Electroencephalographic characterization of a case of infantile spasm with atypical presentation

Infantile spasm is one of the common seizure disorders with serious consequences. It is generally characterized by a muscle spasm of various intensity and distribution, salaam spells, and infantile myoclonic seizures with typical electroencephalography (EEG) features of hypsarrhythmia. Here, a unique case is being reported in which breath holding spells for few seconds were the sole presentation of infantile spasm. The EEG features of the case included typical high voltage spike and slow wave pattern followed by very poor suppression representing modified hypsarrhythmia, a classical feature of infantile spasm. Fast Fourier transformation of hypsarrhythmic spells confirmed the delta dominance with the highest power spectral density of delta waves. The breath holding spells being the sole presentation of infantile spasm makes it an important case clinically due to the possibility of misdiagnosis due to its inconspicuous presentation

Comprehensive management of Mayer-Rokitansky-Küster-Hauser syndrome management: A case report

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian aplasia, is a congenital condition characterized by uterine and upper vaginal aplasia. It affects females with a normal female karyotype and typical secondary sex characteristics. The aim of this case report was to highlight the multidisciplinary management approach for MRKH syndrome, focusing on tailored interventions to address physical and psychological challenges and improve reproductive prospects. A 26-year-old married female presented to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, India in January 2023 with primary amenorrhea. Physical examination revealed a blind vagina and a hypoplastic uterus, indicative of MRKH syndrome. Further evaluation, including pelvic magnetic resonance imaging (MRI), confirmed Müllerian duct abnormalities and bilateral ovarian anomalies. The absence of a functional vagina significantly impacted the patient's quality of life, leading to difficulties with sexual intercourse and emotional distress related to infertility. A collaborative approach involving a gynecologist and a psychiatrist at AVBRH was initiated to address these challenges. The patient underwent vaginoplasty to create a neovagina, enhancing the sexual function and intimate relationship with the spouse. However, due to the hypoplastic uterus, achieving motherhood through traditional means was not possible. Therefore, assisted reproductive techniques, in particular surrogacy, were explored. Normal, functional ovaries were harvested from the patient for use in surrogacy procedures. This comprehensive management strategy exemplifies the challenges associated with MRKH syndrome and underscores the importance of tailored interventions and long-term follow-up. The case highlights the significance of collaborative care in improving the quality of life and reproductive prospects for individuals with MRKH syndrome

The effect of short-term exposure to red and blue light on the autonomic tone of the individuals with newly diagnosed essential hypertension

The research study aimed to study the effect of short term exposure to light basically red, blue and white on the autonomic tone of essential hypertensive individuals. The objective was to find out the baseline cardiac autonomic function along with the effect of these lights on the cardiac autonomic function among them. Till date few if any study have been conducted upon the individuals with certain disorder as common as essential hypertension. This was a cross sectional observational study conducted in the institute itself that included 77 newly diagnosed hypertensive subjects who willingly participated in the study. After written informed consent, brief history taking with the help of self-made questionnaire and clinical examination, they were randomized to different intervention groups (IG) namely IG I (red) IG II (blue) and IG III (white). HRV analysis of the last 5-6 minutes of both the baseline and color exposure was finally analyzed using MS Excel version 13 and Graph Pad Prism version 7.05. Different HRV parameters have been found to be affected differently on different color exposures. Red has shown to have an impact, mainly on the sympathetic system whereas white showed a dominant vagal component thus acting as a parasympathetic regulator. On one hand, where no conclusive result was found on blue light exposure, white light showed the most prominent results affecting various time and frequency components of HRV like SDRR, TP, LF etc. The present study, both, contradicts as well as supports various other works done on the similar area of interest. One reason of such high variation in different results is because HRV is itself a very dynamic function affected by even a slight change in both the internal and external environment of the subject. As artificial lights of various colors are part and parcel of the aesthetics and designing of most of the work environment all over world, it is very pertinent to study its impact upon human health status. The outcome of the study may play a decisive role in the diagnostics and therapeutics of essential hypertension in days to come. Furthermore, on the basis of the present findings, a future study could be undertaken with bigger data base addressing the limitations of the present study to find some conclusive evidence in the area highlighted

What would it cost to scale-up private sector engagement efforts for tuberculosis care? Evidence from three pilot programs in India.

BackgroundPrivate providers dominate health care in India and provide most tuberculosis (TB) care. Yet efforts to engage private providers were viewed as unsustainably expensive. Three private provider engagement pilots were implemented in Patna, Mumbai and Mehsana in 2014 based on the recommendations in the National Strategic Plan for TB Control, 2012-17. These pilots sought to improve diagnosis and treatment of TB and increase case notifications by offering free drugs and diagnostics for patients who sought care among private providers, and monetary incentives for providers in one of the pilots. As these pilots demonstrated much higher levels of effectiveness than previously documented, we sought to understand program implementation costs and predict costs for their national scale-up.Methods and findingsWe developed a common cost structure across these three pilots comprising fixed and variable cost components. We conducted a retrospective, activity-based costing analysis using programmatic data and qualitative interviews with the respective program managers. We estimated the average recurring costs per TB case at different levels of program scale for the three pilots. We used these cost estimates to calculate the budget required for a national scale up of such pilots. The average cost per privately-notified TB case for Patna, Mumbai and Mehsana was estimated to be US$95, US$110 and US$50, respectively, in May 2016 when these pilots were estimated to cover 50$91 and US$101, respectively. In comparison, the national TB program's budget for 2015 averages out to$150 per notified TB case. The total annual additional budget for a national scale up of these pilots was estimated to be US$267 million.ConclusionsAs India seeks to eliminate TB, extensive national engagement of private providers will be required. The cost per privately-notified TB case from these pilots is comparable to that already being spent by the public sector and to the projected cost per privately-notified TB case required to achieve national scale-up of these pilots. With additional funds expected to execute against national TB elimination commitments, the scale-up costs of these operationally viable and effective private provider engagement pilots are likely to be financially viable

Impact of prenatal technologies on the sex ratio in India: an overview

Genetics of disease, diagnosis and treatmen