Outcome of office hysteroscopy in postmenopausal women with red flag signs: a single centre-based study from Northern Ireland

Background: Assessment of postmenopausal women with red flag signs like postmenopausal bleeding/ endometrial thickness ≥5 mm is needed for early detection of any pathology. Early-stage endometrial cancer detection through office hysteroscopy is one of crucial modality for effective management. Objective was to assess the outcome of office hysteroscopy in postmenopausal women with red flag sign and correlated with histopathology findings.  Methods: A prospective observational study at a single facility in Northern Ireland involving 122 post-menopausal women aged ≥45 years subjected to AUB/increased endometrial thickness. Advance diagnostic examination by office hysteroscopy followed by histopathology to detect and rule out endometrial cancer and related ailments. Results: The mean age of the study population was 63.07±10.317 SD years and 91.8% were over-weight. 71.3% women had endometrial thickness <5 mm. Hysteroscopic reported for 8.2% (10 cases) endometrial cancers having diagnostic accuracy of 98.36%. The histological and hysteroscopic diagnoses were having significantly similar outcomes. Office hysteroscopy has 100% specificity and positive predictive value in detecting normal endometrium whereas 98.25% specificity and 100% negative predictive value in case for cancer detection. Conclusions: In Irish women, office hysteroscopy proved helpful in determining the pathologies that cause postmenopausal bleeding. Correlating hysteroscopic and histological findings with red flag indications should be the focus of future explorations

A study on outcome of pregnancy of unknown location

Background: Pregnancies of unknown location (PUL) are becoming more common as women presenting to early pregnancy assessment units when a pregnancy test comes positive but there is no evidence of an intrauterine pregnancy. The objective of the present retrospective study was to find out the outcome of women with pregnancy of unknown location presenting to a tertiary hospital in Northern Ireland.Methods: This retrospective analytic study used medical record data between July 2019 and December 2021 from the Altnagelvin Area Hospital of Northern Ireland. TVUS was considered to diagnose the PUL and thereafter beta-human chorionic gonadotrophin (β-hCG) level was monitored as per institutional protocol. Expectant management was carried out until the pregnancy outcome was finalised. Using Statistical package for social sciences (SPSS) version 26, all collected data were analysed using the multinomial logistic regression.Results: For the analysis among the 63 participants, 25.4% were primi gravida and 38.1% presented with 4-5 weeks of gestation. Pain abdomen and vaginal bleeding was represented by 20.6% and 52.4% respectively. Confirmed ectopic pregnancy was observed among 4.8% and was surgically managed. Also, persistent PUL was 7.9% and these cases were successfully managed by Methotrexate.Conclusions: The large proportion will be biochemical pregnancy or intrauterine pregnancies, with a tiny fraction of ectopic pregnancies. Early detection of ectopic pregnancy is most challenging part among the women presented with PUL category

EXPLORATORY STUDY TO ASSESS THE EFFICACY OF JALAUKAVACHARANA (HIRUDOTHERAPY) IN THE MANAGEMENT OF VICHARCHIKA (ECZEMA)

Though the skin diseases are not a life threatening, they make the patient worried due to its appearance. Severe itching or burning or oozing disturbs his routine and its nature susceptible to be chronic. Even though many skin diseases may be cured yet the relapsing nature of few diseases (eczema, psoriasis, seborricdermatitis etc.) makes it much harassment for patients and trouble some for physician too. Eczema is a pattern of inflammatory response of the skin characterized by redness, skin edema, itching and dryness, with possible crusting, flaking, blistering, cracking, oozing or bleeding. Ayurvedic science explains this disease as Vicharchika. As the Ayurveda classics have detailed the use of Jalauka (leech) in the treatment of various skin manifestations, the present study has been performed to assess the effectiveness of blood-letting by making use of leech in the management of Eczema. By the study, making use of leeches has found to be very effective in reliving the signs and symptoms of Eczema

A COMMUNITY BASED CROSS-SECTIONAL STUDY: INCREASING PREVALENCE OF TYPE 2 DIABETES AMONG RURAL ADULT POPULATION OF KARNATAKA, INDIA

A community based cross-sectional study in the age group 25 years and above conducted at the field area of primary health centre Chakenahalli, Hassan district, Karnataka, India. The population was similar in characteristics regarding occupation, socio-economic status and food habits. Total of 626 subjects were included by multi-stage sampling. Information collected by the interviewers through face to face interview, after informed consent. The individuals were assessed on anthropometric parameters and screening was done by Random Blood Glucose (RBG) with a standardized technique; diagnosis of type 2 diabetes done by WHO criteria. Prevalence of diabetes was found in 11.3% males and 15% females, altogether the total prevalence was 13.09% with 8.79% self reported cases of diabetes . Hypertension was associated with 25.6% diabetic subjects. It was also observed that 28.1% of study population had BMI ≥ 25

Ayurnutrigenomics: Ayurveda-inspired personalized nutrition from inception to evidence

Ayurveda proclaims food and drugs are intersecting concepts that are vital for human survival and for the prevention and mitigation of diseases. Food interferes with the molecular mechanisms of an organism's “physiome”. It is consumed in large amounts compared to any drug. Hence, research on its effect and interaction with genome is highly relevant toward understanding diseases and their therapies. Ayurgenomics presents a personalized approach in the predictive, preventive, and curative aspects of stratified medicine with molecular variability, which embodies the study of interindividual variability due to genetic variability in humans for assessing susceptibility, and establishing diagnosis and prognosis, mainly on the basis of the constitution type of a person's Prakriti. Ayurnutrigenomics is an emerging field of interest pervading Ayurveda systems biology, where the selection of a suitable dietary, therapeutic, and lifestyle regime is made on the basis of clinical assessment of an individual maintaining one's Prakriti. This Ayurveda-inspired concept of personalized nutrition is a novel concept of nutrigenomic research for developing personalized functional foods and nutraceuticals suitable for one's genetic makeup with the help of Ayurveda. Here, we propose and present this novel concept of Ayurnutrigenomics and its emerging areas of research, which may unfold future possibilities toward smart yet safe therapeutics

Exploratory Study on the Ayurvedic Therapeutic Management of Cerebral Palsy in Children at a Tertiary Care Hospital of Karnataka, India

Cerebral palsy (CP) is the leading cause of childhood disability affecting cognitive function and developments in approximately 1.5 to 3 cases per 1000 live births. Based on Ayurvedic therapeutic principles, CP patients were subjected to Abhyanga (massage) with Moorchita Tila Taila (processed sesame oil) and Svedana (fomentation) with Shastikashali Pinda Sveda (fomentation with bolus of drugs prepared with boiled rice). Study group received Mustadi Rajayapana Basti (enema with herbal decoction) and Baladi Yoga (a poly-herbo-mineral formulation), while the placebo group received Godhuma Vati (tablet prepared with wheat powder) and saline water as enema. Treatment with Mustadi Rajayapana Basti and Baladi Yoga improved the activities of daily life by 8.79%, gross motor functions by 19.76%, and fine motor functions 15.05%, and mental functions like memory retention got improved by 15.43%. The placebo group showed an improvement of 0.21% in daily life activities, 2.8% in gross motor, and 2.4% in fine motor functions. Mustadi Rajayapana Basti and Baladi Yoga proved to be more supportive in improving the motor activities and gross behavioral pattern. Further clinical trials are required to evaluate and validate the maximum effect of the combination therapy in a large sample with repetition of the courses for longer duration

Exploratory studies on the therapeutic effects of Kumarabharana Rasa in the management of chronic tonsillitis among children at a tertiary care hospital of Karnataka

The effect of an Ayurvedic poly-herbo-mineral formulation Kumarabharana Rasa (KR) in the management of chronic tonsillitis (Tundikeri) in children has been assessed in this study. This clinical study was a double-arm study with a pre- and post-test design at the outpatient level in a tertiary Ayurveda hospital attached to a teaching institute located in district headquarters in Southern India. Patients (n = 40) with chronic tonsillitis satisfying diagnostic criteria and aged between 5 and 10 years were selected from the outpatient Department of Kaumarbhritya, SDM College of Ayurveda and Hospital, Hassan. Among them, 20 patients were treated with Kumarabharana rasa (tablet form) at a dose of 500 mg once daily for 30 days (Group A). The other 20 patients were treated with Godhuma Vati (placebo) at a dose of 500 mg once daily for 30 days (Group B). In both groups, Madhu was the Anupana advised. After completion of 30 days of treatment, the patients were assessed on the following day and another investigation took place 15 days later. Statistically significant effects (p < 0.05) in the reduction of all signs and symptoms of chronic tonsillitis after KR treatment were observed. These results indicate that Kumarabharana Rasa has an ameliorative effect in reducing the signs and symptoms of chronic tonsillitis

CLINICAL INVESTIGATIONS ON THE AYURVEDIC MANAGEMENT OF ALLERGIC RHINITIS (VATAJA PRATISHYAYA) BY PRATIMARSHA NASYAAS NASAL DRUG DELIVERY SYSTEM.

Allergic Rhinitis (AR) is an immunoglobulin (Ig) E mediated inflammatory disease caused by the inflammation of airway mucosa with hypersensitivity resulting from seasonal or perennial responses to specific allergens. Prevalence of AR is increasing and has risen considerably in the past few decades with self reported prevalence up to 41%. According to Ayurvedic texts indication of Anutaila (classical Ayurvedic oil preparation) used in the form of Pratimarsha Nasya a traditional nasal drug delivery system has been used for a long period has shown beneficial effects on diseases of head and neck. A pretest and post test design of single group consisting of 37 patientsdiagnosed as allergic rhinitis were administered Pratimarsha Nasya (PN)with Anutaila daily for a period of 60 days. Effect ofPratimarsha Nasya with Anutaila on the chief complaints and totals nasal symptom score showed ameliorative improvement with statistical significance. Laboratory immunological parameters which included Total Leucocyte Count, Absolute Eosinophil Count, Neutrophils and Lymphocytes showed improvement with high statistical significance (< 0.001). At the end after 60 days of medication the patients showed marked relief in symptoms which can open a new direction in Ayurveda inspired novel targeted drug delivery systems

Ayurpharmacoepidemiology en Route to Safeguarding Safety and Efficacy of Ayurvedic Drugs in Global Outlook

Ayurpharmacoepidemiology is a new field developed by synergy of the fields of clinical pharmacology, epidemiology, and ayurveda. It will use the effects of ayurvedic medicinal products on large populations to describe and analyze the practices, evaluate the safety and efficacy, and carry out medicoeconomic evaluations. Good pharmacoepidemiology practices in ayurveda is projected to assist with issues of ayurpharmacoepidemiologic research. The embraced good pharmacoepidemiology practices guideline in this viewpoint will be able to provide valuable evidence about the health effects of ayurvedic herbs/drugs and consider different fields like pharmacovigilance, pharmacoeconomics, and drug discovery with ayurvedic reverse pharmacology approach, also pass out significant data for further basic sciences study in ayurveda biology, ayurgenomics, ayurnutrigenomics, and systems biology. Several unanswered questions about ayurvedic drug use and informed interventions or policies that can be addressed by informatics database, which will eventually demonstrate the credibility and rationality of ayurceuticals in the future