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SUMMARY: Stroke is the leading cause of acquired physical disability in adults and second leading cause of mortality throughout the world. Treatment strategies to curb the effects of stroke would be of great benefit. Pongamia pinnata is a recent attraction in medicine, owing to its abundant medicinal benefits with minimal side effects. The present study aimed to examine acute and subacute effect of Pongamia pinnata leaf extract on transient cerebral hypoperfusion and reperfusion (tCHR) in Wistar rats. 24 adult Wistar rats (12 each for acute and subacute study) were divided in to four groups each viz normal control group, tCHR + NS group, tCHR + 200mg/kg bw and tCHR + 400mg/kg bw groups. Cerebral ischemia induction was carried out by bilateral common carotid artery occlusion and reperfusion. Ethanolic extract of Pongamia pinnata leaves were orally administered for 7 days and 21 days after the surgical procedure for acute and subacute study respectively. Behavioural analysis, histological assessment, and estimation of mRNA levels of HIF-1, GDNF, BDNF and NF-kB were performed. In both acute and subacute study, there was significant improvement in the beam walking assay, neuronal count, decreased neuronal damage in histological sections and higher mRNA expression of BDNF and GDNF in the treatment groups. There was no significant difference in the expression of HIF1 and NF-kB. Thus, Pongamia pinnata has excellent neurorestorative property reversing many of the effects of ischemic stroke induced by tCHR in rats with the underlying mechanism being an improvement in the expression of neurotrophic factors GDNF and BDNF.
El ataque cerebrovascular es la principal causa de discapacidad física adquirida en adultos y la segunda causa de mortalidad en todo el mundo. Las estrategias de tratamiento para frenar los efectos del ataque cerebrovascular serían de gran beneficio. Pongamia pinnata es una atracción reciente en la medicina, debido a sus abundantes beneficios medicinales con mínimos efectos secundarios. El presente estudio tuvo como objetivo examinar el efecto agudo y subagudo del extracto de hoja de Pongamia pinnata sobre la hipoperfusión y reperfusión cerebral transitoria (tCHR) en ratas Wistar. Se dividieron 24 ratas Wistar adultas (12 cada una para el estudio agudo y subagudo) en cuatro grupos, el grupo control normal, el grupo tCHR + NS, los grupos tCHR + 200 mg/kg de peso corporal y tCHR + 400 mg/kg de peso corporal. La inducción de la isquemia cerebral se llevó a cabo mediante oclusión y reperfusión bilateral de la arteria carótida común. El extracto etanólico de hojas de Pongamia pinnata se administró por vía oral durante 7 días y 21 días después del procedimiento quirúrgico para estudio agudo y subagudo respectivamente. Se realizaron análisis de comportamiento, evaluación histológica y estimación de los niveles de ARNm de HIF-1, GDNF, BDNF y NF-kB. Tanto en el estudio agudo como en el subagudo, hubo una mejora significativa en el ensayo de desplazamiento del haz, el recuento neuronal, una disminución del daño neuronal en las secciones histológicas y una mayor expresión de ARNm de BDNF y GDNF en los grupos con tratamiento. No hubo diferencias significativas en la expresión de HIF1 y NF-kB. Por lo tanto, Pongamia pinnata tiene una excelente propiedad neurorestauradora que revierte muchos de los efectos del ataque cerebrovascular isquémico inducido por tCHR en ratas, siendo el mecanismo subyacente una mejora en la expresión de los factores neurotróficos GDNF y BDNF.
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The human bodies and organs have traditionally been preserved using formalin solution, although it irritates the eyes, nose and throat. Plastination is an unique and expensive method for preserving biological samples that can be used in teaching and research. Therefore, the goal of the current study was to prepare a costeffective solution using thermocol to plastinate the brain specimens as a supplement for teaching and research. Two human brains were used in this pilot research project. According to standard procedures, the brains were first fixed in 10% formaldehyde, sectioned horizontally, sagittally and coronally dehydrated in acetone, and then immersed in the plastination solution at room temperature and pressure. Then the specimens were airdried at room temperature. A team of 62 Anatomists and Pathologists assessed the quality of the specimens using a self-developed grading scale. The grading was provided based on the specimens’ clarity, stability, aesthetic look, colour and smell. Statistical analyses was performed using SPSS software, Kruskal Wallis test showed that the lowest mean score was 4.04 provided for colour and highest mean score was 5 provided for the smell with a statistically significant p<0.001. Thus our plastinated specimens were of good quality, durable and handlefriendly. Our study demonstrated that the cost-effective plastination solution (CEPS) procedure is an inexpensive and efficient way to create plastinated specimens that are appropriate for teaching neuroanatomy.
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Justification: The diagnosis of Down syndrome (DS) is easily made clinically but the management is multi-disciplinary and life-long. There is no standard protocol available for its management in India. Process: A committee was formed under the Indian Academy of Pediatrics (IAP) chapter of Neuro developmental pediatrics consisting of 20 experts working in the related field. The various aspects of the condition were discussed and allotted to the concerned experts related for preparing the guidelines. The material received was collated to form a set of guidelines, which were reviewed by the committee, and a consensus statement made. The guidelines were then approved by the chapter, and by the IAP. Objectives: To define the condition and to look into the various aspects of antenatal and postnatal diagnosis. To explain briefly about the involvement of the various systems that are involved and formulate recommendations for management. To recommend early and sustained interventional therapies to enable children with DS lead an independent life. Recommendations: The stress on bio-psycho-social strategy for the management of children with DS is reiterated, and the need for a medical, social and rights model is recommended after each section. The age-wise recommendations are also highlighted in addition to the recommendations under each system.
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Background: There is evidence to suggest that lack of physical activity, a common experience among adults, can negatively impact executive functions such as attention, memory, and decision making. Trataka can improve eye deformity, executive ability, willpower, and relaxation. Trataka may also have a protective effect on the brain, reducing inflammation and the risk of neurodegenerative diseases. The immediate effect of Trataka on executive Aim of the study: Material & methods: function among adults. Forthy healthy Adults to observe the immediate effects of thirty minute trataka regimen for one day. Participants were recruited through convenient sampling and were between the ages of 18-40. The study used a single group pre-post design. After single trataka session Results: showed that 11.59% significant increase (P< 0.05) in total attempted score on DLST. Similarly, there was 11.48% significant increase (P = 0.05). and there was 16.6% increase in (P> 0.05) in wrong attempt scores. After single trataka session it showed that 22.48% significant increase (P< 0.01) in total attempted score on SLCT. Similarly, there was 22.71% significant increase (P = 0.01) in NS. However, there was 70.58% reduction in wrong attempt score which was highly significant (P = 0.001). the available evi Conclusion: dence suggests that the practice of single session trataka has a positive on executive function among adults.
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INTRODUCTION Surgical site infections (SSI) are one of the terrifying nosocomial infections that affecting surgical patients and cause a compromise to the quality of health care provided in the hospital. Nearly 5% of people who undergo surgeries might develop SSI, which can have serious consequences and even be deadly. To identify the microbiological profile of explant AIM: culture from suture materials and its correlation in development of SSI in the same patient. Infected and non-infected METHODOLOGY: suture materials that were removed aseptically from the patients were collected and transported to the Microbiology laboratory in sterile BHI broth.With the isolated colonies obtained. Identification was performed by standard microbiological technique and antimicrobial susceptibility testing was done. The culture reports of the swab collected from the pus/ exudate from the surgical site and the suture were compared. This was a prospective cross sectional study for a duration of 6 months. A sum of 190 isolates RESULTS: were obtained from 182 suture samples. 156(86%) suture materials had growth [monomicrobial (70%) polymicrobial growth (16%)] while 26(14%) had no growth. 7 different suture materials were employed in this study. Isolated organisms were gram positive bacilli (n=20), gram positive cocci (n=82), gram negative bacilli (n=87) and fungi (n=1). Escherichia coli, Klebsiella pneumoniae (n=19) and CONS (n=71) were commonly isolated gram negative organisms. The least common organism grown colonizing the suture material was Klebsiella oxytoca, Citrobacter species, Candida species, Enterococcus faecalis and Enterococcus species (n=1, 0.5%). Isolates like Escherichia coli (n=5), Klebsiella pneumoniae (n=2) and Acinetobacter species, Staphylococcus aureus (n=1) were found to have multiple drug resistance in the suture thread culture. SSI was seen eight cases (4.3%) and in two of them, the microorganism isolated from the surgical site and suture material was identical. Out of 190 isolates in this study, 96 DISCUSSION isolates (CONS-71, Streptococcus-4, Diphtheriods-2, Aerobic spore bearers-18, Candida-1) were members of normal flora of the skin which shows 50.5% of the suture materials were colonized by normal flora. The current study shows that ability of bacteria to adhere varies between different suture materials. Overall, the adhesion of bacteria to 3-0 Ethilon (10.4%) was found to be lower compared to 3-0 vicryl No 1,3 Prolene, 2-0 Ethilon and Silk. Suture thread must be taken out as soon as possible since opportunistic infections could result from the skin's regular flora.
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Bladder cancer is one of the leading malignancies in the world associated with signi?cant morbidity and mortality. About 80% of a bladder cancer is urothelial variant, remaining 20% will have a divergent histological presentation. The pathophysiological study of these variants has recently increased because the therapeutic approach is not uniform for all variants. These variants have important diagnostic, prognostic and therapeutic implications. A molecular and genetic study of these variants will allow them to be better de?ned. Here we present four cases of Histological variants of bladder tumors with varying presentations in the department of urology, Madurai medical college, which is studied over the period of one year (2022-2023).
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Background: Hospitalization is an important landmark in the history of heart failure. Patients admitted for acute heart failure have a high chance of readmission. We require predictors which can foresee readmission. Functional capacity assessment by the 6-minute walk test is one such predictor. Objectives: To compare the mean 6-minute walk distance among acute heart failure patients readmitted within 30 days, those readmitted within 60 days, those readmitted within 90 days, and those not readmitted at 90 days following discharge after the first admission. Methodology: This is a follow-up study conducted in Madras Medical College from March 2021 to August 2021. The study included patients who were admitted for the first time in their life for acute heart failure. The clinical details were noted, and the patients were managed as per standard protocols. Before discharge, a 6-minute walk test was performed. The patients were followed up at the end of 30, 60, and 90 days. Results: 25% of the patients had one readmission at the end of 90 days. Majority of readmissions occurred at the end of 30 days. A low 6-minute walk distance at discharge was a significant predictor of readmission at the end of 30 days. A distance of 200 m was a reasonable cutoff in our population. A lower time walked was also a significant predictor of readmission at the end of 30 days. A slower walking speed was also a significant predictor of readmission at the end of 30 days. Some other parameters such as a longer duration of stay, a longer duration of intravenous (IV) diuretic requirement, discharge respiratory rate, and lower serum albumin at admission were also significant predictors of readmission at the end of 30 days.
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Background: Atypical presentations of acute coronary syndrome (ACS) delay its recognition and treatment in the elderly patients. Functional decline and delirium which are common to the elderly during hospitalization, leads to cognitive impairment and poor health outcomes. Steps taken for its prevention is usually not considered the top priority by the cardiologist. The present study was conducted to identify cognitive decline among elderly patients who developed ACS during hospitalization for noncardiac illness and their outcome. Materials and Methods: Three hundred and ten elderly patients above 60 years of age with ACS were included from June 26, 2020 to October 13, 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS following admission for noncardiac illness (Group II, n = 216). Co-morbidities, medications, investigations, management, clinical outcome, and Montreal Cognitive Assessment scale were compared between the two groups at the time of admission, after 30 days and after 6 months. Results: Majority of the subjects were admitted due to acute kidney injury (27.1%) in Group II and had a non-ST elevation ACS (90.2%). Optimum management was given to a lesser extent due to the clinical condition of these patients. Poor clinical outcome, cognitive impairment during hospitalization and cognitive decline during follow-up was more in Group II. Conclusion: Clinicians must be vigilant for the development of cognitive impairment and cognitive decline when an elderly patient is admitted to the hospital, as early detection and optimum management provides better clinical and cognitive outcome.
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@#Oral route drug delivery system is still considered as the most convenient and patient friendly drug delivery route. Over the decades, many research has been performed to improve the functionality oral dosage form. Orally disintegrating film (ODF) is a newer oral drug delivery system, which is in the form of a thin film that will disintegrate in the oral cavity within a matter of seconds. The aim of this review paper is to recap ODF, its benefits, formulation contents and manufacturing method. With more research and development work has been conducted on ODF, the dosage form is expected to be manufactured and scaled up to be commercializable products to be sold in the market.
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Methods@#A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences. @*Results@#Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p 0.05). Complications were only observed in the GA+SA group (19%). @*Conclusions@#The study results suggest that the addition of RA to GA may provide better working conditions and surgeon’s satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.
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In the modern era, chronic kidney failure due to diabetes has spread across the globe. Prunetin (PRU), a component of herbal medicines, has a broad variety of pharmacological activities; these may help to slow the onset of diabetic kidney disease. The anti-nephropathic effects of PRU have not yet been reported. The present study explored the potential nephroprotective actions of PRU in diabetic rats. For 28 days, nephropathic rats were given oral doses of PRU (20, 40, and 80 mg/kg). Body weight, blood urea, creatinine, total protein, lipid profile, liver marker enzymes, carbohydrate metabolic enzymes, C-reactive protein, antioxidants, lipid peroxidative indicators, and the expression of insulin receptor substrate 1 (IRS-1) and glucose transporter 2 (GLUT-2) mRNA genes were all examined. Histological examinations of the kidneys, liver, and pancreas were also performed.The oral treatment of PRU drastically lowered the blood glucose, HbA1c, blood urea, creatinine, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase, lipid profile, and hexokinase. Meanwhile, the levels of fructose 1,6-bisphosphatase, glucose-6-phosphatase, and phosphoenol pyruvate carboxykinase were all elevated, but glucose-6-phosphate dehydrogenase dropped significantly. Inflammatory marker antioxidants and lipid peroxidative markers were also less persistent due to this administration. PRU upregulated the IRS-1 and GLUT-2 gene expression in the nephropathic group.The possible renoprotective properties of PRU were validated by histopathology of the liver, kidney, and pancreatic tissues. It is therefore proposed that PRU (80 mg/kg) has considerable renoprotective benefits in diabetic nephropathy in rats.
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Background@#Ellipticine (Ellip.) was recently reported to have beneficial effects on the differentiation of adipose-derived stem cells into mature chondrocyte-like cells. On the other hand, no practical results have been derived from the transplantation of bone marrow stem cells (BMSCs) in a rabbit osteoarthritis (OA) model. @*Objectives@#This study examined whether autologous BMSCs incubated with ellipticine (Ellip.+BMSCs) could regenerate articular cartilage in rabbit OA, a model similar to degenerative arthritis in human beings. @*Methods@#A portion of rabbit articular cartilage was surgically removed, and Ellip.+BMSCs were transplanted into the lesion area. After two and four weeks of treatment, the serum levels of proinflammatory cytokines, i.e., tumor necrosis factor α (TNF-α) and prostaglandin E2 (PGE2), were analyzed, while macroscopic and micro-computed tomography (CT) evaluations were conducted to determine the intensity of cartilage degeneration.Furthermore, immuno-blotting was performed to evaluate the mitogen-activated protein kinases, PI3K/Akt, and nuclear factor-κB (NF-κB) signaling in rabbit OA models. Histological staining was used to confirm the change in the pattern of collagen and proteoglycan in the articular cartilage matrix. @*Results@#The transplantation of Ellip.+BMSCs elicited a chondroprotective effect by reducing the inflammatory factors (TNF-α, PGE2) in a time-dependent manner. Macroscopic observations, micro-CT, and histological staining revealed articular cartilage regeneration with the downregulation of matrix-metallo proteinases (MMPs), preventing articular cartilage degradation. Furthermore, histological observations confirmed a significant boost in the production of chondrocytes, collagen, and proteoglycan compared to the control group. Western blotting data revealed the downregulation of the p38, PI3K-Akt, and NF-κB inflammatory pathways to attenuate inflammation. @*Conclusions@#The transplantation of Ellip.+BMSCs normalized the OA condition by boosting the recovery of degenerated articular cartilage and inhibiting the catabolic signaling pathway.
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Diabetes is an untreatable metabolic disorder characterized by alteration in blood sugar homeostasis, with submucosal insulin therapy being the primary treatment option. This route of drug administration is attributed to low patient comfort due to the risk of pain, distress, and local inflammation/infections. Nanoparticles have indeed been suggested as insulin carriers to allow the drug to be administered via less invasive routes other than injection, such as orally or nasally. The organic-based nanoparticles can be derived from various organic materials (for instance, polysaccharides, lipids, and so on) and thus are prevalently used to enhance the physical and chemical consistency of loaded bioactive compounds (drug) and thus their bioavailability. This review presents various forms of organic nanoparticles (for example, chitosan, dextron, gums, nanoemulsion, alginate, and so on) for enhanced hypoglycemic drug delivery relative to traditional therapies.
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A 19-year-old man had an accidental fall from the 2nd floor and sustained multiple injuries. On radiological evaluation, the patient had symmetrical quadruple limb involvement with bilateral humerus shaft, bilateral olecranon, bilateral femur shaft, and bilateral patella fractures. The patient was actively managed using damage control orthopaedics, and a sequence of skeletal fixation was planned based on the hemodynamic stability and periodical serum lactate assessment. Symmetrical quadruple limb fractures are very rare, which could be associated with higher mortality. A meticulous clinical evaluation, periodical blood parameter assessment and strict adherence to the principles of damage control orthopaedics can be conducive to prevent life-endangering complications.
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Masculino , Humanos , Adulto Joven , Adulto , Fracturas del Fémur/complicaciones , Fémur , Fijación de Fractura , Accidentes por Caídas , RadiografíaRESUMEN
Objective:To report our initial experience with on?table extubation following cardiac surgery for congenital heart disease, assessing its efficacy and safety, and the potential for fast?tracking these patients through the intensive care unit (ICU). Methods: We decided to implement a multidisciplinary protocol aiming toward on?table extubation following congenital cardiac surgery at our hospital. Between December 2018 and January 2020, 376 patients underwent congenital cardiac surgery. The management strategy involved choosing the patients preoperatively, a specific anesthetic technique, application of a standard extubation protocol, multidisciplinary team approach, and perioperative echocardiogram for assessment of surgical repair. Relevant data were collected and analyzed. Results: Out of the 376 patients who underwent congenital cardiac surgery during the study period, 44 patients were extubated on?table. Although a majority of these patients belonged to Risk Adjustment for Congenital Heart Surgery?1 score (RACHS?1) 1 and 2 categories, 18% of the patients who were extubated on?table were of RACHS?3 category. This included a wide spectrum of anatomical substrates such as endocardial cushion defects, pulmonary venous anomalies, single ventricle physiology, valvular defects, and others such as cor triatriatum and sinus of Valsalva aneurysm. There was no in?hospital mortality related to on?table extubation. Only one patient was reintubated following on?table extubation resulting in a reintubation rate of 2.27% among those patients extubated on?table. The patients extubated on?table had a shorter ICU stay (25.89 ± 7.20 h) compared with those patients who underwent delayed extubation (59.30 ± 6.80 h). The duration of the hospital stay was also significantly reduced in these patients (91.09 ± 20.40 h) leading to an earlier discharge compared with those patients who underwent delayed extubation (134.40 ± 16.20 h). Conclusion: On?table extubation is an attractive alternative in limited?resource environments to enhance recovery in patients following congenital cardiac malformations. Owing to the lack of significant comorbidities such as Chronic Obstructive Pulmonary Disease (COPD) in this patient population, corrective surgery for cardiac malformation usually optimizes the cardiorespiratory status. This results in more chances of successful extubation immediately following surgery. However, this requires proper perioperative planning, a careful discussion about the choice of patients, adoption of an extubation protocol, and most importantly, a multidisciplinary team approach. It is associated with low morbidity and mortality, with reduced length of stay in the ICU and hospital. This preliminary study demonstrated that on?table extubation is feasible following congenital cardiac surgery at our center and greatly reduces the intensive care requirements. This article focuses mainly on the decision?making process which determines the ideal candidates for on?table extubation and the anesthetic protocol implemented in a low?resource environment to enable the same
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Background: Diabetes is a public health problem of colossal proportions. The National Family Health Survey 5 (2019–2020) has found high blood sugar levels among 13.5% of women and 15.6% of men in India. The high morbidity and mortality in diabetes mellitus are due to uncontrolled hyperglycemia resulting in micro- and macrovascular changes affecting multiple organs in the body. The objectives of this study were to estimate glycemic control and its determinants among type 2 diabetics in the Ernakulam district. Methods: A community-based cross?sectional study was conducted among 364 type 2 diabetics who had the disease for at least 5 years duration in the Ernakulam district of Kerala. Probability proportional to size cluster sampling technique was adopted. A semi-structured questionnaire was used to collect sociodemographic and behavioral profiles. Participants’ HbA1c levels were assessed to determine glycemic control. Results: The proportion of people with good glycemic control was 21.4%. Determinants such as female gender adjusted odds ratio (aOR = 2.36, P = 0.005), body mass index >23 kg/m² (aOR = 2.71, P = 0.002), combined drug treatment with Oral Hypoglycaemic agents (OHA) and insulin (aOR = 3.76, P = 0.004), and poor compliance with medications (aOR = 1.93, P = 0.030) were found to be significantly associated with poor glycemic control. Conclusions: Poor compliance with medications and unhealthy lifestyle choices has resulted in a high proportion of diabetics with poor glycemic control in the district. Women are particularly more vulnerable to uncontrolled hyperglycemia than males. Type 2 diabetes mellitus people should be encouraged to maintain strict glycemic control, which is an important measure for secondary prevention of complications.
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Background & objectives: A subset of diabetic individuals are known to develop progressive renal insufficiency without albuminuria, referred to as normoalbuminuric chronic kidney disease (NACKD). There is, however, a paucity of studies regarding this condition in India. So, this study, aimed to find the prevalence of normoalbuminuric renal dysfunction and its clinical associations in diabetic Indian population. Methods: Medical record search of patients with type 2 diabetes mellitus at a tertiary care centre was done. Based on the urinary albumin:creatinine ratio (>30 mg/g creatinine) and estimated glomerular filtration rate (e-GFR) (<60 ml/min/1.73m2), individuals were classified as having, (i) no kidney disease (NKD), (ii) chronic kidney disease (CKD), (iii) albuminuria alone (ALB), (iv) normoalbuminuric low e-GFR (NACKD) and (v) albuminuria with low e-GFR albuminuric CKD (ACKD). Furthermore, the clinical and biochemical parameters of these groups were also compared. Results: Data from 3534 diabetes patients with a mean age of 53.8±10.9 yr and mean duration of diabetes of 10.3±7.5 yr were available for the analysis. NACKD constituted 39.1 per cent of the patients with reduced e-GFR, NACKD was found in 2.1 per cent and ACKD in 3.4 per cent of all diabetic patients. Compared to NKD patients, was found an independent association between NACKD and higher age, male sex, lower body weight and statin intake but not with glycated haemoglobin, fasting and postprandial plasma glucose. Patients with NACKD were found to be older than those with ACKD. Retinopathy was found to be more prevalent in the ACKD patients, whereas the rates of macrovascular complications were found to be similar between the groups. The prevalence of NACKD relative to ACKD decreased in CKD stages 3b, 4 and 5. Interpretation & conclusions: The results of this study suggest that NACKD constituted greater than one third of patients with diabetes and decreased e-GFR, which showed a strong association with age but not with duration or severity of hyperglycaemia or the presence of retinopathy. Both NACKD and ACKD showed similar associations with macrovascular disease
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Rural development was once equated with agriculture, allied sectors, and infrastructure. Rural development has become a strategy to enhance the rural poor's economic and social existence. It concerns rural development. Rural development is the process through which rural society progresses up the economic ladder, improving its social and economic standing. The study tries to analyse the financial performance of the Karnataka State Co-Operative Agriculture and Rural Development Bank. The study relies on secondary data extracted from numerous NABARD Annual Reports, Sahakari Soudha, the Department of Cooperatives, Bangalore, and other publications and periodicals. The research spans a decade, from 2006 to 2021. Several statistical measures, including mean, percentage, and growth rate, are employed to evaluate the study. The study found that between the research periods, the KSCARD bank deposits, reserve money, total loan disbursed, and total share capital have all increased; however, the loan recovery percentage has fallen throughout the same period. In general, the KSCARD is an organisation that makes significant contributions to the growth of rural communities.
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Headache during pregnancy is a common complaint in the emergency room. In pregnancy, pituitary disorders include both hormone active and hormone inactive tumors. Apoplexy may be the first clinical presentation of an underlying pituitary tumor. Red flag signs of presenting symptoms, to be assessed for identifying life-threatening etiology. Various pathophysiological mechanisms have been passed for pituitary apoplexy in pregnancy. Magnetic resonance imaging of the brain is the gold standard investigation. The mainstay of management is the initiation of steroids. Transnasal transsphenoidal removal of the tumor is the definitive treatment that requires a multidisciplinary approach. The indications of surgery are the presence of symptoms due to compression and endocrine abnormalities; however, gestational period should be taken into consideration. We report a case of headache in antenatal women who presented to our emergency room diagnosed with pituitary apoplexy managed with steroids and early surgery, and discharged with good clinical outcome. We recommend a methodical approach to common symptoms that assist in diagnosing forgotten etiology.