Autonomic dysfunctions in patients with scorpion sting: early predictors of severe disease.

Scorpion sting envenomation is a common medical emergency accounting for nearly 2.8% of annual intensive cardiac care unit admissions and much more outpatient visits. Symptomatology and severity of envenomation varies greatly. Autonomic storm may end up in loss of life. Methods: This is a clinical study conducted between April 2011 and February 2013. Patients with moderate to severe envenomation were examined at frequent intervals for various autonomic manifestations. Various demographic, clinical and electrocardiogram (ECG) changes were studied for their association with severity of envenomation. Results were statistically evaluated for their significance. Results: A total of 106 patients were studied with a mean age of 27.25 years and peak incidence between 11 and 30 year age groups. 91% reached the hospital within 12 h. 7.55% of the patients had Grade 2, 74.53% had Grade 3 and 17.92% had Grade 4 disease, all grades were common in 11-30 age group. Autonomic disturbances; profuse sweating seen in 72.6% of the patients that showed a strong correlation with pulmonary edema and ECG manifestations (p ≤ 0.0001). Pulmonary edema was present in 37.7% of the patients. Excessive salivation was seen in 28.3%, and persistent nausea and vomiting were seen in 24.5%, both were associated with severe cardio-pulmonary manifestations. Hypotension was present in 14.2% of patients that was associated with poor prognosis (p ≤ 0.0001). Conclusions: Scorpion sting envenomation is a life-threatening problem requiring immediate attention. Presence of autonomic dysfunctions; profuse sweating, excessive salivation, persistent nausea and vomiting, hypotension at presentation are poor prognostic factors.

Historical review of Vicharchika as per Ayurvedic classics.

Vicharchika which is one of the common skin diseases, is most prevalent among masses whether rural or urban. A critical peep with regard to this into the various Ayurvedic Classics reveals that, the various kushtha rogas (including Vicharchika) were known to ancients of remote antiquity. Though all Ayurvedic classics have described eighteen varieties of Kushthas dividing into the two main groups viv. Mahakushthas and Kshudra Kushthas, but they differ in nomenclature, order, description, doshas involved and prognosis etc.

A medico-historical review of Arjuna

Ancient Indian Medical knowledge known as Ayurveda goes back to a immemorial past. The Vedas and Puranas refer various materials of medical importance including herbs, plants and trees etc. The ancient medical scientists have mentioned the properties of the Arjuna, and recommended mainly for the management of Hirta/Rudhira vikaras, Vrana, Prameha, Visa Vikaras, Asrugdhara, Kshetriya/Shukra dosha etc. The modern medical/Botanical scientists have also carried out so many researches on Arjuna and do not find any difference with the ancestery knowledge.

Epidemiological evaluation of BCG vaccine efficacy in Delhi--1989.

A field evaluation of efficacy of BCG vaccine to prevent tubercular meningitis was undertaken in a case control study in Delhi during 1988-89. Each case of tubercular meningitis was matched by age and neighbourhood with 2 controls from the community. Thirty-seven cases of tubercular meningitis were matched with 74 controls and thus 37 triplets were analysed. ODDS RATIO between BCG vaccinated and non vaccinated individuals for acquisition of tubercular meningitis was 11.3. This gives 84 per cent efficacy of BCG vaccine in the prevention of TB meningitis under the field conditions prevailing in Delhi. Paired matched analysis of tubercular meningitis with the control group 1 and 2 separately revealed the ODDS RATIO to be 9.5 and 15 respectively. The corresponding BCG vaccine efficacy worked out were 90 and 93 per cent respectively. Authors suggest that this method of evaluating BCG vaccine efficacy is fairly reliable and cost effective. This methodology could be further simplified by using hospital patients as control and be introduced to evaluate BCG vaccine efficacy in different areas with reference to its role in preventing tubercular meningitis under the programme of immunisation.