Effect of Garbh Sanskar (Yoga) on Maternal and Perinatal Outcome

Aims and Objectives: ‘Garbh’ implies embryo in the womb and ‘Sanskar’ implies instructing thepsyche. The objective of this prospective interventional study was to assess the effects of Garbhsanskar on maternal and fetal outcomes. Material and Methods: A total of 200 antenatal motherswere selected at Aarogya Hospital, Vaishali, Ghaziabad and Chitra Vihar, Delhi, and asked to attendthree sessions of Garbh sanskar for one 1year (Jan 2019 to Jan 2020). Information booklet andstructured questionnaires were provided to assess their performance and feedback during thisperiod. Result: Analysis of maternal and fetal outcome showed that out of 200 females, 20% hadLSCS, 6% had an instrumental vaginal delivery and 74% had a normal vaginal delivery. Only 7%developed some medical complications like PIH, GDM etc. Mean stress score decreased from 38 to12(by 46.4%) while mean anxiety score decreased from 40 to 8(by 64%) after Garbh Sanskar. Only16% of babies were LBW (< 2.5 kg), 88% had Apgar >7 and 6% of neonates required NICUadmission. Conclusion: Garbh Sanskar is highly effective in reducing maternal stress, anxiety,medical co-morbidities and incidence of operative deliveries and gives better neonatal outcomes interms of better growth, birth weight and Apgar, hence its practice must be encourage

Ophthalmology research in the UK’s National Health Service: the structure and performance of the NIHR’s Ophthalmology research portfolio

Purpose- To report on the composition and performance of the portfolio of Ophthalmology research studies in the United Kingdom’s National Institute for Health Research (NIHR) Clinical Research Network (UK CRN). Methods- Ophthalmology studies open to recruitment between 1 April 2010 and 31 March 2018 were classified by: sub-specialty, participant age, gender of Chief Investigator, involvement of genetic investigations, commercial/ non-commercial, interventional/observational design. Frequency distributions for each covariate and temporal variation in recruitment to time and target were analysed. Results- Over 8 years, 137,377 participants were recruited (average of 15,457 participants/year; range: 5485–32,573) with growth by year in proportion of commercial studies and hospital participation in England (76% in 2017/18). Fourteen percent of studies had a genetic component and most studies (82%) included only adults. The majority of studies (41%) enrolled patients with retinal diseases, followed by glaucoma (17%), anterior segment and cataract (13%), and ocular inflammation (6%). Overall, 68% of non-commercial studies and 55% of commercial studies recruited within the anticipated time set by the study and also recruited to or exceeded the target number of participants. Conclusions- High levels of clinical research activity, growth and improved performance have been observed in Ophthalmology in UK over the past 8 years. Some sub-specialties that carry substantial morbidity and a very high burden on NHS services are underrepresented and deserve more patient-centred research. Yet the NIHR and its CRN Ophthalmology National Specialty Group has enabled key steps in achieving the goal of embedding research into every day clinical care

Role of gastric brush cytology in the diagnosis of giardiasis

<b>Background:</b> Giardiasis, common in developing countries, has mostly nonspecific clinical symptoms, resulting in a limited role for preliminary tests. <b> Aims:</b> The present study aims to highlight the utility of endoscopic brush cytology (EBC) in the diagnosis of giardiasis in clinically unsuspected cases. <b> Materials and Methods:</b> Endoscopic brush smears (EBS) are routinely obtained in all patients presenting with gastric symptoms.<b> </b> The present study is a retrospective analysis of EBS, consisting of 12 cases whose smears had revealed trophozoites of <i> Giardia lamblia</i> . Biopsy correlation was available in five cases. <b> Results:</b> The patients ranged in age from 15 to 78 years (mean age: 34.08 years) with a 1:1 sex ratio. Stool examination in all 12 cases yielded negative results for giardiasis. Upper gastrointestinal endoscopy was normal in all these cases. EBS from these cases revealed <i> Giardia</i> trophozoites, which were identified by their typical morphology. <b> Conclusions:</b> Endoscopic brush cytology can be used as a reliable screening tool in the diagnosis of gastro-duodenal giardiasis in clinically unsuspected cases, especially in developing countries where parasitic infections are common

Viscogonioplasty in narrow angle glaucoma:a randomized controlled trial

PURPOSE: To determine the effect of viscogonioplasty and cataract extraction on intraocular pressure in patients with narrow angle glaucoma. METHODS: This was a double-masked randomized controlled trial involving 50 eyes (25 cases and 25 controls) from 38 consecutive patients. All patients underwent phacoemulsification with or without viscogonioplasty. The main outcome measures were intraocular pressure post-treatment and number of glaucoma medications post-treatment. RESULTS: Cases had a greater reduction in intraocular pressure than controls, with a mean intraocular pressure (standard deviation) at 12 months of 13.7 (±2.89) mmHg compared with 16.2 (±3.55) mmHg in controls (P = 0.009). Cases had a greater reduction in mean number of antiglaucoma medications than controls at 12-month review, with 13 of 25 eyes (52%) of cases controlled without any antiglaucoma therapy versus 9 of 25 (36%) of the controls (P = 0.005). CONCLUSIONS: Viscogonioplasty combined with cataract extraction has a significantly greater effect than cataract extraction alone on lowering intraocular pressure in patients with poorly controlled narrow angle glaucoma and should therefore be considered as a treatment option for patients with this condition

Tocolytic plant Tectona grandis Linn. extended study on other systemic effect.

Introduction: Tectona grandis Linn. (T.G) is one of the well-known Indian herbs. In Ayurveda, T.G stem extract has tocolytic effect. Our previous study conformed the tocolytic activity of the T.G stem extract on rat uterine contraction. Conventional tocolytic drugs are known to have cardiovascular, skeletal muscle toxicity. This study is undertaken to observe possible adverse effects of T.G stem extract especially on cardiovascular and musculoskeletal system. Materials and Methods: Wistar rats (Rattus norvegicus) and frogs (Rana tigrina) were used for this study. Animals were divided into six groups. Each group contains six animals. To study the effect on the blood vessels and skeletal muscles, frogs were used and for direct cardiac effects, Wistar rats were used. The results were compared with standard drugs such as sodium nitrate (2%), nifedipine, and magnesium sulfate. Results: After analysis by t-test, it was observed that T.G causes vasodilatation same as that of the sodium nitrate, without causing any cardiac toxicity seen with nifedipine and no neuromuscular blockade as seen with magnesium sulfate. Conclusion: T.G causes uterine tocolytic effect without causing any cardiac toxicity or neuromuscular blockage; however, further human studies are desirable

Diabetic retinopathy and diabetic macular oedema pathways and management: UK Consensus Working Group

The management of diabetic retinopathy (DR) has evolved considerably over the past decade, with the availability of new technologies (diagnostic and therapeutic). As such, the existing Royal College of Ophthalmologists DR Guidelines (2013) are outdated, and to the best of our knowledge are not under revision at present. Furthermore, there are no other UK guidelines covering all available treatments, and there seems to be significant variation around the UK in the management of diabetic macular oedema (DMO). This manuscript provides a summary of reviews the pathogenesis of DR and DMO, including role of vascular endothelial growth factor (VEGF) and non-VEGF cytokines, clinical grading/classification of DMO vis a vis current terminology (of centre-involving [CI-DMO], or non-centre involving [nCI-DMO], systemic risks and their management). The excellent UK DR Screening (DRS) service has continued to evolve and remains world-leading. However, challenges remain, as there are significant variations in equipment used, and reproducible standards of DMO screening nationally. The interphase between DRS and the hospital eye service can only be strengthened with further improvements. The role of modern technology including optical coherence tomography (OCT) and wide-field imaging, and working practices including virtual clinics and their potential in increasing clinic capacity and improving patient experiences and outcomes are discussed. Similarly, potential roles of home monitoring in diabetic eyes in the future are explored. The role of pharmacological (intravitreal injections [IVT] of anti-VEGFs and steroids) and laser therapies are summarised. Generally, IVT anti-VEGF are offered as first line pharmacologic therapy. As requirements of diabetic patients in particular patient groups may vary, including pregnant women, children, and persons with learning difficulties, it is important that DR management is personalised in such particular patient groups. First choice therapy needs to be individualised in these cases and may be intravitreal steroids rather than the standard choice of anti-VEGF agents. Some of these, but not all, are discussed in this document

Anatomical and functional outcomes following switching from aflibercept to ranibizumab in neovascular age-related macular degeneration in Europe: SAFARI study

Background/Aims: Prospective data on switching anti-vascular endothelial growth factors in patients with neovascular age-related macular degeneration (nAMD) who have previously shown no/partial response are limited. This prospective study assessed the effect of switching from aflibercept to ranibizumab on anatomical and functional outcomes in patients with persistent/recurrent disease activity. Methods SAFARI (NCT02161575) was a 6-month, prospective, single-arm study conducted in the UK and Germany. Patients, meeting strict eligibility criteria for one of two subgroups (primary treatment failure or suboptimal treatment response), received 3 monthly intravitreal ranibizumab injections (0.5 mg). Thereafter, ranibizumab was administered pro re nata at monthly visits. The primary endpoint was change from baseline (CfB) to day 90 in central subfield retinal thickness (CSRT). Best-corrected visual acuity (BCVA) and retinal morphology parameters were assessed. Results One hundred patients were enrolled (primary treatment failure, 1;suboptimal treatment response, 99). In the overall population, there was a significant CfB in median CSRT of -30.75 mu m (95% CI -59.50,-20.50;p= 15 letters versus baseline at day 90 and day 180, respectively. However, mean improvements in BCVA (CfB) to each time point were small (<= 2 letters). No new safety signals were identified. Conclusion Switching from aflibercept to ranibizumab led to a significant improvement in CSRT, with similar to 60% experiencing stabilised/improved BCVA. Therefore, patients with nAMD who have shown a suboptimal response to aflibercept may benefit from switching to ranibizumab