 42 (41.6%) patients wound showed infection during the intense follow‑up in the OPD. However, 59 patients (59/101, 58.4%) showed wound swab culture positivity before discharge. These 42 patients developed signs and symptoms of infection post‑discharge; 23 (22.7%) of them had change of antibiotic therapy during the follow‑up period due to culture positivity. Acinetobacter sp., Staphylococcus aureus and Klebsiella pneumoniae were the predominant organisms isolated in the study. A total of 45 patients (44.5%) had to be readmitted due to wound site infections. Conclusions: Wound infections are common after discharge among trauma patients highlighting the importance of active surveillance and participation of patients.

Detecting mutation pattern of drug‑resistant Mycobacterium tuberculosis isolates in Himachal Pradesh using GenoType® MTBDRplus assay.

Context: Tuberculosis (TB) is a major public health problem in India and a principal cause of death in adults, especially among the economically productive age group. India accounts for one‑fifth of the global burden of TB. It is estimated that about 40% of Indian population is infected with TB bacillus. The GenoType® MTBDRplus molecular method allows rapid diagnosis of the clinical samples and detection of the most common mutations in the genes associated with rifampicin (R) and isoniazid (H) resistance. Aims: To study the drug resistance and mutational patterns in multidrug‑resistant (MDR) suspects clinical strains using GenoType® MTBDRplus assay. Subjects and Methods: A total of 770 sputum samples of the MDR‑TB suspects were included in this study, which were received at Intermediate Reference Laboratory, Government TB Sanatorium, Dharampur, Solan, Himachal Pradesh from the Designated Microscopy Centres of Himachal Pradesh for the culture and susceptibility testing. All the 521 Mycobacterium tuberculosis complex (MTBC) strains were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay to detect molecular resistance pattern to first line anti‑tubercular drugs (isoniazid and rifampicin). Results: Of 770 samples, 556 (72.20%) were from male and 214 (27.80%) were from female. Among the 521 MTBC strains, 19.76% were found to be MDR and mono‑resistance to isoniazid and rifampicin was detected in 8.63% and 6.14% strains respectively. About 74.81%, 76.35% and 5.40% strains harboured known mutation in rpoB, katG and inhA genes respectively. Conclusions: In rpoB gene, the most common mutation is associated with S531 L region. The GenoType® MTBDRplus assay is a rapid test for the detection of the most common mutations in MDR‑TB strains. In our study, unknown rpoB gene mutations were found in 25.18% strains that may further be detected by gene sequencing.

Spontaneous rupture of a congenital umbilical hernia in an infant: a rare complication.

Umbilical hernia is not uncommon in children. Most of these hernias close spontaneously as the children grows; they are often remarkably free from complications. Though in no way affecting the accepted principles of management of umbilical hernia, we feel that this case of spontaneous rupture is worth recording. To report a case of spontaneous rupture of a congenital umbilical hernia with evisceration of small intestines in a 45-day-old 3.5 kg female infant.

Transoral migration of peritoneal end of ventriculoperitoneal shunt with perforation of gastro-esophageal junction: a case report of a rare complication.

A rare complication of ventriculoperitoneal (VP) shunt is presented. A 11-year old boy presented with a tube coming out of the mouth. He had multiple VP shunt done earlier. Clinical features, laboratory investigations and imaging studies showed that the peritoneal end had perforated the gastro-oesophageal junction and then prolapsed trans-orally. The shunt was removed and he made an uneventful recovery. Though migration of the peritoneal end of the shunt tube into various organs is known, to our knowledge, only six/seven cases have been reported in the English literature of a shunt tube coming out of the mouth and this is the next. The management of this very rare problem is discussed.

An experimental study on the effect of isoniazid on the efficacy, plasma concentration and toxicity of paracetamol in Albino rats.

Background: Paracetamol is used for symptomatic treatment of fever and pain with isoniazid and other anti-tubercular drugs in patients of tuberculosis. Literature has conflicting data regarding their interaction. Some studies show that isoniazid increases oxidative metabolism of paracetamol whereas some other suggest that isoniazid has an inhibitory effect. The present study was conducted to find out the possible interaction between paracetamol and isoniazid. Methods: The study was undertaken on Wistar strain of Albino rats. Group I and Group II animals were treated with paracetamol (500 mg/kg) and the combination of paracetamol (500 mg/kg) and isoniazid (30 mg/kg) respectively for 2 months. Blood samples were taken before and during the study for biochemical and histopathological studies of liver and renal functions and plasma paracetamol concentration was also evaluated. Results: Isoniazid decreased the plasma paracetamol concentration without affecting its analgesic activity. However, the hepatotoxic and nephrotoxic effects of paracetamol were found to be further aggravated by isoniazid co-administration. Conclusion: Isoniazid potentiates the hepatotoxic and nephrotoxic effects of paracetamol possibly due to hepatic enzyme induction by isoniazid.

Screening of the Antibacterial Activity of Amorphophallus Campanulatus from Bastar Region of Chhattisgarh, India.

The present study was aimed to evaluate the antibacterial activity of Amorphophallus campanulatus (family: Araceae) commonly known as jangli suran. The root, stem and leaf of A. campanulatus, extracted successively with polar (aqueous, methanol), dipolar (acetone) and non polar (chloroform) solvents, yielded more phyto compounds in case of root followed by stem and leaf. The extracts were assessed for their antibacterial activity against both gram positive and gram negative bacteria viz., Bacillus cerus, Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus vulgaris, Pseudomonas aeruginosa and Klebsiella pneumoneae. The gram positive bacteria were found to be more sensitive than gram negative bacteria. The inhibition of both gram positive and gram negative bacteria by the extracts indicate the presence of broad spectrum antibiotic potential. The root extract of the plant was found to be more effective in inhibiting the bacterial growth as compared to stem and leaf. The methanol root extract of the plant showed maximum inhibition against all gram positive and one gram negative Pseudomonas aeruginosa bacteria followed by acetone and chloroform. The highest activity index was recorded in methanol extract of root in Pseudomonas aeruginosa. The results were promising and supported the use of plants root by traditional healers in curing several ailments.

Planting geometry to optimize growth and productivity in faba bean (Vicia faba L.) and soil fertility.

Faba bean (Vicia faba L.) responses to alteration of its ambient environment leads to certain modification in the crop phenology, yield attributes and economic yield. To know the extent and pattern of response by faba bean to alterations, a two year field experimentation was carried out with two crop establishment methods (i) flatbed planting (ii) raised bed planting, four planting geometry (i) 30X20 cm(ii) 30X30 cm (iii) 30X45 cm and (iv) 45X45cm and three seeding depth. All the treatment (two crop establishment methods, four planting geometry and three seeding depth) were combined together consisting twenty four treatments, were organized in factorial experiment in complete randomized block design (CRBD) with three replications. Data were recorded on growth and development; yield attributes and yield. Soil analysis was done and finally statistical tool were applied to come in to valid conclusion. Raised bed planting proves superior over flatbed in case of seed yield. Square planting architect with 30 cm apart prove better (3690.9 kg ha-1) than other tested planting geometry. Seeding at 10 cm depth showed, significant improvement in seed yield per plant and per ha over other two tested seeding depth. Phosphorus availability was significantly higher in raised bed planting (36.9 kg ha-1). However, available K (kg ha-1) was significantly influenced by planting geometry and seeding depth. It was maximum (155.2 kg ha-1) with 30X 45 cm plant geometry, proved significantly higher than 30X20 cm and 30X30 cm and at par with 45X45 cm planting.

Rosai-Dorfman disease with sinonasal mucosal involvement.

Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy (SHML) is a rare benign disorder that typically manifests as massive lymphadenopathy and systemic symptoms. The authors report a 27-year-old man who presented with nasal mass and generalised cervical lymphadenopathy. Cytological and histopathological examination of lymph nodes demonstrated lymphophagocytosis (emperipolesis) consistent with a diagnosis of RDD. There was remarkable regression in the size of nasal polyps and lymph nodes after systemic corticosteroids. The clinical and histological aspects of the disease are discussed as a rare cause of generalised lymphadenopathy.

Comparison of the health-promoting orientation of three tertiary care hospitals of India.

Background. Hospitals have been considered as places for the provision of curative services. Nowadays, services related to health promotion are also sought to be provided through hospitals. We compared the health-promoting hospital (HPH) orientation of the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh with two other tertiary care hospitals in India, which have been declared HPH by WHO. Methods. The score obtained by PGIMER as an HPH as per the WHO standards tool was compared with that of two other tertiary care hospitals in India. A short survey was also conducted of patients visiting PGIMER for their treatment through a selfadministered, pretested questionnaire. A statistical test for difference in proportions was applied. A SWOT analysis was done to assess how PGIMER performed as an HPH. Results. The HPH score of PGIMER was significantly lower (35/80) than that of the other two hospitals. There was no formal HPH policy in PGIMER. One-third of the patients interviewed were not satisfied with the overall preventive and health-promoting services of PGIMER. Apart from the parameters of the HPH standards, PGIMER seemed to satisfy the expectations from it being an apex medical institute. Conclusion. In view of its low score as an HPH, PGIMER should frame an appropriate HPH policy and devise strategies to provide leadership to other hospitals in India.