Management of insomnia: current trends

Insomnia is one of the most commonly occurring sleep disorders worldwide.1 With increased prevalence of insomnia the demand of the people seeking pharmacological treatment for this disease is continuously increasing. Numerous options are currently available for its treatment and with our increased understanding of the neurophysiological factors involved in the insomnia continuous research is being conducted to seek newer pharmacological treatments. Recent advancement in treatment of insomnia is the introduction of non-benzodiazepine hypnotic medications such as zaleplon, zolpidem, and eszopiclone. Ramelteon, a melatonin agonist, is also helpful for sleep initiation difficulties. Tri-cyclic antidepressants have long been used for insomnia but use has been limited by unwanted anticholinergic side-effects. A hypocretin/orexin antagonist MK-4035 is presently in clinical trials. Serotonin antagonists and inverse agonists are being investigated for their usefulness in insomnia; newer research examining other mechanisms of action suggest that agents which modulate the histaminergic, serotonergic, melontonergic, and hypocretin/ orexin and perhaps gamma-aminobutyric acid B systems could play a promising role in management of insomnia

Effect of Rapid Thermal Annealing of CIGS Thin Film as an Absorber Layer

The influence of rapid post-deposition thermal annealing (500 °C for 2 minutes) on the CIGS thin films of different thicknesses (0.4 to 1.0 m) has been investigated. The deposition of CIGS is carried out using the flash evaporation at the substrate temperature of 250 °C. The as-grown and annealed CIGS is characterized by XRD, SEM, EDS, TEM, optical transmission, reflection, and electrical measurements. Lowering the thickness of CIGS absorber shows the remarkable influence on crystal structure, surface morphology, and composition of the overall film. Further improvement was observed by the rapid annealing process. Cu-rich composition was observed for annealed CIGS thin film having a thickness below 0.6 μm, while for 1.0 m thickness the composition is slightly Cu-poor and the compactly packed faceted grains observed. Optical band gap near to 1.05 eV and the electrical resistivity in the order of 104 Ωcm shows its future use as an absorber layer for CIGS solar cell. Furthermore, an attempt of making CIGS / CdS hetero-structure shows ideal behavior of the Schottky hetero-structure with the ideality factor of 1.5. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/3100

Effect of calcium channel blockers on the serum levels of thyroid hormone

Background: The effect of the calcium channel blockers on the cardiovascular system is implemented judiciously in different conditions related to cardiovascular system such as angina pectoris, hypertension, and in cardiac arrhythmias but the aspect that deals with the impact of blockade of calcium channels in other systems like endocrine system remains eclipsed. These effects generally go unnoticed and the present study was formulated to elucidate the serum T3, T4, TSH levels after administration of calcium channel blockers and to observe the resultant side effect on the endocrine glands, if any by this commonly used group of drugs.Methods: The study was conducted on male albino rabbits, they were divided in three groups of ten each and each group received one of the calcium channel blockers- Verapamil, Diltiazem and Nifedipine for three months. At the end of each month the serum T3, T4, TSH levels were evaluated by chemiluminisence.Results:It was found that on continuous daily administration of calcium channel blockers there was a gradual fall in levels of T3 and T4 with rise in TSH levels in comparison to the control value taken before initiating the drug therapy.Conclusion: These findings could have potential clinical implications and this study proposes the importance of blood thyroid hormone level follow up in the long-term calcium channel blocker therapy.

TRYPSIN, RUTOSIDE AND BROMELAIN ALONE AND FIXED DOSE COMBINATION: A NATURAL, SAFER AND EFFECTIVE ANTI-INFLAMMATORY AGENT

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Psychosocial factors in patients with kidney failure and role for social worker : a secondary data audit

Background: People with kidney failure face a multitude of psychosocial stressors that affect disease trajectory and health outcomes. Objectives: To investigate psychosocial factors affecting people with kidney failure before or at start of kidney replacement therapy (KRT) and kidney supportive and palliative care (KSPC) phases of illness and to explore role of social worker during the illness trajectory. Methods: We conducted a secondary data audit of patients either before or at start of KRT (Phase 1) and at the KSPC (Phase 2) of illness and had psychosocial assessments between March 2012 and March 2020 in an Australian setting. Results: Seventy-nine individuals, aged 70 ± 12 years, had at least two psychosocial assessments, one in each of the two phases of illness. The median time between social worker evaluations in Phase 1 and Phase 2 was 522 (116−943) days. Adjustment to illness and treatment (90%) was the most prevalent psychosocial issue identified in Phase 1, which declined to 39% in Phase 2. Need for aged care assistance (7.6%−63%; p < 0.001) and carer support (7.6%−42%; p < 0.001) increased significantly from Phase 1 to Phase 2. There was a significant increase in psychosocial interventions by the social worker in Phase 2, including supportive counselling (53%−73%; p < 0.05), provision of education and information (43%−65%; p < 0.01), and referrals (28%−62%; p < 0.01). Conclusion: Adults nearing or at the start of KRT experience immense psychosocial burden and adaptive demands that recognisably change during the course of illness. The positive role played by the nephrology social worker warrants further investigation

Transposing tirtha: Understanding religious reforms and locative piety in early modern Hinduism

The paper deals with a historical and hitherto obscure case of de-commercialisation of sacred geography of India. Sahajanand Swami, an eighteenth century religious leader from Gujarat who became popular as Bhagwan Swaminarayan took an initiative to eliminate corruption in Dwarka, one of the most sacred destination in Hindu imagination. He also attempted to transpose the piety of Dwarka and recreate a parallel religious experience at Vadtal, an important site in Swaminarayan Hinduism. This process of making sacred sites more egalitarian is classified here as a 'religious reform'. The paper assesses this bivalent pursuit as an institutional reform within religion as well as a religious process in the context of piety, authority and orthodoxy. Through the example of Sahajanand Swami, it is argued to calibrate the colonial paradigm of reform that was largely contextual to social issues and western thought and failed to appreciate the religious reforms of that era. By constructing a nuanced typology of 'religious reform' distinct from 'social reforms', the paper eventually calls for a reassessment of religious figures who have significantly contributed in reforming the Hindu tradition in the medieval and modern era

Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months). Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months) and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome

Assessment of feasibility and efficacy of Class IV laser therapy for postoperative pain relief in off-pump coronary artery bypass surgery patients: A pilot study

Background: Laser therapy, for its established analgesic properties with minimal side effects, has been used for the treatment of chronic pain. However, it has not been used for the treatment of acute postoperative pain. This pilot study was designed to assess the feasibility and efficacy of Class IV laser on postoperative pain relief following off-pump coronary artery bypass graft (OPCABG) surgery, as a component of multimodal analgesia (MMA) technique. Methods: This open observational prospective study comprised of 100 adult patients (84 male, 16 female) who underwent OPCABG through sternotomy. For postoperative analgesia, they were subjected to laser therapy subjected to laser therapy in addition to the standard institutional pain management protocol comprising of IV infusion/bolus of tramadol and paracetamol and fentanyl bolus as rescue analgesic. Pain intensity was measured by Verbal Rating Scale (VRS). The laser therapy was scheduled as once a day regime for three consecutive postoperative days (PODs) starting on POD 1, 30 min following tracheal extubation. The subsequent laser applications were also scheduled at the same time of the day as on day 1 if VRS was ≥5. 10 W Class IV laser was applied over 150 cm 2 sternal wound area for 150 s. VRS was used to assess pain severity and was recorded for statistical analysis using Friedman Test. Results: The mean (standard deviation [SD]) VRS of all the 100 patients just before application of the first dose of laser was 7.31 (0.94) while on MMT; the same fell to 4.0 (1.279) and 3.40 (2.697) at 1 h and 24 h respectively following first dose of laser. The change of VRS over first 24 h among all the 100 patients was statistically significant (P = 0.000). Laser was re-applied in 40 patients whose VRS was ≥5 (mean [SD] - 6.38 [0.868]) at 24 th h. After receiving the 2 nd dose of laser the VRS scores fell significantly (P = 0.000) and became 0 at 54 th h. No patients required 3 rd dose of the laser. No patient required rescue analgesic while on laser therapy. Conclusion: Class IV laser can be an effective technique for postoperative analgesia following OPCABG surgery through sternotomy when included as a component of MMA technique