Pharmaceutico analytical study of Ashwagandha Ghrita

Ashwagandha (Withania somnifera (L) Family - Solanaceae) known as Indian ginseng is an effective immunomodulator, aphrodisiac, sedative and adaptogen. Ashwagandha Ghrita is a ghee based Ayurvedic formulation which is available in the market, but Ashwagandha Ghrita containing Rasasindura and Tamra Bhasma along with Ashwagandha and Musta Churna is also mentioned in classical text which many of us are not aware of. As we all know that the action of Rasaushadhis are quick and require very less dose the one mentioned by Vagbhatacharya (author of Rasaratnasamuchaya) is the need of the hour for the immunomodulation. The current trend in applied instrumental medical research encourages good medical practice, clinical and research based drug analysis. The main aim of analytical study is to find out working standards for the formulations and safe use of therapeutics

Bioresorbable Film for the Prevention of Adhesion to the Anterior Spine After Anterolateral Discectomy

Background context The development of scar tissue and adhesions postoperatively is a natural consequence of healing but can be associated with medical complications and render reoperation difficult. Many biocompatible products have been evaluated as barriers or deterrents to adhesions. Purpose To evaluate the efficacy of a bioresorbable polylactide film as a barrier to adhesion formation after anterolateral discectomy. Study design Experimental study. Methods Seven, skeletally mature female sheep underwent a retroperitoneal approach to the anterolateral lumbar spine. A discectomy was performed at two levels with an intervening unoperated disc site. One site was treated with a polylactide film barrier (Hydrosorb Shield; MacroPore Biosurgery, San Diego, CA) affixed with tacks manufactured from the same material. The second site was left untreated. Treatment and control sites were randomly assigned. Postmortem analysis included scar tenacity scoring on five spines and histological evaluation on two spines. Results The application of the Hydrosorb film barrier allowed a definite dissection plane during scar tenacity scoring and there was a significant difference in the development of adhesions to the disc between the control and treated sites. Histological evaluation revealed evidence of barrier formation to scar tissue and no significant adverse inflammatory reactions. Conclusions Hydrosorb Shield appears to be an effective postoperative barrier to scar tissue adhesion after anterolateral discectomy. The use of polylactide tacks was beneficial to affix the barrier film in place. Safety issues associated with delayed healing or adverse response to the film or tacks were not observed. Hydrosorb film may be useful as an antiadhesion barrier facilitating dissection during surgical revision in anterior approaches to the spine. Further studies are indicated to evaluate the performance of the bioresorbable material as an antiadhesion barrier in techniques of spinal fusion and disc replacement

Evaluation of laryngoscopic view, intubation difficulty and sympathetic response during direct laryngoscopy in sniffing position and simple head extension: a prospective and randomized comparative study

Background: Airway management is critical to the care of patients and direct laryngoscopy is the mainstay of airway management. Despite the proliferation of difficult airway devices, sniffing position for laryngoscopy remains the gold standard and ideal position. This prospective, randomized and single-blind study was done to evaluate and compare the laryngoscopic view, complexity of intubation and sympathetic response during laryngoscopy in sniffing position and simple head extension.Methods: One hundred and twenty patients, aged 20-50 years with American Society of Anesthesiologists (ASA) status 1 and 2 undergoing general anesthesia requiring orotracheal intubation were randomized into two groups. Group A used sniffing position and group B was put in simple head extension. Glottis visualization was assessed using Cormack and Lehane grade and ease of intubation was assessed on intubation difficulty scale. Laryngoscopic sympathetic response in two positions was also assessed.Results: Both the groups were comparable in demographic profiles. Glottic visualization and intubation difficulty score were better and statistically significant in sniffing position as compared to simple head extension. Although, sympathetic response was lower in sniffing position as compared to simple head extension, it was statistically insignificant.Conclusion: Sniffing position provided better glottis visualization and intubation difficulty score and increased the success rate of intubation as compared to simple head extension.

A study of drug prescription patterns, disease-therapy awareness and of quality of life among patients with migraine visiting a tertiary care hospital in Mumbai, India

Background: Migraine is one of the leading causes of disability globally. There is scarcity of data on disease -therapy awareness and its correlation with demographic factors. Hence its was of interest to assess those along with quality of life in these patients. Methods: A Cross-sectional observational study was conducted in108 patients attending the Neurology and headache OPD at a tertiary care hospital between March 2017 and August 2018. Disease and therapy awareness among patients were evaluated using validated questionnaires and correlation was done with demographic factors. The severity of the disease and its impact on the patients' quality of life were assessed using the migraine disability assessment scale. Results: The mean disease and therapy awareness scores were 9 and 7 respectively. Both had a positive correlation with education and socioeconomic factors. The quality of life was affected moderately in 48.1% of the patients followed by severely 32.4% of the patients. The average number of drugs prescribed per encounter was 3.05. NSAIDS were used more commonly as compared to Triptans for acute attacks. Conclusions: The disease and therapy awareness were fair and positively correlated with education/ socioeconomic status. However, a significant disability was found among patients even with treatment. This highlights the need for educating these patients for effectively controlling the disability

A Review on Pottali Kalpana w.s.r. to Kaparda Purana Putapaka method of preparation

Pottali Kalpana is one of the unique Kalpana mentioned in our classics. It is one among the four Moorchita Parada Yogas. Kaparda Purana Putapaka method is one the methods mentioned for preparation of this Kalpana. It brings in the compactness of the Dravyas. Pottali Kalpana are a blend of extremely important trace elements which form the crux of the immune system. Various Kaparda Purana Method of preparation of Pottalis have been compiled here which have been mentioned in classical Rasashastra texts along with its ingredients and other variations. The alkalinity of the Kaparda Purana method of preparation owing to calcium probably has a significant role to play in the management of Atisara and Grahani. This Kalpana can be used in emergency care as well

In Vitro Susceptibility of Canine Influenza A (H3N8) Virus to Nitazoxanide and Tizoxanide

Infection of dogs with canine influenza virus (CIV) is considered widespread throughout the United States following the first isolation of CIV in 2004. While vaccination against influenza A infection is a common and important practice for disease control, antiviral therapy can serve as a valuable adjunct in controlling the impact of the disease. In this study, we examined the antiviral activity of nitazoxanide (NTZ) and tizoxanide (TIZ) against three CIV isolates in vitro. NTZ and TIZ inhibited virus replication of all CIVs with 50% and 90% inhibitory concentrations ranging from 0.17 to 0.21 μM and from 0.60 to 0.76 μM, respectively. These results suggest that NTZ and TIZ are effective against CIV and may be useful for treatment of canine influenza in dogs but further investigation of the in vivo efficacy against CIV as well as the drug's potential for toxicity in dogs is needed

A Review on Ashwagandha Ghrita

Ashwagandha (Withania somnifera (L) Family - Solanaceae) known as Indian ginseng is an effective immunomodulator, aphrodisiac, sedative and adaptogen. Ashwagandha Ghrita is a ghee based Ayurvedic formulation which is available in the market, but Ashwagandha Ghrita containing Rasasindura and Tamra Bhasma along with Ashwagandha and Musta Churna is also mentioned in classical text which many of us are not aware of. As we all know that the action of Rasaushadhis are quick and require very less dose the one mentioned by Vagbhatacharya (author of Rasaratnasamuchaya) is the need of the hour for the immunomodulation

In vitro evaluation of efficacy of different rotary instrument systems for gutta percha removal during root canal retreatment

Background: Complete removal of old filling material during root canal retreatment is fundamental for predictable cleaning and shaping of canal anatomy. Most of the retreatment methods tested in earlier studies have shown inability to achieve complete removal of root canal filling. Therefore the aim of this investigation was to assess the efficacy of three different rotary nickel titanium retreatment systems and Hedstrom files in removing filling material from root canals. Material and Methods: Sixty extracted mandibular premolars were decoronated to leave 15 mm root. Specimen were hand instrumented and obturated using gutta percha and AH plus root canal sealer. After storage period of two weeks, roots were retreated with three (Protaper retreatment files, Mtwo retreatment files, NRT GPR) rotary retreatment instrument systems and Hedstroem files. Subsequently, samples were sectioned longitudinally and examined under stereomicroscope. Digital images were recorded and evaluated using Digital Image Analysing Software. The retreatment time was recorded for each tooth using a stopwatch. The area of canal and the residual filling material was recorded in mm 2 and the percentage of remaining filling material on canal walls was calculated. Data was analysed using ANOVA test. Results: Significantly less amount of residual filling material was present in protaper and Mtwo instrumented teeth ( p < 0.05) compared to NRT GPR and Hedstrom files group. Protaper instruments also required lesser time during removal of filling material followed by Mtwo instruments, NRT GPR files and Hedstrom files. Conclusions: None of the instruments were able to remove the filling material completely from root canal. Protaper universal retreatment system and Mtwo retreatment files were more efficient and faster compared to NRT GPR fles and Hedstrom files

QUALITY CHARACTERIZATION OF MADHUYASHTI GHRITA

Madhuyashti Ghrita, is an Ayurvedic medicated ghee preparation containing Yashtimadhu. It is used for treating external ulcers and wounds in vital points of the body. However, there is no quality monograph available for Madhuyashti Ghrita. Hence, the present work was carried out to characterize this Ghrita to confirm its identity, quality and purity. This work reported various pharmacognostic and physicochemical parameters of Madhuyashti Ghrita along with its TLC based rapid fingerprinting as per the present standards of Ayurvedic Pharmacopoeia of India. Moreover, the presence of toxic contaminants like heavy metals, and microbial load were also evaluated. In organoleptic evaluation, the Ghrita was found to be semi–solid and dark yellow in colour, sweet and bitter in taste with a characteristic and pleasant odour. The values of the physicochemical parameters such as acid value, saponification value, peroxide value, refractive index, rancidity and pH value of the Ghrita were also assed. In the microscopical analysis of the rhizomes of Yashtimadhu, the presence of pitted vessels, fibres, prismatic crystals and starch grains were noted as a confirmation characteristic for the genuinely of this raw material in Madhuyashti Ghrita. The amount of heavy metals such arsenic, lead, mercury, cadmium, nickel, zinc, copper and chromium as well as total bacterial count and total fungal count were found to be much below their API limits. The TLC showed different characteristic spots indicating the presence of Yashtimadhu in this product. The parameters of Madhuyashti Ghrita presented in this paper may be utilized for preparing a quality monograph for this product

Factors affecting delayed and non-receipt of healthcare during the COVID-19 pandemic for women in rural Maharashtra, India:Evidence from a cross-sectional study

BACKGROUND: Pathways to low healthcare utilisation under the COVID-19 pandemic are not well understood. This study aims to understand women's concerns about the health system's priorities and their increased burden of domestic responsibilities during COVID-19 as predictors of delayed or non-receipt of needed care for themselves or their children. METHODS: We surveyed married women in rural Maharashtra, India (N = 1021) on their health and economic concerns between Feb 1 and March 26, 2021. This study period was when India emerged from the first wave of the pandemic, which had severely impacted the health systems, and before the second—even more devastating wave had started. We captured if women were concerned about access to non-COVID health services due to healthcare being directed solely to COVID-19) (exposure 1) and whether their domestic responsibilities increased during the pandemic (exposure 2). Our outcomes included women's reports on whether they delayed healthcare seeking (secondary outcome and mediator) and whether they received healthcare for themselves or their children when needed (primary outcome). We conducted adjusted regression models on our predictor variables with each outcome and assessed the mediation effects of delayed healthcare seeking for each of the exposure variables. FINDINGS: We found that women who were concerned that healthcare was directed solely towards COVID-19 were more likely not to receive healthcare when needed (Adjusted Risk Ratio [ARR] = 1.49, 95% CI = 1.14, 1.95). We also found that women whose domestic care burden increased under the pandemic were more likely to delay healthcare seeking (ARR = 1.84, 95% CI = 1.05, 3.21). Delayed healthcare seeking mediated the associations between each of our exposure variables with our outcome variable, non-receipt of needed healthcare. INTERPRETATION: Our findings suggested that women's perceptions of healthcare systems and their domestic labour burdens affected healthcare seeking during the pandemic in India, even before the second wave of COVID-19 incapacitated the health system. Support for women and health systems is needed to ensure healthcare uptake during crises. FUNDING: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA (grant numbers: R01HD084453- 01A1 and RO1HD61115); Department of Biotechnology, Government of India (grant #BT/IN/US/01/BD/2010); the EMERGE project (Bill and Melinda Gates Foundation Grants: OPP1163682 and INV018007; PI Anita Raj), and Bill and Melinda Gates Foundation Grant number INV-002967