ABSTRACT
Maternal nutrition and congenital malformation are considered as very important factors for intra uterine growth restriction. Present case deals with these two factors in parallel way. A 32 years young lady second gravida, G2P0A1, housewife, residence of Jaipur, came to NIA OPD with complaint of amenorrhea since a month. According to patient her last menstrual period was on 3/3/20. Her antenatal care was continued in NIA OPD. First fetal wellbeing scan reveals mild ventriculomegaly so she was advised for second level scan and quadruple marker but due to low socioeconomic condition patient was not able to do second level anomaly scan and she continued her pregnancy on her own risk. After 7 months she came to us with the complaints of decreased fetal movements. Fundal height corresponding to period of gestation and fetal heart sound was present which was regular. A color doppler was advised which shows normal fetoplacental and uteroplacental circulation, fetal weight was normal according to period of gestation. On the eighth month the fundal height was found decreased along with maternal weight decreased by 1kg. She was suspected for IUGR and planned for Ksheerbasti. After four episodes Ksheer basti on the 36 weeks of gestation, mother had significant weight gain of 2 kg along with increase in fundal height. USG was done which reveals Single live intra uterine pregnancy of 33 weeks 2 days with lumbar spina bifida with meningomyelocele, CHIARI-II brain malformation, EFW– 2282gm. She delivered a live female child of 2300gm through normal vaginal delivery at maternity hospital. Child was having severe form of myelomeningocele with brain malformation.
ABSTRACT
Background: We report a case of primary cervical dystocia managed successfully with Ayurveda therapy. The classical Ayurveda lexicons comprise detailed descriptions regarding Prasava (labor) and its management based on which the present case was intervened which resulted in achieving progressive improvement in cervical dilatation and achieving normal labor. Case Presentation: The case reported in this study is primigravidae, 25 years’ old visited prasutitantra OPD, NIA hospital with 37.2 weeks gestational age complaining of labor pains. Since her contraction and per vaginal findings were suggestive of onset of labor, she was hospitalized for further monitoring and awaited spontaneous progress of labor. Repeated Per vaginal examination revealed no progress in cervical dilatation even after 28 hours and she was diagnosed with primary cervical dystocia. Intervention of Kebuka taila yonipichu-25ml 2 hourly was made which resulted in remarkable cervical dilatation equivalent to mean standard rate following 3 interventions of yonipichu within 6 hours. Conclusion: The status of the cervix during labor is a significant determinant of mode and ease of labor. Ayurveda therapeutic strategy of Kebuka taila yoni-pichu can effectively prime the cervix due to the Garbhashayaka sankochaka and estrogenic properties of Kebuka and the activation of Ferguson's reflex by Yoni-pichu.
ABSTRACT
Ksharakalpana is one of the unique pharmaceutical preparation forms described in Ayurveda. Kshara is ashes of herbal drugs and is alkaline in nature. A detailed description of Kshara Kalpana preparation methods, types, properties and applications of different Kshara are available in Ayurvedic classics. Kshara is the substance having Ksharana and Kshanan properties. Various plants are mentioned as suitable for the preparation of Kshara viz., Apamarga, Arka (Calotropis gigantea Linn.), Mulaka (Raphanus sativus Linn.), Snuhi (Euphorbia nerifolia Linn.) etc. Among these Apamarga, Arka are the most common drugs used for the preparation of Kshara. In the present study whole plant of Apamarga (Achyranthes aspera Linn.) was used for the preparation of Kshara. Different opinions are there about the amount of water to be used, number of filtrations etc., while preparing the Kshara. Generally Apamarga kshara is prepared by decantation process in a single wash. In order to obtain increased yield and to reduce the loss during straining, in the present study it was prepared by the capillary action and three times washing. This method gave 49% more yield of Apamarga kshara and is far more when compared to traditional methods. Physicochemical evaluation of the prepared Kshara complied with the pharmacoepial standards.
ABSTRACT
<p><b>INTRODUCTION</b>Because invasive fungal infections cause significant morbidity and mortality in liver transplant recipients, the use of antifungal prophylaxis, and the early empirical use of antifungal agents, is widespread on liver transplant units. The new-generation azoles such as voriconazole and the echinocandins have been welcome additions to the antifungal armamentarium. These agents have become the leading options for prophylaxis in liver transplant units, despite the absence of strong data for their efficacy in this setting.</p><p><b>CLINICAL PICTURE</b>We report two recipients of living-donor liver transplants who became infected/colonised with fungi resistant to an echinocandin and the azoles after exposure to these agents. One patient developed trichosporonosis while on caspofungin and the other became infected/ colonised with Candida glabrata that was resistant to voriconazole and posaconazole.</p><p><b>CONCLUSION</b>We report these to highlight some of the consequences of using the newer antifungal agents.</p>