Critical Review of Ayurvedic and Contemporary Concept of Dushi Visha and its Treatment

Poisoning is a major public health concern that is becoming more common by the day. Poison can be consumed directly or indirectly from a variety of sources. Poisoning can now be found in a variety of areas, including junk food with chemical preservatives, various sorts of growing products like rice and wheat, and pesticide-laced veggies. As a result of diverse human behaviours, water, air, and soil have become contaminated, posing a hazard to human health. According to Ayurvedic doctrine, there are several sources of obtaining of toxins i.e., either through animate, inanimate or Kritim(artificial). Such toxins are accumulated without eliminating through the body or remains with being the less potent inside the body for several years generally called Dushi Visha. All the sign and symptoms of Dushi Visha looks like that of chronic poisoning and varies from organs to organs, where it becomes deposited. Such accumulated Visha then vitiates Dosha and that leads to vitiation of different kinds of Dhatus respectively. like, Rakta Dusti, Kitiva, Vrana, Kotha are the major manifestations that will see after prolong exposure to Dushi Visha. The main line of treatment of Dushi Visha is through Detoxification (i.e., Vamana, Virechana, Raktamokshana karma) followed by Dushivisari Agad Paana, that has mentioned by Charak. Classical text book has mentioned different level of clinical manifestations including sign and Symptoms and its complication along and its management with specific Justification.

Sharing a Novel Experience of Treating Addiction to Opium and Derivatives with only Ayurvedic Approach- A Case Series

Introduction: Opium and its derivative addiction are one of the most prevalent addictions in western Rajasthan, because it is easily available and is being used openly in social programs as the culture of the same. In western Rajasthan, mainly Doda poppy, opium milk, smack, tramadol, etc. are major forms of opium-derived addictions. Withdrawal symptoms such as nausea, vomiting, diarrhea, chills, body ache, sleeplessness and flu-like symptoms begin, these symptoms can grow severe enough to necessitate emergency medical attention, and in extreme situations, they might have life-threatening consequences for the user as a result of respiration depression, and pupil dilation in the later stages. The assessment was based on Clinical Opiate Withdrawal Scale (cows) before and after the treatment. Intervention: Efforts have been applied to depict 8 cases of opium addiction in form of series who have been treated with Ahiphenmochanadi vati in the dose of 250 mg twice a day and Sameergaja kerari rasa in the tapering method (Padanshika Krama) starting with the dose of 375 mg along with panchakarma procedures, Shirodhara with til tail, Abhayanga, and Swedana with Mahanarayan Tail and Dashmool kwath respectively for a period of 1 month. Reduction in cows scale was observed, about 75-80% of symptoms subsided in all cases and the results have been reported very encouraging within a period of twenty to thirty days. Conclusion: Altogether, multimodal Ayurveda treatment can be an effective and safe solution for smack addictions.

Study the iron status in children with febrile seizures: a hospital based cross sectional study

Background: Febrile seizures are most common among childhood seizures, accounts to 2% to 5% in children below 5 years of age. Iron deficiency can cause many neurological deficits and may lower the seizure threshold. The present study was conducted to determine the iron status in children with febrile seizures.Methods: The present cross-sectional study was conducted in the Department of Pediatrics, HIMS, Dehradun, over a period of 12 month from January 2018 to December 2018. A total of 105 children of age group 6 month to 5 years, coming to pediatrics department were included in the study. Total study subjects were divided into two groups, Group I (febrile seizure) and Group II (other than febrile seizure).  A consecutive sampling method was done for selection of study subjects.Results: In Group I (febrile seizure), the number of males were 71.7% while females were 28.3% with male: female ratio of 2.5:1. In Group I (febrile seizure), 61.7% of subjects had deficient iron level while 38.3% of subjects had normal serum iron level. Our study shows significantly low mean serum ferritin and mean serum iron level in subjects with febrile seizures.Conclusions: We concluded that iron deficiency is more common in febrile seizures and there is a positive association between serum iron level and febrile seizures.

Clomiphene citrate versus letrozole for ovulation induction in anovulatory infertility: a prospective study

Background: The objective of this study was to compare clomiphene citrate with letrozole for ovulation induction in anovulatory infertile women.Methods: This study was conducted in the infertility clinic and department of obstetrics and gynecology, S.P. Medical College and Associated P. B. M. Hospital, Bikaner, Rajasthan, from 1st August 2018 to 31st July 2019. The study group comprised of infertile females attending infertility clinic or gynae outdoor in department of obstetrics and gynecology, S. P. Medical College Bikaner for infertility. 100 women with anovulatory infertility were enrolled in the study after fulfilling the inclusion and exclusion criteria. Proper counseling was done and written informed consent taken.Results: Ovulation rate was statistically significantly greater in letrozole group. Monofollicular development was statistically significant greater in let group (CC 18%, Let 66%). The endometrial thickness on the day of ßhCG administration in CC group was 7.40±1.08 mm and in let group was 8.20±0.82 mm. Letrozole treated cases had better trilaminar pattern of endometrium as compared to clomiphene. The pregnancy rate was higher in letrozole group.Conclusions: As compare to clomiphene, letrozole is associated with higher pregnancy rate and ovulation rates among infertile women with anovulation.

Histological Correlation of Karmans Endometrial Sampling with Dilation and Curettage in Abnormal Uterine Bleeding

The study was done to compare the diagnostic efficacy of endometrial biopsy obtained by Karman suctioncannula with conventional D&C following TVS in patients with AUB. 100 patients of AUB presenting ingynaecology OPD were studied with history, examination, laboratory investigations, TVS, endometrial aspirationusing Karman cannula and endometrial curettage. It is concluded that endometrial aspiration is an effective,useful and minimally invasive procedure and can be used for the primary investigation of women with AUBalong with TVS.

Study of Acute Kidney Injury Associated with Pregnancy

Background: Pregnancy related acute kidney injury(PRAKI) is common in developing countries like India. The aim of the study was to identify the etiology, prognosis, management and to have preventable measures, to improve the maternal and fetal outcome. Methods: The study was conducted in S.P. Medical College& Hospital – Obstetrics and Gynecology Department from July 2017 to December 2017.A total of 22 cases has been studied. Results: The incidence of PRAKI was 1.3% in our hospital. Pregnancy induced hypertension, pre-eclampsia, eclampsia was found to be commonest cause. Incidence of PRAKI was high in third trimester. The outcome was favorable with complete recovery in 45.47% patients. Conclusion: The low incidence of PRAKI was probably due to improved obstetric practices. Future research is further needed, to decrease the incidence.

Water Conservation For Sustainable Future.

It is always easier to waste than to accumulate. The same principle works too when it comes to the issue of conservation of water resources. We all know how precious water is for everyone; still we do not take any initiative for the conservation of water resources and waste it in futility. Almost every country in the world is facing a growing challenge to meet the increasing demand for water that is driven by expanding population and economic growth. We depend upon fresh water that we require for our domestic, agriculture and industrial uses. Water supplies are affected by more industrialization, urbanization, mechanization and their polluting by products. As this water is quite limited, we must be very careful while using it and actively participate towards the conservation of water resources. This paper will help creating awareness among the readers about their contribution towards its scarcity and develop a consciousness about water conservation.

Environmental Pollution and Global Warming.

Our planet earth being an evolutionary planet is capable of supporting life, including human life. The impact of man upon the environment has existed ever since man himself walked on planet earth. Now a days the environmental damage done, particularly the heating up of the atmosphere due to the discharge of so-called green house gases such as nitrous oxide, carbon dioxide, methane etc. are posing major threat to this planet. Green house gases concentration is increasing in the atmosphere, thereby increasing the temperature of the Earth and atmosphere. This increase in temperature can have catastrophic effects on weather, sea level, bio-diversity, human health etc. across the world threatening the survival of mankind on earth. Environmental sensitivity can only grow through a major public awareness campaign. In the present paper an attempt has been made to draw attention towards threatening impacts of global warming, measures to curb global warming and need of value based environmental education to transform the mind set of people.

Methicillin resistant Staphylococcus aureus (MRSA) in India Prevalence & susceptibility pattern.

Background & objectives: Methicillin resistant Staphylococcus aureus (MRSA) is endemic in India and is a dangerous pathogen for hospital acquired infections. This study was conducted in 15 Indian tertiary care centres during a two year period from January 2008 to December 2009 to determine the prevalence of MRSA and susceptibility pattern of S. aureus isolates in India. Methods: All S. aureus isolates obtained during the study period in the participating centres were included in the study. Each centre compiled their data in a predefined template which included data of the antimicrobial susceptibility pattern, location of the patient and specimen type. The data in the submitted templates were collated and analysed. Results: A total of 26310 isolates were included in the study. The overall prevalence of methicillin resistance during the study period was 41 per cent. Isolation rates for MRSA from outpatients, ward inpatients and ICU were 28, 42 and 43 per cent, respectively in 2008 and 27, 49 and 47 per cent, respectively in 2009. The majority of S. aureus isolates was obtained from patients with skin and soft tissue infections followed by those suffering from blood stream infections and respiratory infections. Susceptibility to ciprofloxacin was low in both MSSA (53%) and MRSA (21%). MSSA isolates showed a higher susceptibility to gentamicin, co-trimoxazole, erythromycin and clindamycin as compared to MRSA isolates. No isolate was found resistant to vancomycin or linezolid. Interpretation & conclusions: The study showed a high level of MRSA in our country. There is a need to study epidemiology of such infections. Robust antimicrobial stewardship and strengthened infection control measures are required to prevent spread and reduce emergence of resistance.

A Rare Case of Syncephalus Thoracopagus Monster.

Conjoined twins are rare with an incidence of 1 in 1,00,000 to 2,00,000 births. They are always monozygotic and are more common in females (3:1). About 40 to 60 % are stillborn and another 35 % die within 24 hours after the delivery. We hereby Report a rare case Syncephalus Thoracopagus Monster.

Thyroid Profile In Menstrual Disorders.

To study the thyroid related complaints & thyroid function tests in women with DUB and to study the menstrual pattern in women with thyroid disease. Fifty patients of DUB (GP-A) in reproductive age group presenting with menstrual irregularities like menorrhagia, oligomenorrhoea, amenorrhoea, hypomenorrhoea and polymenorrhoea were studied for thyroid profile and fifty thyroid patients were studied in endocrinology for menstrual patterns (GP-B). Out of 50 women (GP-A), hypothyroidism was detected in 11 (22%) and hyperthyroidism in 7 (14%). In Group-B 56 % of hypothyroid patients had disturbed menstrual cycles with associated problems and 62 % of hyperthyroid patients were found to have disturbed menstrual cycles ranging from menorrhagia to oligomenorrhoea to amenorrhoea. Thyroid function tests must be ordered in women presenting with DUB, to avoid unnecessary hormonal treatment and surgery in such patients.

Nebulized salbutamol vs salbutamol and ipratropium combination in asthma.

OBJECTIVE: To see the additional benefit of combined frequent nebulization with salbutamol and ipratropium bromide in acute attack of asthma with moderate severity. METHODS: Fifty asthmatic children in the age range of 6-14 years were divided into two equal groups. Group I children were nebulized with three doses of Salbutamol alone (0.03 ml/kg/dose) and Group II children were given combined nebulization of Salbutamol (dose as in group I) and Ipratropium bromide (250 microgm/dose for three doses) at 20 minutes interval. Children were observed at 15, 30, 60, 120, 180 and 240 minutes interval. RESULTS: A significant improvement in % of PEFR starting at 30 minutes and lasting the entire study period of 4 hours was noted in both the groups. However on analysis of varience the results were better in group II. CONCLUSION: Frequent combined nebulization with Salbutamol and Ipratropium bromide is beneficial in acute asthma of moderate severity.

Neonatal adrenal hemorrhage with intraperitoneal spill managed conservatively.

A neonate presented with anemia, hyperbilirubinemia and bilateral flank fullness at 23 days of age. Ultrasound abdomen showed bilateral adrenal hemorrhage with intraperitoneal extension on the left side. This was managed nonoperatively and the hematoma resolved completely. Literature regarding this rare entity is described.

Lipid peroxidation in bronchial asthma.

OBJECTIVE: To study the levels of free oxygen redicals in children with bronchial asthma during an attack and symptom free interval. METHODS: Serum Malondiadehyde (MDA) levels were studied in 25 children between the age of 6 years-14 years who presented with an acute attack of bronchial asthma. In each patient, serum MDA levels were measured at the time of admission, 24-48 hours after good response to treatment and after a symptom free interval of 3 weeks. Results were compared with control group. RESULTS: In study group serum MDA levels were highest at the time of admission, which decreased significantly at 24-48 hours with treatment. After a 3 weeks symptom free interval serum MDA levels had decreased further but were still higher than healthy control group. CONCLUSION: Lipid peroxidation is increased in bronchial asthma during an acute attack and symptom free period.

Study on efficacy of WHO-ORS in malnourished children with acute dehydrating diarrhoea.

Twenty-five well nourished children (group A) and 25 malnourished children (group B) of acute diarrhoea with some dehydration were taken up for the study. Both the groups were given World Health Organisation-oral rehydration solution (WHO-ORS) as per WHO guidelines. In both the groups, isonatraemic dehydration was the commonest (group A 64%, group B 56%). Hypokalaemia was noted in 32% cases in group A and 60% cases in group B. Oral rehydration therapy (ORT) was successful in 92% cases in well nourished group A cases and in 80% in group B cases. The mean time in hours required for hydration (group A 8.1+/-1.6; group B 9.1+/-1.4; p<0.05) and hospital stay in days (group A 1.6+/-0.9; group B 3.2+/-3.3; p<0.05) were longer in group B.

A profile of renal/renovascular abnormalities in patients of hypertension.

After a thorough dinical examination and laboratory investigations, ultrasonography (USG) followed by minute sequence urography (MSU) and aortography and/or selective renal angiography were done in 108 patients, clinically suspected of having renal hypertension of which 32 patients (29.6%) were found to be positive for renal/renovascular disease. Out of 82 patients, who were only young hypertensives, a definite diagnosis of renal/renovascular disease could be made in only 15 cases (18.3%), whereas the pick up rate increased to 65.4% in the rest of the 26 patients who had some other clinical criteria besides hypertension and it further increased up to 92.3% (out of these 26 patients) who had 2 or more than 2 clinical criteria of selection of patients besides hypertension. USG was useful in diagnosing renal parenchymal disease/ suggesting renal abnormalities in 30 cases and MSU was able to detect renal changes in 31 patients. Aortography and/or selective renal angiography could make a definite diagnosis of renovascular disease in 17 cases and renal agenesis in one case.

Malignant Gastrointestinal Stromal Tumour Presenting as Ovarian Cyst

A rare case of malignant gastrointestinal stromal tumour presenting as ovarian cyst on clinical and radiological diagnosis is discussed with its presentation and management.