A survey of some medicinally important plants of the Euphorbiaceae family used by the Santhal tribes of Santhal Pargana

610-614Plants belonging to Euphorbiaceae family are widely used in rural India since it has important secondary metabolites like flavonoids, phenols, triterpenes, polysterols, etc. The objective of the ethnomedicinal survey was to study the different plants of the Euphorbiaceae family that are used by the Santhal tribe of Santhal Pargana. In this study 10 plants were found to be effective against many human diseases. The different plants surveyed included Jatropha gossypifolia, Euphorbia species, Phyllanthus species, Tragia involucarata and Ricinus communis. These plants are being used for the treatment of various ailments like dental problems, eye infection, cough and cold, cancer, ulcers, wounds, jaundice, etc. Ricinus communis and Jatropha gossypifolia are used for treating rheumatism, Phyllanthus nirurii and P. amarus for diarrhea and jaundice. For treating skin infection and other related diseases Euphorbia neriifolia, E. hirta and E. thymifolia are used by the Santhals. Euphorbia neriifolia is even used for the treatment of their cattle. The various parts used are leaves, stem, flowers, bark, roots, seeds and latex. The medicinal plants used by them can form huge source of therapeutic compounds for different scientific purposes

A survey of some medicinally important plants of the Euphorbiaceae family used by the Santhal tribes of Santhal Pargana

Plants belonging to Euphorbiaceae family are widely used in rural India since it has important secondary metabolites like flavonoids, phenols, triterpenes, polysterols, etc. The objective of the ethnomedicinal survey was to study the different plants of the Euphorbiaceae family that are used by the Santhal tribe of Santhal Pargana. In this study 10 plants were found to be effective against many human diseases. The different plants surveyed included Jatropha gossypifolia, Euphorbia species, Phyllanthus species, Tragia involucarata and Ricinus communis. These plants are being used for the treatment of various ailments like dental problems, eye infection, cough and cold, cancer, ulcers, wounds, jaundice, etc. Ricinus communis and Jatropha gossypifolia are used for treating rheumatism, Phyllanthus nirurii and P. amarus for diarrhea and jaundice. For treating skin infection and other related diseases Euphorbia neriifolia, E. hirta and E. thymifolia are used by the Santhals. Euphorbia neriifolia is even used for the treatment of their cattle. The various parts used are leaves, stem, flowers, bark, roots, seeds and latex. The medicinal plants used by them can form huge source of therapeutic compounds for different scientific purposes

Burn out and depression in paramedical workers of tertiary care hospital during COVID-19 pandemic

Background: Medical/paramedical professionals are prone to various behavioral disorders due to work pressure. The aim of the study was to evaluate burnout and depression in paramedical workers of a tertiary care hospital during COVID-19.Methods: Paramedical health care workers were assessed using online questionnaire containing self-administered questionnaire in this cross-sectional study between March 2021 and May 2021. Burnout self-test, depression, and anxiety were measured.Results: In this study, only 2.6% had at very severe risk of burnout and 7.8% were at severe risk of burnout while 3.9% had no signs of burnout. Approximately 80% of the patients had no depression. While there were 19.5% had mild to severe depression. Only eight out of 77 subjects had clinically significant symptoms of anxiety. Two subjects were having comorbid illness.Conclusions: A considerable percentage of HCWs experience burnout, depression, and anxiety

Efficiency of nalbuphine as an adjuvant to bupivancaine in lower limb orthopaedic surgery-a prospective study

Background: Spinal Anaesthesia is a well-known technique of performing lower limb orthopaedic surgeries. It has a shorter duration of action and early arising postoperative pain due to which various adjuvant needs to be added and their roles are being evaluated in various studies. Intrathecal opioids act synergistically with local anaesthetics and thus intensifying the sensory block without having any effect on sympathetic blockage. The main aim of present study is to investigate and evaluate the effectiveness of intrathecal nalbuphine (preservative free) as an adjuvant and also the efficacy of nalbuphine for postoperative analgesia and its complications if there are any.Methods: A total of 60 patients were included in this study belonging to ASA I and ASA II score with normal coagulation profile. Patients were randomly divided into 2 groups of 30 patients each. Group I receiving 3 ml of hyperbaric bupivacaine 0.5%+1.0mgm of nalbuphine (preservative free) injection made in 0.5 ml normal saline intrathecally. Group II received 3 ml of hyperbaric bupivacaine 0.5%+0.5 ml injection Normal saline intrathecally. The following criteria were noted. The onset of sensory blockade and complete motor blockade highest level of sensory blockade, duration of sensory blockade, duration of motor and duration of effective analgesia were recorded. Any hemodynamic alterations were also noted.Results: The mean time for the onset of sensory blockage was 56 sec in Group I and 59 sec in Group II (control). The difference were statistically insignificant (p>0.05). The mean onset of motor blockage was 106 sec in Group I and 208 sec in Group II (control). The difference was statically insignificant. The peak onset time in Group I and Group II was 372 sec and 220 sec respectively (p>0.05). Two segment regression times for sensory blockage was prolonged in Group I (118.20±8.56 min) compared to Group II (104.56±15.20 mins).Conclusions: The duration of postoperative analgesia was 6-8 hours in Group I compared to 3-4 hours in Group II (p value= 0.0001, statistically significant)

Exploring immunogenomic influences on the microenvironment of colorectal cancer

This thesis focussed on the immunobiology of colorectal cancer (CRC). It explored the role of the γδ T cell ligand Endothelial Protein C Receptor (EPCR) in tumourigenesis, and subsequently characterised the relationship between intra-tumoural immunity and tumour genetics. In silico analyses and immunohistochemistry indicated EPCR was commonly overexpressed in epithelial cancers including CRC. EPCR was upregulated due to gene amplification and DNA hypomethylation alongside neighbouring genes on chromosome 20q, a region previously implicated in tumourigenesis. These results clarify why EPCR is upregulated in diverse epithelial malignancies, with implications for EPCR-focussed clinical studies and understanding of γδ T cell immunity. TCGA analyses revealed that a novel immune signature, termed The Co-ordinate Immune Response Cluster (CIRC), comprising 28 genes, was co-ordinately regulated across CRC patients. Four patient subgroups were delineated based on CIRC expression. Microsatellite instability and POLE/POLD1 mutations were associated with high mutational burden and immune infiltration. Immune checkpoint molecules were highly co-ordinated in expression. RAS mutation was associated with lower CIRC expression. Further analyses revealed that RAS-associated immunosuppression was greatest in the most immunosuppressed transcriptional subtype, CMS2. These findings have implications for design of stratified immunotherapy approaches and highlight factors contributing to the particularly poor outcome of RAS mutant CRC

Pregnancy, Children and Inter-Relating Factors Affected by Geohelminthiasis

A life-threatening parasitic infection arising in evolving countries, principally prevalent in children below 5 years and pregnant women, has led to the growing interest for understanding the condition acknowledged as geohelminthiasis. Decreased cell-mediated immunity (a necessity in fetal retention) leading to a compromised immunological response is what makes pregnant women more prone to the infection thereby increasing the risk of maternal anemia, preterm deliveries and stillbirths based on reports. An outcome of geohelminthiasis on children is its deteriorative effect on cognition. This chapter highlights the relationship between the helminthic infection with respect to pregnant women and children additionally focusing on other associated factors such as poverty, hygiene, etc. that further contribute to the decline in quality of life in developing countries

Mortality following Hartmann's procedure – correlation of Dr. Foster's report with CR-POSSUM

AbstractAimsDr. Foster Intelligence highlighted a higher than expected mortality rate from emergency Hartmann's procedure at a district general hospital from April 2007 to March 2009 (6.5% expected, 30% actual mortality). A retrospective audit of all Hartmann's procedures over 4 years was performed.MethodsNotes were examined for all emergency Hartmann's procedures between April 2006 and March 2010. CR-POSSUM scores were calculated for each patient. Results were analysed in SPSS (IBM Corp.).ResultsThe mean CR-POSSUM score for the entire cohort was 27.78%, which compared to an observed mortality rate of 22.5% (18/80 cases, p = 0.61). There was a significant correlation between mortality and CR-POSSUM score (p = 0.001) and ASA grade (p = 0.001). Those aged 81 and above had a significantly higher mortality (P ≤ 0.05).There was no statistically significant correlation between grade of surgeon and mortality (p = 0.42). Overall consultant presence in theatre was 72.5% (58/79 cases) and in those that died 82.4% (14/17 cases). Those patients who had an admission to diagnosis time of 10 days or more were at significantly greater risk of death (p < 0.05).ConclusionsDr. Foster's data does not sufficiently take into account the pre-operative state of each patient. The CR-POSSUM predicted mortality scores for the studied patient population and the actual mortality were similar. This suggests that the studied patient population were of a higher risk group than presumed by Dr. Foster's data.This study has highlighted that an older population and a delay in diagnosis following admission may have contributed to the increase in mortality in some cases

Large Splenic Abscess: A management challenge

Splenic abscesses are rare in children. Mostly, they present in immunocompromised children or in children with hematological malignancies. In most of the cases these are smaller, isolated or multiple abscesses and are being successfully treated with broad spectrum antibiotics and percutaneous drainage. However, large abscesses pose a management challenge and require a careful decision to go for either total or partial splenectomy. Ultrasound and CT scan both play a crucial role to decide on these larger abscesses which are prone to rupture and can cause septicemia and death. Different organisms have been isolated from these abscesses as bacteria, fungi and atypical bacteria. We report a case of a massive splenic abscess with septicemia managed successfully by timely operative intervention

Study of fetomaternal outcome in emergency peripartum hysterectomy at pannadhay zanana hospital, Udaipur, India

Background: Peripartum or obstetric hysterectomy is the removal of the corpus uteri alone or with the cervix at the time of a caesarean section or shortly after a vaginal delivery. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times it is a very difficult decision and requires good clinical judgment. Most of the time the operation is carried out when the condition of patient is too critical to withstand the risks of anesthesia or surgery, but proper timing and meticulous care may reduce or prevent maternal complications. Methods: The study is prospective study and was conducted on cases of peripartum emergency hysterectomy performed at PDZH, Udaipur, during the period from April 2021 to October 2022. Results: Our study depicts following results on the basis of 31498 deliveries during the study period (April 2021 to October 2022), so the overall incidence of peripartum hysterectomy is 1 in 1049 (0.095%). Incidence of hysterectomy following vaginal delivery found to be 0.15%, whereas following caesarean incidence found to be 0.24%. Conclusions: Increase in caesarean section rates may lead to a rise in the number of peripartum hysterectomies required in the future because of increased chances of scar dehiscence and morbidly adherent placenta and Thus, there is a need for institutions to reassess their indication for first caesarean section to decrease the incidence of caesarean sections.

Study of maternal and perinatal outcome in twin pregnancy at a tertiary care hospital

Background: Twin pregnancy refers to the presence of two fetuses in the uterus. The phenomenon of twinning has fascinated mankind throughout its recorded history. The major problems occurring in twin pregnancy are prematurity, Lbw, IUGR, birth trauma, birth asphyxia and congenital anomalies. The most serious risk is preterm delivery, which accounts for most of the increased perinatal mortality, neonatal morbidity, and long-term morbidity of twins. Methods: This prospective observational study included analysis of 250 women with twin pregnancies, over a period from 01st November 2021 to 31st October 2022 with 28 completed weeks of gestation, admitted at PDMC, Udaipur, Rajasthan. Results: In our study 250 twin pregnancies delivered Out of total 15209 deliveries were studied in our institute. incidence of twin pregnancy was 1.64%. The majority of study participants were in the age group 20 to 29 year and delivered between the gestation age 34-37week, multigravida was 51.2% and in primi it was 48.8%. The 4% patients underwent caesarean section and 48% delivered by vaginal delivery. Conclusions: Twin pregnancy is a great challenge to the concerned obstetricians. Complications associated with twin pregnancies cannot be prevented but can be detected early and controlled adequately by proper and prompt management. Timely diagnosis and treatment of nutritional anaemia and pre-eclampsia helps in preventing additional complications. Hence the need for better obstetric care, neonatal care, health services to get a better fruitful outcome