Resistance to Gender Identity in Doris Lessing’s The Golden Notebook

Gender identity is defined as social and cultural conception of an individual as a male or a female. This concept is associated with certain gender roles and behaviour in patriarchal societies that want to develop power hierarchy between men and women. Doris Lessing’s The Golden Notebook came into existence as a feminist fiction that bewildered common readers’ mind with its description about free women who were trapped in gender identity like other traditional women of Britain but slowly they resisted their femininity by acquiring social, political and economic equality with men and enjoying divorce and sexual liberty

ASHTVIDHA SHASTRA KARMA WITH SUTURING IN DETAIL

Ayurveda is considered by many scholars to be the oldest healing science. In sanskrit, Ayurveda means the Science of life. Ayurvedic knowledge originated in India more than 5000 years ago and is often called the Mother of healing. Ancient surgical science- Shalya Tantra is one of the vital components of Ayurveda science which involves surgical and para-surgical interventions. The Shalya chikitsa deals with different surgical approaches for the management of various diseases such as Bhagandra, Pilonidal sinus, Arshas etc. Shalya Tantra embraces all processes aiming at the removal of factors responsible for producing pain or misery to the body or mind. Acharya sushruta has mentioned Trividha Karma and Ashtavidha Shastra Karma as versatile approaches for therapeutic purposes. The concept of Ashtavidha karma is a unique contribution of Acharya Sushruta. These eight specific surgical procedures are useful in the management of all the diseases which require surgical intervention. In the present time though modern surgery has developed a lot but the basic procedures used in major conditions remained same. These eight basic surgical procedures mentioned by Sushruta are equally applied even today with required modifications to manage the diseases which require surgery including surgical emergency conditions. This article summarizes role of Ashtvidha Shastra Karma in Shalya karma for the management of various surgical problems

TO STUDY THE EFFICACY OF KANCHNAR GUGGULU AND DASHMOOL MATRA BASTI IN THE MANAGEMENT OF VATASHTHEELA W.S.R TO BENIGN PROSTATIC HYPERPLASIA

Benign prostatic hyperplasia is a common senile disease. It is a non-cancerous [benign] enlargement of the prostate gland, also called as fibromyoadenoma. It is involuntary hyperplasia due to disturbance of the ratio and quantity of circulating androgens and estrogens. As the age advances the serum testosterone levels slowly but significantly decreases, but levels of oestrogenic steroids are not decreased equally. According to this theory the prostate enlarges because of increased oestrogenic effects. It is likely that the secretion of intermediate peptide growth factors plays a part in the development of BPH. Vatashtheela as described in Ayurveda, closely resembles benign prostatic hyperplasia of modern medicine in its signs and symptoms. In the Vatashtheela, Mutravaha Srotodushti and vitiation of Vata and Kapha Doshas are involved. So Vata Kapha pacifying drugs along with Matra Basti considered to be helpful in reducing the size of prostate and enhancing the tonicity of urinary bladder. This study was conducted to find out the potency of Ayurvedic regimen of Kanchnar Gugglu orally and Dashmool Tail Matra Basti for the treatment of Vatashtheela as the Kanchnar Gugglu is having Granthihar property and Dashmool Tail pacifies Vata and having Tridoshghana, Deepana, Anulomana, Shothghana and Shoolghana properties. The drug Kanchnar Gugglu was given to 30 patients of group -1, with the dose of 500mg TDS before meals for 30 days. And Dashmool Tail Matra Basti was given to 30 patients of group – 2, with the dose of 50ml once a day for 15 days

MEDICAL ASPECTS OF ESTERASES: A MINI REVIEW

Nowadays, esterases represent high growth potential in the World Industrial Enzymes Market. The industrial applications of esterases provide an immense contribution to the eco-friendly approaches towards nature as also in the food, textile industries as additives in detergents, agrochemical (herbicides, insecticides) industries, and bioremediation. The current review is focused mainly on different medical aspects of esterases because they find implications in treatment of cancer, cardiovascular diseases and neuropathy. The role of esterase has been observed in the treatment of hereditary angioedema (HAE). The arylesterase (ARE) has been found to show antioxidant activity in plasma cells and its low activity resulted in multiple myelomas accounting for 1% of neoplastic diseases and 13% of hematological malignancies in U. S. A. Lung cancer is one of the most lethal forms of cancers and reports have indicated that tumors of the lung, colon and liver had high esterase expressions and therefore could be exploited for selective drug conversion using an ester prodrug strategy. Human serum paraoxonase (PON1) and arylesterase (ARE) are lipophilic antioxidant enzymes. Hypercholesterolaemia has been found to be associated with reduced PON1 enzyme activities and patients are under increased oxidative stress. Esterases from animal and plant origins have been used as effective drugs and as detection probes for toxic compounds using chiral technology

Objective assessment of handwriting in outpatient prescriptions of a tertiary care hospital

Background: Poor physician handwriting may lead to wrong comprehension and dispensing errors. This study was planned to objectively assess the quality of handwriting of doctors and their readability by physician, pharmacist and patient and to explore the impact of experience and familiarity of pharmacist on prescription readability.Methods: A 100 prescriptions were selected and were given to a pharmacist, a doctor and an educated lay person. They rated the readability of prescriptions on a scale of 1-10 and an average readability score was calculated. Prescriptions with average score 4 or less were subjected to analysis by a pharmacist working at the hospital dispensary (P1) and another pharmacist not working at hospital pharmacy (P2).Results: Average score of pharmacist, physician and lay person was 6.14, 5.2 and 3.14 respectively.  A total of 28 prescriptions, containing 93 medicines, had an average readability score of 4 or less. P1 was not able to comprehend one medicine while P2 could not comprehend 19 medicines out of these 93. The performance of both pharmacists was compared by diagnostic tests (EPI 6.04D). The sensitivity of P2 was 80% (95% CI 70.6-87.7), specificity and positive predictive value were 100, and negative predictive value was 5.3 (0.3-28.1).Conclusions: Familiarity of the pharmacist with the prescribing physicians’ handwriting is an important factor in comprehension of poorly legible prescriptions. This could limit the patients to pharmacists around the prescribers. Implementation of appropriate steps need to be assured to minimize the prescription errors

Case series of pubic bone diastasis causing severe pelvic girdle pain in pregnancy

Pelvic girdle pain (PGP) is a pregnancy discomfort that causes pain and limitation of mobility and functioning in any of the three pelvic joints. The patient usually presents antenatally with persistent suprapubic pain which is exaggerated during moving, walking or climbing stairs. Intrapartum, this could be associated with disruption of sacroiliac joint, hematuria and bladder dysfunction in severe cases. Pelvic X-rays, ultrasound, and magnetic resonance imaging aid in confirmation of diagnosis by measuring the degree of separation of symphysis. Treatment modalities range from conservative management to orthopedic interventions in form of pelvic strapping, open reduction and internal fixation. Postpartum pain often masks clinicians to make the diagnosis of pubic symphysis diastasis. A case series of three cases which were diagnosed and confirmed with ultrasound and managed with orthopedic consultation. till their delivery and in post-partum period till recovery. Although there is still no specific consensus on treatment guideline, management generally of conservative management to surgical in the form of pelvic bracing or strapping. Awareness of this rare condition can help in management of pain and associated disability which improves post-delivery

Correlation of severity of hyperandrogenism with ovarian stroma to area ratio and stromal echogenicity in polycystic ovary syndrome patients

Background: Polycystic ovary syndrome is one of the most common endocrine disorders of reproductive age group. Rotterdam consensus although includes ovarian volume in diagnosis of PCOS but its ovarian stroma area that corresponds histological and thus its clinical features.Methods: A prospective study conducted on 55 PCOS cases and 55 age and weight matched healthy volunteers. Detailed medical, menstrual history and examination for clinical hyperandrogenism and anthropometry was done. Fasting venous blood samples were obtained on day 2 for androgen profiles. All the patients were subjected to pelvic ultrasound and also a 3D ultrasound was done. The S/A (ovarian stroma to area ratio) were obtained by outlining the peripheral profile of the stroma with a caliper and similarly total ovarian area by outlining in the maximum plane section. Stromal echogenicity was assessed semi quantatively.Results: S/A exhibits positive and significant correlation with DHEAS (r = 0.565, p0.05) in cases, whereas stoma echogenicity was increased in 78.2% cases and 20% controls and correlated significantly with DHEAS levels and not H score, probably due to small sample size.Conclusions: S/A bears a positive significant correlation with androgenic parameters studied and can be considered as one of the best predictor of hyperandrogenism. The stroma echogenicity measured semiquantatively can act as a clue for PCOS diagnosis. Their measurement and follow up during course of treatment may show significant role in defining the severity, progression or regression of the disease

Analyzing Wellness in UMMS Students

Background: Burnout in medical school students is an ongoing, growing issue that can be exacerbated in the clinical years, however, there have been challenges addressing individual student needs due to the variance of wellness practices and academic constraints. Objective: To provide longitudinal support to third year medical students (MS3s) at the University of Massachusetts Medical School while identifying sources of stress. Methods: Beginning in May 2020, MS3s were given four opportunities to participate in large group discussions with fourth year medical students (MS4s) to speak openly about current stressors and concerns. In concert, surveys were sent to MS3s to identify primary causes of stress and concern to guide discussions. Results: The August survey had a 97% response rate (165/170 responses) and the December survey had a 56% response rate (96/170 responses). Five main themes were identified as sources of stress: COVID-19, Step 1, No Voice/Feeling Unwanted, Lack of Communication, and Lack of Preparedness/Knowledge. A 6th non-stress related theme, Normalization, was noted in interactions among MS3s and facilitators. These themes continued to be prevalent in responses. In December, students ranked COVID-19 and clerkship grades highest and Step 1 being ranked lower. Conclusions: Check-ins throughout the year allowed MS3s to express their concerns, and have them validated by peers. Continuing supportive sessions and providing spaces for near-peer interactions can help decrease feelings of burnout and isolation among MS3s. Additionally providing medical students with opportunities to engage with self-identified interventions to support wellness while addressing systemic causes of burnout will be beneficial.https://escholarship.umassmed.edu/capstones/1009/thumbnail.jp