Literary review of Grahani Roga

A healthy body creates a healthy mind. A healthy gut molds a healthy body. This establishes the relation of gut with that of the brain. Ayurveda emphasized the relation with gut and brain dating back to the centuries. It is very much evident while going through Manasika Vikaras mentioned in our classics. Manas Roga Lakshanas can get manifested or precipitated by bowel pathologies or Koshtajanya Vikaras. Brain and spinal cord carries abundant network of neurons. Surprisingly, the human body carries a second brain in its gut and we address it as the enteric nervous system. It has the capacity to function independently. Aahara can manipulate the body constructively or even destructively, which later influences at the psychic and somatic level. Therefore, food or diet was considered to be superior to the medicines in the ancient classics. In the current era of fast moving life, due to injudicious and erratic diet nature and pattern which induces stress to the gut, causing Dushti of Samana Vata which plays a major role in the digestion along with Pachaka Pitta, Kledaka Kapha which ultimately effects Sadhaka Pitta

The Spousal Assault Policy: A Critical Analysis

This article examines the complex relationship between PCLS\u27s spousal assault policy and the clinic\u27s mandate to practice poverty law. The author addresses the conflict which arises from the clinic\u27s attempt to reconcile two goals-access to justice for all members of Parkdale\u27s poor community and advocacy in the area of violence against women. The article also examines whether poverty can serve as a catalyst for violent behaviour or whether such a hypothesis is based on classist myths and assumptions. Ultimately, the author concludes that if battering can be linked to poverty, then PCLS (as a poverty law clinic) has an obligation to assist abusive men with legal issues unrelated to the battering

Literary review of Manas in Ayurveda

Manas is the chief component of life (Ayu) which is the combined state of Sharira (body), Indriya (senses), Satwa (psyche) and Atma (Soul). The study of Manas (psychology) is an integral part of the basic thought of Ayurveda. Mind, Soul and body are the tripod on which life depends. In Bhela Samhita, Shira (brain) has been described as the abode of Manas. Manas is stated to be under the control of Vata. It has been stated that Manas and Vata work as synergism. Understanding the concept of mind is the ultimate source of health. Mental fitness of patient can be assessed with the help of Satwa examination. Depending upon its strength, it is of three types, viz. Pravara, Madhyama and Avara Satwa. Satwajaya therapy is to restrain mind from desire for unwholesome objects

Открытое сравнительное рандомизированное исследование эффективности и безопасности применения растительных препаратов Персен® и Персен® Ночь у пациентов с кратковременной инсомнией

Herbal sedatives serve an alternative to antipsychotics and hypnotics aimed to alleviate symptoms of anxious disorders and insomnia. Valeriana officinalis L., Mentha piperita L. and Melissa officinalis are most widely used in neurology as sedatives of herbal origin. We present the results of a randomized open-label trial on efficiency and safety of Persen® and Persen® Night containing extracts of the above mentioned plants in patients with short-term insomnia. The study consisted of 60 subjects of 18–65 y.o. (mean 42.4 ± 6.9 y.o.) with short-term insomnia due to adjustment disorder or mixed anxiety-depressive disorders: 30 of them got Persen® 2 tablets a day and 30 – Persen® Night, 1 capsule 30–60 min before sleep during 4 weeks. The majority (76.5 %) of patients referred the onset of insomnia with psychosocial traumatic stressor. Persen® Night’s main action was found on superficial sleep, number of night awakenings, sleep onset rate. At the end of the therapy with this substance 39.7 % of patients fell asleep in 10–15 min, and 92.2 % – in 30 min, accordingly, while for Persen® at 17.4 and 80.3 % accordingly (р < 0.05). In the meantime Persen® decreased the bad sleep perception at awakening and day somnolence, mostly attributed to the mood improvement and decrease of anxiety. Levels of efficacy and safety for both substances were significant, allowing to regard them as potential phytotherapeutic agent in the treatment of insomnia and mixed anxiety-depressive disorders.Седативные растительные средства являются альтернативой рецептурным лекарствам для облегчения симптомов тревожных расстройств и инсомнии. В качестве успокаивающих средств наиболее широкое применение в неврологии нашли валериана лекарственная (Valeriana officinalis L.), мята перечная (Mentha piperita L.) и мелисса лекарственная (Melissa officinalis L.). В настоящей статье представлены результаты открытого сравнительного исследования эффективности и безопасности применения растительных препаратов Персен® и Персен® Ночь, содержащих экстракты указанных растений, у пациентов с кратковременной инсомнией. В исследовании приняли участие 60 пациентов в возрасте 18–65 лет (средний возраст 42,4 ± 6,9 года), страдающих кратковременной инсомнией на фоне нарушений адаптации или коморбидных тревожно-депрессивных расстройств; 30 из них получали препарат Персен® по 2 таблетки в сутки и 30 – Персен® Ночь по 1 капсуле за 30–60 мин до сна на протяжении 4 нед. Большинство (76,5 %) больных связывали начало инсомнии с какой-либо психотравмирующей ситуацией (остро возникшие финансовые трудности, проблемы на работе и др.). Персен® Ночь в основном влиял на пресомнические и интрасомнические проявления: наличие поверхностного сна, количество ночных пробуждений, скорость засыпания. К окончанию терапии этим препаратом у 39,7 % пациентов засыпание наступало через 10–15 мин, а у 92,2 % – в течение 30 мин, тогда как для препарата Персен® – у 17,4 и 80,3 % соответственно (р < 0,05). В то же время Персен® достоверно уменьшал ощущение невыспанности при пробуждении и постсомнические расстройства, такие как дневная сонливость, в большей степени способствовал уменьшению тревожности и улучшению настроения. Оба препарата обладают благоприятным профилем эффективности и безопасности, что позволяет рекомендовать их пациентам, страдающим инсомнией и коморбидными тревожно-депрессивными расстройствами

Etiology, epidemiology and clinical characteristics of acute moderate-to-severe diarrhea in children under 5 years of age hospitalized in a referral pediatric hospital in Rabat, Morocco

The objective of the study was to describe the etiology, epidemiology, and clinical characteristics of the principal causes of acute infectious diarrhea requiring hospitalization among children under 5 years of age in Rabat, Morocco. A prospective study was conducted from March 2011 to March 2012, designed to describe the main pathogens causing diarrhea in hospitalized children >2 months and less than 5 years of age. Among the 122 children included in the study, Enteroaggregative E. coli (EAEC) and rotavirus were the main etiologic causes of diarrhea detected. Twelve (9.8%) children were referred to the intensive care unit, while 2, presenting infection by EAEC and EAEC plus a Shigella sonnei respectively, developed a hemolytic uremic syndrome. Additionally, 6 (4.9%) deaths occurred with EAEC being isolated in four of these cases. Diarrheogenic E. coli and rotavirus play a significant role as the two main causes of severe diarrhea while other pathogens such as norovirus or parasites seem to have a minimal contribution. Surveillance and prevention programs to facilitate early recognition and improved management of potentially life-threatening diarrhea-episodes are needed

Long-term outcomes of different rehabilitation programs in patients with long COVID syndrome: a cohort prospective study

After the resolution of the acute SARS-COV-2 infection, an important percentage of patients do not fully recover and continue to present several symptoms. Nevertheless, there is a lack of data in the literature on the effects of rehabilitation programs on medium- and long-term long COVID symptoms. Therefore, the aim of this study was to evaluate the long-term outcomes after rehabilitation programs in long COVID syndrome patients. A prospective cohort study was conducted from August 2021 to March 2022, involving 113 patients with long COVID syndrome. The patients in the experimental group (EG, n=25) received a tailored and multidisciplinary rehabilitative program, involving aquatic exercises, respiratory and motor exercises, social integration training and neuropsychologic sessions, LASER therapy and magnetotherapy. Patients in the other three comparison groups received eastern medicine techniques (CG1), balneotherapy and physiotherapy (group CG2), self-training and home-based physical exercise (CG3). Once the several rehabilitation protocols had been performed, a structured telephone contact was made with the patients after 6 months ± 7 days from the end of the rehabilitation treatment, in order to record the frequency of hospital ad-missions due to exacerbation of post-exacerbation syndrome, death or disability, and the need for other types of care or drugs. The patients in the comparison groups were more likely to request therapeutic care for emerging long COVID symptoms (χ2=6.635, p=0.001; χ2=13.463, p=0.001; χ2=10.949, p=0.001, respectively), as well as more likely to be hospitalized (χ2=5.357, p=0.021; χ2=0.125, p=0.724; χ2=0.856, p=0.355, respectively) when compared to the patients of the EG. The relative risk (RR) of hospital admissions in the observed cohort was 0.143 ±1,031 (СI: 0.019; 1.078); 0.580±1,194 (CI: 0.056; 6.022); 0,340±1,087 (CI: 0.040; 2.860). The RR of hospital admissions for patients with long COVID syndrome was reduced by 85.7%; 42.0% and 66.0%, respectively, when the experimental rehabilitation technique was employed. In conclusion, a tailored and multidisciplinary rehabilitative program seems to have a better preventive effect not only in the short term, but also over the next 6 months, avoiding the new onset of disabilities and the use of medicines and specialist advice, than other rehabilitative programs. Future studies will need to further investigate these aspects to identify the best rehabilitation therapy, also in terms of cost-effectiveness, for these patients

Периферическая ритмическая магнитная стимуляция при нейрогенных расстройствах мочеиспускания: обзор литературы и результаты клинического исследования

Urinary disorders caused by peripheral nervous system injury are characterized by weakness of neural control of lower urinary tract. Clinical and urodynamic examination demonstrate detrusor-hyporeflexia and its reduced contractility. Magnetic stimulation influences autonomic and somatic nerves innervating pelvic organs but the mechanism of action is still unclear. This paper presents literature review on diagnostics and treatment of neurogenic urinary disorders by using magnetic stimulation and the results of our investigational study. 7 patients with neurogenic urinary retention were included in a prospective study of peripheral repetitive magnetic stimulation. Prolonged clinical improvement during the follow-up of 3 months was observed in all patients.Расстройства мочеиспускания, обусловленные повреждением периферической нервной системы, характеризуются ослаблением активной иннервации нижних мочевых путей. Клинико-уродинамическая картина соответствует гипорефлекторному мочевому пузырю, при котором наблюдается нарушение сократительной активности детрузора. Магнитная стимуляция оказывает воздействие на вегетативные и соматические нервные волокна, участвующие в иннервации органов малого таза, однако в настоящее время механизм действия остается неизученным. В статье представлены обзор данных литературы, касающейся диагностики и лечения нейрогенных расстройств мочеиспускания с помощью магнитной стимуляции, а также результаты собственного клинического исследования. Были выполнены обследование и наблюдение 7 пациентов с нейрогенной задержкой мочеиспускания вследствие поражения периферической нервной системы. Больным проводили процедуры периферической ритмической магнитной стимуляции ежедневно, на курс 10 сеансов. У всех пациентов наблюдался клинический результат в течение 3 мес. 

A comparative appraisal of some community-based alternatives to institutionalization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44037/1/10464_2004_Article_BF00878045.pd

Neuropsychological evaluation of cognitive disorders in children after COVID-19

The article presents the results of neuropsychological remote and face-to-face testing of 25 children aged 12 to 17 years in the nearest (during and 1-2 weeks after the treatment) and later period (2-12 months) after COVID-19 infection with predominant respiratory tract infection, organized in Ekaterinburg in the State Autonomous Institution "Children's Hospital № 8". Indication of family contact with patients with a new coronavirus infection was found in all patients, a positive nasopharyngeal swab for SARS-CoV-2 RNA by PCR was found in 58%, non-focal neurological complaints were found in 54% of children. The control group consisted of 25 pupils of Moscow comprehensive schools (14 girls and 11 boys) aged between 12 and 16 years who were examined before the pandemic. The methods included: investigation of the kinesthetic, spatial, dynamic, graphic praxis; auditory-motor coordination; visual, object-constructive gnosis; auditory-speech, visual memory; voluntary attention; thinking. Significant differences with the results of neuropsychological tests performed in children in the control group were found, allowing us to assert impairment of memory, attention, visual gnosis, visual-spatial function, kinesthetic and dynamic praxis, verbal and non-verbal component of thinking. According to A.R. Luria's theory, the topic of the disorders involves the temporo-parieto-occipital, mediobasal, frontotemporal parts of the brain, the reticular formation and limbic structures. This necessitates the development of corrective educational programs and an in-depth diagnostic algorithm that determines the morphological substrate of cognitive disorders in children, who have undergone COVID-19. © 2022 PAGEPress Publications. All rights reserved.Ministry of Health of the Russian FederationPirogov Russian National Research Medical University, RNRMUThe study was funded by Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow

Внебольничная пневмония, вызванная Legionella pneumophila («болезнь легионеров»): краткий обзор и клинические наблюдения

“Legionnaire's Disease” is an acute infectious disease caused by Legionella of the Legionellaceae family. Clinical forms of legionellosis are diverse, but the risk of severe community-acquired pneumonia (СAP) is the main clinical significance. Unfortunately, as technological progress increases, epidemiological risks of foci of infection associated with artificial water systems (favorable habitat for Legionella) are increasing, which has led to numerous epidemic outbreaks and group cases of legionellosis infection recorded in the world recently. There are no pathognomonic symptoms and signs that allow it to be reliably differentiated from CAP by another etiology for “Legionnaire's disease”. An important role in the early verification of the disease is assigned to taking into account known risk factors of infection (a recent trip accompanied by possible contact with a water spray of a centralized air conditioning system) – age over 40 years, male sex, smoking, chronic concomitant diseases (diabetes mellitus, etc.), immunosuppression and timely laboratory diagnosis. The most accessible and convenient methods of primary diagnostics of community-acquired legionellosis are tests based on the detection of soluble antigen L. pneumophila serogroup-1 in urine. The treatment of Legionellosis CAP is based on antibacterial therapy, levofloxacine and macrolides are the drugs of choice. In this article, a series of clinical observations (2017 – 2019) in one of the multidisciplinary hospitals of Moscow is given as a confirmation of the clinical significance of legionella in the etiology of CAP in hospitalized patients and the need for timely diagnosis of the disease. «Болезнь легионеров» – острое инфекционное заболевание, вызываемое бактериями рода Legionella семейства Legionellaceae. Клинические формы легионеллеза разнообразны, однако основное клиническое значение определяется риском развития тяжелой внебольничной пневмонии (ВП). К сожалению, с ростом технического прогресса повышаются и эпидемиологические риски возникновения очагов инфекций, связанных с искусственными водными системами (благоприятной средой обитания Legionella), что явилось причиной многочисленных эпидемических вспышек и групповых случаев легионеллезной инфекции, зарегистрированных в мире в последнее время. Для «болезни легионеров» не существует патогномоничных симптомов и признаков, которые позволяют надежно дифференцировать ее с ВП другой этиологии. Важная роль при ранней верификации болезни отводится учету известных факторов риска инфицирования, среди которых – не только недавнее путешествие, сопровождающееся возможным контактом с водным аэрозолем централизованной системы кондиционирования воздуха, но и возраст старше 40 лет, мужской пол, курение, хронические сопутствующие заболевания (сахарный диабет и т. п.), иммуносупрессия, а также своевременной лабораторной диагностике. Наиболее доступными и удобными методами первичной диагностики внебольничного легионеллеза являются тесты, основанные на обнаружении растворимого антигена L. pneumophila серогруппы-1 в моче. Основу лечения легионеллезной ВП составляет антибактериальная терапия, препаратами выбора являются левофлоксацин и макролиды. В данной статье в качестве подтверждения клинической значимости легионелл в этиологии ВП у госпитализированных больных и необходимости своевременной диагностики заболевания приводится серия клинических наблюдений (2017–2019) в одном из многопрофильных стационаров Москвы