Adverse drug reactions to ibuprofen: a case report

Ibuprofen is a commonly used drug available by prescription and over the counter for treatment of fever, joint pain, headache, migraine, inflammatory states. It is available in combination with paracetamol and various other drugs. Side effects associated with aspirin & non-steroidal anti-inflammatory drugs (NSAIDs) are rash, gastrointestinal ulcers, hepatic toxicity, Steven Johnson syndrome, respiratory skin rashes, acute exacerbation of asthma and anaphylaxis. We have reported here severe distress hypersensitive reaction with ibuprofen induced hypersensitivity syndrome. Within two hours of consumption of ibuprofen patient developed severe bronchospasm, throat & laryngeal oedema leading to respiratory distress. He was treated with salbutamol, hydrocortisone, deriphylline and supportive oxygen, but did not respond and went into coma. Unlike acetaminophen, ibuprofen does not have any antidote hence managing adverse drug reactions (ADR) due to ibuprofen is big challenge. Therefore understanding pathophysiology of ADR to Ibuprofen is necessary to manage the patient. Literature in the field of allergic drug reaction shows that epinephrine, a physiological antagonist of histamine is the first drug of choice for the treatment of allergic or drug induced angioedema, laryngeal oedema and bronchospasm due to its direct action on target organs. Such reactions should therefore be managed by epinephrine without loss of time. ADR due to ibuprofen could be prevented by (a) avoiding unnecessary intake of drug, (b) educating patients / families and public about adverse drug reactions (c) surveillance and monitoring of drug reactions (d) record keeping (e) drug audit and (f) reporting of ADR to state/central pharmacovigilance agency. We do observe doctors having misconception about adrenaline, its actions, usage & side effects especially cardio-vascular, hence are reluctant to use. But in severe violent adverse drug reaction we have to use our wisdom and judgement and see whether usage of adrenaline overweighs the ADR or not. In acute drug reaction like this where respiratory system is compromised use adrenaline could have been helpful. We therefore suggest adequate teaching of the field of adverse drug reactions, early diagnosis of drug reactions and judicious use of epinephrine if warranted

Meditation as primary intervention strategy in prevention of cardiovascular diseases

Heart diseases especially Hypertension, Coronary Artery Diseases (CAD) and stroke are the leading causes of death all over the world. Hostility, anxiety, depression and increased reactivity to mental stress have been strongly associated with hypertension and CAD. Mental stress or anxiety causes increased sympathetic activation and poor vagus nerve control over heart.  Imbalance between sympathetic and parasympathetic nervous system leads to vasospasm and has been associated with Hypertension, Coronary Artery Disease and Myocardial Infarction. Psychosocial stress has also been found to be responsible for imbalance in autonomic nervous system, causing sympathetic dominance over parasympathetic leading to acute coronary events. Meditation is a process of self-contemplation and purification of mind. Practitioner of meditation brings about desirable changes in their behaviour and lifestyle. During Meditation sympathetic activity is reduced and there is parasympathetic dominance over sympathetic. During meditation and after meditation person feels calm, quiet and relaxed. Meditation causes decrease in metabolic rate. The blood pressure may come to normal or falls, pulse rate comes to normal or low, vascular spasm if any, is reduced and myocardial perfusion increase. Thus meditation helps in preventing hypertension, coronary artery disease and other cardiac events.  This may be beneficial before a person gets coronary event and post-myocardial infarction.   In view of the beneficial effects of meditation, it may be introduced as primary intervention strategy in preventing Cardio-vascular Diseases. We did this review study to find out: (1) Can meditation bring about desirable changes in human mind and body in post-intervention group compared to control group? (2) Its effectiveness in prevention of heart diseases like hypertension, coronary events and post-MI complications. This review included all randomised controlled trials on patients above 18 years, both sexes, any setting with medication & meditation or meditation, Controlled group was on medication alone. Clustered and crossover studies were excluded

Comparison of intramuscular diclofenac sodium, diclofenac sodium suppository and intravenous tramadol for postoperative analgesia in gynaecological surgeries done under spinal anaesthesia

Background: Postoperative pain management is a vital factor contributing towards speedy recovery of the patient in the perioperative period without significant morbidity. The purpose of this study was to compare the analgesic efficacy and safety of three most frequently used analgesic drugs-intramuscular diclofenac sodium, diclofenac suppository and intravenous tramadol hydrochloride in patients undergoing gynaecological surgeries.Methods: A hospital based, prospective, randomized, comparative study was undertaken in tertiary care hospital for a period of two years. The study included 90 adult patients undergoing gynaecological surgeries in spinal anaesthesia. Postoperative pain intensity was assessed by visual analogue scale. Level of sedation was assessed by four point scale along with haemodynamics.Results: There were no significant changes in the pulse rate, systolic blood pressure and diastolic blood pressure after giving I.M. diclofenac, diclofenac suppository and I.V. tramadol. The mean VAS scores were comparable in all three groups (p>0.05). The level of sedation was more in tramadol group than in diclofenac intramuscular and rectal group which was statistically significant (p=0.001).Conclusions: Diclofenac suppository provides effective postoperative analgesia when compared with Inj. Diclofenac I.M. and Inj. tramadol I.V. in patients undergoing infraumbilical gynaecological surgeries with stable vitals and no side effects

EVALUATION ON THE SEED GERMINATION RATE OF ASHOKA (SARACA ASOCA (ROXB.) DE WILDE) WITH SPECIAL REFERENCE TO VRIKSHAYURVEDA

Ashoka (Saraca asoca (Roxb.) de Wilde) is one of the most auspicious plant mainly for females belonging to family Fabaceae. The stem bark is the widely used in several Ayurvedic preparations such as Ashokarishta which is prescribed in leucorrhoea, haematuria, menorrhagia and other gynecological disorders. It is getting “endangered†due to over exploitation and enormous use of its bark. Because of destructive means of extraction and the absence of an organized cultivation programs, the availability of the crude drug is diminishing and this has resulted in substitution and adulteration. It affects the Good Manufacturing Practices and resulting in deprived quality of the product which leads to hamper its efficacy. Subsequently it is a need of hour, to cultivate it in large extent, which is getting deprived because of its slow growth rate, seed dormancy and low germination rate. The present study was conducted to overcome this problem with the help of one of the method described in Vrikshayurveda.In this study, seed germination of Ashoka is carried out by three different methods i.e., conventional method, H2SO4 method and Vrikshayurveda method. Out of which Germination rate of Ashoka seeds was maximum (38%) with conventional method minimum (6%) with Vrikshayurveda method and (24%) with H2SO4 treatment. In view of observations, methods like conventional and H2SO4are more effective than the Vrikshayurveda for good germination of seeds of Ashoka. The low germination rate in Vrikshayurveda may be due to the limited description of methodology described in Vrikshayurveda with respect to quantity of cow milk, cow dung, honey, and Vidanga powder and time period for soaking seeds in cow milk, rubbing of cow dung and application of Vidanga and honey with respect to procedure. It should be studied in detail so as to get scientific insight of ancient methods of Vrikshayurveda, may prove its important with respect to maximum germination rate and healthy growth of plants

Bacterial detection using an anharmonic acoustic aptasensor

Infectious diseases are currently, one of the greatest global challenges in medicine. Rapid and precise diagnosis and identification of pathogen is important for timely initiation of appropriate antimicrobial therapy. However, many patients with infectious diseases receive empirical treatment rather than appropriate pathogen-directed therapy. As a result antimicrobials have been overused and/or misused, which has ultimately led to antimicrobial resistance (AMR). AMR is broadly considered as the most significant public health threat facing the world today. Policy makers from all over the world have recognised the urgent need for rapid point-of-care (POC) diagnostics that would not only identify pathogens but also provide antimicrobial susceptibility profiles in meaningful timeframe to initiate appropriate antimicrobial therapy and thereby, prevent AMR. Traditional culture-dependent diagnostic methods are still considered as gold standard methods. But they are very slow and generally require 18 to 48 hours with further 8 to 48 hours to perform antibiotic susceptibility test. Among culture-independent methods, PCR and ELISA are label-based, costly, laborious and require specialised equipment and trained personnel to operate them. Lateral flow assays (LFAs) that are low-cost, simple, rapid and paper-based portable detection platforms are very popular, as they can be applied at the POC. [Continues.

A LITERARY STUDY ON NIDANAPANCHAKA OF PANDU ROGA

Pandu means pallor. In this disease there is predominance of paleness all over the body. due to its similarity it can be co-related with modern disease anaemia. Pandu Roga is explained by almost all of our Acharyas. This article is based on Nidanapanchaka of Pandu Roga from Ayurvedic texts as Charak samhita, Susruta samhita, Astanga hrudaya etc with all commentaries. Rasavaha and Raktavaha srotas are chiefly involved in pathogenesis of Pandu Roga. The changing lifestyle of human being by means of Ahara and Vihar plays a major role in manifestation of various diseases. Pandu Roga is also one of them. Our faulty dietary habits and lifestyle produces Ama which further causes Agnimandya and ultimately Amayukta Ahararasa produced. It hampers Rasa Dhatu utpatti and manifests Pandu Roga. Aggravated Pitta is responsible for the production of Posaka (nutrient portion) from the Rasadhatu as a result depletion of Rakta takes place. The detail knowledge of Nidanapanchaka and types of Pandu Roga will help in its diagnosis and management in this modern era also

MASS CULTIVATION OF SARPAGANDHA (RAUWOLFIA SERPENTINA BENTH. EX KURZ) IN CONSIDERATION WITH ENVIRONMENTAL FACTORS AND CULTIVATION TECHNIQUES

Sarpagandha (Rauwolfia serpentina Benth. Ex Kurz.)A perennial medicinal plant of family Apocynaceae is well known as Serpentina root, the natural source of alkaloid reserpine used for the treatment of Hypertension, neuro disorders like psychosis, schizophrenia, insanity, insomnia and epilepsy. It contains alkaloids reserpine, yohimbine, ajmaline, ophioxylin, resin, wax, starch are used as a sedative and tranquilizing agent. Main Ayurvedic products of Sarpagandha are Sarpagandha Ghanvati, Sarpagandha Yoga, Sarpagandha Churna and Mahesvari Vati. The world requirement for dry Sarpagandha roots is around 20,000 t per annum which is a great demand because of its high medicinal value. The internal consumption of dried roots is ≈150 t per annum. It is the red listed plant and as its germination rate is low and high demand in national and international market, it is necessary to increase its commercial production by using various effective and low cost techniques. This paper is going to through light upon various effective cultivation techniques and environmental factors responsible for growth of plants so that cultivars interest in Sarpagandha cultivation would increase on commercial basis and it will become again a boon for Ayurveda

VLSI Implementation of a Rate Decoder for Structural LDPC Channel Codes

AbstractThis paper proposes a low complexity low-density parity check decoder (LDPC) design. The design mainly accomplishes a message passing algorithm and systolic high throughput architecture. The typical mathematical calculations are based on the observation that nodes with high log likelihood ratio provide almost same information in every iteration and can be considered as stationary, we propose an algorithm in which the parity check matrix H is updated to a reduced complexity form every time a stationary node is encountered which results in lesser number of numerical computations in subsequent iterations. In this paper, we contemplately focuses on computational complexity and the decoder design significantly benefits from the high throughput point of view and the various improvisations introduced at various levels of abstraction in the decoder design. Threshold Controlled Min Sum Algorithm implements the LDPC decoder design for a code compliant with wired and wireless applications. A high performance LDPC decoder has been designed that achieves a throughput of 0.890 Gbps. The whole design of LDPC Decoder is designed, simulated and synthesized using Xilinx ISE 13.1 EDA Tool

Application of Fractal Dimension for Quantifying Noise Texture in Computed Tomography Images

Purpose Evaluation of noise texture information in CT images is important for assessing image quality. Noise texture is often quantified by the noise power spectrum (NPS), which requires numerous image realizations to estimate. This study evaluated fractal dimension for quantifying noise texture as a scalar metric that can potentially be estimated using one image realization. Methods The American College of Radiology CT accreditation phantom (ACR) was scanned on a clinical scanner (Discovery CT750, GE Healthcare) at 120 kV and 25 and 90 mAs. Images were reconstructed using filtered back projection (FBP/ASIR 0%) with varying reconstruction kernels: Soft, Standard, Detail, Chest, Lung, Bone, and Edge. For each kernel, images were also reconstructed using ASIR 50% and ASIR 100% iterative reconstruction (IR) methods. Fractal dimension was estimated using the differential box‐counting algorithm applied to images of the uniform section of ACR phantom. The two‐dimensional Noise Power Spectrum (NPS) and one‐dimensional‐radially averaged NPS were estimated using established techniques. By changing the radiation dose, the effect of noise magnitude on fractal dimension was evaluated. The Spearman correlation between the fractal dimension and the frequency of the NPS peak was calculated. The number of images required to reliably estimate fractal dimension was determined and compared to the number of images required to estimate the NPS‐peak frequency. The effect of Region of Interest (ROI) size on fractal dimension estimation was evaluated. Feasibility of estimating fractal dimension in an anthropomorphic phantom and clinical image was also investigated, with the resulting fractal dimension compared to that estimated within the uniform section of the ACR phantom. Results Fractal dimension was strongly correlated with the frequency of the peak of the radially averaged NPS curve, having a Spearman rank‐order coefficient of 0.98 (P‐value \u3c 0.01) for ASIR 0%. The mean fractal dimension at ASIR 0% was 2.49 (Soft), 2.51 (Standard), 2.52 (Detail), 2.57 (Chest), 2.61 (Lung), 2.66 (Bone), and 2.7 (Edge). A reduction in fractal dimension was observed with increasing ASIR levels for all investigated reconstruction kernels. Fractal dimension was found to be independent of noise magnitude. Fractal dimension was successfully estimated from four ROIs of size 64 × 64 pixels or one ROI of 128 × 128 pixels. Fractal dimension was found to be sensitive to non‐noise structures in the image, such as ring artifacts and anatomical structure. Fractal dimension estimated within a uniform region of an anthropomorphic phantom and clinical head image matched that estimated within the ACR phantom for filtered back projection reconstruction. Conclusions Fractal dimension correlated with the NPS‐peak frequency and was independent of noise magnitude, suggesting that the scalar metric of fractal dimension can be used to quantify the change in noise texture across reconstruction approaches. Results demonstrated that fractal dimension can be estimated from four, 64 × 64‐pixel ROIs or one 128 × 128 ROI within a head CT image, which may make it amenable for quantifying noise texture within clinical images

Issues and Methods in Meditation Research

Most research has been seen the growing interest in the neurobiological correlates of meditation. They omitted the philosophical aspects of meditation on human being and its wider implications on human. Hence the following issues like definition, study design, and its outcomes need to be study. In meditation research the effects of meditation practice need to examine and also how meditation works is need to study and examine. Some meditation techniques reduce pain, but how meditation affects the brain’s response to pain is not been studied. The brain structural differences between a well-matched sample of long-term meditators and controls using whole-brain cortical thickness also need to analysze. This paper describes the issues related to meditation and their effects on the study of meditation with some explanation of methods in meditation research