Efficacy and Safety of Stomatab Capsules® in Improving Oral Health in Recurrent Aphthous Stomatitis: An Open-labeled Clinical Study

Background: Recurrent aphthous stomatitis (RAS) is a common ulcerative disease of the oral mucosa, which is difficult to treat. In Ayurveda, several medicinal plants have been evaluated for their anti-inflammatory and antioxidant effects in many oral diseases as an alternative for modern medicines. Method: A study with open-label, non-comparative single-arm design was conducted to evaluate the efficacy of “Stomatab” capsules in improving oral health in 30 subjects with RAS. The secondary objectives were to assess the improvement in oral health and tolerability of the herbal formulation. Subjects were instructed to take one capsule thrice daily after meals for 14 days. Patients were evaluated at three assessment points: screening and baseline (Visit 1, Day 0) with follow-ups done at Visit 2 (Day 5 ± 2) and Visit 3 at the end of the study (Day 14 ± 2). Results: There was a significant reduction in the mean ulcer size from 3.66 ± 1.27 mm (V1) to 0.64 ± 0.78 (V3). The mean number of ulcers reduced from 1.97 ± 0.72 (V1) to 0.90 ± 0.66 (V3). Significant improvement in ulcer-related symptoms of pain (Ruja), burning sensation (Daha) and redness (Raktavarnata) was noted. The total ulcer symptom scores decreased from 7.67 ± 2.38 (V1) to 0.63 ± 0.56 (V3). No side effects were reported by the study participants. Conclusion: These results show that the polyherbal formulation “Stomatab” capsule is safe and effective for the treatment of RAS.

Current understanding of frictional dermatoses: A review

Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as ‘a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.’ The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms ‘frictional dermatitis,’ ‘friction and skin,’ ‘dermatoses and culture,’ ‘clothing dermatitis,’ ‘friction melanosis,’ ‘PPE induced dermatoses in COVID-19 era,’ etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.

Effectiveness of Structured Teaching Programme on Knowledge Regarding Early Identification and Prevention of Thyroid Disorders among Women

Background: One of the utmost prominent illnesses in India is thyroid disease, and it has a significant impact on women of childbearing age. Various metabolic processes are regulated by the thyroid gland. Therefore, any abnormalities in this organ may cause those physiological functions to become dysfunctional. The postpartum period and pregnancy both frequently include thyroid problems. Method: Total 50 women are included as the sample. A convenient sampling method was used. A structured knowledge questionnaire was used to gather information, and Chi-square analysis was used to uncover the relationship between knowledge about thyroid disorders with socio-demographic factors. Result: The post-test results show that 50% of women were having good knowledge and 42% of women were having average knowledge. According to the pre-test, (68%) of women had inadequate knowledge and (32%) average knowledge. The computed knowledge 憈�-value (14.05) for the degree of freedom 49 and 0.05% level of significance was considerably greater than the table value (1.96). As a result, the planned teaching method worked. Conclusion: After evaluation of knowledge on the subject of thyroid disorders, it was found that most women had average knowledge regarding thyroid disorders. As a result, research has shown that STP was quite helpful in raising women's awareness of thyroid issues.

A Series of Ocular Tuberculosis Cases from A Rural Tertiary Care Center in West Bengal

Tuberculosis in Eye can have diverse presentations leads to diagnostic difficulty. If no extra-ocular tubercular lesions are found then it becomes a challenge to diagnose & treat. Here authors present 6 cases of Ocular Tuberculosis without any associated extra-ocular tubercular lesions. One case of tubercular anterior uveitis, eales disease, solitary Choroidal Tuberculoma, bilateral multiple Choroidal Tuberculoma, multifocal & serpiginous like Choroiditis are presented here. All of them were resolved with first line anti-tubercular regimen and corticosteroids. Authors recommend initial visual assessment for all Tuberculosis cases to diagnose & treat hidden cases of Ocular Tuberculosis which may be sight threatening.

Spiritual Intelligence And Rejection Sensitivity Among Young Adults

Aim: The aim of the study was to scrutinize the impact of spiritual intelligence on rejection sensitivity among young adults. The study also assessed the association between, Spiritual intelligence and rejection sensitivity. Methods: The data was drawn from an online survey of 203 adults between the age of 19-30 years, through convenience sampling the data was collected using, The Spiritual Intelligence Self-Report Inventory (SISRI 24), constructed by David B King and the RS-Adult questionnaire (A-RSQ) is an adaptation of the RSQ developed by Downey & Feldman, 1996. Statistical Analysis Used: The statistical technique of correlation was used to access the relationship between spiritual intelligence and rejection sensitivity, a t-test to access the gender difference in spiritual intelligence and rejection sensitivity was also used. Regression analysis was also used to understand the impact of spiritual intelligence on rejection sensitivity. Results: The findings of the study indicated that there is a negative correlation between spiritual intelligence and rejection sensitivity. In males and females, there was no significant gender difference in spiritual intelligence and rejection sensitivity which is in line with the previous studies. Finally, in terms of impact, spiritual intelligence had an impact of 42% on rejection sensitivity.

Multiple renal veins clogging the hilum of the right kidney / 대한해부학회지

Knowledge of variations of renal vessels is of utmost importance in retroperitoneal surgeries and kidney transplant surgeries. We report concurrent variations of the right renal vessels, observed in an adult male cadaver during dissection classes. The right kidney was supplied by three renal arteries, out of which two entered the kidney through the hilum and the other one entered through the lower pole of the kidney. There were five renal veins, emerging independently from the hilum and opening separately through five openings into the inferior vena cava. Among the veins, only one emerged anterior to the renal pelvis and the other four emerged behind it. Four of them terminated into the posterolateral aspect of the inferior vena cava, whereas one terminated into its anterior aspect. Fourth vein from above, received the right testicular vein. The renal hilum was clogged with the presence of seven vessels and renal pelvis.

Fatal intracranial bleedings in a viper bite: A case report / 中华创伤杂志(英文版)

Viper bite envenomation represents a significant occupational hazard among agricultural workers in India. The viper bite envenomation is usually suspected when a patient presents with predominant local symptoms at the bitten site, including pain, swelling, and necrosis. Further, systemic findings such as diffuse intravascular coagulation, hypotension, and shock may alert physicians of viper bite envenomation rather than a neurotoxic snake bite. However, cerebral complications are rare in viper bites but may potentially fatal. Central nervous system involvement in a viper bite is either due to neurotoxins or hemorrhagins present in the venom, which may induce cerebral thrombosis, ischemia, infarction, and hemorrhage. Here we present a case of a previously healthy adult male who succumbed to extensive subarachnoid, intracerebral, and intraventricular hemorrhages involving bilateral cerebral hemispheres following viper snake bite envenomation. This report highlights the importance of anticipating cerebral complications in viper bite envenomation, a rare occurrence. It also emphasizes the need for early antisnake venom administration to prevent and control systemic envenomation and its complications.

Prevalence, patterns, clinico-social, and behavioral factors associated with the consumption of sugar-sweetened beverages among undergraduate medical students of central India

Introduction: Excessive consumption of sugar-sweetened beverages (SSBs) in adolescents has become a global issue. As its link to obesity and noncommunicable diseases is clear, it is imperative to understand SSB consumption behaviors in the future health-care professionals. The objective of this study is to document the prevalence, patterns, and clinico-social and behavioral factors predicting high intake of SSBs among medical students. Material and Methods: This cross-sectional study was conducted using a self-reported, web-based, questionnaire. All the students and interns who were part of a publicly funded premiere teaching hospital between October and November 2019 were included in this study. The semi-structured questionnaire enquired regarding socio-demographic, clinical details, amount, behavioral patterns, and money spent in connection with SSB consumption. Data were analyzed using IBM SPSS version 24. Results: The mean age of participants was 19.3 ± 1.6 years, 71.7% being males. The current prevalence of SSB consumption was 90.5%. Furthermore, 49.9% and 29.1% of participants preferred soft drinks and sweetened fruit juice, respectively. Multivariate analysis showed that male gender (adjusted odds ratio [aOR]: 1.83, (1.03–3.25), current alcohol consumption (aOR: 4.09, 1.25–13.42), and recent (last week) consumption of a SSB predicted high intake of SSBs [aOR: 7.36, (3.41–15.87)] whereas, preference of energy/sports category of drinks predicted low intake of SSBs [aOR 0.10, (0.02–0.47)]. Conclusion: The consumption of SSBs among medical students was high. Targeted health education and behavior change interventions should be provided to males, alcohol users, and frequent consumers

PARENTING STYLE AND ASSERTIVENESS AMONG ADOLESCENTS WITH LEARNING DISABILITIES

Parents influence children's conduct, emotions, and personality. This study examined parental style and assertiveness in teens with and without learning difficulties. The researcher drew 80 student demographics to do this. 40 with learning impairments and 40 without were chosen. T-test and correlation were used to examine the data. The study found a difference in assertiveness between learning disabled and nondisabled teens. The study found a moderate association between authoritative, authoritarian, permissive/indulgent, and negligent parenting and assertiveness. The study recommended that parents of teens be mindful of how parenting style affects their children's assertiveness.

Histomorphological Analysis of Nephrectomy Specimens: Experience at a Tertiary Care Institute

Introduction: For a range of kidney abnormalities, including both neoplastic and nonneoplastic disorders, nephrectomy is a popular surgical treatment. We conducted this study to examine the range of lesions found in the nephrectomy specimens obtained and to ascertain the distribution of these lesions by age and sex. MaterialsandMethods: This study was conducted in the department of pathology, from 2017 to 2022. All nephrectomy specimens received during 5 years were included. Results: The spectrum of renal lesions observed in the study included both neoplastic (43.75%) and nonneoplastic (56.25%) conditions. Nineteen patients were males (59.37%) and 13 were females (40.62%) (M: F = 1.4:1). The most common entity in the nonneoplastic category was chronicpyelonephritis (n = 9, 28.12%). In our study, we documented two unusual cases of renal replacement lipomatosis (RRL), a type of pseudotumor related to nonfunctioning kidneys. Fourteen patients underwent nephrectomy for neoplastic conditions such as Wilm’stumor and renal cell carcinoma (RCC). Conclusion: Nephrectomy for the nonneoplastic condition was performed more frequentlyin our series. Histopathological evaluation of nonneoplastic nephrectomy specimens must be thoroughly considered, particularly in unusual circumstances such as RRL, where a preoperative erroneous initial impression of a malignant lesion such as angiomyolipoma or liposarcoma is possible.

Histomorphological Analysis of Gestational Trophoblastic Disease Spectrum with Clinicopathological Correlation at a Teaching Hospital

Introduction: Clinically, all trophoblastic lesions are frequently combined under a broad spectrum of gestational trophoblastic diseases (GTDs)without the use of specific pathological terms. However, studies now demonstrate that various forms of GTDs demonstrate differences in etiology, histogenesis, morphology, and clinical behavior. Thus, the need for diagnostic histopathology of these lesions to distinguish gestational trophoblastic neoplasms from nonneoplastic lesions and molar pregnancies and also for early anticipation for early anticipation, risk category stratification, prognostication, management, and prediction of persistent GTD. Our study aimed to study the histomorphological patterns of various types of GTD with light microscopy and the pattern of occurrence of GTDs in relation to age, parity, and gestation. MaterialsandMethods: The present study was conducted in the department of pathology, from January 2020 to April 2022. All GTDs confirmed by histopathological examination by hematoxylin‑ and eosin‑stained slides were included. Results: The spectrum of GTDs found in this study was seventy cases of hydatidiform mole (92.10%), three cases of exaggerated placental site (EPS) reaction (3.94%), and two cases of choriocarcinoma (2.63%) and one case (1.31%) of placental site trophoblastic tumor (PSTT). The most common presenting symptom was vaginal bleeding (93.42%). Conclusion: Hydatidiform mole forms the most common type of GTD with an incidence of complete moles more than partial moles. Histomorphological examination and analysis are helpful for confirmatory diagnosis. The most common clinical presentation of GTD was vaginal bleeding followed by amenorrhea. Emphasis on detailed descriptive morphological assessment can help in the histological distinction of benign lesions such as EPS reaction and placental site nodule and avert such cases from being erroneously diagnosed as neoplastic. The Ki‑67 proliferation index helped in distinguishing the EPS reaction from neoplastic lesions such as PSTT which requires surgical intervention and chemotherapy.

Study of changes in pre-existing against-the-rule astigmatism after temporal manual small-incision cataract surgery using frown, straight, and smile incisions

Purpose: To assess the change in the amount of astigmatism caused by frown, straight, and smile incision in patients with pre?existing against?the?rule (ATR) astigmatism of more than and equal to 1 diopter Methods: This is a prospective, comparative study conducted over 18 months on 60 patients. Twenty patients were allocated to each incision using simple random sampling. Demographic details, best?corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment evaluation, and A?scan were done. An average of three measurements of K horizontal (Khavg), K vertical (Kvavg), and difference between the two (Khavg ? Kvavg) were taken using manual keratometry. All surgeries were performed by a single surgeon. All the data analyses were performed by using IBM Statistical Package for the Social Sciences (SPSS) version 20 software. Frequency distribution and cross tabulation were performed to prepare the tables. Results: In frown incision, Khavg ? Kvavg was significantly decreased on day 45 from the preoperative value (P < 0.001), followed by straight incision (P < 0.001), and smile incision (P < 0.001). Maximum decrease was observed in frown incision (49.15%) followed by straight (37.75%) and smile (28.57%) incisions. Conclusion: Our results are consistent with reduction of pre?existing ATR astigmatism with temporal incisions, and frown incision seems to be the best approach.

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.

Ayurvedic Management of Tamaka Swasa w.s.r to Bronchial Asthma

Bronchial asthma is one of the most distressing chronic illness in all socio- economic status people, affecting all age groups. Changing in lifestyle, demographic factors, urbanization, environmental charges are the triggering factors of bronchial asthma. Tamaka swasa is characterized by paraoxysmal attacks of breathlessness, cough, coryza, due to chest tightness, rapid respiration, distress inability to expectorate and prolonged expiration. Methods: This is a single case study of a 34 year male patient, came with the complaints of difficulty in Breathing since 5 years. He also complaints of abdominal distension and decreased appetite. According to patient, he was apparently well before 5 years. Gradually he developed breathing difficulty because of his smoking habit. Patient also c/o abdominal distension and decreased appetite at that time. In the case study patient was given Sadhyo vaman first followed by Snehapana with Brahmi ghrta was given along with Internal medications. Result: Patient showed remarkable improvement in severity of symptoms and as well as time period between 2 successive episodes of dyspnea is increased. During this course we observed that the patient had partial relief of symptoms. Lesser the chronicity greater the relief and improvement in chronic condition was observed. Interpretations and Conclusion: The patient was given Sadhyovamana, followed by Snehapana with Brahmi ghrtam for Virechana. The contents of Brahmi ghrtham are Ghee, Brahmi, Shankapushpi, Trikatu, Shweta trivrt, Krishna Trivrt, Vidanga, Nipadruma, Saptala, Danti, followed by Virechana with Trivrt lehaya. Tamake tu virechana In this condition Virechana is advised as the best line of treatment, and in the above mentioned case after Virechana patient feels better and got much more relief from symptoms.

Perioperative Management of Patients with Prosthetic Heart Valves?A Narrative Review

Worldwide, about 13% of the 200,000 annual recipients of prosthetic heart valves (PHV) present for various surgical procedures. Also, more and more females are opting for pregnancies after having PHV. All patients with PHV present unique challenges for the anesthesiologists, surgeons and obstetricians (in case of deliveries). They have to deal with the perioperative management of anticoagulation and a host of other issues involved. We reviewed the English language medical literature relevant to the different aspects of perioperative management of patients with PHV, particularly the guidelines of reputed societies that appeared in the last 20 years. Regression of cardiac pathophysiology following valve replacement is variable both in extent and timeline. The extent to which reverse remodeling occurs depends on the perioperative status of the heart. We discussed the perioperative assessment of patients with PHV, including focused history and relevant investigations with the inferences drawn. We examined the need for prophylaxis against infective endocarditis and management of anticoagulation in such patients in the perioperative period and the guidelines of reputed societies. We also reviewed the conduct of anesthesia, including general and regional anesthesia (neuraxial and peripheral nerve/plexus blocks) in such patients. Finally, we discussed the management of delivery in this group of high?risk patients. From the discussion of different aspects of perioperative management of patients with PHV, we hope to guide in formulating the comprehensive plan of management of safe anesthesia in such patients.

Serological survey for SARS-CoV-2 antibodies among tribal communities of Odisha post-second wave

Background & objectives: Serial national level serosurveys in India have provided valuable information regarding the spread of COVID-19 pandemic in the general population, but the impact of the ongoing pandemic on the tribal population in India is not well understood. In this study, we evaluated the seroprevalence of COVID-19 antibodies in the tribal population of Odisha post-second wave (September 2021). Methods: A population-based, age-stratified, cross-sectional study design was adopted for the survey, carried out in seven tribal districts of Odisha from 30th August to 16th September 2021. A multistage random sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein in each district, and a weighted seroprevalence with 95 per cent confidence interval (CI) was estimated for each district. Results: A total of 2855 study participants were included from the seven tribal districts of Odisha in the final analysis. The overall weighted seroprevalence was 72.8 per cent (95% CI: 70.1-75.3). Serological prevalence was the highest among 18-44 yr (74.4%, 95% CI: 71.3-77.3) and from Sambalpur district [75.90% (66.90-83.10)]. Among participants, 41.93 per cent had received at least one dose of any COVID-19 vaccine. Kandhamal district had the highest number of fully immunized participants (24.78%), and in Sundergarh district, most of the study participants (58.1%) were unimmunized.Interpretation & conclusions: This study found high seroprevalence against SARS-CoV-2 in the tribal population of Odisha. The vaccination coverage is at par with the general population, and efforts to address some knowledge gaps may be needed to improve the coverage in the future

A Rare Variation in the Course of C5 Root of Brachial Plexus.

Variations in the formation of the upper trunk of the brachial plexus are relatively rare. Knowledge of its possible variation is useful to orthopedic surgeons dealing with the problems of cervical spine, anesthesiologists performing brachial plexus blocks and general surgeons performing lower neck surgeries. In this report, we present a variation in the formation of the upper trunk of the brachial plexus. The upper trunk was formed by the union of ventral rami of fifth and sixth cervical spinal nerves. The fifth cervical ventral ramus passed ventral to the scalanus anterior muscle, while the sixth cervical ventral ramus passed between the scalanus anterior and medius muscles. The upper trunk was formed at the lateral border of the scalenus anterior muscle.

Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door?to?door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate?to?severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Super refractory status epilepticus in a parturient with preeclampsia undergoing cesarean delivery under spinal anesthesia

Super refractory status epilepticus (SRSE) is a rare but serious neurological emergency. This case report aims to highlight the challenges faced during the diagnosis and management of SRSE in a 36-year-old preeclamptic patient taken for cesarean delivery under spinal anesthesia. The patient developed a seizure episode minutes after administration of intrathecal bupivacaine, necessitating administration of general anesthesia. Postoperatively, SRSE developed which did not respond to multiple anti-epileptics and thiopentone sodium infusion. Although the clinical picture and magnetic resonance imaging findings supported the diagnosis of posterior reversible encephalopathy syndrome, the role of intrathecal bupivacaine in causing SRSE could not be ruled out due to the temporal association of events. The patient had a prolonged and complicated hospital stay and despite a multimodal approach to the treatment, suffered neurological sequelae.