A CLINICAL STUDY ON SHWITRA (VITILIGO) AND ITS MANAGEMENT WITH VIRECHAN KARMA AND SHAMAN CHIKITSA

Purpose: The human skin is the largest organ of the integumentary system, plays an important role towards the beauty of human beings. Although the disease Shwitra does not produce any other systemic mal-functions, it creates many psychological as well as social problems for the patients. Though the disease, Shwitra is not fetal but it may interferes the enjoyment of life as white discoloration takes place on the body. Shwitra (Vitiligo) is a social problem not only in India but all over World. Methods: In the present study 20 patients were treated with internal intake of Khadira, Rohitak & Manjistha along with local application by Shweta Aparajita and Khadira for the duration of 6 months. Another 20 patients were treated with additional use of Virechan karma by Shyama Trivritchurna. Result: The result of the study was assessed by clinical improvement on regular interval of follow up of the patients. Conclusion: The drugs used for the management of the disease Shwitra are safe, effective, cheap & easily available. No untoward affect of the trial drug has been observed during the study

Relationship between personality traits, spiritual intelligence and well being in university students

Objective: This research was carried out to explore the relationship between personality traits, spiritual intelligence and well being among university students. Method: Big Five Factor Inventory by Rammstedt and John was employed to assess personality traits, Spiritual Intelligence Scale of King (SISRI -24) to measure spiritual intelligence and WHO-Five Well-being Index (WHO-5) to measure well being of 120 students doing post graduation in Psychology from the University of Jammu (N=50) and Indira Gandhi National Open University (N=70). The mean age of the sample was 24.79. Independent samples t test was employed to assess the difference in personality traits and spiritual intelligence in students from two universities. Data was subjected to correlation and regression analysis.Results: Differences in personality traits and spiritual intelligence emerged in this study. Positive relationship was found between personal meaning production and two factors namely agreeableness and neuroticism. Significant relationship appeared between transcendental awareness and openness. Regression analysis revealed that transcendental awareness predicted well being.  Conclusion: To further enhance the well being steps should be taken to develop and strengthen transcendental awareness in students. Keywords: Personality traits, Spiritual Intelligence, Well Being, Student

Colloid Carcinoma of Gallbladder - Incidental Finding of a Rare Entity

Majority gall bladder carcinomas are conventional adenocarcinomas of pancreatobiliary type. Mucinous carcinomas in gall bladder constitutes 2.5% of all gallbladder carcinomas. Pure mucinous (colloid carcinomas) are even rarer. Its rarity deserves this case being highlighted. Less than twenty-five cases of mucinous carcinomas of the gallbladder have been reported so far. A 46-year-old female presented with recurrent right upper quadrant pain along with nausea and vomiting for last one year. Liver function tests & kidney function tests were within range. USG Abdomen revealed an enlarged gallbladder measuring 8x5 cm with no stones. No other abnormalities were found on USG. A simple cholecystectomy was performed for chronic cholecystitis. Gross examination of specimen showed glistening, globular, soft and cystic gall bladder filled with mucoid tenacious yellowish material. There was no discernible mass lesion. Microscopic examination revealed pools of extracellular mucinous material dissecting muscular wall containing few signet ring cells. A diagnosis of colloid or pure mucinous adenocarcinoma of the gallbladder was made. Pure mucinous carcinomas as seen in exocrine glands like breast, pancreas and skin are very uncommon in gall bladder. Mucinous variant (>50% stromal mucin) are most of the time admixed with conventional type. Mucinous carcinomas most of the time are large and advanced at the time of diagnosis and are aggressive in nature than conventional type. This case is presented owing to its extreme rarity

Spindle Cell Variant of Medullary Carcinoma Thyroid- A Case Report

A 14-year-old girl presented with a solitary thyroid nodule since 1 year. Fine needle aspiration cytology (FNAC) from the thyroid swelling revealed discretely arranged spindle cells with scant cytoplasm. Because of diagnostic dilemma, a provisional diagnosis of spindle cell lesion of thyroid was given as distinction of amyloid from collagen and basement-like material was difficult on cytology smears. Also, spindle cell might be seen in anaplastic carcinoma, melanoma, soft tissue sarcomas, etc. Tumor cells were positive for cytokeratin and chromogranin in cell block preparation. Thus, the diagnosis of spindle cell variant of medullary carcinoma thyroid was given

Purification and characterization of a Bacillus subtilis keratinase and its prospective application in feed industry

We have isolated a Bacillus subtilis strain (RSE163) from soil and explored for keratinase production. Keratinase was purified using chromatographic methods (Sephadex G-75 and Q Sepharose) resulting in 8.42-fold purification with 3303 U/mg specific activity.The purified enzyme displayed 3 bands in close proximity between 20 to 22 kDa in SDS-PAGE which were apparent to the zone of hydrolysis in gelatin zymogram. Enzyme was stable over a wide pH (7.0-10.0) and temperature (30 °C to 70 °C) range with optimum activity at pH 9.0 and 60 °C. Keratinase activity was stimulated in presence of Mn2+, β-mercaptoethanol and surfactants (Triton-X and Tween-80) and inhibited by Fe3+, Cd2+, K+, PMSF (phenyl methane sulfonyl fluoride) and other chelating and reducing agents. The enzyme efficiently hydrolyzed a variety of complex protein substrates (chicken feather, keratin hydrolyzate and casein) and enzyme kinetics parameters were determined using Lineweaver Burk plot (Km = 6.6 mg/ml, Vmax = 5 U/ml/min). Hydrolyzed feather keratin obtained through fermentation with B. subtilis RSE163 has been explored for its cytotoxicity using liver cell line (HepG2). No cytotoxicity has been determined up to 0.015% concentration of hydrolyzed product indicating its potential applicability as feed supplement

Lomiphene citrate versus letrozole as first line ovulation induction drug in infertile anovulatory polycystic ovarian syndrome women: a prospective randomized controlled trial

Background: The present study was design to compare letrozole (5 mg) and clomiphene citrate (100 mg) as first line ovulation induction drug in infertile anovulatory polycystic ovarian syndrome (PCOS) women.Methods: This prospective randomized clinical trial included 60 cases of PCOS with anovulatory infertility. The first group comprised of 30 patients who received 5 mg letrozole daily and the second group received 100 mg clomiphene citrate daily for 5 days starting on day 2-5 of menses. Both the groups were followed by ultrasound for follicle monitoring, ovulation and endometrial thickness. When dominant follicle reaches a diameter of more than or equal to 18mm and endometrial thickness ≥7.5 mm, human chorionic gonadotrophin (hCG) 5,000 IU was given intramuscularly and timed intercourse was advised. Main outcome measures were occurrence of ovulation, endometrial thickness and pregnancy rates.Results: The mean age, body mass index, and number of cases of primary and secondary infertility in both the groups showed no statistically significant difference. Multi-follicular development during induction was statistically significantly greater in the clomiphene group (1.27±1.11 versus 2.03±1.65; p=0.041). Ovulation occurred in 24 subjects (80%) in letrozole group and 18 subjects (60%) in the clomiphene group, with a statistically significant difference between the two groups (p=0.024). Pregnancy occurred in 16 subjects (53.33%) in letrozole group and 7 subjects (23.33%) in clomiphene group, which shows statistically significant difference between the two groups (p=0.048).Conclusions: Though number of developing follicles was found statistically significant with clomiphene citrate but ovulation rate and pregnancy rate were higher with letrozole group. Therefore, letrozole is a safe and better alternative for ovulation induction in patients of anovulatory PCOS, and it may be considered as a first line treatment for ovulation induction in these patients.

Relationship of degree of anemia as direct or indirect causes of heart failure and its impact on maternal and fetal outcome

Background: Objective of current study was to determine the impact of anemia as cause of heart failure in pregnancy and its associated maternal and fetal outcome.Methods: It was a prospective study conducted in department of obstetrics and gynecology GSVM medical college, Kanpur, from January 2012 to august 2013 with total number of subjects being 6800. All maternal and fetal records were reviewed.Results: Total number of antenatal patients admitted to our hospital during 20 month duration were 6800, out of which 48 (0.17%) had heart failure. 47.91% patients among them had severe anemia as direct cause of heart failure, whereas anemia was associated as indirect cause of heart failure in 52.08% of patients. Poor maternal and fetal outcome were observed in patient with increasing severity of anemia.Conclusions: With increase in degree of anemia susceptibility to heart failure increases and it was observed that there was increased incidence of adverse maternal and neonatal outcome in severe anemia when compared to mild and moderate anemia.

Patterns and predictors of complementary and alternative medicine use in people presenting with the non-communicable disease in an urban health facility, North India

Background: The rising burden of non-communicable diseases (NCDs) is a threat to India. Increasingly, individuals interested in improving their health and making healthy lifestyle changes are turning to complementary and alternative medicine (CAM) as a health-care option.Design and Methods: The objective of this study was to determine the prevalence, pattern, and predictor of alternative medicine use among NCDs patients undergoing allopathic treatment in an urban health centre. The study design was a hospital-based cross-sectional study, which was done in a government hospital, Srinagar, Pauri District, Uttarakhand, India among adult males and females aged above 20 years. The patients having NCDs were systematically sampled.Result: Among 233 studied patients 57.1% were males. The mean age of the patients was 55.8 years (SD 13.5). Of the total studied patients 46.8% were diagnosed with DM, and 43.8% of HTN. Nearly one-fifth of the patients were known to have a CVD or COPD. A total of 49.8% of the studied NCD patients reported use of both allopathic and alternative medicine treatment and nearly 3.4% of the studied NCD patients in the last one year to seek exclusive alternative medicine treatment. The overall use of exclusive alternative medicine was low that is 3.7%, 1.0%, and 5% in diabetes, hypertension, and chronic lung disease patients, respectively.  The most common form of alternative medicine used by studied patients was medicinal herbs/biological-based medicine (MB) (62.9%). Among MB commonly used were a bitter gourd, aloe vera, and others. 29.8% of the patients used Indian/Ayurveda medicine in total.Conclusions: The use of exclusive alternative medicine is low in adult patients with NCD. However, medical pluralism is prevalent. A better understanding of practices especially that focuses on alternative medicine needs a qualitative study, which was beyond the scope of this study

Seizure disorders in pregnancy: an insight beyond eclampsia and epilepsy

Background: Seizures in pregnancy contribute to poor maternal and perinatal outcome. Though eclampsia and epilepsy are common causes of seizures in pregnancy but there are several other conditions apart from eclampsia and epilepsy which give rise to convulsions. Objective of this study was to evaluate fetomaternal outcome in patients with seizure disorders as well as to analyze the other causes of seizures in pregnancy apart from eclampsia and epilepsy.Methods: This prospective study was conducted in Shri. Guru Ram Rai institute of medical and health sciences, Dehradun, India over a period of 39 months from January 2017to March 2020, in all pregnant women with seizure disorders delivered in this hospital. In all cases demographic characteristics, causes of seizure with special attention on noneclamptic, non-epileptic conditions, maternal complications, mode of delivery and fetal outcome were noted.Results: Total 97 cases with seizure disorders were included in the study. Mostly seizures were due to eclampsia and epilepsy in 91.75% cases. Among other causes neurocysticercosis, cerebral malformation, posterior reversible encephalopathy syndrome, brain tumor, and cerebral infarcts contributed to seizures in pregnancy in 8.25%cases. Maternal complications were premature rupture of membranes, gestational diabetes mellitus, hypothyroidism, anaemia, jaundice and abruption observed in37.11% cases. Live birth rate was 76.28%, prematurity was present in 27.83% cases and fetal growth restriction was seen in 7.21% neonates. There were 5 (5.15 %) neonatal deaths.Conclusions: Seizure disorders in pregnancy are associated with significant increase in maternal and fetal risk. Maternal complications, cesarean section rate and neonatal complications are increased. Several other conditions apart from eclampsia, need to be considered in patients without epilepsy presenting with convulsions in pregnancy.