Phrenic Nerve Impingement and Effect of Superficial Neck Flexors Stretching in Improving Diaphragmatic Function among Patient with Chronic Neck Pain

Background: The phrenic nerve is formed on the lateral border of scalenus anterior. It runs vertically downward on the anterior surface of the scalenus anterior. The muscle is oblique and nerve cross it obliquely from its lateral to medial border. In this part the nerve is related anteriorly sternocleidomastoid. The decline in the diaphragm function can occur due to phrenic nerve block but to the best of our search, there is dearth of literature pertaining to involvement of phrenic nerve in patient with chronic neck pain secondary to superficial neck flexors tightness. So, evaluation of these muscle for tightness may be considered which may affect the maximum inspiratory pressure (MIP). Objective: To find the change in diaphragmatic function secondary to phrenic nerve impingement measured through maximum inspiratory pressure (MIP) following stretching of superficial neck flexors in patient with chronic neck pain Methods: An experimental (pre-post design) study involving 40 subjects with mean (±SD) age 22.4 ± 2.8 years was performed. Using purposive sampling 40 subjects (77.5% female and 22.5% male) were used to check phrenic nerve impingement by looking at the effect of superficial neck flexors stretching (sternocleidomastoid and anterior scalene) in improving diaphragmatic function in patient with chronic neck pain. The included subject’s diaphragmatic function was measured through maximum inspiratory pressure using a device capsule sensing pressure gauge followed by stretching of superficial neck flexors on both sides. After two minutes of stretching diaphragmatic function was again measured. Results: There was increase in diaphragmatic function following stretching of superficial neck flexors by 13.2cm H2O which was found to be highly significant statistically with p value < 0.01 Conclusion: The result of present study concluded that superficial neck flexors stretching was effective in treating the impingement of phrenic nerve as measured through maximum inspiratory pressure in patients with chronic neck pain

Assessment of the effect of injection magnesium sulphate on fetal heart rate pattern in patients of eclampsia and preeclampsia

Background: To assess the effect of injection magnesium sulphate on fetal heart rate pattern in severe preeclampsia and eclampsia.Methods: This is a hospital-based prospective observational study. It was conducted in the Dept. of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur over period of one year from August 2014 to July 2015.Total 122 patients with diagnosis of severe preeclampsia and eclampsia who received injection MgSO4 were included in the study. Patients who delivered within 1 to 2 hrs of injection MgSO4, had pulmonary edema, respiratory depression, renal insufficiency, patients with recurrent convulsions not controlled by MgSO4 alone, fetus who had abnormal fetal heart rate pattern prior to administration of injection MgSO4, IUD baby, baby of gestetional age <28 weeks were excluded from the study. Fetal heart rate pattern tracings were taken by CTG machine before administration of injection magnesium sulphate. Injection magnesium sulphate was given according to Pritchard Regime. Fetal heart rate pattern after injection MgSO4 were compared with fetal heart rate pattern before injection magnesium sulphate regarding all four parameters fetal heart rate, variability, accelerations and deceleration.Results: Before injection magnesium sulphate mean fetal heart rate was 148.7 bpm+10.78. After 15 minutes mean fetal heart rate was 147.8 bpm+10.32.After 1hour, 2 hour and 4 hour of injection magnesium sulphate mean fetal heart rate was139.1 bpm+9.6,139.2 bpm+9.8 and 137 bpm+9.4 respectively which was statistically significant (p value <0.001). Only patients with good variability were included in the study. After 1 hour of injection magnesium sulphate 16.4%, after 2 hour 23% and after 4 hour 31.1 % developed poor variability i.e. <5. Before injection magnesium sulphate only 4% had no acceleration, after 15 minutes, 1 hour, 2 hour and 4 hour of injection magnesium sulphate 4.9%, 29.5%, 49% and 55% patients had no acceleration respectively. Before injection magnesium sulphate no patient had late deceleration. After 15 min only 2 patients had variable prolonged deceleration. After 1 hour, 2 hour and 4 hour 0%, 4.1% and 6.6% had late deceleration respectively.Conclusions: Maternal exposure to magnesium sulphate in severe preeclampsia and eclampsia is associated with persistent fall in baseline fetal heart rate by approximately 9-11 bpm which appeared at 1 hr of injection MgSO4 but it is within the accepted normal range (110 bpm - 160bpm). Statistically significant patients developed decreased beat to beat variability <5 after 1 hr of injection MgSO4. Statistically significant patients developed absent acceleration. Few patients developed late decelerations but it was not significant

The Uniqueness of Albumin as a Carrier in Nano Drug Delivery

The quest for precision medicine hinges on targeted drug delivery, minimizing off-target effects while maximizing therapeutic impact. Among nanocarriers, albumin – the most abundant protein in human blood – emerges as a uniquely biocompatible stealth bomber. Its inherent advantages, including exceptional biodegradability, prolonged circulation, and natural affinity for diseased tissues, perfectly align with the goals of personalized medicine. Albumin readily solubilizes poorly soluble drugs, enhancing bioavailability and broadening the therapeutic arsenal. Its versatile surface allows for targeted modifications, enabling dual diagnosis and treatment (theranostics) tailored to individual needs. While challenges remain in optimizing drug loading and targeting specificity, albumin-based nanocarriers hold immense promise for revolutionizing personalized healthcare, delivering potent therapeutics with pinpoint accuracy. The burgeoning field of nanodrug delivery seeks to redefine therapeutic landscapes by engineering nanoscale carriers that meticulously deliver potent drugs to their designated targets, minimizing systemic exposure and maximizing therapeutic efficacy. This pursuit aligns perfectly with the burgeoning field of precision medicine, where personalized treatments demand exquisite control over drug delivery. Within this intricate choreography, albumin, the abundant and versatile protein resident in human plasma, emerges as a maestro, orchestrating a symphony of advantages that make it a prime candidate for nanocarrier construction

Caffeine Levels and Dietary Intake in Smokers with Schizophrenia and Bipolar Disorder

This study investigates the relationship between caffeine levels and dietary intake among individuals with schizophrenia and bipolar disorder who are smokers. The research aims to understand the patterns of caffeine consumption and dietary habits in this specific population. A sample of participants diagnosed with either schizophrenia or bipolar disorder and who smoke will be analyzed to assess their caffeine intake through self-reported measures and biological markers. Additionally, their dietary patterns, including the consumption of caffeine-containing products and nutritional choices, will be evaluated. The findings of this study aim to contribute to a better understanding of the dietary behaviors of individuals with mental health disorders, specifically focusing on caffeine intake among smokers with schizophrenia and bipolar disorder

Prevalence and risk factors for group B streptococcal colonization in pregnant women in northern India

Background: Group B Streptococci are a constituent of the normal vaginal bacterial microflora. During pregnancy there are optimal conditions for GBS multiplication in the vagina, which may have serious consequences for both the mother and her child. Aims: To study the prevalence of Group B Streptococcal colonization in pregnant women in Eastern U.P and antibiogram of the isolates (GBS) with a view to determine the pattern of antibiotic resistance. Study design: Observational cross-sectional study.Methods: 300 pregnant women admitted at term gestation or with preterm labour were recruited in the study. Swabs were taken from the lower one third of vagina and the anorectal region and then placed in Todd-Hewitt Broth, an enrichment media for GBS and later subcultured on blood agar. It was then examined for beta haemolytic colonies. The Chi-square test and Fisher’s exact test were used to compare the two groups. P values 30 years, p3, p<0.03), and higher socioeconomic status (p<0.007). No significant association found between GBS colonization and level of education, urban/rural area and gestational age. Prevalence of GBS in PROM was 5.6% and in preterm labour 3.3%. All the isolates were sensitive to ampicillin and resistant to gentamicin.Conclusions: GBS colonization among pregnant women was significantly correlated with age, parity and socioeconomic status. In pregnancy GBS colonization can cause premature rupture of membranes and preterm labour.

Amniotic fluid index, non-stress test and color of liquor: as a predictor of perinatal outcome

Background: The universal aim of maternity care provision is birth of a healthy baby to a healthy mother. All birth attendants strive to achieve a good standard of care during labor to prevent an outcome such as ‘birth asphyxia’. The aim was to study the role of AFI, NST and color of liquor in predicting perinatal outcome in term pregnancy in active labor.Methods: Prospective observational study of in women 18-35 years of age in active Labor admitted in department of Obstetrics and Gynecology BRD Medical College Gorakhpur, India.Results: In patient with AFI &lt;5 cm, 83% needed intervention during labor (77% LSCS, 6% instrumental vaginal delivery) and 89% newborn had APGAR &lt;7, while in AFI &gt;5 cm group only 29% needed intervention (24% LSCS, 5% instrumental vaginal delivery) and only 20% newborn had APGAR &lt;7. Normal NST (Cat.-I) group had 89% normal vaginal delivery and only 11% (9.5% LSCS, 1.5% instrumental vaginal delivery) needed intervention with 6% newborn with APGAR&lt;7 at 1 minute (‘p’&lt;0.00001), while pathological NST (Cat.-III) group had 16% normal vaginal delivery and 84% (8% instrumental vaginal delivery, 76% LSCS) needed intervention during labor with 92% newborn with APGAR &lt;7 at 1 minute (‘p’&lt;0.00001). Clear liquor group had 85% had normal vaginal delivery and only 15% needed intervention (14% LSCS, 1% instrumental vaginal delivery) with 8.3% newborn with APGAR &lt;7 at 1 minute, while meconium stained liquor group only 6.5% had normal vaginal delivery and 93.5% needed intervention (16% instrumental vaginal delivery, 77.5% LSCS) with 87% newborn with APGAR &lt;7 at 1 minute.Conclusions: AFI, NST and color of liquor can effectively detect fetal distress already present at admission, thereby avoiding unnecessary delay and decrease in decision to delivery time and improve fetal outcome

A brief study on Strebulus Asper L. -A Review

Streblus asper L. is a small tree found in tropical countries, such as India, Sri Lanka, Malaysia, the Philippines and Thailand belonging to family moraceae. Various parts of this plant are used in Ayurveda and other folk medicines for the treatment of different ailments such as filariasis, leprosy, toothache, diarrhea, dysentery and cancer. Research carried out using different in vitro and in vivo techniques of biological evaluation support most of these claims. This review presents the botany, chemistry, traditional uses and pharmacology of this medicinal plant

Study - Half an hour versus three hour contact of topical steroid (clobetasol propionate)

BACKGROUND: Steroids when left on the skin for longer duration may contribute to the side effects without any additional clinical benefit. The relationship between the duration of topical steroid contact with the skin and its effectiveness has not been established. The ability of the topical steroids to inhibit the size of histamine induced wheal was used to assess their relative efficacy. AIM: To determine whether half an hour contact and three hour contact of a topical steroid, clobetasol propionate, is equally effective in inhibiting the size of the histamine induced wheal. METHODS: On 30 volunteers, 4 squares were marked on flexor aspect of both forearms using a template. One fingertip unit of clobetasol propionate 0.05% was applied on all the areas. Half an hour later all areas of left forearm and last square of right forearm were wiped. Prick testing was done with histamine and size of wheal recorded after 15 minutes. Similarly steroid was wiped from the 1st, 2nd, 3rd square after 1 hr, 2 hr and 3 hrs on right forearm and the corresponding areas prick tested on both forearms. RESULTS: There was statistically significant wheal suppression at the end of 2 hrs and 3hrs as compared to half an hour. CONCLUSION: We conclude that half an hour application of clobetasol propionate is ineffective and that it is effective only after two hours of contact and hence short contact of half an hour will be less effective than relatively prolonged contact of 2 hours

Retro-peritoneal plasmacytoma: A case report and review of literature

Solitary Extramedullary Plasmacytoma (EMP) is an uncommon neoplasm. When diagnosed, head and neck region is its most likely location. Rarely, it may occur in the retro-peritoneum. We report a 44year old man with solitary extramedullary plasmacytoma in the retro peritoneum (RPEMP). The patient did not show response to three cycles of VAD chemotherapy. Thereafter Surgical excision of the mass was performed successfully. This is probably the first case report from Indian subcontinent

Immunotherapy with Injectable Hydrogels to Treat Obstructive Nephropathy

Hydrogels are gaining attention as injectable vehicles for delivery of therapeutics for a range of applications. We describe self-assembling and injectable Dock-and-Lock hydrogels for local delivery of interleukin-10 (IL-10) to abate the progression of inflammation and fibrosis that leads to chronic kidney disease. As monitored with a fluorescent tag, hydrogels degraded within a few days in vitro and matched IL-10 release profiles; however, hydrogels remained in the kidney for up to 30 days in vivo. A unilateral ureteral obstruction (UUO) mouse model was used to investigate in vivo outcomes after hydrogel injection and IL-10 delivery. Eight groups were investigated (7, 21, 35 days, n = 4): healthy, sham, healthy injected with mouse serum albumin (MSA), healthy + hydrogel, UUO, UUO + IL-10, UUO + hydrogel, UUO + hydrogel/IL-10. 15 μL of IL-10, hydrogel, or hydrogel/IL-10 was injected under the renal capsule 3 days after the UUO. Immunohistochemistry (IHC) was performed on paraffin sections to identify macrophages and apoptotic cells and trichrome staining was used to evaluate fibrosis. There were no significant differences in inflammatory markers between all control groups. With hydrogel delivery, macrophage infiltration and apoptosis were significantly reduced at days 21 and 35 compared to untreated animals. By day 35, IL-10 delivery via hydrogel reduced macrophage infiltration and apoptosis more than IL-10 injection alone. Fibrosis was decreased by day 35 in all treatment groups. This work supports the use of hydrogel delivery of IL-10 to treat chronic kidney disease