Pharmaceutico-Analytical Study of Agnikumara Rasa - A Kupipakwa Kalpana

Agnikumara Rasa is a Sagandha, Sagni, Kantastha Bahirdhuma Kupipakwa Rasayana mentioned in Rasakamadhenu under Sangrahani Chikitsa Adhikara. It is prepared under Kramagni Tapa for 18 hours as per classics. The core ingredients are Shuddha Parada, Shuddha Gandhaka, Shuddha Vatsanabha and Hamsapadi Swarasa. It is indicated in conditions like Sannipata Kasa, Shwasa, Kshaya, Panduroga and Mandagni. Even though a total of 50 formulations have been explained in classics under the name of Agnikumara Rasa, no research work has been done till date on this particular yoga explained in Rasakamadhenu

A critical review on Chardighna Eladi Churna

Eladi Churna is a poly herbal formulation which has wide variety of applications. Most of the pharmaceutical companies are manufacturing with respect to Varnya aspect, while the Chardighna Eladi Churna is sparely available in the market. In the rise of gastro-intestinal issues in the society, a potent formulation like Eladi Churna is expected by the common people to ward off their GIT ailments. There are total 11 Eladi Churna mentioned in Bharatha Bhaishajya Ratnakara. Different Granthas have varied ingredients in this formulation, and their therapeutic efficacies also differ depending upon condition of the patient and disease. Some Yogas even have mineral composition. Chardi is a Vata Pradhana Tridosha Vyadhi in which there will be an act of expulsion of gastric contents through the oral cavity. So, the drugs having properties of Pritvi and Ap Mahabhoota and Karmas like Stambhana, Ama Pachana, Deepana are needed to pacify the Chardi. An attempt is made here to give new insights on the synergic action of phytochemicals in Eladi Churna to revalidate the clinical evidences in the aspect of Chardi

Pharmaceutico-Analytical Study of Soota Taila- An Inimitable Formulation

Ayurveda is one of the oldest systems of medicines, is momentous in audience of worldwide on virtue of its holistic approach of life.Rasashastra and Bhaishajya Kalpana is specialized branch in the field of Ayurveda which deals with pharmaceutical and therapeutic scopes, the nature possesses an immense valuable and powerful medicine in form of metals, minerals and plants.Soota taila is unique preparation mentioned in Rasa Ratna Sammucchaya. This formulation is prepared like that of dhruti preparation, having ingredients like Shuddha Parada, Shuddha Gandhaka, Shuddha Manashila, Shuddha Haratala, Tila taila and Kanjika aid in managing conditions like Kampavata (Parkinson’s disease), Bahukampa, Shirakampa [head tremor], Janghakampa, Ekangavata (hemiplegia) and all the various types of vata vyadhi’s. Physical test shows Loss on Drying at 105°C is 0.01%, Saponification value is 187.95%, Iodine value is 111.67%, Acid value is 2.02%, Peroxide value is 5.15%, Ester value is 185.93, Refractive index at 30°C is 1.451, Specific gravity is 0.9435, Weight (gm) per ml is 0.9373 gm/ml, Viscosity at 30°C is 94.6031 cP, Rancidity test (Kreis test) is Negative, Total aerobic counts is Nil, Total fungal count is Nil. FTIR analysis states: soota taila contains d-lactone, Conjugated anhydride, Tertiary alcohol, Sulfone, Fluro compound, Sulfonamide, Sulfonic acid anhydrous hydride, Ester, Sulfate, Sulfonyl chloride, Fluoro compound, Phenol, 1, 4- disubstituted or 1,2,3,4-tetrasubstituted and 1, 3- disubstituted, Halo compound. This shows the presence of organic compounds in the drugs. HPTLC Shows presence of various functional groups such as HPTLC technique major phytochemical present in the drug or formulation can be estimated. Considering all analytical parameters through the study conducted, one can conclude that Soota Taila may benefit in managing conditions like Kampavata (Parkinson’s disease), Bahukampa, Shirakampa [head tremor], Janghakampa, Ekangavata (hemiplegia) and all the various types of vata vyadhi’s as mentioned in the classics

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Genetic diversity fuels gene discovery for tobacco and alcohol use

Tobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury(1-4). These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries(5). Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.Peer reviewe

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe