COMPARATIVE PHARMACOGNOSTICAL AND PHYTOCHEMICAL STUDY OF VARIOUS SPECIES OF THE CONTROVERSIAL DRUG ‘PUNARNAVA'

Objective: Punarnava is a controversial drug i.e. its true botanical identity has not been ascertained, and several different species are used as Punarnava. It is a part of many medicinally important traditional formulations. Ayurvedic Pharmacopoeia of India describes three different species–Roots of Boerhaavia diffusa, Trianthema portulacastrum and Boerhaavia verticillata. The present work deals with the microscopic, macroscopic and phytochemical comparison of the roots of these species of Punarnava, so as to differentiate them and establish their quality parameters.Methods: Roots of these three species were collected, and their comparative morphological, microscopical (transverse section, powder study) and the phytochemical (screening, tannin estimation) study was performed.Results: Roots of Boerhaavia diffusa showed morphological characteristics which clearly distinguished it from the other species. They showed the presence of well developed and stratified cork, abnormal vascular bundles which were discontinuous, and a central cavity, presumably formed due to the disintegration of tissues. Boerhaavia verticillata showed the presence of xylem bundles arranged in the form of a ‘X'-shaped cross in the central region. Thick-walled cork cells and pitted xylem vessels were present only in Boerhaavia diffusa root powder, whereas bundles of fibrovascular tissue were present only in the powder of Boerhaavia verticillata. Tannin content was found to be highest in Boerhaavia diffusa roots.Conclusion: The present investigation will help herbal industries and traditional medicinal practitioners to detect adulteration of the medicinally important immunomodulator Boerhaavia diffusa by Trianthema portulacastrum and Boerhaavia verticillata, which are considered to have no immunomodulatory activity.Â

Venous Myocardial Infarction in an Infant with Obstructed Totally Anomalous Pulmonary Venous Drainage and Coronary Sinus Ostial Atresia

We report a rare causal association between obstructed supracardiac totally anomalous pulmonary venous drainage and coronary sinus ostial atresia. Our 12-week-old patient developed venous myocardial infarction secondary to coronary venous hypertension because her sole route of coronary venous drainage was obstructed. She recovered after the obstruction was relieved by balloon dilation. Surgical repair then included anastomosis of the pulmonary venous confluence to the left atrium, ligation of the vertical vein, and unroofing of the coronary sinus. Coronary sinus ostial atresia is rarely diagnosed before autopsy

Awareness Regarding Anesthesiology and Anesthesiologists Among General Population in Developing Country- A Cross Sectional Survey

Background: Anaesthesiologists are playing decisive role in pa- tient management. Nowadays, they are involved in pain clinic and critical care also but the general public know little about them. So this study was undertaken to assess the perception of general population from poor socioeconomic area regarding the anaesthe- siology and role of anaesthesiologists. Methods: The study was carried out at Shardaben Hospital, Saraspur, in 200 participants, between the age group of 18-75 yrs of age to assess their knowledge regarding anaesthesiology and anaesthesiologists. A questionnaire containing three parts was filled by asking each question one by one in Guajarati or Hindi. The collected data analysed with SPSS software 17. Results: In our study population, 6.5% were HSC passed and 58.5% were SSC pass. While 24.5% were illiterate and only 10.5% were graduate pass. Only 26% of participants were known about anaesthesiology and role of anaesthesiologists. Conclusion: Results of study showed that the wide spread igno- rance and misconceptions about anaesthesiology and anaesthesi- ologists are still prevalent in general population and these are more in poor socioeconomic area

A comparative analysis of upper airway space with lateral cephalogram and cone beam computed tomography in north Gujarat population

Objective : The Aim and objective of this study is to evaluate the accuracy of upper airway measurement using with lateral cephalogram , CBCT lateral reconstruction and CBCT axial planes as well as to correlates these finding with area measurements acquired with the latter imaging methods. Methods : In this study , 44 subject (22 males & 22 females) included from north Gujarat adults . Landmark were defined for measurement of naso and Oropharynx , for different planes , using linear antero-posterior measurement and the corresponding area. Result : Analysis of variance shows linear measurement in nasopharynx and oropharynx area wise distribution and Inter Group Wise Distribution in Nasopharynx , all three group have significant different value. In inter Group Wise Distribution in Oropharynx, there is statistically no significant difference between Lateral Reconstruction Group and Lateral Cephalogram Manual Tracing Group. Statistically, no significant difference between Lateral Reconstruction Group and Axial Slice Group & also Statistically, no significant difference between Lateral Cephalogram Manual Tracing Group and Axial Slice Group. Conclusion : The linear measurements of the airway space obtained using the different techniques correlated positively with the respective area measurements, which demonstrate the reliability of the investigated techniques

Guillain-Barré Syndrome with asystole requiring permanent pacemaker: a case report

Abstract Introduction Guillain-Barré syndrome is an acute demyelinating disorder of the peripheral nervous system that results from an aberrant immune response directed at peripheral nerves. Autonomic abnormalities in Guillain-Barré syndrome are usually transient and reversible. We present a case of Guillain-Barré syndrome requiring a permanent pacemaker in view of persistent symptomatic bradyarrhythmia. Case Presentation An 18-year-old Caucasian female presented with bilateral lower limb paraesthesias followed by bilateral progressive leg weakness and difficulty in walking. She reported an episode of an upper respiratory tract infection 3 weeks prior to the onset of her neurological symptoms. Diagnosis of Guillain-Barré syndrome was considered and a lumbar puncture was performed. Cerebrospinal fluid revealed albuminocytologic dissociation (increased protein but normal white blood cell count) suggestive of Guillain-Barré syndrome and hence an intravenous immunoglobulin G infusion was started. Within 48 hours, she progressed to complete flaccid quadriparesis with involvement of respiratory muscles requiring mechanical ventilatory support. Whist in the intensive care unit, she developed multiple episodes of bradycardia and asystole requiring a temporary pacemaker. In view of the persistent requirement for the temporary pacemaker for more than 5 days, she received a permanent pacemaker. She returned for follow-up three months after discharge with an intermittent need for ventricular pacing. Conclusion Guillain-Barré syndrome can result in permanent damage to the cardiac conduction system. Patients with multiple episodes of bradycardia and asystole in the setting of Guillain-Barré syndrome should be evaluated and considered as potential candidates for permanent pacemaker implantation.</p