ABSTRACT
Introduction: Growing evidences of the health benefits of yoga are available in the literature. But physicians are not aware of it. Methodology: Databases like PubMed, PubMed Central, Google Scholar, and Scopus are searched for the articles on preventive, therapeutic, and rehabilitation potential of yoga. Scientific evidences available are analyzed and incorporated into the article. Result: Yoga provides relief from stress, anxiety, depression, and obsessive thoughts. It promotes better sleep. It relieves psychosomatic disorders. Yoga helps to cope with post-traumatic stress disorder (PTSD). Pranayama appears to alter autonomic responses by breath-holding that increases vagal tone and decreases sympathetic discharge and causes relaxation. Yoga increases GABAergic activity that has an anxiolytic effect. Yoga reduces stress-induced cortisol release and reduces hyperglycemia. Yoga reduces seizure frequencies, prevents rapid cognitive decline in Alzheimer’s disease, and helps in poststroke rehabilitation. Reduction of blood pressure and heart rate are seen with yoga. Yoga increases heart rate variability (HRV) and reduces health consequences of allostatic overload. Pranayama improves the vital capacity of lungs. Yoga improves musculoskeletal flexibility and enhances the ability of sustained isometric muscle contraction. Yoga is proved to be a viable adjunct of drug therapy for depression and anxiety. It is a promising alternative to psychoanalysis and cognitive behavior therapy. Yoga prevents lifestyle disorders. Conclusion: Yoga is safe and affordable. Integration of yoga in modern medicine needs intensification because of its various health-promoting, disease-preventing, therapeutic, and rehabilitative effects.
ABSTRACT
Introduction: Herbicides are the chemical compounds used to control the growth of unwanted plants or to eliminate them. The common poisonous herbicides available in India are paraquat, glyphosate, pretilachlor, etc. Ingestion of herbicides with suicidal intention is common in rural India and West Bengal but very scanty literature is available. Methodology: We conducted a unicentric, hospital-based, noninterventional, cross-sectional study comprising 50 consecutive patients to estimate the morbidity, case fatality, and clinical features of acute suicidal poisoning of different herbicides used in agricultural fields. Data were collected from history, clinical features, and laboratory findings. Proper statistical method was used for data analysis. Results: Most of the study population were from 26 to 40 years age group (48%), followed by 13–25 years age group (34%). Paraquat was ingested by 64%, followed by pretilachlor (20%) and glyphosate (16%). Common symptoms were vomiting (60%), abdominal pain (40%), throat discomfort (26%), oral ulcer (24%), decreased urination (50%), and respiratory distress (30%). In laboratory investigation, 64% patients had deranged liver enzymes, 58% patients had acute kidney injury, and 30% patients had alveolar damage. A total of 62% patients were discharged after recovery and 38% patients died. Case fatality rate of paraquat was 56.2%, glyphosate was 12.5%, and pretilachlor was nil (0%). Conclusion: Herbicides like paraquat and glyphosate are associated with high morbidity and case fatality. Paraquat has the highest case fatality rate. Pre-emergent herbicide pretilachlor is relatively safe.
ABSTRACT
Palmar fasciitis and polyarthritis syndrome is a rare paraneoplastic syndrome that has been reported mainly for ovarian cancers. It is thought to be a tumour-associated autoimmune disorder. It is associated with polyarthritis and rapid flexion contractures of hands with palmar nodules due to palmar fasciitis. Similar paraneoplastic features in gastric cancers have seldom been reported. Here, I am reporting a case of paraneoplastic syndrome of metastatic gastric adenocarcinoma with polyarthritis of hands and contractures of multiple joints with asymmetric clubbing (right hand more than left hand) and hyperpigmentation over back of hands and fingers. Hyperpigmentation and asymmetric clubbing have not been reported in literature in palmar fasciitis and polyarthritis syndrome. ©
ABSTRACT
A 40 year-old female presented with gradual onset generalised swelling, followed by thickening of skin for one year. She had symmetrical polyarthritis and firm, shiny skin with areas of depigmentation and absence of normal skin wrinkling. She had flexion contracture of fingers, masked facies, difficulty in opening mouth and Raynoud’s phenomenon. She had dysphagia to solid for last two months with recurrent heartburn. ESR was 120mm/1st hr. ANF was positive. X-ray hands showed periarticular osteopenia. Barium swallow X-ray showed dilated distal esophagus with loss of peristaltic contractions and a stricture at lower end of esophagus. Fundic gas was visible (Fig. 1). Upper GI endoscopy excluded any malignancy but showed features of reflux esophagitis with a stricture at lower esophagus causing difficulty in passing the endoscope through it. The esophagus is involved in 50-90% of patients of scleroderma.1 Smooth muscle atrophy and fibrosis lead to thinness and weakening in lower two-third of esophagus and incompetence of lower esophageal sphincter (LES). The proximal one third with its striated muscle is spared. The commonest manifestation is reflux esophagitis, which may be complicated by peptic stricturing near the junction with stomach. Dysphagia occurs due to esophageal dysmotility or stricture. Barium swallow X-ray shows dilatation and loss of peristaltic contractions in lower esophagus. LES is patulous. Esophageal mucosal ulceration and stricture may be visible. Manometry shows decreased amplitude or absence of peristaltic waves in lower esophagus. Resting pressure of LES is subnormal, but sphincter relaxation is normal. The differential diagnosis, achalasia shows esophageal dilatation with persistent beaklike narrowing of terminal esophagus due to non-relaxing LES. Chest X-ray shows absence of gastric air bubble and an air-fluid level in mediastinum on erect posture. Manometry shows normal or elevated resting pressure of LES and elevated resting pressure in esophageal body. Management of scleroderma esophagus includes proton pump inhibitors and dietary adjustments with soft foods. Bougie dilatation may be required for stricture. REFERENCE Kahan A, Menkes CJ. Gastrointestinal involvement in systemic sclerosis.Clin Dermatol 1994;12:259-65.