An Ayurvedic Management of Kitibha Kushta (Plaque Psoriasis) - A Case study

Skin disease makes a great impact as other serious medical conditions when assessed by effects on health-related quality of life. Skin diseases are ranked as the fourth most common cause of human illness, resulting in an enormous non-fatal burden. According to Global burden of diseases, skin and subcutaneous diseases are increasing at an alarming rate since few decades. Due to altered lifestyle, lack of physical exercise, unhygienic, mental stress, over eating, nutrition deficiency, skin diseases are commonly observed. All the skin diseases in Ayurveda  have been discussed under the broad heading of Kushta which is further divided into Mahakusta and Kshudra Kusta. Kitibha Kusta is included under Kshudra Kusta which simulates with signs and symptoms of Psoriasis. Psoriasis is chronic disorder which is commonly encountered in day today’s clinical practices accounting for wide spared prevalence. As it is relapsing in nature it requires treatment for long duration. In this case study, 41 years old male patient  had come to OPD of Agadatantra with chief complaint of Kandu (itching), dry silvery white patches over both the elbow, blackish discoloration over lower limbs, abdomen and back treated with Shodhana Chikitsa [Body purification] using Virechana Karma and Shamana Chikitsa using Panchatikta Guggulu Ghrta, Bilvadi Gutika, Manjista Choorna as Lepa and Marichadi Taila for application. Thus, this paper highlights a case study of Kitibha Kusta (Plaque Psoriasis) treated with Ayurvedic principles

SHERLOCK and DETECTR CRISPR-CAS systems as better diagnostic tools for COVID-19

SARS-CoV-2, the mighty manslayer, responsible for COVID-19, has currently killed over 1.54 million people worldwide and 141,000 in India alone. It has affected around 67 million people globally and 9.68 million in India. It has quarantined the whole world. Doctors and scientists are working around the clock to save the world from this deadly virus. Since the number of patients is increasing rapidly, it is essential to test as many suspects as possible. But with the diagnostic tests that are being used currently, the polymerase chain reaction, antibody detection (Serological tests), Rapid Diagnostic tests (RDT), antigen tests and Isothermal Amplification assays are time consuming and there is a high chance that the test might come back with the wrong results. SHERLOCK and DETECTR are CRISPR-based diagnostic tool that were recently worked upon and showed very promising results. The test results come back in less than 40 minutes and the tests are far more accurate than all of the current diagnostics which makes them far more efficient than the others. DOI: http://dx.doi.org/10.5281/zenodo.523735

Indoor games to reinforce learning

During this pandemic, when most of our children are not able to attend school and online classes are not the solution to reach a majority of them, indoor games can prove to be an effective means for not just learning but also to build various cognitive and emotional skills

The Value of Immunofluorescence in Renal Diseases with Special Reference to Periodic Acid Schiff and Jone’s Methanamine Silver Stain

BACKGROUND: The evaluation of the understanding of medical diseases of the kidney which dwells predominantly upon Glomerulopathies, is one of the most fascinating stories in the history of Medicine. There is a rising incidence of kidney disease and it is responsible for high rate of morbidity. Glomerulonephritis constitutes nearly 60% of all non-surgical renal diseases and accounts for a substantial number of cases of end stage renal disease. End stage renal disease is one of the reasons for increasing input of patients in hemodialysis units. AIM OF THE STUDY: To analyse the histomorphology, the extent of involvement of GBM using special stains like Periodic acid sciff and Jone’s methanamine silver stains and specific immunofluorescence pattern of the renal diseases to diagnose and categorize them. MATERIALS AND METHODS: The study was done for a period of 20 months between October 2012 and July 2014. A total number of 58 renal biopsies were received from the Department of Nephrology, Coimbatore Medical College and Hospital, Coimbatore. The biopsy was subjected to light microscopic examination and immunofluorescence studies. RESULTS: A total of 58 renal biopsies were analysed in Coimbatore Medical College and Hospital, Coimbatore between October 2012 and July 2014. The most common age group affected was between 31 years to 40 years. Females (51.72%) were slightly more affected than males (48.27%). Out of 58 cases, 46 (79.31%) showed primary glomerular lesions, 10 (17.24%) showed secondary glomerular lesion and 2 (3.45%) showed tubulointerstitial nephritis. Diffuse proliferative glomerulonephritis was the most common primary glomerular lesion with a total of 13 out of 58 cases (22.41%). Lupus nephritis was the most common secondary glomerular lesion with a total of 7 out of 58 cases (12.07%). Jones’s methanamine silver stain along with PAS stain aided in demonstrating the extent of GBM involvement and thereby helped in typing/staging of membranous glomerulopathy and membranoproliferative glomerulonephritis. Immunofluorescence studies showed positivity in 42 patients accounting for 72.41%. The predominant pattern was granular glomerular basement membrane which was noted in 18 patients (31.03%). The diagnostic utility of IF was noted in 4 cases (6.90%) whose diagnoses included IgA nephropathy and C1q nephropathy. The IF studies helped in modification of the final diagnosis in 1 case (1.72%) whose final diagnosis was lupus nephritis class I. CONCLUSION: Immunofluorescence studies have complemented the clinical, histomorphological findings in 53 patients both in primary and secondary glomerular diseases. However, it was even more of diagnostic importance in 5 patients including IgA nephropathy, C1q nephropathy and Lupus nephritis class I where a confident diagnosis could be rendered only because of availability of immunofluorescence studies. Hence, immunofluorescence studies when combined with histomorphologic findings by light microscopy, clinical, biochemical and serological markers can yield a better and precise diagnosis

Learning to adapt

This pandemic has shown that ‘necessity is the basis of all adaptations’ by creating a need for our teachers to build their skills in various areas of Information and Communication Technology (ICT), once alien to them, just so that they can reach their students. To be with their students as a supportive adult, listen to how they are feeling, provide emotional support and, if possible, try to teach something so that children do not get completely disconnected with education is the goal of most of our teachers

Neonatal outcome in randomized controlled trial of low dose oral misoprostol in comparison with intracervical Dinoprostone gel for labour induction

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. To study the neonatal outcome in induction of labour with low dose oral misoprostol compared with intracervical dinoprostone gel and also to assess occurrence of meconium staining liquor.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses. Oxytocin was administered. Fetal outcome was assessed in terms of APGAR score, meconium staining and need for NICU.Results: Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). NICU admissions were seen in 7 neonates in both groups.Conclusions: Low dose oral misoprostol is a safe method of labour induction. APGAR and NICU admission rates were comparable in both groups. Meconium staining was more in misoprostol group compared to dinoprostone group

Randomized control trial of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. Objective of this study was to compare efficacy, safety of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score &lt;6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses.Results: Bishops score improvement after 6,12,18 hours in both the groups was statistically insignificant. Induction delivery interval was11.96±5.88 for misoprostol and 10.95±4.58 in dinoprostone group with P value 0.341 which was statistically insignificant. Need for oxytocin augmentation was less (18%) in misoprostol group as compared to dinoprostone group (44%). Caesarean section rate was slightly higher in misoprostol group (26% vs 24%). Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). Maternal complications were minimal and neonatal outcome was good in both the groups.Conclusions: Compared to dinoprostone; misoprostol is easy to store, cost effective, stable at room temperature, can be easily administered and had better patient compliance and acceptability. It was found to be a better cervical ripening agent with similar maternal and fetal safety profile

DEVELOPMENT OF pH-DEPENDENT CHRONOMODULATED DELIVERY SYSTEMS OF 5-FLUOROURACIL AND OXALIPLATIN TO TREAT COLON CANCER

Objective: To develop two different oral formulations such as 5-fluorouracil (5-FU) tablets and oxaliplatin (OX) microspheres which were further filled into capsules and coated with pH-sensitive polymer (eudragit S-100) for the chronotherapeutic treatment of colon cancer (Fluorouracil: Oxaliplatin regimen) to perform as a substitute for intravenous (IV) route based chronomodulated chemotherapy. Methods: The 5-FU tablet formulation was prepared with alginate and guar gum polymers in varied concentrations using wet granulation technique in two varieties such as granules coated and tablet coated formulations using eudragit RSPO as coating material to achieve controlled drug release. Alongside OX microspheres were formulated using the ionotropic gelation methodology in combination with alginate and chitosan polymers in varying concentrations to accomplish a time-controlled drug release. Prepared formulations were evaluated for pre-compression and post-compression parameters, percentage yield, percentage drug entrapment, Fourier transformed infrared spectroscopy (FT-IR), Differential scanning calorimetry (DSC), Scanning electron microscopy (SEM), In vitro and Ex vivo dissolution studies. Results: Pre-compression and post-compression parameters for 5-FU tablets were satisfied with Indian pharmacopeia specifications. The entrapment efficiency of OX microspheres were increased due to the elevated concentration of polymers up to a certain level as seen in A7M, further greater the concentration of polymer resulted in a decline of entrapment efficiency as seen in A4M and A8M. The optimized formulations A14T and A14M were shown in vitro drug release of 90.36 % by 24 h and 79.63 % by 9 h respectively. Conclusion: The two different oral formulations of 5-FU (Tablets) and OX (Microspheres) were found to be successful in controlled drug release. Therefore they can be efficiently used to control the rate of drug release to the colon in synchronization with the circadian timing system in the belief of improved therapeutic efficacy, tolerability and overall survival rate of cancer patients. Hence it is promised to be a better alternative for intravenous route based chronomodulated chemotherapy

Children Activity Alert System Using Accelerometer and GSM Technology

In this paper the discussion is about monitoring a child. Most of the children’s takes there first step sometime between 9 and 12 months and are walking well by the time ,when they are 14 or 16 months old and they will be in danger, during this age as they start walking. Hence we place a Accelerometer and RFID on the body of child to secure child from accidents such as falling or any injuries at home .The Accelerometer and RFID placed on hands and waist of baby which gives every movements of child. Temperature sensor is used to check the home temperature for safety of child