A Clinical Study to Evaluate the Efficacy of Shirovirechana Gana Dravya Siddha Asava Nasya in Dusta Prathishyaya w.s.r to Chronic Sinusitis

The word Prathishyaya indicates recurrent attack and can participate due to minute etiological factors. Prathishyaya can occur as a separate disease entity or symptoms of many systemic diseases or as a complication of other diseases. Prathishyaya if not treated well in early stage and Ahara-Vihara which are harmful for the disease is continued, it leads to a more complicated stage of Prathishyaya i.e., Dusta Prathishyaya. Virechana Nasya which is recommended in Urdwajatrugata Vikaras is indicated in Prathishyaya. For Virechana Nasya- Madhu, Saindhava, Asava, Pitta, Mutra etc drugs has been mentioned by Acharya Vagbhata. So, Asava is prepared by Shirovirechana Gana Dravya as a Prakshepaka Dravyas which possess Katu, Tiktha, Madhura rasa, Laghu and Teekshna Guna, Ushna Veerya, Katu Vipaka and Vata-Kapha shamaka predominantly, which may help in pacify Dusta Prathishyaya. Materials and Methods: A single group study was undertaken in which, 30 patients of Dusta Prathishyaya were randomly selected and were subjected to Asava Nasya - 4 Bindu (2ml) each nostril for 7 days. The patients were assessed with severity of symptoms subjectively and objectively before and after treatment. Data obtained was statistically analysed. Result and Discussion: In overall effect of treatment in Dusta Prathishyaya, out of 30 patients, 3 patients (10%) got moderate improvement, 23 patients (76.6%) got marked improvement and 4 patients (13.33%) got significant improvement. In overall effect of treatment, statistical analysis showed that the mean score which was 6.86 in before treatment was reduced to 4.81 in after treatment and further reduced to 1.86 in follow up, and there is a statistically significant change (P<0.001). Conclusion: The present study showed highly significant results in which the symptoms like Nasa Srava, Nasa Avarodha, Gandha Agnyana, Shirashoola and Shiro Gaurava got reduced and it indicates that the therapeutic effects is mainly achieved by the efficacy of Shirovirechana Gana Dravya Siddha Asava Nasya in Dusta Prathishyaya w.s.r to Chronic Sinusitis.

Prevalence of Dental Caries and Treatment Needs among Adult Population of Mangalore Taluk - A Pilot Survey.

Dental caries remains the most common oral disease affecting a considerable proportion of people worldwide. It not only causes damage to the tooth, but is also responsible for several morbid conditions of the oral cavity and other systems of the body. Without treatment, caries can proceed and destroy the tooth leading to infection of dental pulp. We wanted to evaluate the prevalence of dental caries and treatment needs among adult rural population. METHODS619 participants aged 18 years and above from peripheral health centres were examined to determine the prevalence of caries and treatment needs. A pretested proforma was used for data collection. Collected data was analysed using Chi Square test. P<0.05 was considered as significant. RESULTSNo significant difference was found in the mean number of teeth affected by caries between the two age groups (<40 years & >40 years) (p= 0.352), between genders (p=0.704) and education levels (p=0.983). When treatment needs (TN) was considered, maximum 2 surface fillings were needed in both the age groups (<40 years 45.6% & >40 years 54.4%). Various treatment needs prevailed among participants of different education level. CONCLUSIONSOral health educative programs may change the attitude of an individual and population as a whole towards maintenance of oral health.

Subcurative radiation significantly increases cell proliferation, invasion, and migration of primary glioblastoma multiforme in vivo / 癌症

Tumor cell proliferation, infiltration, migration, and neovascularization are known causes of treatment resistance in glioblastoma multiforme (GBM). The purpose of this study was to determine the effect of radiation on the growth characteristics of primary human GBM developed in a nude rat. Primary GBM cells grown from explanted GBM tissues were implanted orthotopically in nude rats. Tumor growth was confirmed by magnetic resonance imaging on day 77 (baseline) after implantation. The rats underwent irradiation to a dose of 50 Gy delivered subcuratively on day 84 postimplantation (n = 8), or underwent no radiation (n = 8). Brain tissues were obtained on day 112 (nonirradiated) or day 133 (irradiated). Immunohistochemistry was performed to determine tumor cell proliferation (Ki-67) and to assess the expression of infiltration marker (matrix metalloproteinase-2, MMP-2) and cell migration marker (CD44). Tumor neovascularization was assessed by microvessel density using von-Willebrand factor (vWF) staining. Magnetic resonance imaging showed well-developed, infiltrative tumors in 11 weeks postimplantation. The proportion of Ki-67-positive cells in tumors undergoing radiation was (71 +/- 15)% compared with (25 +/- 12)% in the nonirradiated group (P = 0.02). The number of MMP-2-positive areas and proportion of CD44-positive cells were also high in tumors receiving radiation, indicating great invasion and infiltration. Microvessel density analysis did not show a significant difference between nonirradiated and irradiated tumors. Taken together, we found that subcurative radiation significantly increased proliferation, invasion, and migration of primary GBM. Our study provides insights into possible mechanisms of treatment resistance following radiation therapy for GBM.

Successful management of phaeochromocytoma using preoperative oral labetalol and intraoperative magnesium sulphate report of four cases

Phaeochromocytoma is a rare neuroendocrine catecholamine-secreting tumour. This type of tumour poses multidimensional anaesthetic challenges as it has an unpredictable clinical course during surgical resection. The alpha-blocking agent phenoxybenzamine remained the mainstay in preoperative preparation before the introduction of beta-blocking agents. We report four cases operated between 2009-2012 at Sultan Qaboos University Hospital, Muscat, Oman. The cases were prepared with oral labetalol, as the alpha-blocking drug phenoxybenzamine was not immediately available. Responses to simulated stress were tested in the theatre before surgery. Anaesthesia was induced under invasive arterial pressure monitoring and magnesium sulphate infusion. Rare intraoperative surges in blood pressure during tumour manipulation were treated with sodium nitroprusside infusions and phentolamine boluses. All of the patients had an uneventful postoperative recovery. Preoperative treatment with labetalol has rarely been reported and can be considered as a potential therapeutic option with optimal patient monitoring if phenoxybenzamine is unavailable