A single-case study of management of Jalodara (ascites).

Most common manifestation of liver dysfunction is ascites and most common cause of ascites is liver disease. Ascites is the accumulation of fluid in the peritoneum. Inspite of advanced medical facilities, still, there is no sure treatment which cures a patient of ascites totally. The modern treatments only provide provisional relief with time dependent recurrence but, the fluid gets collected in the abdominal cavity repeatedly. In such case, Ayurvedic treatment gives relief without any side effect, in such cases and can be correlated with Jalodara (ascites) which mentioned in Ayurveda medical science. Diet restriction, medicinal treatment and surgical procedure are mentioned in Samhita. Diet restriction is an important feature of the management of this condition. A 46-year-old female came to outpatient department with anorexia, abdominal distension, vomiting after meal, respiratory distress etc. She was given Nitya Virechana (daily therapeutic purgation) with Abhayadi Modaka, cow's urine, SharapunkhaSwarasa, PunarnavaKwatha, etc. and restricted diet plan for 3 months. After 3 months, a significant improvement was noted in all the symptoms of the patient. Hb% was also increased from 7.5% to 11.2% and erythrocyte sedimentation rate and serum creatinine were decreased from 35 mm/h to 10 mm/h and 1.2 mg/dl to 0.9 mg/dl respectively. Ultrasonographic findings also showed improvement in comparison with previous report. Hence, it was concluded that Ayurvedic management gives relief in ascites.

Local house prices and mental health.

This paper examines the impact of local (county-level) house prices on individual self-reported mental health using individual level data from the United States Behavioral Risk Factor Surveillance System between 2005 and 2011. Exploiting a fixed-effects model that relies on within-county variations, relative to the corresponding changes in other counties, I find that while individuals are likely to experience worse self-reported mental health when local house prices decline, this association is most pronounced for individuals who are least likely to be homeowners. This finding is not consistent with a prediction from a pure wealth mechanism but rather with the hypothesis that house prices act as an economic barometer. I also demonstrate that the association between self-reported mental health and local house prices is not driven by unemployment or foreclosure. The primary result-that lower local house prices have adverse impact on self-reported mental health of homeowners and renters-is consistent with studies using data from the United Kingdom.

Prevalence of retinopathy of prematurity in Brunei Darussalam.

AIM: To identify the prevalence of retinopathy of prematurity (ROP) among preterm neonates admitted to Department of Neonatology, RIPAS hospital, Brunei Darussalam. METHODS: We studied 67 preterm infants fulfilling the eligibility criteria for ROP screening. All infants studied were admitted to the Department of Neonatology, RIPAS Hospital, within a period of one year. Birth weight (BW), gestational age (GA), corrected age at each review, initial and final diagnoses and number of reviews required was recorded for each infant. Infants were followed up two weekly until they reach a corrected age of 40 weeks or complete vascularization was noted. Prevalence of ROP was identified. Descriptive analysis, regression analysis and independent-sample t-test were used to statistically check for differences between ROP and non-ROP groups. RESULTS: A total number of 201 ROP screenings were carried out for 67 preterm infants. Males outnumbered females (56.7%). The mean number of reviews per child was (3.19±1.1) times (range: 1-6 times), the mean GA among the preterm babies examined was (29.5±2.6) weeks (range: 23-36 weeks), and the mean BW was 1300±500g (range: 660-3600g). The prevalence of ROP among the examined infants was 34.8%. Prevalence of threshold disease that required laser treatment was 25.4%. Prevalence of ROP among those with extremely low BW was 86.7% compared to 27.8% in those with very low BW. Respiratory distress and congenital heart diseases were significantly associated with higher incidence of ROP. CONCLUSION: Lower BW, lower GA and female gender are associated with higher risk of developing ROP among preterm infants in Brunei Darussalam.

Spectrum of intra-ocular foreign bodies and the outcome of their management in Brunei Darussalam.

To review the etiologies, prognostic factors and treatment outcomes of intraocular foreign bodies (IOFBs) occurring in the population of Brunei Darussalam, and provide guidelines to prevent and manage such injuries. A retrospective review was performed for all cases of traumatic IOFBs managed in our centre during a 3-year period between May 2008 and April 2011. The mechanism of injury, management, complications and visual outcomes were analyzed. Majority of the patients were males (93 %) and the mean age was 36 years. The main causes of trauma were metal hammering and grass cutting (43 % each). Other causes include road traffic accidents and firecracker explosion (7 % each). The visual outcome was ≥6/18 in 50 % and 'No perception of light' in 29 %. Causes of poor visual outcome were retinal detachment with proliferative vitreoretinopathy (21 %), endophthalmitis (21 %) and globe maceration (7 %). Prognostic factors associated with significantly worse final visual outcome included posterior location of the IOFB (p = 0.05) and larger IOFB size (p < 0.001). The time from injury to surgery did not correlate with a worse visual prognosis. In Brunei Darussalam, the commonest causes of IOFBs are hammering metal and cutting grass using power tools. The visual outcome varies between 6/6 and NPL. Poor visual outcome is related to the severity of the initial ocular injury, posterior segment IOFB and endophthalmitis.

Comparative study of Vamana and Virechanakarma in controlling blood sugar levels in diabetes mellitus.

Diabetes mellitus (DM) with its devastating consequences is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. The characteristic features of DM have close resemblance with Prameha (obstinate urinary disorders including diabetes) in Ayurveda. Madhumeha is a Vatika subtype of Prameha that is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed if Samshodhana (bio-cleansing) is used in early stages of disease followed by palliative treatment. Vamana (emetic therapy) and Virechana (purgation therapy) are the Samsodhana Karma (bio-cleansing therapies) that are compatible to overcome this Aavarana (occlusion). A comparative study was planned to compare their efficacy in controlling blood sugar levels in patients with DM. Although none of them were completely able to control blood sugar in the long-term but the study yields some very interesting results in reducing the blood sugar levels which could be useful in the future studies related to DM.

A comparative study of Shankhapushpyadi Ghana Vati and Sarpagandhadi Ghana Vati in the management of "Essential Hypertension".

Hypertension is a major public health problem of this era. Hypertension related morbidity and mortality rates have dramatically increased over the last 25 years. Stressful life style is one of the leading causes of Hypertension. The treatment of hypertension remains a primary goal in the effort to reduce morbidity and mortality from cardiovascular disease, stroke and kidney disease. In this study, 20 patients were randomly divided in two groups and treated along with restricted diet pattern for 8 weeks. Patients of Group A received poly-herbal compound formulation Shankhapushpyadi Ghana Vati (2gm/day). It was found that, relief in overall symptoms (63.93%) elevated blood pressure (8.91% in Systolic blood pressure and 8.44% in diastolic blood pressure). In group-B, with Sarpagandhadi Ghana Vati (2gm/day) the percent relief was better on elevated blood pressure (12.00% in Systolic blood pressure and 11.02% in diastolic blood pressure). When data is subjected in between both the groups, it is found that, both drugs are equally effective.

Clinical efficacy of Shiva Guggulu and Simhanada Guggulu in Amavata (Rheumatoid Arthritis).

Amavata is the second most common joint disorders. Nowadays erroneous dietary habits, lifestyle and environment have led to various autoimmune disorders i.e. Amavisajanya Vikaara and Amavata is one among them. Rheumatoid arthritis can be correlated with Amavata in view of its clinical features. Many research studies have been done to solve this clinical enigma, but an effective, safe, less complicated treatment is still required for the management of Amavata. In the present study, 24 patients of Amavata were registered and randomly grouped into two. In group A, Shiva Guggulu 6 g/day in divided doses and in group B, Simhanada Guggulu 6 g/day in divided doses were given for 8 weeks. On analysis of the results, it was found that Simhanada Guggulu provided better results as compared to Shiva Guggulu in the management of Amavata.

Clinical efficacy of Panchamuladi Kaala Basti (enema) in the management of Amavata (Rheumatoid Arthritis).

Amavata (Rheumatoid Arthritis) has been a challenging problem to the medical field. Various treatment protocols are applied in this disease with partial success. In present clinical study, 12 patients of clinically proven Amavata (Rheumatoid Arthritis) were treated with Panchamuladi Kaala Basti to evaluate its efficacy. All clinical Ayurvediya nidanadi parameters and American Rheumatism Association guidelines for Rheumatoid Arthritis were followed. Before treatment and after treatment, analysis was done and results were calculated statistically using paired 't' test. Results obtained are encouraging and indicate the efficacy of Panchamuladi Kaala Basti over Amavata (Rheumatoid arthritis), exploring many aspects of this clinical entity.