Management of Gridhrasi WSR to Sciatica: Ayurveda

Gridhrasi (Sciatica) is one of the severe debilitating syndromes among all the neurological disorders. The main symptoms of Gridhrasi are Ruka (pain), Toda (pricking sensation), Stambha (stiffness) and Muhuspandana (twitching) in the Sphika (Gluteal Region), Kati (Waist), Prishtha (Low Back), Uru (Thigh), Janu (Knee), Jangha (Calf) and Pada (Foot) respectively and Sakthikshepa Nigraha (restricted lifting of the leg). The above mentioned symptoms can be compared with sciatica syndrome which is characterised by severe pain starting from low back region and radiating down towards the foot. This is a common entity encountered in a clinical practice. The review elaborates the general description of disease Gridhrasi w.s.r. to Sciatica. The general principle of treatment and procedures for the management of Gridhrasi/Sciatica according to various Ayurveda classics have been discussed

Ayurvedic Management Of Gridhrasi W.S.R. Sciatica-A Case Study

Gridhrasi is one of the most common disorders of Vata, which closely resembles with sciatica, which is characterized by pain or discomfort associated with sciatic nerve. The prevalence of sciatica varies considerably ranging from 3.8% in the working population to 7.9% in the nonworking population. Contemporary medicine has limitations giving short-term relief in pain or surgical intervention with side effect. Aim and Objectives: The aim of this study was to access the efficacy of Ayurvedic management with shephali patra kwath in Gridhrasi. It is a single case study of a 49‑year‑old woman who was diagnosed with sciatica by an Allopathy doctor who gave her steroids but this had no positive impact on her condition. The condition worsened and she had swelling at her ankle joint. She approached Ayurvedic treatment further where she was given Shephali patra kwath. The treatment was continued for consecutive 30 days.  Symptomatic assessment of patient was carried out after every  8 days and satisfactory outcome was there and overall quality of life of patient was significantly improved

An open labeled clinical trail on the effect of Vrikshamla in Sthaulya (obesity) w.s.r to hyperlipidaemia

Obesity is one of the leading cause for more than 53 diseases and in India around 30 million peoples are suffering with Sthaulya (obesity), individual habits with stressful life, wrong dietary habits and sedentary life is the main cause of disease and no satisfactory treatment is available in conventional system. Hence there is need explore alternative system of Indian medicine like Ayurveda for the benefits of sufferers Ayurveda dealt this disease as Sthaulya (obesity) under Medoroga (Adipose tissue disorder) and many treatment modalities have been explained number of drugs in Brahatrayi (Charaka, Sushruta & Vagbhat) were cited Bhavamishra was the author of Bhavaprakash Nighantu (Lexicon) which is one of the Laghutrayis (Sharanghadara, Madhavanidhana & Bhavaprakash) text is highlighted with Karmaoushadi (action based drug) such as Amradi Phala Varga explained Vrikshamla considered as drug index of Ayurveda, thus present study was designed to screen the drug with properties of Kapha Medohara (ability to reduce Kapha & Fat), Medorogahara (reduces Adipose tissue), Sthaulyanashaka (Anti obesity) and Karshyakara (ability to make lean) from Bhavaprakasha Nighantu in Ayurveda

Identification of novel Angiogenin (ANG) gene missense variants in German patients with amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disease characterized by the selective death of motor neurons in the motor cortex, brain stem and spinal cord. Recently, missense variants in the angiogenin gene (ANG), an angiogenic factor expressed in ventral horn motor neurons that is up-regulated by hypoxia, have been found in ALS patients of Irish/Scottish, North American, Italian, French and Dutch descent. To investigate the role of ANG in the German population, we screened for mutations by sequencing the entire coding region of the ANG gene in a large sample of 581 German ALS cases and 616 sex- and age-matched healthy controls. We identified two heterozygous missense variants, F(−13)L and K54E, in two German sporadic ALS cases but not in controls. Both missense variants are novel and have not been previously found in ALS cases. Our results suggest that missense variants in the ANG gene play a role in ALS in the German population and provide further evidence to support the hypothesis that angiogenic factors up-regulated by hypoxia are involved in the pathophysiology of ALS

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Improved Protective Efficacy of a Species-Specific DNA Vaccine Encoding Mycolyl-Transferase Ag85A from Mycobacterium ulcerans by Homologous Protein Boosting

Vaccination with plasmid DNA encoding Ag85A from M. bovis BCG can partially protect C57BL/6 mice against a subsequent footpad challenge with M. ulcerans. Unfortunately, this cross-reactive protection is insufficient to completely control the infection. Although genes encoding Ag85A from M. bovis BCG (identical to genes from M. tuberculosis) and from M. ulcerans are highly conserved, minor sequence differences exist, and use of the specific gene of M. ulcerans could possibly result in a more potent vaccine. Here we report on a comparison of immunogenicity and protective efficacy in C57BL/6 mice of Ag85A from M. tuberculosis and M. ulcerans, administered as a plasmid DNA vaccine, as a recombinant protein vaccine in adjuvant or as a combined DNA prime-protein boost vaccine. All three vaccination formulations induced cross-reactive humoral and cell-mediated immune responses, although species-specific Th1 type T cell epitopes could be identified in both the NH2-terminal region and the COOH-terminal region of the antigens. This partial species-specificity was reflected in a higher—albeit not sustained—protective efficacy of the M. ulcerans than of the M. tuberculosis vaccine, particularly when administered using the DNA prime-protein boost protocol

ARGONAUTE10 and ARGONAUTE1 Regulate the Termination of Floral Stem Cells through Two MicroRNAs in Arabidopsis

Stem cells are crucial in morphogenesis in plants and animals. Much is known about the mechanisms that maintain stem cell fates or trigger their terminal differentiation. However, little is known about how developmental time impacts stem cell fates. Using Arabidopsis floral stem cells as a model, we show that stem cells can undergo precise temporal regulation governed by mechanisms that are distinct from, but integrated with, those that specify cell fates. We show that two microRNAs, miR172 and miR165/166, through targeting APETALA2 and type III homeodomain-leucine zipper (HD-Zip) genes, respectively, regulate the temporal program of floral stem cells. In particular, we reveal a role of the type III HD-Zip genes, previously known to specify lateral organ polarity, in stem cell termination. Both reduction in HD-Zip expression by over-expression of miR165/166 and mis-expression of HD-Zip genes by rendering them resistant to miR165/166 lead to prolonged floral stem cell activity, indicating that the expression of HD-Zip genes needs to be precisely controlled to achieve floral stem cell termination. We also show that both the ubiquitously expressed ARGONAUTE1 (AGO1) gene and its homolog AGO10, which exhibits highly restricted spatial expression patterns, are required to maintain the correct temporal program of floral stem cells. We provide evidence that AGO10, like AGO1, associates with miR172 and miR165/166 in vivo and exhibits “slicer” activity in vitro. Despite the common biological functions and similar biochemical activities, AGO1 and AGO10 exert different effects on miR165/166 in vivo. This work establishes a network of microRNAs and transcription factors governing the temporal program of floral stem cells and sheds light on the relationships among different AGO genes, which tend to exist in gene families in multicellular organisms

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Interpenetrated Magnesium–Tricalcium Phosphate Composite: Manufacture, Characterization and In Vitro Degradation Test

Magnesium and calcium phosphates composites are promising biomaterials to create biodegradable load-bearing implants for bone regeneration. The present investigation is focused on the design of an interpenetrated magnesium–tricalcium phosphate (Mg–TCP) composite and its evaluation under immersion test. In the study, TCP porous preforms were fabricated by robocasting to have a prefect control of porosity and pore size and later infiltrated with pure commercial Mg through current-assisted metal infiltration (CAMI) technique. The microstructure, composition, distribution of phases and degradation of the composite under physiological simulated conditions were analysed by scanning electron microscopy, elemental chemical analysis and X-ray diffraction. The results revealed that robocast TCP preforms were full infiltrated by magnesium through CAMI, even small pores below 2 lm have been filled with Mg, giving to the composite a good interpenetration. The degradation rate of the Mg–TCP composite displays lower value compared to the one of pure Mg during the first 24 h of immersion test.Magnesium and calcium phosphates composites are promising biomaterials to create biodegradable load-bearing implants for bone regeneration. The present investigation is focused on the design of an interpenetrated magnesium–tricalcium phosphate (Mg–TCP) composite and its evaluation under immersion test. In the study, TCP porous preforms were fabricated by robocasting to have a prefect control of porosity and pore size and later infiltrated with pure commercial Mg through current-assisted metal infiltration (CAMI) technique. The microstructure, composition, distribution of phases and degradation of the composite under physiological simulated conditions were analysed by scanning electron microscopy, elemental chemical analysis and X-ray diffraction. The results revealed that robocast TCP preforms were full infiltrated by magnesium through CAMI, even small pores below 2 lm have been filled with Mg, giving to the composite a good interpenetration. The degradation rate of the Mg–TCP composite displays lower value compared to the one of pure Mg during the first 24 h of immersion test