Immobilization Parameters Statistically Optimized for Whole Cells of Pseudomonas Putida G7 to Enhance Limonin Biotransformation

This study was aimed for optimizing the immobilization parameters for Pseudomonas putida G7 in Ca-alginate beads, in order to establish a debittering strategy for citrus juices, by biotransforming the bitter principle - Limonin. Response Surface Methodology (RSM) with Central Composite Design (CCD) was employed to model the significant parameters for an enhanced response. An enhanced limonin bioconversion and immobilized bead stability was obtained with alginate concentration (2%), cell load (47.2g/l), and a bead diameter (2.1mm); which had significant effects (p <0.001) on limonin biotransformation. The R2 values of 0.9 showed good agreement between experimental and predicted response. Validation experiments under optimized parameters showed good association between experimental (limonin biotransformation and stability response of 65.8% and 0.97 OD respectively) and predicted responses (limonin biotransformation and stability of 65.1% and 0.094 respectively). Thus, the approach is promising to develop a strategy for debittering citrus juices by biotransforming limonin at a faster rate

Fibroid with unilateral streak ovary in Mullerian Agenesis! A rare case report

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly (1/5000) associated with uterine and vaginal aplasia with normal ovaries. A fibroid in a normal uterus is common but a fibroid arising from rudimentary horn in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is very rare. It is also rare to have the association of unilateral ovarian dysgenesis in MRKH. A 37 year old married female with primary amenorrhea presented to the OPD of Dr. RML Hospital with abdominopelvic mass for one year. She was phenotypically normal looking and there was no other associated cardiac, ocular or skeletal abnormality. A large 15 × 15 cm abdominopelvic mass was present in suprapubic area which was firm in consistency and non-tender. A Two and a half inch long blind vaginal pouch was present with absence of cervix and uterus. A provisional diagnosis of solid ovarian tumor in MRKH syndrome was made. Her investigations -Serum FSH, LH, estradiol and tumor markers were normal. Her ultrasound and MRI reported a fibroid with normal ovaries. Laparotomy revealed absence of uterus and cervix and a large fibroid arising from right rudimentary horn with left streak ovary. Right ovary was enlarged to 4 × 4 cm, showing multiple small follicles. Fibroid along with the rudimentary horns and the streak ovary was removed, preserving the normal right ovary. Histopathology confirmed the diagnosis of leiomyoma in rudimentary horn with left streak ovary, making it class1 type b anomaly under American fertility society classification. Preoperative assessment of rare anomalies can be different from intraoperative findings in certain female reproductive tract anomalies. Awareness of rare combinations can help in judicious management of such cases.

ROLE OF NIDANA PANCHAKA IN VARIOUS AYURVEDIC ASPECTS

Ayurveda, the Indian system of medicine, has its own branch of specialty for understanding the disease process and proper diagnosis of a disease. Caraka has stated that the diagnosis is very important and essential before proceeding to medicine prescription. Ayurvedic way of diagnosis has 2 basic components namely Rogapariksha and Rogipariksha, which refers to Examination of disease and Examination of patient respectively. Among them Rogapariksha gives us the detailed knowledge about a disease starting from the etiological aspects to the actual manifestation of disease. The five basic components of Rogapariksha are Nidana, Purvarupa, Rupa, Upasaya and Samprapti, which are collectively known as Nidana Panchaka. Apart from diagnosing a disease, they also play a key role in planning the treatment of that disease. Nidana, the foremost component of Nidana Panchaka, not only gives the knowledge of causative factors of a disease but also helps in treatment by avoiding them. Purvarupa refers to Premonitory signs & symptoms and represents the 4th stage of disease formation. If physician is able recognize them as early as possible and treat accordingly, then the further progression of disease is ceased. In the same way, every component of Nidana Panchaka helps the physician for the better understanding of disease process and treating the disease at an earliest possible stage. The details of Nidana Panchaka and its role in diagnosis & treatment are explained elaborately in full paper

Placenta accreta not previa: a rare case report of placenta accreta in an unscarred uterus

Placenta accreta spectrum disorders are usually associated with direct surgical scar such as caesarean delivery, surgical termination of pregnancy, Dilatation and curettage, Myomectomy, Endometrial resection and Asherman’s syndrome. It can also be associated with non-surgical scar and uterine anomalies. Rarely it can be encountered in unscarred uterus. Mrs X, 35-year female, unbooked patient, G7P2L2A4 with nine months of amenorrhoea reported in emergency of RML Hospital on 30/07/2019 with history of labour pains since 2 days. Patient gave history of four dilatation and curettage for incomplete abortion. On examination patient was found to be severely anaemic (Hb -6 gm). 2 Packed RBC were transfused preoperatively. There was no progress in labour beyond 6 cm for 4 hours. Patient was thus taken for LSCS for NPOL, with blood on flow. Intraoperatively, after delivery of the baby placenta which was fundo-posterior did not separate. In view of parity and morbidly adherent placenta (clinical grade III), subtotal hysterectomy was done. Patient was transfused 4 PRBC, 4 FFP and 2 platelets. Uterus with placenta in situ was sent for histopathology. Patient was in ICU for 2 days and recovered well. Post-operative period was uneventful. Placenta accreta is defined as abnormal trophoblast invasion of whole or a part of placenta into myometrium of uterine wall. Caesarean delivery is associated with increased risk of placenta accrete and the risk increases with each caesarean section, from 0.3% in woman with one previous caesarean delivery to 6.47% for woman with five or more caesarean deliveries. Placenta accreta spectrum disorders occur in 3% of woman diagnosed with placenta previa and no prior caesarean. In the developing world, the obstetrician should be prepared to encounter un diagnosed placenta accrete even in absence of previous LSCS. Curretage following MTP is also a risk factor, so vigourous currettage should be avoided to prevent endometrial damage

ENLIGHTENING THE ROLE OF SAMANYA AND VISESA SIDDHANTA IN CHIKITSA ASPECT

Ayurveda is a science of life. It says, one has to strictly follow the regimens and dietary habits advocated in Samhitas, the classical Ayurvedic texts, to achieve long and healthy life. Any sort of deviation from these principles will lead to the manifestation of disease. According to Ayurveda, the basis for disease manifestation is either Vriddhi or Kshaya of Doshas, and bringing back to normalcy of these Doshas leads to the restoration of health. This process of bringing normalcy is known as Chikitsa and the basic principle of the Chikitsa is Samanya and Visesa siddhanta. According to this Siddhanta, intake of medicine or food having similar properties to that of our body tissues, will results in the increase and those with opposite properties will results in the decrease of our body tissues. Thus, if a disease is manifested due to the Vriddhi of a Dosha, then to pacify that Vriddha dosha, Dravyas having opposite Guna or Karma should be administered. If a disease is manifested due to the Kshaya of a Dosha, then to nourish that Ksheena dosha, Dravyas having similar Guna or Karma should be administered. This Samanya and Visesa Siddhanta should be followed in a rational way while describing the medicine or diet based on the quantitative and qualitative knowledge of Vriddhi or Kshaya of Doshas. Thus, the Samanya and Visesa Siddhanta plays a crucial role in treating diseases and has become the fundamental principle for Ayurvedic management. He details of this Siddhanta are explained elaborately in full paper

Immobilization Parameters Statistically Optimized for Whole Cells of Pseudomonas putida G7 to Enhance Limonin Biotransformation

This study was aimed for optimizing the immobilization parameters for Pseudomonas putida G7 in Ca-alginate beads, in order to establish a debittering strategy for citrus juices, by biotransforming the bitter principle - Limonin. Response Surface Methodology (RSM) with Central Composite Design (CCD) was employed to model the significant parameters for an enhanced response. An enhanced limonin bioconversion and immobilized bead stability was obtained with alginate concentration (2%), cell load (47.2g/l), and a bead diameter (2.1mm); which had significant effects (p <0.001) on limonin biotransformation. The R2 values of 0.9 showed good agreement between experimental and predicted response. Validation experiments under optimized parameters showed good association between experimental (limonin biotransformation and stability response of 65.8% and 0.97 OD respectively) and predicted responses (limonin biotransformation and stability of 65.1% and 0.094 respectively). Thus, the approach is promising to develop a strategy for debittering citrus juices by biotransforming limonin at a faster rate

SIGNIFICANCE OF USING UPAMANA PRAMANA IN AYURVEDA

Ayurveda, the ancient Medico Holistic Science, which is comprised of numerous fundamental concepts with basic doctrines. Ayurveda along with its concepts is eternal (Shaswata), and have their own identity which does not require other science to indulge in between. Such fundamental concepts are literally better understood, analyzed and merely utilized in clinical practice only with the proper utility of Pramanas. Pramanas in Ayurveda are means of true knowledge. Acharya Sushruta describe four Pramanas and among the four Pramanas i.e. Pratyaksha (Direct perception), Agama (Teaching of scriptures), Anumama (Inference), Upamana (Analogy). Upamana Pramana is used widely in Ayurvedic literatures. Upamana is having its own importance. Upamana or Aupamya give the knowledge or idea of an object by similar comparison. Acharya Charaka has not included Upamana Pramana under Pramanas but he described it under Vada Marga i.e. technical terms used in Sambasha by Vaidya-Samuha and ultimately helps in attaining valid knowledge, but more than being used in Sambasha, Upamana is having its clinical utility. Upamanas are the analogies or similes that bridge the known to the unknown and after the conceptual system of existing knowledge by modifying and strengthening its associations. Prime intention of such Upamana is incorporating open-ended, forced and visual similes to teach complex concepts and involving students in a creative dynamic though process to enhance understanding of such complex medical concepts. But we have to be very careful about its understanding such analogies, otherwise it may lead to wrong concepts. As said that “An Analogy is like a car, if you take it too far, it breaks downâ€. So here a sincere effort has been made to evaluate and analyze the Upamana Pramana in a simple way in three aspects i.e., physiological, diagnostic, philosophical aspects.

Mangement of Yuvana Pidaka using Mukha Lepa

Yuvana Pidaka (acne vulgaris) is one of the most common, troublesome and frustrating skin care problem for people around the world. It is caused by to Kapha, Vata and Rakta Dhatu involving Rasavaha and Raktavaha Srotas. Apart from others unhealthy life style is identified as the major reason behind the eruption of such lesions. It has adverse effect on self esteem of the subjects and decreases one’s self confidence. Present study tries to understand the therapeutic effect of Mukha Lepa - an external application of Manjishta, Chandana, Yastimadhu and Kushta over the face mixed with milk once every morning for fifteen days after Sadhyovirechana with Avipathi Churna. Study was conducted on ten subjects and assessed with the parameters like Ruja, Kandu, Daha, number and type of eruptions before and after the procedure. The response to the treatment was recorded and the therapeutic effect was evaluated by statistical tests. A considerable change in the complexion over the face of subjects was also noted. It is observed that this particular Lepa is beneficial in the treatment of Yuvana Pidaka apart from improving the complexion of the skin

Understanding unmet need for family planning

Unmet need represents the gap between women’s reproductive intentions and their contraceptive behavior. There are some 225 million women in the world who want to use safe and effective family planning methods are unable to do so. Control over fertility is very important not only because of its far-reaching implications on prosperity and overall growth of the nation, but also because of its impact on the freedom of young women to lead life of their own choice. Reduction in unmet need for family planning is critical for the overall development of the society. Combination of the mutually reinforcing effects of investments in education, health and family planning programmes is needed