Pregnancy outcome in women with heart disease at a tertiary referral teaching center in Northern India

Background: Pregnancy causes a significant burden on cardiovascular system due to hemodynamic changes therefore a diseased heart may not be able to adjust with extra load resulting in heart failure and even maternal mortality.Methods: A prospective study was done in 50 women with heart disease over a period of 12 months from 2010 to 2011 at G.S.V.M. Medical College, Kanpur. At the first antenatal visit baseline data is recorded included age, parity, gestational age, NYHA class, co-morbid conditions, prior cardiac events, cardiac lesion (if already diagnosed), prior surgery/interventions, cyanosis and medications. A thorough clinical examination and investigations were done.Results: Maximum numbers of patients (56%) were in the age group 20-24 years. 52 % of patients were primigravida and 48 % of patients were multigravida. Maximum numbers of patients (76.67%) were in the lower socioeconomic group. Chronic rheumatic heart disease (84%) was the most common type of heart disease followed by congenital cardiac disease (14%). Heart disease if diagnosed preconceptionally or during earlier period of gestation both maternal (8.9%) and foetal complications (22.8%) are lesser as compared to patients in whom diagnosis was made late. There is also the significant difference with majority of the foetal complications in group IV (80%) (preterm birth, IUGR and perinatal mortality) as compared to group I (14.2%).Conclusions: Maternal and perinatal outcome in women with heart disease depends mainly on the functional cardiac status during pregnancy, the risk being greater in NYHA III and IV. Our study shows that surgical intervention or medical management in pregnancy improves the functional class and also improves the maternal and fetal outcomes. Interventions can only be successfully done either before pregnancy or during 2nd trimester. When patients were diagnosed before pregnancy we have enough time for counseling and treatment. Counseling further increase the compliance and acceptance for medical and surgical interventions

Phytochemical and Pharmacological potential of Flemingia Roxb. ex W.T.Aiton (Fabaceae)

The Flemingia genus is an important source of medicinal natural products, particularly Flavonoids and steroids. The collected information is an attempt to cover the more recent developments in the ethnobotany, pharmacology and phytochemistry of this genus. The review includes 39 references on the genus Flemingia, and comprises ethnopharmacology, morphology, phytoconstituents, pharmacological reports, clinical study and adverse effects of the prominent species of Flemingia. A few species of this genus have medicinal value, among these, F.strobilifera ,F.macrophylla, F.chappar (Fabaceae) have been traditionally used in the treatment of epilepsy, insomnia, ulcer, pain ,swelling. Despite a long tradition of use of some species, the genus has not been explored properly. In the concluding part, the future scope of Flemingia species has been emphasized with a view to establish their multifarious biological activities and mode of action. The information summarized here is intended to serve as a reference tool to practitioners in the fields of ethnopharmacology and natural products chemistry. Key words: Flemingia strobilifera, F. macrophylla, F.chappar, Fabaceae, Flavonoid

Sedative and Anticonvulsant Activities of the Ethanol Root Extract of Flemingia chappar Benth

Purpose: To investigate the sedative, hypnotic and anticonvulsant activities of the ethanol extract of the roots of the Flemingia chappar (ERFC) on the central nervous system (CNS) of mice.Methods: The ethanol extract of the roots of F. chappar in doses of 200, 400 and 600 mg/kg, p.o., was studied in mice for its sedative effect by evaluating its locomotor activity; its hypnotic effect was assessed by measuring pentobarbital–induced sleeping time, while anticonvulsant effect was determined by evaluating its activity on maximal electroshock–induced and pentylenetetrazole-induced seizures. The latency of tonic convulsions and number of animals protected from tonic convulsions were noted.Results: ERFC (200 - 600 mg/kg) significantly (p < 0.05) decreased locomotor activity. ERFC also produced dose-dependent prolongation of pentobarbitone sleeping time. In addition, ERFC (400 and 600 mg/kg) significantly (p < 0.05) reduced the duration of seizure induced by maximal electroshock (MES), The same dose also protected from pentylenetetrazol-induced tonic seizures and significantly (p < 0.05) delayed the onset of tonic seizures.Conclusion: The results indicate that the ethanol root extract of F. chappar has sedative and anticonvulsant activities, thus justifying its use in traditional medicine for epilepsyKeywords: Flemingia chappar, Anticonvulsant activity, Pentylenetetrazole , Electroshock seizure, CNS depressant

ALTERATIONS IN PARATHORMONE, CALCIUM AND PHOSPHORUS LEVELS IN CKD PATIENTS ON MAINTENANCE HAEMODIALYSIS IN A HOSPITAL SETTING IN PUNJAB.â€

Objective: Many people who have severe chronic kidney disease (CKD) will eventually develop kidney failure and will require dialysis. The controlof parathormone (PTH), phosphorus, and calcium metabolism is one of the objectives in an adequate dialysis protocol. Therefore, we conductedthis study to describe alterations in PTH, calcium, and phosphorous homeostasis in patients with CKD on hemodialysis in our center. Our study alsoaimed to find an association between hormonal and biochemical abnormalities in CKD patients, who have been on hemodialysis for ≥5 months andcomparing the results obtained with that recommended by Kidney Disease Improving Global Outcomes (KDIGO) guidelines.Methods: This was a hospital-based cross-sectional observational study. The study population of 330 patients (>18 years) on maintenancehemodialysis coming to dialysis Unit of Department of Medicine of Gian Sagar Hospital, Ramnagar (Patiala), over a period of 3 years (2012-2015),were enrolled in the study. Each patient was considered only once for the study. In addition, biochemical analysis of serum intact PTH (iPTH), correctedcalcium, phosphorus, total alkaline phosphatase (tALP), serum creatinine, blood urea, serum albumin, and hemoglobin of all cases was done usingfully automated equipment. All statistical analyses were performed using SPSS statistical software, version 17.Results: The study population of 330 patients comprised adults, mainly illiterate (54.5%) predominantly belonging to the rural (66.4%) strata witha mean age of 52.67±15.05 (range: 25-98 years). The abnormality in the laboratory profile of the patients was found to be hyperparathyroidism in40.3% as compared to hypoparathyroidism in 33.5% and normal iPTH levels in 26.2%. Hypocalcaemia was detected in 50.6% and hyperphosphatemiain 62.1% of the patients. There was statistically significant association of serum iPTH, with corrected calcium and phosphorus (P=0.032 and P=0.035,respectively). Corrected calcium was also significantly associated with phosphorus (P=0.001) and tALP (P=0.007).Conclusion: We showed in the present study that disorders of mineral metabolism are common in hemodialysis patients and that only a smallproportion adheres to the targets as advised in the KDIGO guidelines for bone metabolism and disease in CKD. We demonstrated that these disordersare associated with important negative clinical outcomes, such as increased all-cause lack survival, more muscle and bone problems. Our findings,therefore, support a strict control of mineral metabolism in dialysis patients. Further research and progress in this area are required to establish amore rational approach with a view toward improving patient outcomes.Keywords: Parathormone, Calcium, Phosphorus, Hemodialysis.Â

Surgico-therapeutic management of thoroughpin in two Camels (Camelus dromedarius)

Abstract Tenosynovitis of the tarsal sheath is called thoroughpin of tarsal sheath. It is common in horses but in present report it is found in two camels. One camel respond to injection of corticosteroid into the cavity of the tarsal sheath but other did not, therefore surgical approach was determined. There was a remarkable improvement in the swelling as well as degree of lameness after surgery

Therapeutic efficacy of artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria from three highly malarious states in India

Additional file 1. Flowchart showing site-wise enrolment and follow-up profile

Regional and experiential differences in surgeon preference for the treatment of cervical facet injuries: a case study survey with the AO Spine Cervical Classification Validation Group

Purpose: The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon’s geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods: A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results: A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion: More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe