RÉSUMÉ
When the time lows of the psychological body, about the human mind, there is a vital relationship between the psychological and somatic body leading to stress and mishaps. This could be a lack of coherence among significant components in the body, which are characterized by hormones such as cortisol and adrenaline that come into play. Cortisol and adrenaline are released when there is usually a response of fight or flight, where these hormones get ready to handle the body’s reaction, and when this happens properly, it yields stress. Stress occurs through all age groups across every ethnicity and population, as the functioning of the mind is very similar. Managing this emerging stress and anxiety condition could be done through the easy way of the modern system of medicine, allopathy. Alternatively, the traditional method comes in handy to maintain such a condition with hardly any long-term side effects. A few conventional techniques like the practice of yoga, support of the proper nutrients, and certain medicinal herbs are bent to see a change in the perspective of coping mechanisms that results in a stress-free environment within the human mind. Many patterns of practices are noticed that there are specific nutrients and supplements formulated with medicinal herbs with significant pharmacological properties and the ancient activity of yoga aid in stress management. Using and practicing regularly can help in an integrated caliber of living. This review article sheds information and collation on such significant medicinal herbs, nutrients, and renounced practices of yoga that play together in the balance of the human body to overcome the distress of the mind. Many studies have noticed that medicinal herbs, nutrients, and specific yogic asanas help handle stress and anxiety, giving a holistic living pattern.
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Background: Labour analgesia though widely practised is still not routinely administered to all parturients in India. We conducted this historical observational cross-sectional study to assess parturient knowledge and factors affecting satisfaction in those who received epidural labour analgesia; aiming at improving the services.Methods: All parturients requesting epidural labour analgesia have the catheter sited and the drug administered as per institutional protocols. A feedback form is given to these parturients, postnatally. The form consists of questions regarding her knowledge of and experience with labour analgesia, including her satisfaction score on a scale of 0 to 10. Author collected these forms and analyzed them along with information from the labour epidural register and the discharge summary.Results: The mean satisfaction score was 7.1 (SD- 2.28). 46 parturients (31.08%) had ‘low satisfaction’ (<7 score) and 102 parturients (68.9%) had ‘high satisfaction’ (≥7 score). The timing of initiation of epidural analgesia within the parturients expectations and adequate analgesia were two factors that were found to affect satisfaction scores, with statistically significant values (p=0.002 and p=0.006 respectively). Those with a very short or very long duration of labour analgesia, were more likely to give less satisfaction scores (p=0.023 and p=0.002). Only 30% of parturients had heard of labour analgesia in the past.Conclusions: In this setting good analgesia and receiving it on time are of utmost importance in those receiving epidural labor analgesia, emphasising the need for adequate analgesia and prompt initiation of the same.
RÉSUMÉ
Background: Aim was to estimate the prevalence of vitamin D deficiency in pregnant women and their infants and to analyse the effect of maternal vitamin D deficiency on the infant.Methods: A prospective study was done in the Department of Obstetrics and Neonatology in a tertiary centre in South India with 150 women seen in the antenatal clinic after 36 weeks of pregnancy were recruited. Serum vitamin D levels were obtained. Babies were followed up and sampled once between 10 and 20 weeks of age for vitamin D, calcium, phosphate and alkaline phosphatase. Vitamin D levels less than 20 ng/ml was considered as deficiency. Analysis of the data was done using SPSS 16.0 version.Results: Vitamin D deficiency was seen in 64.8% of the pregnant women. Follow up of 76 babies showed vitamin D deficiency in 72.6% infants. Significantly high levels of alkaline phosphatase were noted in infants who were born to mothers with vitamin D deficiency, which indicates risk of developing bone disease.Conclusions: This study highlights the high prevalence of Vitamin D deficiency in pregnant women and their infants in South India in a region with abundant sunshine. This study also emphasises treating vitamin D deficiency in pregnancy to reduce the risk of developing rickets in infancy.
RÉSUMÉ
Background: Pemphigus has a protracted course and multiple factors influence its prognosis. The objective of this study was to describe the epidemiology and clinical profile of pemphigus patients and to study its influence on treatment end points. Methods: This was a retrospective chart review done in an Indian tertiary care hospital from December 1991 to December 2013. Patients with less than 3 months' follow up and those who had paraneoplastic pemphigus were excluded. Results: There were 132 patients with pemphigus, of which 118 (89.4%) had pemphigus vulgaris and 14 (10.6%) had pemphigus foliaceous. The time to disease control (TDC) was available for 100 patients (n = 100, 75.7%); patients with a minimum follow up of 3 months (n = 80) were included for studying the end points like time to first disease remission (TDR) and time to first disease relapse (TDRe). The median period of follow up was 23 months (range 3–245). Out of the 100 patients, 61.9% were on oral steroids with adjuvant therapy. The steroid dose required for disease control for n = 100, ranged from 0.2 to 1.5 mg/kg body weight. Of these, 60% were treated with steroid dose of 1 mg/kg, 22% with >1 mg/kg, and 18% with <1 mg/kg. The mean time to disease control (in months) in the group which received <1 mg/kg steroid was 1.02 ± 0.68, 1 mg/kg was 0.72 ± 0.51, and >1 mg/kg was 1.02 ± 0.62 (P = 0.017); with a significant difference between the groups 2 and 3 (P = 0.007), implying a faster disease control in those who received 1 mg/kg dose. This difference was significant after adjusting for the steroid sparing drugs taken at baseline (P = 0.009, C.I. - 1.44-13.59). The mean time to first disease remission (TDR) was 11.46 ± 2.06 months. Out of the 80 patients with a minimum follow up of 3 months, 75% had achieved either partial or complete remission. None of the other epidemiological, clinical or immunological parameters had an impact on the TDC or TDR. Conclusions: The epidemiological, clinical or immunological parameters had no impact on the treatment end points like time to disease control and time to first disease remission. The dose of steroids required for disease control higher than 1 mg/kg offered no advantage in the time to disease control as compared to 1 mg/kg. Limitations: The study was retrospective and disease severity scores were not applied. In view of the shorter follow up period, long term prognostic end points and mortality could not be well represented. The median period of follow up was 23 months. The serum anti- desmoglein antibody titres were not available at various treatment end points for correlation at different time intervals.
RÉSUMÉ
Background: Pemphigus has a protracted course and multiple factors influence its prognosis. The objective of this study was to describe the epidemiology and clinical profile of pemphigus patients and to study its influence on treatment end points. Methods: This was a retrospective chart review done in an Indian tertiary care hospital from December 1991 to December 2013. Patients with less than 3 months' follow up and those who had paraneoplastic pemphigus were excluded. Results: There were 132 patients with pemphigus, of which 118 (89.4%) had pemphigus vulgaris and 14 (10.6%) had pemphigus foliaceous. The time to disease control (TDC) was available for 100 patients (n = 100, 75.7%); patients with a minimum follow up of 3 months (n = 80) were included for studying the end points like time to first disease remission (TDR) and time to first disease relapse (TDRe). The median period of follow up was 23 months (range 3–245). Out of the 100 patients, 61.9% were on oral steroids with adjuvant therapy. The steroid dose required for disease control for n = 100, ranged from 0.2 to 1.5 mg/kg body weight. Of these, 60% were treated with steroid dose of 1 mg/kg, 22% with >1 mg/kg, and 18% with <1 mg/kg. The mean time to disease control (in months) in the group which received <1 mg/kg steroid was 1.02 ± 0.68, 1 mg/kg was 0.72 ± 0.51, and >1 mg/kg was 1.02 ± 0.62 (P = 0.017); with a significant difference between the groups 2 and 3 (P = 0.007), implying a faster disease control in those who received 1 mg/kg dose. This difference was significant after adjusting for the steroid sparing drugs taken at baseline (P = 0.009, C.I. - 1.44-13.59). The mean time to first disease remission (TDR) was 11.46 ± 2.06 months. Out of the 80 patients with a minimum follow up of 3 months, 75% had achieved either partial or complete remission. None of the other epidemiological, clinical or immunological parameters had an impact on the TDC or TDR. Conclusions: The epidemiological, clinical or immunological parameters had no impact on the treatment end points like time to disease control and time to first disease remission. The dose of steroids required for disease control higher than 1 mg/kg offered no advantage in the time to disease control as compared to 1 mg/kg. Limitations: The study was retrospective and disease severity scores were not applied. In view of the shorter follow up period, long term prognostic end points and mortality could not be well represented. The median period of follow up was 23 months. The serum anti- desmoglein antibody titres were not available at various treatment end points for correlation at different time intervals.