Multimodal ayurvedic approach in the management of moderate SARS-COV2 infection with co-morbidities - A case report.

Introduction: The World Health Organization (WHO) declared COVID-19 a pandemic which has claimed more than 1.4 million lives as of today. This unprecedented period demands greatly for the traditional and native medical systems which are time-tested and holistic. Some of the recent studies have reported severe infection in individuals with comorbidities such as obesity, diabetes mellitus, old age, etc. Ayurveda understands this condition as Agantuja Jwara of Sannipatika origin. Madhumeha (diabetes mellitus) is basically a disease of depleted Ojus (immunity) as per Ayurveda. Methods: Here, we report a case of COVID-19 in an elderly overweight patient with diabetes, which was managed successfully with Ayurvedic medicines, diet, lifestyle, yoga, and rejuvenative therapy. Case Description: A 70-year-old male consulted our physician through phone call and willfully wanted to take Ayurvedic management for COVID-19. On the 1st day of treatment, the patient complained of fever at 103 F, headache, and severe body ache. Later on, started with a cough, headache, shortness of breath, excessive thirst, etc. Based on the symptom cluster and food-exercise routine, Kapha and Pitta were the vitiated body humors. Results: After thorough Ayurvedic assessment, the patient was administered with Langhana, Pachana (procedures to improve digestive metabolism), anti-pyretic, and antidiabetic medications followed by yoga and pranayama. The patient was also advised rejuvenative therapy to prevent further post-COVID complications. Quality of Life was assessed with Quality of Life Instrument for Indian Diabetes Patients (QOLID) and EuroQol five-dimensional (EQ-5D). The patient was completely relieved from major symptoms in 4 days and tested negative after 12 days, with considerable improvement in QOL. The case was followed up for 60 days, and no post-COVID symptoms were reported.

Nosocomial infections in patients admitted in intensive care unit of a tertiary health center, India.

BACKGROUND: Patients in Intensive Care Units (ICUs) are a significant subgroup of all hospitalized patients, accounting for about a quarter of all hospital infections. AIM: The aim was to study, the current status of nosocomial infection, rate of infection and distribution of infection among patients admitted in Medical Intensive Care Unit (MICU) of a District Hospital. SUBJECTS AND METHODS: Data were collected retrospectively from 130 patient's records presented with symptoms of nosocomial infection in MICU of a Tertiary Health Center, Tumkur from August 2012 to May 2013. Descriptive statistics using percentage was calculated. RESULTS: Incidence of nosocomial infections in MICU patients was 17.7% (23/130). Of which 34.8% (8/130) was urinary tract infection (UTI) being the most frequent; followed by pneumonia 21.7% (5/130), 17.4% (4/130) surgical site infection, 13.0% (3/130) gastroenteritis, 13.0% (3/130) blood stream infection and meningitis. The nosocomial infection was seen more in the 40-60 year of age. The male were more prone to nosocomial infections than the female. CONCLUSION: The most frequent nosocomial infections (urinary, respiratory, and surgical site) were common in geriatric patients in the MICU setting and are associated with the use of invasive device. Large-scale studies are needed to be carried out in Indian population to plan long-term strategies for prevention and management of nosocomial infections.

Descending auditory pathway and identification of phonetic contrast by native listeners.

The present study investigated the ability of native listeners to identify subtle phonetic contrasts in nonsense words and its relationship with the contralateral inhibition of transient evoked otoacoustic emissions (TEOAE). A group of 45 young adults with normal hearing sensitivity who were native speakers of Malayalam participated in the behavioral experiment. Phone identification score and reaction time for four phonetic pairs in nonsense words were measured for each participant. Based on the phone identification score, the participants were divided into high and low performers. Twelve participants randomly selected from each group were evaluated for contralateral inhibition of TEOAEs. Phone identification score and global contralateral inhibition amplitude of TEOAE were significantly higher and reaction time was significantly shorter in high performers than that of low performers. Significant correlation was found between the phone identification score and contralateral inhibition of TEOAE. Strength of the medial olivocochlear bundle activity explained about 30% of the variance in the phone identification scores providing evidence for the involvement of the descending auditory pathways in identifying the phonetic contrasts that are acoustically similar. These results support the emerging view that top down influences from higher centers shapes the responses of lower centers.

The efficacy of antiseptic mouth rinses in comparison with dental floss in controlling interproximal gingivitis.

OBJECTIVES: Maintaining good oral hygiene is important to combat periodontal diseases. The use of tooth brush alone does not serve the purpose, especially in inaccessible areas like proximal embrasures, which demand the use of some adjuncts like proximal cleaning aids. Hence, the objective of this study was to compare the clinical efficacy of two antimicrobial mouth rinses (Cool mint Listerine and 0.2% Chlorhexidine gluconate) with dental floss in reducing interproximal gingivitis and dental plaque in an unsupervised condition. MATERIALS AND METHODS: A randomized, controlled, single-blind (observer), parallel-group clinical trial in accordance with the ADA guidelines was conducted for a period of 6 months. Four index age groups (12, 15, 35-44, and 65-74 years) were divided into four groups, i.e., brushing, brushing and flossing, brushing and rinsing with Listerine, and brushing and rinsing with Chlorhexidine, so that each group comprised 40 subjects. Interproximal gingivitis and dental plaque were assessed using Modified Gingival Index, Turesky-Gilmore-Glickman modified Quigley-Hein Plaque Index and Gingival Bleeding Index. Analysis of variance (ANOVA) was used for multiple group comparisons, followed by Tukey's post hoc for group-wise comparisons. RESULTS: Chlorhexidine and Listerine showed significant reduction in plaque and gingivitis level compared to others, the activity of Chlorhexidine being more significant. CONCLUSIONS: The level of interproximal gingivitis control efficacy provided by the Listerine and Chlorhexidine was "at least as good as" that provided by the dental floss. Hence, they can be recommended for the patients with gingivitis as an adjunctive to the usual home care routine.

Fluoride and bacterial content of bottled drinking water versus municipal tap water.

BACKGROUND: Water is a divine gift. People quench their thirst without questioning the source of water. But, apprehension about contaminants in municipal water supplies along with increased fear of fluorosis made bottled drinking water as one of the important tradable commodities. OBJECTIVES: The objectives of the study were to determine and compare the fluoride and bacterial contents of commercially available bottled drinking water and municipal tap water in Davangere city, Karnataka. MATERIALS AND METHODS: Fifty samples of 10 categories of bottled drinking water with different batch numbers were purchased and municipal water from different sources were collected. Fluoride levels were determined by an ion-selective electrode. Water was cultured quantitatively and levels of bacteria were calculated as colony-forming units (CFUs) per milliliter. RESULTS: Descriptive analysis of water samples for fluoride concentration was in the range of 0.07-0.33 for bottled drinking water, Bisleri showing the highest of 0.33. A comparison of the mean values of microbial count for bottled drinking water with that of municipal tap water showed no statistically significant difference, but was more than the standard levels along with the presence of fungus and maggots. CONCLUSION: The fluoride concentration was below the optimal level for both municipal tap water and bottled drinking water. CFUs were more than the recommended level in both municipal tap water and bottled drinking water.

'Thinfat' phenotype in newborns.

OBJECTIVE: The objectives of the study was to know whether the 'thinfat' phenotype exists in newborns, in Central Karnataka and to correlate various factors that contribute to this peculiar phenotype, with emphasis on genetic and maternal environmental factors. METHODS: For 1000 consecutive singleton term newborns, weight, length, head, mid arm, abdominal circumferences, biceps and subscapular skinfolds were measured at birth and compared with measurements of white Caucasian babies born in Southampton UK and Mysore babies at birth. RESULTS: The Davangere babies were significantly smaller in all measurements at birth (p < 0.001) compared to Southampton babies. The deficit varied according to the measurements; It was greatest for birth weight (-1.6 SD, CI -3.0, -0.2), mid arm circumference (-2.0 SD, CI -3.3, -0.8), head circumference (-1.8 SD, CI -3.1, -0.5) and least for length (-0.4 SD, CI -1.9, 1.1) and subscapular skin fold (-0.3 SD, CI -0.25, -0.12). Predictors of skinfold thickness were maternal body mass index (p < 0.05), maternal mid arm circumference (p < 0.001) and consanguinity (p < 0.05). CONCLUSION: Despite being small, truncal adiposity was present in Davangere neonates confirming the 'thinfat' phenotype. The role of consanguinity in other words, the role of genes, is important in determining this 'thinfat' phenotype in newborns.