COVID-19 in Children with West Syndrome: An Ambispective Study

Objectives To study the course of West syndrome (WS) and coronavirus disease-19 (COVID-19) in children with WS who contracted SARS-CoV-2 infection. Methods This ambispective study was conducted at a tertiary-care center in North India between December 2020 and August 2021 after approval from the Institute Ethics Committee. Five children with WS, positive for COVID-19 based on RT-PCR, fulflled the inclusion criteria. Results One child with COVID-19 during the frst wave was retrospectively included while four children (of the 70 children screened) were prospectively enrolled. The median age at onset of epileptic spasms was 7 mo (2 boys), and that at presentation with COVID-19 was 18.5 mo. Three had underlying acquired structural etiology. Three were in remission following standard therapy, while two had ongoing spasms at the time of COVID-19 illness. During the illness, two of those in remission continued to be in remission while one child had a relapse. The children with ongoing epileptic spasms had variable course [one had persistent spasms and other had transient cessation lasting 3 wk from day 2 of COVID-19 illness, but electroencephalography (on day 8 of COVID-19 illness) continued to show hypsarrhythmia]. Fever was the most typical symptom (and sometimes the only symptom) of COVID-19, with a duration ranging from 1–8 d. Two children had moderate COVID-19 illness requiring hospitalization, while the rest had a mild illness. All the afected children had complete recovery from COVID-19. Conclusion The severity of COVID-19 illness in children with WS is often mild, while the subsequent course of WS is variable.

Role of Sthanik Chikitsa in Shweta Pradara Associated with Madhumeha (DM Type- II): A Case Study

Shweta Pradara or excessive vaginal discharge is one of the commonest complaints among women of reproductive age group. An increase in the normal vaginal secretion develops physiologically at puberty, at ovulation, premenstrual phase and during pregnancy. Excessive discharge causes irritation and itching in the genetalia. Ayurveda explained this condition as Shweta Pradara. Shweta Pradara is a symptom which is present in most of the diseases or present as a complication. Shweta Pradara is not a disease it produces as a symptom, hence etiopathogenesis of principal disease and Shweta Pradara would be same. It is a Kaphaja disorder at the place of Apana Vayu. A 47 years old female patient suffering from intermittent Yonigata Shwet Strava since two years with aggravation of symptoms from one week presented to Prasuti Tantra Evam Stree Roga OPD. Yonigat Shwet Strava was associated with Yoni Kandu, Katishool, Yoni Daha. On enquiry, it was found that she was the known case of Type II Diabetes Mellitus since 10 years. She was taking medication for the same but her blood sugar levels were uncontrolled in spite of taking medication as per her recent investigations. In this case Shwet Pradar was the Updrava of Madhumeh, thus line of management was planned to control her sugar level by supplementing Ayurvedic drugs along with allopathic medicine for DM II (Madhumeh) and treated her with Yoniprakshalan with Triphala Kwath followed by Cutis ointment tamponing per vaginum for 14 days. She had followed the schedule of Yoni Prakshalana, oral medicines and Pathya-Apathya properly. It was observed that, symptoms were started to reduce gradually which has been depicted by documentation of investigations and local examination in this case study.

A CASE REPORT ON PROSTATIC ADENOCARCINOMA WITH MUCINOUS FEATURES

We present a case of primary adenocarcinoma of the prostate with mucinous feature. Mucinous adenocarcinoma (MC) of the pros¬tate gland is rare morphological variant of Prostate carcinoma characterized by pools of extracellular mucin in >25% of tumor. A 72-year-old male presented to our hospital with urinary frequency, nocturia and voiding difficulties;on digital rectal examination enlarged prostate was observed without any palpable nodule. on Ultrasonography hypoechoic lesion was observed in left lobe of prostate suggestive of prostate tumor. A transurethral resection of prostate confirmed the diagnosis of Prostatic adenocarcinoma with mucinous features and Gleasons score 9(4+5). We report the cases due to the aggressive beahviour and uncommon diagnosis of mucinous variant of adenocarcinoma of the prostate. But it is seen that its proper diagnosis and treatment significantly contribute to favourable prognosis

Clinical Study of Risk Factors for Diabetic Maculopathy

Aim:To determine the association between various systemic risk factors with diabetic maculopathy. Methodology:A prospective observational study was conducted on 50 patients having diabetic maculopathy. Patients with maculopathies secondary to Vitreous Haemorrhage, Ocular disorders like Glaucoma, Uveitis, Advanced Diabetic Eye Disease, Vitreo-macular traction, maculopathy along with proliferative diabetic retinopathy, ischemic maculopathy, and history of laser treatment in last six months were excluded from the study. Data was collected using a structured proforma that included name, age, sex, occupation, height, weight, history of other systemic diseases like hypertension, investigations and treatment taken in past, family history, duration of DM, smoking, hyperlipidemia, hyperglycemia and nephropathy. Results:Out of 50 patients, 38 (76%) were males and 12 (24%) were females suggestive of male predominance. Mean age of the patient was 57.36±11.65 years in males and 56.67±10.17 years in females. Among 50 patients, 19 patients had diabetes mellitus for 6-10 years duration, 14 patients had diabetes mellitus for 1-5 years, in 12 patients for 11-15 years, in 2 patients for 16-20 years, in 2 patients for 21-25 years and only 1 patient more than 25 years. Mean duration of DM was 12.2±6.1 years. Majority of patients having maculopathy had duration of DM up to 20 years. Among 50 patients, 27 patients (54%) had systemic hypertension, 37 patients (74%) had uncontrolled blood sugar level, 29 patients (58%) were found to have hyperlipidemia and 20 patients (40%) had nephropathy. Among 50 patients, pseudophakia was noted in 7 patients (14%), obesity was noted in 21patients (42%). Eleven patients (22%) were found to have anemia, 6 patients (12%) had family history of DM and 13 patients (26%) had history of smoking. Conclusion: Hyperglycemia, hypertension, duration of DM, hyperlipidemia are the major risk factors for the development and progression of diabetic maculopathy. While anemia, smoking, obesity and family history of DM is the less signi?cant risk factors

Study of Anaemia and Iron Profile in the Subjects with Vitamin D Deficiency Comparison with Healthy Controls without Vitamin D Deficiency

Introduction: Iron and vitamin D are two essential nutrientswhich constitute an important worldwide health issue dueto their significant roles in biochemistry. The present studywas conducted to assess the prevalence and risk of anemiain a population of subjects with documented D25 deficiencycompared with those with normal D25 levels.Material and Methods: The present case control study wasconducted among 100 subjects (50 were cases and 50 werecontrols) in the department of Medicine at Chattrapati ShivajiSubharti Hospital. Total serum 25(OH)D concentrationwas analyzed using commercially available ELISA kits.According to the manufacturer’s instructions, concentrationsof 25(OH)D below 25 nmol/L were classified as a deficiency,and values of 25–75 nmol/L were considered a vitamin Dinsufficiency. Difference between two groups was determinedusing chi square test and student T test for categorical data andcontinuous data respectively. P-value of <0.05 was consideredas significant.Results: Hb<13 was found in 75% of the case group (male)and 25% of the control group (male). Hb<12 was found in64.29% of the case group (female) and 45.45% of the controlgroup (female). Mean iron (μg/dl) among the male and femalecase group was less as compared to the control group withstatistically significant difference as p<0.05.Conclusions: The results of the present study showed thatVitamin D metabolism is dependent on iron and its deficiencymight disturb Vitamin D activation

Familial aggregation of inflammatory bowel disease in patients with ulcerative colitis

BACKGROUND/AIMS: Familial occurrence of inflammatory bowel disease (IBD) is well documented. Reports from Western countries have shown a higher familial occurrence of ulcerative colitis (UC) in first- and second-degree relatives than that in the Asian UC population. No data are currently available from the Indian subcontinent in this regard. We present our data on the familial aggregation of UC. METHODS: Records of patients with UC followed at the Inflammatory Bowel Disease Clinic at the All India Institute of Medical Sciences, New Delhi from August 2004 to January 2016 were reviewed. Details regarding the prevalence of family history and characteristics of these patients were recorded. Affected family members were contacted and disease characteristics were noted for assessment of familial aggregation. RESULTS: Of the 2,058 UC patients included in the analysis, a positive family history of IBD was confirmed in 31 patients (1.5%), 24 (77.4%) of whom had only first-degree relatives affected. All the affected relatives had UC and none had Crohn's disease. Among first-degree relatives, siblings were found to have the highest prevalence of IBD (53.3%), followed by parents (26.7%). CONCLUSIONS: The probability of occurrence of IBD in family members of affected North Indian UC patients is lower than that reported in Western populations.

Circulating nucleic acids damage DNA of healthy cells by integrating into their genomes.

Whether nucleic acids that circulate in blood have any patho-physiological functions in the host have not been explored. We report here that far from being inert molecules, circulating nucleic acids have significant biological activities of their own that are deleterious to healthy cells of the body. Fragmented DNA and chromatin (DNAfs and Cfs) isolated from blood of cancer patients and healthy volunteers are readily taken up by a variety of cells in culture to be localized in their nuclei within a few minutes. The intra-nuclear DNAfs and Cfs associate themselves with host cell chromosomes to evoke a cellular DNAdamage- repair-response (DDR) followed by their incorporation into the host cell genomes. Whole genome sequencing detected the presence of tens of thousands of human sequence reads in the recipient mouse cells. Genomic incorporation of DNAfs and Cfs leads to dsDNA breaks and activation of apoptotic pathways in the treated cells. When injected intravenously into Balb/C mice, DNAfs and Cfs undergo genomic integration into cells of their vital organs resulting in activation of DDR and apoptotic proteins in the recipient cells. Cfs have significantly greater activity than DNAfs with respect to all parameters examined, while both DNAfs and Cfs isolated from cancer patients are more active than those from normal volunteers. All the above pathological actions of DNAfs and Cfs described above can be abrogated by concurrent treatment with DNase I and/or anti-histone antibody complexed nanoparticles both in vitro and in vivo. Taken together, our results suggest that circulating DNAfs and Cfs are physiological, continuously arising, endogenous DNA damaging agents with implications for ageing and a multitude of human pathologies including initiation of cancer.