Ayurvedic Management of Psoriasis: A Case Study

Skin, the body’s largest organ, protects from deleterious environmental impacts (physical, chemical, microbiological) and is crucial for the maintenance of temperature, electrolyte and fluid balance and tactile sensation, it sets a boundary between the organism and the environment. Any change in the normal skin texture disturb the patient both mentally and physically. Psoriasis is a common, chronic, recurrent inflammatory disease of the skin, characterized by circumscribed, erythematous, dry, scaly plaques of varying sizes. The severity of psoriasis is found to be ever fluctuating. Individuals are likely to cycle between differing levels of severity throughout lifetime. The course of the disease is punctuated by spontaneous flare-ups and remissions. Psoriasis being a chronic and often disfiguring condition, cause a marked impairment in quality of life. There is no certain cure for this disease. Ayurvedic diagnosis is as Vatha-Kapha predominant Mahakushta namely Sidhma kushta. Here an effort to treat a 13-year-old child having plaque psoriasis by Samsodhana and Samsamana therapy. Initially 6 days Virechana was performed and then followed by Samsamana with intermittent Virechana karma. PASI score is used to assess the severity of psoriatic lesions and the patient’s response to treatment. PASI score before the treatment was found to be 15.7 which became 0 at the end of the treatment. This case report showed the treatment modalities done in the patient obtained great result with no recurrence in the last 1.5 years.

Potential Therapeutic Benefits of Brahma Rasayana in the Management of Tuberculous Cerebrovascular Disease - A Case Report

Tuberculous meningitis (TBM) is an air-borne infectious disease caused by the bacteria Mycobacterium tuberculosis that affects the central nervous system (CNS). Among all the incident cases of TB, CNS TB represents approximately 1% with TBM as the most grievous among all. The basic pathology in TBM is the inflammation of the arachnoid membrane, the pia mater and the cerebrospinal fluid (CSF). It typically presents as mild fever, headache, anorexia and general debility that progress over one to two weeks to cause severe headache, fever, vomiting, confusion, meningismus and cranial nerve deficits. The most common complications of TBM include hydrocephalus, optico-chiasmatic arachnoiditis, seizures and stroke. Out of these, tuberculous cerebrovascular disease is a common neurological sequelae. This case study elaborates the treatment line and observations made in a 29 year old male patient who presented with hemiparesis and significant sensory deficit following an event of tuberculous meningitis. MRI brain was suggestive of basilar meningitis, optico-chiasmatic arachnoiditis, infarcts and tuberculoma with chest X-ray revealing increased bronchovascular markings in bilateral lung fields. Initially on admission, Deepana-pachana was done followed by snehapana with Shadpala ghrta and Virechana as Sodhana karma. Abhyanga, Ushma Sweda, Churna pinda sweda and Jambeera pinda sweda were successively done allied with physiotherapy. Yogavasti with Vedanasthapana gana as Kashaya and Kalka was done intervened by Anuvasana vasti. Succeedingly, Murdhni taila prayoga and Marsha nasya were also incorporated with periodical neurological, hematological and biochemical assessment. On discharge, Brahmi kalyanaka ghrta and Brahma Rasayana were advised inclusive of physiotherapy.

Effectiveness of awareness lecture in improving the knowledge about learning disability among primary school teachers

Background: This study was done to assess the pre-existing knowledge about' Learning Disability (LD) among primary school teachers and the effect of awareness lecture on improving their skills in' early identification and remediation of LD among children having poor scholastic performance.Method: The study was conducted as a part of the IAP state President's action plan 2018-2019 'VIBGYOR'. The study sample consisted of 709' primary school teachers of government schools in Malappuram district in Kerala. The teacher's knowledge level on LD was assessed using a questionnaire following which an awareness class was given. Their knowledge level was assessed again at the end of the class.Results: There is a significant increase in knowledge level about learning disability among the teachers after the awareness lecture (p value<0.001).Conclusion: This study implicates the need for intensive training programmes to primary school teachers on learning disability so as to identify it at an early stage among children with poor scholastic performance.

Assessment of knowledge level on learning disability among primary school teachers

Background: Learning disability (LD) is one of the major causes of poor scholastic backwardness. Undetected and unmanaged specific LDs result in chronic scholastic backwardness ensuing school dropouts, emotional and behavioral problems such as depression, substance abuse and social delinquency. Since teachers are the ones who first encounter academic difficulties of children, their knowledge and training on LD is of utmost importance in identifying it at an initial stage and to prevent further mental and social damage. This study is to assess the knowledge level of primary school teachers on learning disability.Methods: This cross-sectional study was conducted among government primary school teachers of Malappuram district, Kerala from April 16, 2018 to May 20, 2018.Convenient sampling method was adopted. The study sample consisted of 709 primary school teachers from 21 schools in Malappuram district of Kerala and the teacher's knowledge level on learning disability was assessed using a questionnaire.Results: Even though majority of the teachers had some knowledge about the outcome and treatment of learning disability, they lack sufficient knowledge about its concepts and causes and it is grossly insufficient for its practical application in the class room.Conclusions: There is a need to improve the knowledge of primary school teachers on LD and to enhance their basic skills in recognizing learning disability at the earliest. This is very important for the management of these children by introducing and applying the appropriate remedial measures on time. This can go a long way in improving the quality of learning among children with poor scholastic performance.

A comparative study of the effect of dexmedetomidine and lignocaine on hemodynamic and airway responses following extubation

Background: Dexmedetomidine is the newer highly selective alpha 2-adrenoreceptor agonist. It has sympatholytic, sedative and analgesic properties with no respiratory depression. Various studies have evaluated the usefulness of Dexmedetomidine as an adjuvant to general anesthesia, reducing the requirements of inhalational agents and opioids, and for attenuating the intubation stress. A single dose of Dexmedetomidine has been found effective in attenuation of the airway and circulatory reflexes during extubation. Aim of the study: To compare the effects of intravenous Dexmedetomidine and lignocaine on Attenuation of hemodynamic responses and sedation score, Attenuation of airway responses to extubation after intracranial surgeries under general anesthesia. Materials and methods: This was a prospective, randomized, double-blinded study conducted at our institute between June 2018 and July 2018 in Tirunelveli government medical in the department of anesthesiology after getting institutional Ethical committee approval. Written informed consent was obtained from all subjects participating in the study. 50 patients of ASA Grade I and II undergoing craniotomies for non‑vascular ICSOL under general anesthesia were recruited. Patients were divided into two groups of 25 each by computer-generated random numbers. Group D (n=25) received 0.5 microg/kg Dexmedetomidine intravenously. Group L (n=25) received 1.5 mg/kg Lignocaine intravenously. Anesthesiologist who administered the drug and the observer were blinded to the study. Intravenous drugs were prepared by another anesthesiologist not involved in the study. Ebenezer Joel Kumar E, G Vijay Anand, B.S. Aswathy R. A comparative study of the effect of dexmedetomidine and lignocaine on hemodynamic and airway responses following extubation. IAIM, 2019; 6(2): 79-86. Page 80 Results: A decrease in HR, SBP, and DBP were observed up to the A5 stage in group D which was statistically significant. In group L the changes in HR, SBP, and DBP at these stages were statistically insignificant. There was an increase in HR, SBP and DBP in both groups during (E) and immediately after extubation (E1). This was more in group L compared to group D which was statistically significant. Thereafter in group D these values continued to decrease and remained below the pre-drug administration value (A0) at the end of the study (E15). Whereas in group L, these values although decreased from E and E1 values but remained above the A0 values at the end of the study period (E15). This difference was statistically significant (p-value less than 0.05). The degree of sedation was higher in Group D after extubation. 5 patients (20%) showed Grade 2 sedation and 20 patients (80%) showed Grade 3 sedation in Group D. In contrast, only 20% (n=5) patients had mild sedation (Grade 2) whereas 80% (n=20) patients were anxious and agitated or restless or both (Grade 1) in group L. The difference between both groups was statistically significant. Conclusion: From our study, we concluded that administration of a single dose of Dexmedetomidine (0.5 mcg/kg) provides significant attenuation of circulatory and airway responses during extubation when compared to lignocaine in craniotomies for ICSOL. Though patients were sedated in the immediate post-extubation period, the levels of sedation were acceptable without any incidence of desaturation