Drug Utilization Pattern of Psychotropic Drugs Prescribed in the Psychiatric Department of a Tertiary Care Government Hospital, Rajasthan

Abstract: Introduction: Psychiatric disorders form an important public health priority and major causes of morbidity. Drug utilization studies are a pre-requisite for the formulation of drug policies. This review identifies the problems that arise from drug usage in health care delivery system and highlights the current approaches to the rational use of drugs. Objectives: to delineate the various drugs used in psychiatric disorders to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs and to assess prevalence of various psychiatric illnesses . Methodology

The management of Degenerative Lumbar Spondylolisthesis through Ayurveda - A Case Report

Introduction: Back pain is the most common symptom of degenerative lumbar spondylolisthesis. This pain is typically worse with activities such as bending and lifting, and often eases when lying down. This condition occurs as a consequence of the general aging process in which the bones, joints, and ligaments in the spine become weak and less able to hold the spinal column in alignment. In Ayurveda, the complaints of Degenerative Lumbar spondylolisthesis can be effectively managed on the treatment principles of Gridhrasi and Katishula. Methodology: The present article deals with a case of diagnosed grade 1 Degenerative Lumbar spondylolisthesis of L4 and L5 and was advised for surgery. The Ayurvedic diagnosis of Gridhrasi was made. Management included internal medications and procedures like Kati Basti and Agni Karma. Results: The effectiveness of Ayurvedic management was assessed by Roland Morris's low back pain and disability questionnaire scale and Oswestry Low back disability questionnaire. On Roland-Morris's low back pain and disability questionnaire, the before treatment score was 20(83.33%) and at the time of discharge, it was reduced to 4 (16.66%). That means the patient showed an improvement of 66.67% on the Roland-Morris low back pain and disability questionnaire. Conclusion: The present case substantiates the effectiveness of classical Ayurvedic treatment in degenerative lumbar spondylolisthesis

Specific Cognitive Deficits in ADHD: A Diagnostic Concern in Differential Diagnosis

We present a critical account of existing tools used to diagnose children with Attention Deficit Hyperactivity Disorder and to make a case for the assessment of cognitive impairments as a part of diagnostic system. Surveys have shown that clinicians rely almost entirely upon subjective reports or their own clinical judgment when arriving at diagnostic decisions relating to this prevalent disorder. While information from parents and teachers should always be carefully considered, they are often influenced by a host of emotional and perceptual factors. It increases the possibility for misdiagnosis of a condition like ADHD. Recent experimental literature on ADHD has identified unique underlying cognitive dysfunction, specific to ADHD. Therefore, we propose that there is a need to incorporate information on cognitive mechanisms underlying ADHD and inculcate such information in the diagnostic system, which will provide a more sensitive as well as specific tool in differential diagnosis of ADHD

Plakophilin3 Loss Leads to an Increase in PRL3 Levels Promoting K8 Dephosphorylation, Which Is Required for Transformation and Metastasis

The desmosome anchors keratin filaments in epithelial cells leading to the formation of a tissue wide IF network. Loss of the desmosomal plaque protein plakophilin3 (PKP3) in HCT116 cells, leads to an increase in neoplastic progression and metastasis, which was accompanied by an increase in K8 levels. The increase in levels was due to an increase in the protein levels of the Phosphatase of Regenerating Liver 3 (PRL3), which results in a decrease in phosphorylation on K8. The increase in PRL3 and K8 protein levels could be reversed by introduction of an shRNA resistant PKP3 cDNA. Inhibition of K8 expression in the PKP3 knockdown clone S10, led to a decrease in cell migration and lamellipodia formation. Further, the K8 PKP3 double knockdown clones showed a decrease in colony formation in soft agar and decreased tumorigenesis and metastasis in nude mice. These results suggest that a stabilisation of K8 filaments leading to an increase in migration and transformation may be one mechanism by which PKP3 loss leads to tumor progression and metastasis

Aravind Adiga's the White Tiger: a Tryst with the Real Entrepreneur of India

Abstract: The White Tiger is presented as an epistolary novel, written to Chinese Premier He is only the fourth Indian to receive this honor. The book has been published in at least sixteen languages so far and has received excellent reviews for its dark humor and the issues it raises. The White Tiger is the story of Balram who reveries to flout all social restrictions in order to make a place in the world of the people who have enslaved his community for ages. Through Balram's tale Adiga exposes two contrasting worlds existing within India, an India of darkness and an India of light. The India of darkness represented through Laxmangarh, a small village in Bihar, was presided over by feudal lords. It was hidden under the dark cover of corruption, inequality, greed and barbaric attitude of these lords, described as animals living in -high walled mansions just out side Laxmangarh … had there own temples inside the mansions and there own wells and ponds and did not need to come out into the village accept to feed.‖(WT: 25

Concern for Human Rights Violation: A Study of Mahasweta Devi

In the literary landscape, Mahasweta Devi stands out as an illustrious writer who, with precision and visceral detail, traces the saga of tribulations and societal marginalization experienced by tribal communities. Upon a comprehensive reading of Devi’s body of work, an observer might be inclined to conceive of her as a metaphorical celestial emissary, descended upon the terrestrial plane with the sole purpose of assuaging the sorrows of the voiceless; those who, being bound by their fear, were rendered unable to raise their voices against the oppressive landlords and zamindars. Devi, in her profound humanity, contemplates deeply on the circumstances of the impoverished dalits and tribals, who were deprived of basic human rights. The balance of power was tipped in favor of the affluent and zamindars, thereby allowing the latter to exploit the disenfranchised at their discretion. The tribal and dalit communities were victims of both physical and sexual harassment, and they were effectively silenced, stripped of their right to protest their own subjugation and oppression. In the context of the societal framework, these communities were marginalised, excluded from the mainstream discourse of life. Devi, with her empathy and indignation, assumed the role of their voice, tirelessly advocating for their plight. She strived to disseminate information about their gruesome conditions through her research papers and books, which subsequently evolved into a form of literature that voiced the experiences of these communities. During her era, the governmental structure was steeply biased against the indigent. Their interests and welfare were disregarded, and policies largely favored the prosperous. Devi’s work serves as a critique of this system, shedding light on the grim reality of social stratification and advocating for an inclusive society that upholds the dignity and rights of every individual. The present research article draws vivid details of the sufferings and marginalization of the tribals as represented by Mahasweta Devi in her works

One-Step versus Two-Step Diagnostic Test for Gestational Diabetes Mellitus

Comparison between one-step Diabetes in Pregnancy Study Group India (DIPSI) andAmerican Diabetes Association (ADA) recommended two-step oral glucose tolerance test(OGTT). Material and methods: This study has a sample size of 200; 100 participants eachwere subjected to either of the two tests. Gestational diabetes mellitus (GDM) and non-GDMdiagnosed by one-step test versus two-step test, respectively, were compared to one anotherand results were compared on the basis of various antenatal complications and fetomaternaloutcomes. Results: No statistical difference was found between both the groups on the basis ofvarious antenatal and fetomaternal outcomes. Conclusion: In Indian subcontinent with poorresources and lack of follow-up, single-step DIPSI can be preferred to ADA recommendedtwo-step OGTT; however, large database studies are still required

Comparative Clinical Evaluation of Caudal Bupivacaine vs. Bupivacaine Plus Tramadol for Pediatric Infraumbilical Surgeries: A Study on Postoperative Analgesia

Objectve: Effective postoperative pain management is crucial in pediatric patients undergoing infraumbilical surgeries. Various regional anesthesia techniques, including caudal block, have been used to provide postoperative analgesia in children. The addition of tramadol, a synthetic opioid analgesic, to bupivacaine in caudal anesthesia has shown potential benefits. This study aims to compare the clinical efficacy of single shot caudal bupivacaine alone versus bupivacaine plus tramadol for postoperative analgesia in pediatric infra-umbilical surgeries. Method: A prospective, randomized, double-blinded clinical study was conducted at our institute . The present study will be carried out in 60 paediatric patients of ASA grade I and II between the age of 1-8 years, undergoing infraumbilical surgeries. These children were randomly divided into 2 groups. Group B (n=30) received caudal block with 0.25% bupivacaine (1ml/kg) and BT Group (n=30) received caudal block with 0.25% bupivacaine (1ml/kg) with  tramadol (1mg/kg). The variables studied were hemodynamic changes, duration of analgesia and incidence of side effects. Pain assessment was done at 1,2,3,4,8,12, and 24 hours postoperatively using Modified objective pain scale.   Results: It was observed that the mean duration of analgesia in Group BT (9.05±2.21) hrs was significantly longer (p=0.0001) than Group B (3.78±0.94) hrs. Hemodynamic parameters remained comparable during intraoperative and postoperative periods. There were no incidence of    nausea, vomiting, bradycardia, hypotension, pruritis or decrease in respiratory rate in the two groups. Conclusion:   In our study we concluded that a single shot caudal  block with 0.25% bupivacaine (1ml/kg) plus Tramadol (1mg/kg) resulted in longer duration of analgesia when compared to 0.25% bupivacaine (1ml/kg) alone with no incidence of any side effects