Methodological Study of Doshopakramaniya Adhyay of Ashtanga Hridaya

Ashtanga Hridaya is one of the Brihat Trayi of Ayurveda. Sutrashana of Ashtanga Hridaya is stated as best among all the Samhita. Sutrasthan is a string which is connected with other Sthanas of Samhita. It provides brief idea about fundamental concepts which are described detail in other Sthanas. Secret majors are described in Sutrasthana of Ashtanga Hridaya. So study of Sutrasthana is most important to understand Samhita. Acharya Vagbhata stated that he created Ashtanga Hridaya from the essence of all previous treatises. The name of chapter Doshopakramaniya suggests it is related to treatment of vitiated Doshas. Doshas are most important entity for Normal functioning of body. Normal condition of Dhatu and Mala and Agni is depends on Dosha. All these functions they do in proper way when they are in balance condition. So it is most necessary to maintain the balance condition of Doshas. Acharya Vagbhatta also mentioned Doshas are only cause for all diseases. Imbalance state of Dosha is considered as a disease. Vitiated Doshas also vitiates Dhatu and Mala. Hence treatment of vitiated Doshas should be first priority of physician. All the Samhitas have described the way to cure the imbalance condition of Doshas. But these concepts are in scattered manner. So Acharya Vagbhata has created one whole chapter for the treatment of Doshas. In this chapter he has described the way to cure the Doshas in very elaborative manner along with some miscellaneous concepts. Hence this chapter has been selected for study to understand the treatment principles of vitiated Doshas and by this way we can stop the chain of disease formation.

Prevalence and risk factors for anxiety and depression among school going adolescent of Rajkot, Gujarat, India

Background: Adolescence is a period of turmoil, leading to several mental health challenges including anxiety and/or depression. Anxiety and depressive disorders affects 10-15% of adolescents. Anxiety and depression are associated with substantial negative effects on adolescent's social, emotional and academic success. This leads to poor social and coping skills, low self-esteem, perceptions of social rejection, and difficulty forming friendships. This study was carried out with an objective to study prevalence and risk factors for anxiety and depression among adolescents.Methods: A cross sectional study conducted from April 2014 to December 2015 among 1026 school going adolescents from 4 schools of Rajkot, Gujarat, India. Anxiety and depression were measured using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) respectively. Chi-square test was applied as test of significance.Results: Majority of the students (58.1%) was belonged to early adolescent age group. Two third were males. Maximum adolescents (42.5%) were coming from class III. Prevalence of moderate-severe anxiety and depression was 9.9% and 18.5%. Anxiety was not significantly associated with age, gender and socio economic class. Prevalence of depression was significantly higher in boys (20.5%) as compared to girls (14.5%, p=0.02). Moderate to severe depression was gradually increased with increasing in age. Adolescent from upper socio economic class (I, II, III- 19.1%) were severely depressed than adolescent from lower socio economic class (IV, V- 4.1%).Conclusions: Anxiety and depression was significantly present in adolescent age group. Depression was commonly observed in boys and gradually increased with increasing in age. There is need of strengthening school health services with screening and cost effective interventions to minimize the risk of drug abuse, suicide and violence.

Study on impact of protein energy malnutrition on development in children

Background: Majority of the children in India who live below the poverty line in an environment of deprivation and starvation have physical and developmental retardation. The Objective of this study to study the impact and comparison of protein energy malnutrition on the development with normal children.Methods: This was a hospital based cross sectional study in which total 128 cases of protein energy malnutrition and 30 normal children were enrolled from nutritional rehabilitation center and in patients wards. The study population comprised of children less than 5 years of age, having weight for height/length ?3 SD, with visible wasting, or bipedal oedema, with mid arm circumference <11.5 cm were assessed for their development in all four domains using Denver II developmental Screening Test (DDST-II).Results: The gross motor milestones are affected in 62.5% with grade4 PEM & 42.85% with grade 3, the fine motor component is affected more in grade 4 with other domains less affected, no significant relation of language delay with PEM was observed in this study, 40% of children with grade 4 PEM shows delay in social domain while 18.18% of the patients with grade 3 PEM show delay in social domain. No patients with grade 1 or grade 2 PEM showed delay in social domain. All four domains are affected in PEM with a maximum effect in gross motor, but the difference does not seem to be significant as the p value is 0.3 i.e.' >0.05 which is insignificant.Conclusions: My study on the effect of protein energy malnutrition on development proves that there in increasing delay in all the domains of development with increasing grade of malnutrition. Early detection of malnutrition in community can cause early intervention and increase the productivity of nation.

A study of adverse drug reactions to iodinated contrast agents in tertiary care teaching hospital

Background: Contrast agents have long been used for the imaging of anatomic boundaries and to explore normal and abnormal findings in X-ray based imaging technique. These agents are not completely devoid of risk. Adverse effects from administration of contrast media vary from minor physiological disturbance to rare life threatening situation.Methods: A cross-sectional retrospective observational study over one-year duration from 1st August 2015 to 31st July 2016 was conducted at radiology department of a Pandit Deendayal Upadhyay Government Medical College and Teaching hospital, Rajkot, Gujarat. Adverse drug reactions were analyzed to study the nature of reactions caused by iodinated contrast agents. The temporal relationship of time of administration of contrast agents to the occurrence of adverse reaction was analyzed and classified as immediate or delayed type of reaction.Results: Out of 868 patients that were analysed 15 out of 497 male patients and 11 out of 371 female patients developed adverse reaction. Age range of patients that developed reactions was 20-55 years. Most common adverse drug reaction occurred in our study was nausea and vomiting which was treated by parenteral Ondansetron. All the reactions were found to be 憄robable� in causality as per WHO causality assessment scale and Naranjo抯 algorithm.Conclusions: Physicians performing diagnostic or therapeutic procedures with contrast agents must be aware of the risk, preventability & treatment so that reactions can be prevented. Sensitization of physicians is required to increase reporting of adverse drug reactions occurred due to radiocontrast agents.

Evaluation of anthropometric indicators in malnourished children at Nutritional Rehabilitation Center, Gujarat, India

Background: It is very difficult to recognize the cases with mild-to-moderate malnutrition because clinical criteria for their diagnosis are imprecise and are difficult to interpret accurately. The objective of the study was daily weight gain in gram/kg/day in severely malnourished children.Methods: This was a hospital based cross sectional study in which total of 114 consecutive patients of SAM less than 5 years treated for complications of severe acute malnutrition using WHO protocol. The study design included 114 children from the NRC and then followed up the period of 6 months to assess the nutritional status during the period of initial stage and the entire follow up period using available record of anthropometry indicators of the admitted children recruited in the study at the NRC.Results: Mean weight at admission was 6.4 Kg, 6.5 Kg and 6.2 Kg of overall, boys and girls respectively. Mean weight at discharge was 6.8 Kg, 6.7 Kg and 6.6 Kg of overall, boys and girls respectively. Mean MUAC at admission was 10.7 cm, 10.9 cm and 10.6 cm of overall, boys and girls respectively. Mean MUAC at discharge was 10.9 cm, 10.9 cm and 10.8 cm of overall, boys and girls respectively.Conclusions: For treatment of severe acute malnutrition, systematic guidelines required, thus this study indicates that following WHO guidelines, it has become easier to manage SAM in hospital settings, with least possible stay at hospital. The objective of the study was to know the effect of nutritional intervention measures on selected anthropometric indicators of severe acute malnourished children.

Estimation of role of ultrasound and MRI in the examination of shoulder joint.

Background: To recognize different pathologies affecting the shoulder joint with the help ultrasound and MRI scans and to evaluate the features, pattern and extension of the different pathologies affecting the shoulder joint with help of ultrasound and MRI scans so as to help the clinician for further management. Aim: To estimate role of ultrasound and MRI in examination of shoulder joint. Material and methods: Study comprised of an observational hospital based study. Out of 65patients, 20 underwent only ultrasound investigation, 25 underwent only MRI scans whereas 20 patients were evaluated by ultrasound and MRI. These were performed by 3-5 MHZ curvilinear probe and 8-10 MHZ linear probe on HD 7 and HD 9 Philips ultrasound machines and 1.5 T Philips MRI machine. MR arthrography was performed as a follow up in some of the patients in outside centre. Results: USG study also showed that the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infrspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears Were the most frequently occurring in the rotator cuff whereas subscapularis and infraspinatus tears were the most commonly occurring rotator cuff tears were supraspinatus tears whereas alone infraspinatus and subscapularis tears were very rare. MRI study showed supraspinatus tears were the most frequently occurring in the rotator cuff whereas subscapularies and infraspinatus tears were rare. MRI is 100% confirmative in almost all cases of Rotator cuff tears but may sometimes need extra imaging by MR arthrography in partial bursal tears. Conclusion: Rotator cuff tears are the most common pathologies affecting the shoulder joint according to this study. It was proved that, there is no evident difference in the accuracy of ultrasound and MRI in detecting this pathology, even though MRI has proved to be more accurate in evaluating almost all other pathologies as compared to ultrasound.