Comparison of empirical use of low dose aspirin and enoxaprin in the treatment of unexplained recurrent pregnancy loss

Background: Recurrent pregnancy losses have commonly been defined as three or more consecutive spontaneous pregnancy losses. About 1-2% of women suffer from recurrent miscarriages. The cause is multifactorial such as uterine anomalies, endocrine disorders, immunological causes, infections, chromosomal anomalies and maternal autoimmune diseases. In 50-60% of cases recurrent pregnancy losses, the cause remains unclear. Objective of this study was to compare the maternal and fetal outcome in patients with unexplained recurrent pregnancy loss treated with LMWH (Enoxaparin) vs Aspirin during pregnancy.Methods: Women with 3 or more pregnancy losses, aged between 18-40 years, booked for antenatal care and delivery in our hospital between January 2012 and December 2016 were followed till 6 months after delivery.Results: A total number of 146 women were assessed for eligibility. We had 62 women in Group A (aspirin group) and 84 women in Group E (enoxaparin group). Enoxaparin was given to all those ladies who had taken aspirin in previous pregnancies with no live outcome. Good neonatal outcome was observed with Enoxaparin.Conclusions: Live birth rates did not show significant difference between the two study groups. But empirical use of enoxaparin in patients with no live birth who have taken low dose aspirin in previous pregnancy had shown improved results, so enoxaparin should be used empirically as a first line agent in such cases.

Efficacy of Propofol and Etomidate for General Anaesthesia: A Comparative Study

Background: Induction agents are given to induce anesthesiaprior to the drugs given for maintenance of anesthesia, whichare also used as the sole drug for short treatment procedures,to give conscious sedation while undergoing procedures underlocal anesthesia and intensive care unit. The present studywas conducted with the aim to determine the compare theefficacy of propofol versus etomidate.Materials and Methods: This prospective randomized studywas conducted amongst 200 patients belonging to (ASA) gradeI and II between the age of 18 and 60 years irrespective of thegender who were scheduled for surgical procedure under thegeneral anesthesia. Pain on injection was graded On a 4graded scale with 0 meaning no Pain and 3 meaning bothverbal complaint and withdrawal of arm. All the data thusobtained was recorded in a tabulated form and analyzed usingSPSS software.Results: The study enrolled a total of 200 subjects with themean age of 41.78+/-3.94 years. There were 120 males and80 females in the study. There were 100 patients in eachgroup. All the subjects in Group I had grade 0 myoclonus.There were 65 patients in Group II with Grade 0 myoclonus, 15with grade 1 and grade 2 myoclonus respectively and 5 withGrade 3 myoclonus.Conclusion: Etomidate is a better anesthetic compared topropofol. It offers great hemodynamic stability with better paincontrol.

A Case of Pulmonary Hydatid Cyst Misdiagnosed as Encysted Effusion

Echinococcosis or hydatid disease is caused by larvae of the tapeworm Echinococcus. In cystic echinococcosis, humans are an accidental host and are usually infected by handling an infected dog. The liver and lungs are the most frequently involved organs. Pulmonary disease appears to be more common in younger individuals. Although most patients are asymptomatic, some may occasionally expectorate the contents of the cystor develop symptoms related to compression of the surrounding structures. Other symptoms of hydatid disease can result from the release of antigenic material andsecondary immunological reactions that develop from cyst rupture.

Effect of Mindfulness and Yoga on Quality of Life: A Study of Elementary School Students

Background: The current research is conducted to assess theimpact of mindfulness and yoga in an elementary school onstudent for measuring their quality of life.Materials & Methods: This is a randomized controlled trialwas utilized to assess the impact of yoga and mindfulness onthird to fifth-grade students who screened positive forsymptoms of anxiety.50 Students were selected at a random that was exposed toyoga/mindfulness activities for 18 weeks between October2018 and February 2019. The Baseline student scores beforeand after the mindfulness and yoga were gathered with thehelp of their teachers. The same were analyzed by usingpaired sample t test with SPSS software.Results: Our study showed that the group trained at least 45minutes daily have significantly improved their quality of life (pvalue <0.05). The results suggested that a yoga/mindfulnessintervention improves symptoms of anxiety among students.Conclusion: It facilitates stress management amongelementary school students and may be added as acomplement to social and emotional learning activities.

Clinicoradiological Profile of Patients with Connective Tissue related Diffuse Parenchymal Lung Disease

Diffuse Parenchymal Lung Disease (DPLD) is one of the most serious pulmonary complications associated with connective tissue diseases (CTDs), resulting in significant morbidity and mortality. Although the various CTDs associated with DPLD often are considered together because of their shared autoimmune nature, there are substantial differences in the clinical presentations and management of DPLD in each specific CTD. Methods: An observational crosssectional study was carried out in a single tertiary care center in northern India which included 50 consecutive subjects (age >12 years) of DPLD and amongst them patients having connective tissue diseases associated DPLD (CTD)-DPLD were studied.In this study, the clinical, radiological data of the subjects was collected. Results & Conclusion: Out of 50 patients, 13 patients turned out to be CTD-DPLD. The most common of these was Rheumatoid arthritis (53.8%) followed by Systemic sclerosis (38.4%) and sjogresn syndrome (7.7%). The average age in CTD-DPLD came out to be 47.8 years as opposed to 49.04 in DPLD patients. The average age in RA was 58.6 years, Systemic sclerosis was 40 years and Sjogrens syndrome was 45 years. Majority (92.3%) were females.

Measuring impact of Surya Namaskar and Pranayama for management of child obesity in India

Background: Obesity is fast becoming the developed world's greatest health problem. Moreover, childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized.Methods: The current paper analyses the impact of Surya Namaskar and Pranayama on management of child obesity. For this purpose, a group of 120 respondents were selected for a 4-month program to measure that whether the program can improve their living standards or not.Results: The result revealed positive impact on the obesity of the participants, further the variables of their medical condition and living standards improvement is identified.Conclusions: One variable Rate_yoga_1 is predicting the Overall_quality of Surya Namaskar and Pranayama. Further, four variables medi_conImp_3, medi_conImp_2, medi_conImp_5 and medi_conImp_4 are predicting the medical condition improvement under session of Surya Namaskar and Pranayama, and two variables Livi_stanimpr_4 and Livi_stanimpr_3 are predicting the living standard improvement under session of Surya Namaskar and Pranayama.

Anesthetic considerations in patients with Dyke-Davidoff-Masson syndrome: a case report and review of literature

Dyke-Davidoff-Masson syndrome [DDMS] is a rare disorder of cerebral hemiatrophy. The clinical presentation may consist of facial asymmetry, contralateral atrophy [including the trunk and extremities], hemiparesis, speech difficulties, mental retardation and epilepsy. It involves multiple systems, especially problems of the airway, occult myopathy and seizure disorder. Anesthesia for such patients is a challenge to the anesthesiologist. We report the anesthetic care of 9 year old female child of DDMS for fractional lengthening of tendons of the forearm. Airway management, induction technique, pathophysiology of the disease, drug selection and other concerns of anesthesia have been discussed reviewing the sparse literature

Autologous Bone Marrow Stem Cell Therapy Shows Functional Improvement in Hemorrhagic Stroke.

In hemorrhagic stroke, damage to the brain tissue is inevitable and no effective treatment for functional improvement is currently available except neurorehabilitation. Stem cell therapy is a rapidly growing field and has recently opened new avenues for brain repair strategies. We present a case study of a 69-year-old female treated with stem cell therapy for right-sided hemiplegia caused due to left thalamic hemorrhagic stroke. Inspite of regular physiotherapy, the patient had constant residual neurodeficit, one year after the stroke, which was severely incapacitating. In view of the same, the patient was given intrathecal autologous bone marrow derived stem cell therapy as part of the neuroregeneration and rehabilitation therapy (NRRT) along with rehabilitation. After the therapy, patient showed functional as well as neurological improvements (cognition and motor strength) without any side effects. There is accumulating experimental data showing the benefits of cell transplantation on functional recovery after hemorrhagic stroke. This case study supports the concept of neuroregeneration with bone marrow stem cells as a novel strategy having great therapeutic potential. However, large clinical studies are needed to further investigate autologous bone marrow stem cell therapy in addition to neurorehabilitation for treating the disability in hemorrhagic stroke.

Application of autologous bone marrow stem cells in giant axonal neuropathy.

Giant axonal neuropathy is a rare disorder of autosomal recessive inheritance, morphologically characterized by accumulation of neurofilaments in enlargements of preterminal regions of central and peripheral axons. We present a 7-year-old girl with thick and tightly curled lackluster hair suffering from giant axonal neuropathy. The diagnosis was confirmed on the brain MRI which showed white matter abnormalities in the anterior and posterior periventricular regions as well as the cerebellar white matter. In view of the same, the patient was given intrathecal autologous bone marrow-derived stem cell therapy as part of the neuroregenerative rehabilitation therapy protocol. The patient showed functional improvements in her disability after receiving the therapy. A detailed case report is presented here with.

Knowledge of stroke among stroke patients and their relatives in Northwest India.

BACKGROUND: The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries. AIMS: We aimed to assess the knowledge of stroke among patients with stroke and their relatives. SETTINGS AND DESIGN: Prospective tertiary referral hospital-based study in Northwest India. MATERIALS AND METHODS: Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors. STATISTICAL ANALYSIS: Univariable and multivariable logistic regression were used. RESULTS: Of the 147 subjects interviewed, 102 (69%) were patients and 45 (31%) were relatives. There were 99 (67%) men and 48 (33%) women and the mean age was 59.7+/-14.1 years. Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54% recognized hypertension as a risk factor for stroke. In the multivariable logistic regression analysis, higher education was associated with the knowledge of correct organ involvement in stroke (OR 2.6, CI 1.1- 6.1, P =0.02), whereas younger age (OR 2.7, CI 1.1-7.0, P =0.04) and higher education (OR 4.1, CI 1.5-10.9, P =0.005) correlated with a better knowledge regarding warning symptoms of stroke. CONCLUSIONS: In this study cohort, in general, there is lack of awareness of major warning symptoms, risk factors, organ involvement and self-recognition of stroke. However younger age and education status were associated with better knowledge. There is an urgent need for awareness programs about stroke in this study cohort.