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Immature hematopoietic progenitors are a constant source for renewal of hemocyte populations and the basic component of the tissue and cell repair apparatus. A unique property of these cells of internalizing extracellular double-stranded DNA has been previously shown. The leukostimulatory effect demonstrated in our pioneering studies was considered to be due to the feature of this cell. In the present research, we have analyzed the effects of DNA genome reconstructor preparation (DNAgr), DNAmix, and human recombinant angiogenin on both hematopoietic stem cells and multipotent progenitors. Treatment with bone marrow cells of experimental mice with these preparations stimulates colony formation by hematopoietic stem cells and proliferation of multipotent descendants. The main lineage responsible for this is the granulocyte-macrophage hematopoietic lineage. Using fluorescent microscopy as well as FACS assay, co-localization of primitive c-Kit- and Sca-1-positive progenitors and the TAMRA-labeled double-stranded DNA has been shown. Human recombinant angiogenin was used as a reference agent. Cells with specific markers were quantified in intact bone marrow and colonies grown in the presence of inducers. Quantitative analysis revealed that a total of 14,000 fragment copies of 500 bp, which is 0.2% of the haploid genome, can be delivered into early progenitors. Extracellular double-stranded DNA fragments stimulated the colony formation in early hematopoietic progenitors from the bone marrow, which assumed their effect on cells in G0. The observed number of Sca1+/c-Kit+ cells in colonies testifies to the possibility of both symmetrical and asymmetrical division of the initial hematopoietic stem cell and its progeny.
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Objectives: Electroconvulsive therapy (ECT) is commonly indicated for refractory psychiatric disorders. However, little research has compared response across diagnoses. Here, we aimed to evaluate the relative impact of diagnosis and clinical staging as response predictors in a cross-diagnostic sample. Methods: In a retrospective cohort of adult inpatients (n=287) who underwent at least six sessions of ECT, we investigated predictors of complete response (a clinical global impression of 1) to ECT. We use adjusted regression models to estimate the impact of clinical diagnosis and staging on complete response and dominance analysis to assess the relative importance of these predictors. Results: Those for whom a depressive episode was a primary indication for treatment were the most likely to have complete improvement, while those with psychosis were the least likely; clinical stage had a significant influence on outcome in all diagnoses. A diagnosis of psychosis was the strongest predictor of non-response. Conclusions: A diagnosis of psychosis (mainly schizophrenia) was the strongest predictor of non-response. We also found that clinical staging can aggregate information on ECT response that is independent of clinical diagnosis.
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Background: Renal tumors constitute approximately 3% of all malignancies in adults. They form a heterogenous group with variable morphological, immunohistochemical, and molecular features. Aim: The objective of this study was to analyze the spectrum of adult renal tumors at a tertiary care center and study the demographic and histomorphological features. Materials and Methods: In this study, 55/87 nephrectomy specimens resected for adult renal tumors during a 1-year period were analyzed retrospectively. Results: There were 4 benign (7.2%) and 51 (92.7%) malignant tumors. There was a male preponderance with a male: female ratio of 3.42:1. The tumors were seen to occur equally in both kidneys. The most common tumor was clear cell renal cell carcinoma (RCC), the conventional type accounting for 65.5% of our study group. There were one each of multilocular cystic renal neoplasm of low malignant potential, papillary RCC, chromophobe RCC, Mit family RCC, oncocytoma and angiomyolipoma and two clear cell papillary RCC during this 1-year period. Uncommon tumors included neuroendocrine carcinoma (1), epithelioid angiomyolipoma (1), mixed epithelial stromal tumor (1), Ewings sarcoma (2), and glomangioma (1). Five cases of urothelial carcinoma of renal pelvis/ureter also were present. Conclusion: This article gives an overview of the spectrum of adult renal tumors at a tertiary care center with an in-depth literature review providing recent advances in each category of tumors.
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Background: Diabetes is highly prevalent and it is responsible for the increased financial burden on healthcare. Type II diabetes is a more prevalent form of diabetes. Uncontrolled and unsupervised type II diabetes may lead to various microvascular and macrovascular complications which are responsible for high morbidity and mortality. Diabetic nephropathy (DN) is a common complication characterized by the expansion of mesangial cells with thickening of the basement and nodular glomerulosis. TNF-alpha and IL-6 play an important role in causing detrimental changes leading to nephropathy. The study of the role of these inflammatory cytokines in patients with DN may help in the early diagnosis and management. Aims and Objectives: The objectives of this study were to compare the levels of proinflammatory cytokines, TNF-?, and IL-6 in the evolution of DN patients. Materials and Methods: The present study was conducted in the Department of Biochemistry, in collaboration with the Department of Medicine (Nephrology unit); Pt. B.D. Sharma, Post Graduate Institute of Medical Sciences, Rohtak after ethical clearance. Forty patients with DN (Stages 3, 4, and 5) and forty patients with diabetes mellitus without nephropathy were taken up for study after taking informed consent. Results: The mean serum TNF-? levels in cases was 33.05 ± 29.22 pg/mL and in controls was 17.67 ± 12.33 pg/mL. On the basis of unpaired t-test, the difference between the groups was statistically highly significant (P < 0.05). The mean serum interleukin-6 levels in cases was 24.92 ± 30.16 pg/mL (2.95–155.55 pg/mL) and in controls was 6.76 ± 5.82 pg/mL (2.22–35.42 pg/mL). On the basis of the t-test, the difference between the groups was statistically highly significant (P < 0.05). Conclusion: TNF-? and IL-6 may serve as potential biomarkers for patients with DN and also in the development of newer therapeutic modalities for the prevention and treatment of DN.
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Background: Telengiectasias are defined as persistent dilatation of small capillaries in the superficial dermis Case: A 26-year-old woman presented with red lesions, epistaxis, joint pains, color changes of the hands, and breathlessness. On clinical examination and investigations, a final diagnosis of mixed connective tissue disease (MCTD), with interstitial lung disease (ILD), with telangiectasias, and epistaxis was made. Telangiectasias and epistaxis are rare presentations of MCTD.
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Background: Pharmacology, being both basic and applied science, is indeed the foundation of rational therapy. Pharmacology education needs constant reform and reorganization to review and adapt learning and teaching methods. It can be better achieved using student feedback. Aims and Objectives: The study was designed to obtain and evaluate the feedback of students on various teaching and evaluation methods in pharmacology. Materials and Methods: It is a cross-sectional study. A pre-tested questionnaire used for the purpose of this study. After obtaining permission from the Institutional Ethics Committee, a questionnaire was given to the students of Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery, Bachelors in science (Nursing), and Allied Health Sciences (AHS) courses. Students who completed pharmacology as a part of their course curriculum were enrolled in the study. Results: A total of 273 students participants took part in our study. The most common age was 20 years (147 students, 53.8%), more females (153 students, 56%), and the majority of them were MBBS students (153 students, 56%). Most of the students found that knowledge of chemotherapy will be useful during the post-course internship (26.4%) and the knowledge of autocoids will be the least useful in clinical practice (1.1%). Students preferred more than studying method for pharmacology (37.4%). Conclusion: An effective teaching program is beneficial to comprehend pharmacology. Any effort at obtaining constant feedback from students makes our methodologies more relevant and interesting. Any worthwhile effort in this direction will lead to more rational prescribers and/or health-care professionals in the future.
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Objective To evaluate the effect of p-coumaric acid (p-CA) on haloperidol-induced catalepsy in Swiss albino male mice. Method To induce catalepsy, haloperidol (1 mg/kg i.p.) was administered for 21 consecutive days. p-CA (50, 75, and 100 mg/kg, PO) was administered 30 min before haloperidol injection for 21 consecutive days. For catalepsy, locomotor activity and motor coordination scores were recorded on the 17, 14, and 21 days of drug treatment, while the gait analysis score was recorded on day 21. After behavioral testing, animals were sacrificed, and various biochemical and histopathology tests of the brain were conducted. Dopamine, malondialdehyde, reduced glutathione (GSH), superoxide dismutase (SOD), and catalase activity were examined in the brain. Results Chronic administration of haloperidol significantly increased catalepsy in mice. It also produced hypolocomotion, motor coordination, and gait disturbance in mice. p-CA significantly inhibited haloperidol-induced catalepsy. Haloperidol significantly increased malondialdehyde levels in the brain. While dopamine levels in the brain dropped along with GSH, SOD, and catalase activity levels, which also had an impact on the histology of the brain. p-CA significantly reduced haloperidol-induced increases in brain oxidative stress, dopamine levels in the brain, and brain histology in mice. Discussion p-CA significantly reduced haloperidol-induced catalepsy, possibly through reducing oxidative stress and increasing brain dopamine levels. It can be a good candidate drug for extrapyramidal symptoms in Parkinson’s disease and adjuvant therapy with antipsychotic drugs.
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Abstract Cryptosporidiosis is a waterborne protozoal infection that may cause life-threatening diarrhea in undernourished children living in unsanitary environments. The aim of this study is to identify new biomarkers that may be related to gut-brain axis dysfunction in children suffering from the malnutrition/infection vicious cycle is necessary for better intervention strategies. Myeloperoxidase (MPO) is a well-known neutrophil-related tissue factor released during enteropathy that could drive gut-derived brain inflammation. We utilized a model of environmental enteropathy in C57BL/6 weanling mice challenged by Cryptosporidium and undernutrition. Mice were fed a 2%-Protein Diet (dPD) for eight days and orally infected with 107-C. parvum oocysts. C. parvum oocyst shedding was assessed from fecal and ileal-extracted genomic DNA by qRT-PCR. Ileal histopathology scores were assessed for intestinal inflammation. Prefrontal cortex samples were snap-frozen for MPO ELISA assay and NF-kb immunostaining. Blood samples were drawn by cardiac puncture after anesthesia and sera were obtained for serum amyloid A (SAA) and MPO analysis. Brain samples were also obtained for Iba-1 prefrontal cortex immunostaining. C. parvum-infected mice showed sustained stool oocyst shedding for six days post-infection and increased fecal MPO and inflammation scores. dPD and cryptosporidiosis led to impaired growth and weight gain. C. parvum-infected dPD mice showed increased serum MPO and serum amyloid A (SAA) levels, markers of systemic inflammation. dPD-infected mice showed greater MPO, NF-kB expression, and Iba-1 immunolabeling in the prefrontal cortex, an important brain region involved in executive function. Our findings suggest MPO as a potential biomarker for intestinal-brain axis dysfunction due to environmental enteropathy.
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Background: Critically ill (CI) patients, especially those requiring mechanical ventilation (MV) are at a higher risk of malnutrition, which in turn is associated with increased hospitalization and excess mortality. The modified Nutrition Risk in Critically Ill (mNUTRIC) score, a predictor of mortality, has not been validated adequately in CI Indian patients. Thus, this study evaluated the mNUTRIC score as a prognostic marker of morbidity and mortality in CI patients requiring MV. Materials and methods: This prospective observational study was performed, between January 2018 and June 2019, in the intensive critical care unit (ICCU) of the medicine department of a tertiary care hospital. A total of 250 patients aged above 12 years, admitted in ICCU, and requiring MV for >48 hours were included. Based on the data collected, mNUTRIC score was calculated and patients were classified as at low (0–4) and high (5–9) nutritional risk. Mortality was the outcome variable. Results: More than a quarter of patients had a high mNUTRIC score (28.4%) and the overall mortality was 35.6%. A significantly greater proportion of non-survivors had a high mNUTRIC score (p-value<0.0001). Likewise, the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and mNUTRIC score (all p-values<0.0001) were significantly higher among the non-survivors than the survivors. On receiver operator characteristic (ROC) curve analysis, a cutoff value of >2 predicted mortality [area under the curve (AUC): 0.83; 95% confidence interval: 0.778–0.874] with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 80.9, 76.4, 65.5, and 87.9%, respectively. Conclusion: At a cutoff of >2, mNUTRIC score had high sensitivity and specificity in the prediction of mortality.
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Background: Arthritis is a leading cause of physical disability and impaired quality of life. At present, symptomatic treatment is available for arthritis. According to literature, apigenin possess anti-inflammatory activity. Aims and Objectives: The present study aimed to screen the anti-inflammatory activity of Apigenin in freund’s induced arthritis in Wistar albino rats. Materials and Methods: A total 30 rats were selected and divided into five groups each of six animals. Group – I (Normal saline), Group – II (Freund’s adjuvant (0.1 ml of 0.5%), Group – III (Dexamethasone 0.1 mg/kg), Group – IV (Apigenin 50 mg/kg), and Group – V (Apigenin 100 mg/kg) doses were administered to their respective groups for 28 days. X-ray was taken on 28th day and animals were sacrificed and affected paw used for histopathological examination. Results: Group – II rats showed inflammation, thickness, fibro, and fatty changes in joint compared to Group – I X-ray and histopathological examination. Groups – III and V rats showed reduction inflammation, thickness, and fatty changes compared to Group – II. Group – IV showed lesser effect compared Group – V. Conclusion: Apigenin administration significantly prevent the Freund’s induced radiological and histopathological changes in rats.
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Skin, the body’s largest organ, protects from deleterious environmental impacts (physical, chemical, microbiological) and is crucial for the maintenance of temperature, electrolyte and fluid balance and tactile sensation, it sets a boundary between the organism and the environment. Any change in the normal skin texture disturb the patient both mentally and physically. Psoriasis is a common, chronic, recurrent inflammatory disease of the skin, characterized by circumscribed, erythematous, dry, scaly plaques of varying sizes. The severity of psoriasis is found to be ever fluctuating. Individuals are likely to cycle between differing levels of severity throughout lifetime. The course of the disease is punctuated by spontaneous flare-ups and remissions. Psoriasis being a chronic and often disfiguring condition, cause a marked impairment in quality of life. There is no certain cure for this disease. Ayurvedic diagnosis is as Vatha-Kapha predominant Mahakushta namely Sidhma kushta. Here an effort to treat a 13-year-old child having plaque psoriasis by Samsodhana and Samsamana therapy. Initially 6 days Virechana was performed and then followed by Samsamana with intermittent Virechana karma. PASI score is used to assess the severity of psoriatic lesions and the patient’s response to treatment. PASI score before the treatment was found to be 15.7 which became 0 at the end of the treatment. This case report showed the treatment modalities done in the patient obtained great result with no recurrence in the last 1.5 years.
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Background: Thyroid hormone metabolism disrupts after cardiopulmonary bypass both in adults and pediatric patients. This is known as Euthyroid sick syndrome, and it is more evident in pediatric patients who were undergoing complex cardiac surgeries compared to adults. This decrease in serum T3 levels increases the incidence of low cardiac output, requirement of inotropes, prolonged mechanical ventilation, and prolonged intensive care unit (ICU) stay. Aims and Objectives: The primary objective was to compare the mean Vasoactive?inotropic score (VIS) at 72 hours postoperatively between T3 and Placebo groups. Materials and Methods: One hundred patients were screened, and 88 patients were included in the study. Triidothyronine 1 mic/kg 10 doses 8th hourly was given orally postoperatively to cases and sugar sachets to controls. The blood samples for analysis of FT3, FT4, and TSH were taken every 24 hours postoperatively, and baseline values were taken after induction. Mean VIS scores, ejection Fraction (EF), Left ventricular outflow tract velocity time integral (LVOT VTi), hemodynamics and partial pressure of oxygen/ fraction of inspired oxygen(PaO2/ FiO2) were recorded daily. Results: The Mean VIS scores at 72 Hours postoperatively were significantly less in the T3 group (5.49 ± 6.2) compared to the Placebo group (13.6 ± 11.7).The PaO2/FiO2 ratios were comparatively more in the T3 group than the Placebo group.The serum levels of FT3 FT4 were significantly higher in the T3?supplemented group than the Placebo group.TheVIS scores were significantly lower from48 hours postoperatively in children < 6 months of age. Conclusion: In this study, we observed that supplementing T3 postoperatively decreases the ionotropic requirement from 72 hours postoperatively. This is more useful in children <6 months of age undergoing complex cardiac surgeries.
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Background: The prevalence of hypertension is rapidly increasing among both rural and urban populations and is a matter of concern in India. L-Arginine serves as a principle substrate for nitric oxide production which is a potent vasodilator. Aims and Objectives: This study was designed to determine the effects of oral L-arginine on blood pressure in hypertensive patients on antihypertensive drugs. Materials and Methods: This was a randomized clinical trial, registration in Clinical Trial Registry of India (CTRI) Registration number: CTRI/2019/03/018026. All patients with hypertension visiting the medicine outpatient department of Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital, Loni, were included in the study. Study participants were randomized into intervention group (I group) and control group (C group). The I group includes 74 participants and the C group includes 75 participants. The I group received antihypertensive therapy along with add-on L-arginine oral supplementation for 14 days. The C group received only standard antihypertensive therapy and had followed up similar to that of the participants of the I group. Results: The baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the I group and C group was statistically non-significant as analyzed by unpaired t-test, whereas in the I group, there was a significant decrease in SBP and DBP on the 1st, 2nd, and 3rd follow-up visits compared to the C group (Friedman test). Conclusion: The findings of the present study showed that add-on L-arginine supplementation at a dose of 3 g/d (L-arginine 5 g sachet) for 2 weeks in patients of hypertension resulted in significant decrease in the SBP and DBP.
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Cauda equina compression at the level of L4/L5 or L5/S1 level is a surgical emergency with potentially significant consequences, including motor and sensory dysfunction. The causes include disc herniation, spinal stenosis, cancer, trauma, epidural abscess. The common cause is usually a disc herniation which is most commonly due to trauma, age, connective tissue disorders and congenital disorders. Cauda equina syndrome a disorder caused by compression of the nerve roots in the cauda equina region. This can cause permanent loss of bladder and bowel control if not treated within time. The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to the fifth decade of life with a male to female ratio 2:1. If decompressive surgery is delayed, there can be catastrophic consequences for the patient in terms of bladder, bowel and sexual function. In the present case study, a 36 year old female patient who was diagnosed as a case of Cauda Equina compression due to an extruded L4-L5 disc refused to undergo surgery and opted for Ayurvedic treatment. She was admitted in the Kayachikitsa IPD for 45 days. She was treated with the principle of Gridrasi along with Pakwasayagata vata. Deepana pachana and Vasti or Sodhana is the main treatment choice. Rooksha and Snigdha swedas were done which also help to reduce the stiffness and pain. After the management her physical condition and quality of life improved.
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Background: The estimated prevalence of self-medication practices globally and nationally are 95% and 71% respectively. Inappropriate self-medication leads to irrational use of drugs and development of drug resistance. Hence, the present study was conducted to estimate the prevalence and patterns of self-medication practices in urban field practice area, SDMCMS&H, Dharwad. Methods: A cross-sectional study was conducted during 2018-2019 among adult aged 18-60 years. The estimated sample size was 335. Systematic random sampling technique was used to select the samples. Data was collected by administering questionnaire to the consented study participants. Results: A total of 335 adults participated in our study. The prevalence of self-medication practices was 46%. Minor-illness 89(57.7%) and quick relief 50(32.46%) were the major reasons given for practicing self-medication. Fever and headache 146(94.8%) was the most common symptom and analgesic 128(83.11%) was the most common drug used. significant association was found between self-medication practices and religion, age, employment and presence of health care workers in the family. Conclusion: Around half of the study participants practiced self-medication. Easy availability and limited knowledge are the reasons for wide range of practice. Creating awareness about dangers of self-medication is important to prevent untoward effects and drug resistance.
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The Nursing and staff serves as backbone of a healthcare system. Despite being central to any healthcare system, not much has been written about them, especially on the issue of their regulations and legal liabilities emanating from their professional activities. Though they are governed by National and State councils, the implications of their acts are different in Civil Law, Criminal Law and under their respective regulations. These differences are primarily the subject matter of this paper.
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BACKGROUND Persistence of symptoms following Covid-19 infection has now been recognized as an upcoming public health crisis. Understanding these persistent symptoms and quantifying them is vital in planning care for these patients. Studies from India estimating the magnitude of these persistent symptoms are scarce. We aimed to estimate the proportion of symptoms that persist among patients who have recovered from Covid-19 infection. METHODS We conducted this descriptive study among 114 individuals after they recovered from Covid-19 infection. Participants diagnosed as Covid-positive at a tertiary care centre were included in the study. Data were collected from the participants through an online platform. Frequency and proportion of various persistent symptoms were estimated. Analysis was done using SPSS version 16. RESULTS The mean (SD) age of the study participants was 35.5 (15.7) years. Women comprised 62.3% (n=71) of the population. Persistent symptoms were reported by 66 (57.9%; 95% CI 53.07–62.72) participants. The most common symptoms reported were fatigue (n=45, 39.5%) and joint pain (n=23, 20.2%). Those who required hospitalization for longer duration were found to be more associated with having persistent symptoms (p=0.018). CONCLUSION A sizable proportion of individuals had persistent symptoms after recovering from Covid-19 infection. Health facilities should be equipped to address these emerging issues.
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Introduction: Oligometastatic represents a distinctive subset of metastatic breast cancer (MBC). Incidence has been reported, in 1–5% of all newly diagnosed MBC. Literature is very sparse, especially from India. Material and Methods: We have ambispectively screened 500 patients of upfront female MBC between the period of January 2013 and August 2018 at Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi and 120 patients of oligometastatic breast cancer (OMBC) were included for analysis. Clinical, pathological, receptor status (ER estrogen receptor, PR progesterone receptor, and HER2/neu human epidermal growth factor), radiological, treatment, and survival details were recorded. Results: The median age of presentation was 50 (range 22–78) years. One organ was involved in 96 (80%) patients, and two organs were involved in 36 (20%) patients. ER and/or PR was positive in 48 (40.0%), ER/PR, and HER2/neu were positive in 28 (23.3%) cases. Only HER2/neu was positive in 21 (17.5%), and triple negativity was seen in 23 (19.2%) patients. Ninety?four (78.3%) patients received neoadjuvant therapy, and 12 (10%) patients underwent conservative breast surgery. The overall response rate at the metastatic site was 74.1%, and a complete response was seen in 42.5% of patients. Median progression?free survival (PFS) for the cohort was 25.43 months. The estimated PFS at 2 years and, at 5 years, was 54.6% and 21.6%, respectively. The hormone receptor positivity, bone metastasis, and patients with surgery after neoadjuvant chemotherapy (NACT) had a statistically significant better PFS on multivariate analysis. In a subset analysis of HER2/neu receptor?positive patients, who received targeted therapy showed better PFS compared to those who did not receive. Conclusion: The incidence of OMBC is 24% of the total MBC. The patients with OMBC who have hormone receptor?positive, bone?only metastasis, and surgery after NACT show a better outcome.
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Objectives: Listening to music is entertaining but also has different health benefits. Music medicine involves passive listening to music, while music therapy involves active music-making. Indian music is broadly classified into Hindustani and Carnatic music, each having its system of musical scales (ragas). Scientific studies of Indian music as an intervention are meagre. The present study determines the effect of passive listening to one melodic scale of Indian music on cardiovascular electrophysiological parameters. Materials and Methods: After informed consent, healthy individuals aged 18–30 years of either gender were recruited and randomly divided into two groups (n = 34 each). Group A was exposed to passive listening to the music intervention (Hindustani melodic scale elaboration [Bhimpalas raga alaap]), while Group B received no intervention except for a few natural sounds (played once in every 2 min). Blood pressure (BP, systolic, SBP; diastolic, DBP) and electrocardiogram in Lead II were recorded with each condition lasting for 10 min (pre, during and post). Heart rate variability (HRV) analysis was done. Data were analysed using SPSS 18.0 version and P ? 0.05 was considered significant. Results: In Group A, the SBP did not change during the intervention but increased mildly after the intervention (P = 0.054). The DBP increased in both the groups during the intervention, significant in Group A (P = 0.009), with an increase of 1.676 mmHg (P = 0.012) from pre-during and 1.824 mmHg (P = 0.026) from pre-post intervention. On HRV analysis, mean NN interval increased and HR reduced in both the groups, but was significant only in Group B (P = 0.041 and 0.025, respectively). In Group A, most of the HRV parameters were reduced during music intervention that tended to return toward baseline after the intervention, but the change was statistically significant for total power (P = 0.031) and low frequency (P = 0.013); while in Group B, a consistent significant rise in parasympathetic indicators (SDNN, RMSSD, total power and HF [ms2 ]) over 30 min was observed. Conclusion: Unique cardiovascular effects were recorded on passive listening to a particular Indian music melodic scale. The scale, raga Bhimpalas, produced a mild arousal response. This could be due to attention being paid to the melodic scale as it was an unfamiliar tune or due to the features of this melodic scale that led to an arousal or excitation response. In contrast, the control group had only a relaxation response. Exploring electrophysiological effects of different genres, melodic scales and their properties after familiarising with the music may thus be illustrative.
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Renal tuberculosis presenting as renal cyst is rare. Diagnosing renal tuberculosis in pregnancy is usually delayed due to its atypical presentation. We present a 28-year-old postpartum lady who delivered a healthy baby one month back, with history of intermittent fever and chills. She had high spiking fever (102° F), tachycardia (130/min) and computed tomography showed a 16 × 10 cm right renal cyst. Percutaneous drainage was done, 2 litres of thick pus drained and culture was sterile. After three weeks, deroofing and marsupialization of cyst was done. Biopsy revealed granulomatous inflammation composed of epitheliod histiocytes with central incipient necrosis suggestive of tuberculosis. She was treated with anti-tubercular drugs. As the infant was healthy and had no evidence of tuberculosis, no treatment was initiated. The mother is on follow up for 2 years. This case highlights the rare presentation of renal tuberculosis in puerperium.