PHARMACEUTICO-ANALYTICAL STUDY OF GANDHAKA RASAYANA

Ganghaka Rasayana (GR) is a much more beneficial drug on wide variety of skin disease such as psoriasis which is difficult to completely cure, but manufacturing procedure is generally tough and time consuming. As per classical references there were 88 numbers of Bhavana (levigation) and according to practical experience it was taken near about six month for completion. Therefore total effort has been spent here to establish and revalidate standard operative procedure for preparation of GR to fulfill objectives of this work. Successfulness of pharmaceutical study can be confirmed through assessing results of analytical study. Analytical study provides idea about quality of finish product and safety profiles the same on the basis of scientific background. Hence without analytical study of the drug, the research which was related to medicinal field is incomplete. Among the main and important aims of conducted analytical study are to assess chemical configuration and the physico chemical changes which occurred after Samskara (procedures) in the finish product.Objectives: To developed standard operative procedure for preparation of GR, to find out the cumbersome in the preparation, reduce time factor in preparation considering with safety and efficacy, find out suitable dispensing form and to analyze the GR for safety and purity.Material and methods: GR was prepared as per Yogaratnakara Rasayanadikara with some modifications and analyze it as per parameters of “Protocol of testing ASU medicine†published by Govt. of India Dept. of AYUSH, Ministry of health and family welfare. Physical characters, Physico-chemical analysis, HPTLC, Heavy metals, Microbial load etc parameters were used for analysis of sample of test drug which were prepared by using wet grinder.Results & discussion: Weight of GR after 88 Bhavana was increased accordingly total solid content present in the used liquids for Bhavana. Presence of low amount of moisture content of GR (4.67%) is leading to decrease decomposition and enhance the shelf life and therapeutic value of the same. Low Acid insoluble Ash determines the presence of low adherent dirt as well as sand particles. High % of water & alcohol soluble extractives (62.18% & % 63.12% respectively) confirms the presence of more active principles in the sample. Heavy metal test and Microbial analysis were shown within limit results which refers safety profile of the samples and stability of the drug. Retention factor values in HPTLC confirmed about the multi-polarity index of the compounds and wide range of active principles.

Soft tissue coverage techniques for management of open fractures of tibia (type IIIB)

Background: Open fractures are surgical emergencies; incidence of open fractures is increasing with more high-energy road traffic accidents. The tibia is exposed to frequent injury because of its location. The need for aggressive debridement, adequate fracture fixation, and early flap coverage in reducing the morbidity cannot be over emphasized.Methods: Treatment of open fracture by immediate debridement and anatomical fracture reduction using external fixator device. Gastrocnemius muscle flap done in upper 1/3 open fractures (type IIIB) with larger defects along with split thickness skin graft (STSG). In middle and lower 1/3 open fractures (type IIIB), fasciocutaneous and soleus muscle flaps done with relatively smaller soft tissue defects and exposed bone with STSG.Results: The study included 15 patients with open tibia fracture Gustillo Anderson type IIIB classified after the initial debridement. Excellent flap takes up was seen in all cases. 11 cases (73.3%) achieved union at the end of 6 months follow-up while 4 cases (26.7%) showed delayed union which required additional procedures like BMI or bone graft.Conclusions: Soft tissue coverage techniques like fascicutaneous flap, gastrocnemius and soleus muscle flap had a definitive role in the management of open fractures of tibia (type IIIB)

Acute stroke as the initial presentation of Takayasu arteritis: Rare but not infrequent…

Takayasu arteritis is an idiopathic, autoimmune, large vessel vasculitis, mainly affecting the young adults. Its exact etiopathogenesis is not known and it has varied clinical presentations. Acute stroke as initial presentation of Takayasu arteritis is uncommonly reported. Herein we present a case of a 24-year-old female who came to our hospital emergency with sudden onset of weakness of left half of the body of one-day duration. Takayasu arteritis complicated with acute ischemic stroke was diagnosed on the basis of CT angiography findings. The patient was managed accordingly and discharged in a stable condition. Relevant literature is also reviewed. Although considered to be a rare disease, Takayasu arteritis is not infrequent. A high index of suspicion is required for early diagnosis, so as to reduce the significant morbidity associated with the disease

Delayed diagnosis of Scrub Typhus in Dengue epidemic: A Case Report

We report a case of scrub typhus presenting with fever and thrombocytopenia highlighting the wide variation in clinical presentations leading to delayed diagnosis in dengue epidemic. Fever and thrombocytopenia are the most common clinical presentation in viral haemorrhagic fever but others diseases like malaria, typhoid, leptospira, rickettsial and other arboviral diseases, should also be considered in the differential diagnosis. A high clinical suspicion of scrub typhus and early differentiation from other diseases is important as lethal complications can occur because of delay in diagnosis and treatment

Role of bone marrow infiltration in management of delayed union of long bones fracture

Background: Usually delayed union of fracture long bones are managed by putting a bone graft at fracture site , but bone grafting have donor site complication like scar, infection ,hernia ,gait disturbance , cosmetic problem, as well as recipient site complication like soft tissue trauma , de-vascularisation of fracture fragment. Bone marrow infiltration is a minimally invasive method done percutaneously. It is easy, safe procedure with no associated complications that may occur in bone grafting.Methods: This prospective study was conducted in the Department of orthopedics, Government Medical College, Kota from June 2011 to November 2013 to evaluate the efficacy of percutaneous bone marrow infiltration in cases of delayed union of long bones. 27 patients included in study with 28 bones, as one patient has given bone marrow injection in two bones (tibia & femur), so the cases included in study counted as 28 cases. The mean age of this study was 38.28 years, ranging from 18 years to 75 years.  All cases were follow up after 4 to 6 weeks and thereafter one month interval. Final follow up was taken when fracture site shows clinical and radiological sign of union.Results: Out of 23 united cases 19 had excellent results and 04 cases had good results. The five cases which fail to unite were taken as poor results.Conclusions: Bone marrow infiltration is a minimally invasive, safe bone graft substitute for delayed union of long bones and have less complications

Recent Advances in Phytoremediation of Hazardous Substances using Plants: A Tool for Soil Reclamation and Sustainability

Phytoremediation techniques have emerged as a promising approach for soil reclamation and remediation of contaminated sites. This review article provides a comprehensive analysis of the different phytoremediation techniques used for soil reclamation and their effectiveness in removing contaminants from soil. The aim is to evaluate the current state of knowledge and to highlight potential avenues for future research in this field. The review begins with a discussion of the principles underlying phytoremediation, emphasizing the ability of plants to accumulate, tolerate, and detoxify contaminants through various mechanisms such as phytoaccumulation, rhizo-degradation, and rhizo-filtration. Different plant species and their suitability for phytoremediation are reviewed, considering factors such as metal tolerance, biomass production, and pollutant uptake efficiency. In addition, the role of soil amendments and their impact on improving phytoremediation efficiency is critically evaluated. Commonly used amendments, including chelating agents, organic matter, and pH adjusters, are reviewed with emphasis on their ability to increase metal bioavailability and plant uptake. The review also addresses challenges associated with phytoremediation, such as plant growth limitations, long-term sustainability, and potential risks associated with the release of pollutants into the atmosphere during biomass disposal. Strategies to mitigate these challenges, including plant breeding and genetic engineering, are discussed

Endoscopic management of retrocalcaneal pain: a prospective observational study

Background: In an effort to reduce morbidity and complications of open surgery, an endoscopic technique was used for the management of the conditions leading to retrocalcaneal pain. With this purpose, the current study was undertaken to evaluate results of endoscopic management of retrocalcaneal pain using American orthopaedic foot and ankle score (AOFAS).Methods: 20 patients (26 heels) in the age group 18-80 years presenting with retrocalcaneal pain not responding to conservative management underwent endoscopic decompression of the retrocalcaneal bursae and excision of bony spurs. Two portals were created, one laterally and one medially, over the posterosuperior portion of the calcaneus to gain access to the retrocalcaneal space. The inflamed bursal tissue was identified and removed, and the prominent bone was resected. The functional outcome was evaluated pre and postoperatively with the AOFAS.Results: 70% patients have retrocalcaneal bursitis, 20% Haglund’s deformity as confirmed on lateral view of ankle X-ray and only 10% of non-insertional tendinosis. Mean operative time was 54.95 minutes. Mean duration of hospital stay was 3.90±0.64 and the mean follow-up was 66 days (range 30-180 days). The average AOFAS score improved from 65.60 points pre-operatively to 96.80 points at final follow-up. There were fifteen excellent results, seven good results, two fair results and two poor results.Conclusions: Endoscopic procedure for retrocalcaneal bursitis and Haglund deformity seemed to be a safe and efficacious option for surgical treatment of retrocalcaneal pain

Immunophenotyping of non-Hodgkin’s lymphoma by flowcytometry on fine needle aspiration

Background: Lymphoma represents one of the major health problems all over the world. Flow cytometry (FCM) can be used on fine-needle aspiration cytology (FNAC) from lymph node as an ancillary technique. Aim of the study was to assess the utility of flowcytometry (FCM) in diagnosis and differentiation of reactive hyperplasia and non-Hodgkin’s lymphoma (NHL) on FNAC.Methods: The study was carried out on 50 cases, 25 each of reactive hyperplasia and suspicious or confirmed NHL on FNAC. FCI was performed with a complete panel of antibodies on FACS Canto II FCM.Results: All 25 cases of reactive hyperplasia on FNAC were polyclonal on FCM. FCM could be performed in 22 cases (88%) out of 25 suspicious NHL and in three cases the material was inadequate on aspirate. Out of 22 cases of NHL on FNAC 17 cases (77.30%) were diagnosed as B-NHL on FCM. Light chain restriction was demonstrated in 15/17 cases. With the help of FCI, 6 cases were diagnosed as small cell lymphocytic lymphoma, one case as mantle cell lymphoma, one case as follicular lymphoma, and 9 cases as B-NHL-NOS. Histopathology diagnosis was available in nine cases and were in concordance to FCM. Sensitivity of combined FNAC and FCM in sub-classification was 77.30% (17/22). Four cases showed discordance between FNAC and FCM.Conclusion: We concluded that FCM enhances the diagnostic ability of FNAC, playing a crucial role in a rapid and accurate differential diagnosis between reactive hyperplasia, B-NHL and T-NHL

Stigmata of complications on the quality of life of type 2 diabetic patients

Background: Diabetes is a chronic metabolic disorder the prevalence of which has continued to evolve with time. For such chronic illness where there is no permanent remedy, it is important to establish that therapy really makes people feel better. The purpose of the study was to analyze the quality of life (QOL) in a group of diabetic patients with or without complications and its impact on their day to day living.Methods: 270 type 2 DM patients were enrolled for this retrospective done at S P Medical College Bikaner. Assessment of QOL was done with “The audit of diabetes dependent quality of life scale (ADDQoL).”  This composed of 19 domain specific items and their response options.Results: All 19 parameter of QOL were found to be negatively impacted (-4.28 to -6.08) in DM patients. Most negatively impacted parameters were personal life, sexual life and physical work (-6.08, -5.57, -5.11 respectively).Widower patients had worst quality of life as compared to married patients. Modality of treatment had major impact on QOL with patient on insulin therapy having worse QOL as compared to other treatment modality.Conclusions: Patients with DM not only have impairments in their physical functioning but have statistically significant impairment of all aspects of QOL. The stigmata of living with diabetes had influence on every aspect including physical, psychological and social aspects of QOL. Optimal glycaemic control will not only prevent the development of long standing complication but will also help in improving QOL and general wellbeing of the patients

The spectrum of mild cognitive impairment in dyslipidemic non-elderly type 1 diabetics

Background: Diabetics often have reduced performance in numerous domains of cognitive function, a process termed as Diabetic encephalopathy. The exact pathophysiology of cognitive dysfunction in diabetes is not completely understood, but it is likely that hyperglycaemia, vascular disease, hypoglycemia, and insulin resistance play significant roles. Although cognitive dysfunction is quite common in elderly, however, its occurrence in non-elderly diabetics is not much investigated. Aim of the study was to identify the correlation among various components of lipid profile with mild cognitive impairment in non-elderly type 1 diabetics.Methods: 98 type 1 diabetics were enrolled justifying relevant inclusion &exclusion criteria. Anthropometric indices, biochemical and clinical parameters were measured. MoCA test was employed for the assessment of cognitive dysfunction. Receiver operating characteristic, partial correlation, and logistic regression analyzes were employed for evaluation.Results: 71.42% of enrolled diabetics had some degree of cognitive dysfunction. Duration of the disease had a significant impact on cognitive functioning (p=0.032).Gender, residential area as well as the age of onset of diabetes appeared to have an insignificant impact on cognitive functioning (p>0.05). Diabetics with poor glycemic control were more prone to develop MCI (p<0.001).On comparison of various component of MoCA test; it was seen that most significant parameter that was affected was attention (p<0.001), followed by delayed recall /memory, naming and abstraction (p<0.05).Conclusions: The results of our study suggest that dyslipidemia chiefly raised total cholesterol, triglycerides and LDL is quite common in non-elderly type 1 diabetics and are associated with poorer cognitive function. Cognitive dysfunction should be listed as one of the many complications of diabetes, along with retinopathy, neuropathy, nephropathy, and cardiovascular disease in the future