Myelomatous pleural effusion as an initial presenting sign in a case of multiple myeloma

Multiple Myeloma (MM) is a neoplastic disease which mainly affects bone marrow but rarely may infiltrate extramedullary tissues as well. Myelomatous pleural effusions (MPE) develop due to extension of plasmacytoid cell lesions of thoracic bones into pleural tissue and directly presenting as an initial sign in a case of MM is exceedingly rare. It indicates poor prognosis, resistance to treatment and more chance of relapse in spite of aggressive chemo-radiotherapy. The effusions of serous cavities in MM generally develop as a late complication of the disease like heart failure, renal failure, pneumonia and amyloidosis. We are reporting a rare case of IgG subtype myelomatous pleural effusion demonstrating abundance of plasmacytoid cells in pleural fluid. Bone marrow smear examination favoured the diagnosis of multiple myeloma with the presence of predominant population of plasma cells with high cellularity. There were also presence of a heterogenous myelomatous mass lesion in the right infratemporal fossae, multiple erosive lesions in ribs, vertebral bodies, skull and pelvic bones. Pleural fluid and serum protein electrophoresis demonstrated the presence of gamma monoclonal protein peaks confirming the diagnosis

Role of Manas Bhavas in Grahani Roga (Irritable Bowel Syndrome)

Grahani Roga is the prime disease of gastro-intestinal tract and seen often in day-today practice. In our classics Grahani is described as an Agni Adhishthana. Any disturbance in the status of Agni leads to Grahani Roga. The rapid increase in the prevalence of Grahani is a matter of great concern now days. It is a result of sedentary life style, bad dietary habits, stress and also due to the altered environmental conditions. Ayurveda described the individuality of Mana and Shareera and their inseparable and interdependent relation in the body. Grahani Roga is a predominant Pitta-Vata Dosha and the Manasika Bhavas can be easily be disturbed by Vata and Pitta Dosha. IBS can be considered as Agnimandyajanya Vikara. The functional dependency between normal Vata Dosha and Agni is altered in IBS. The role of Dhatus and concerned Srotas i.e., Purishavaha Srotas is also considerable. Purishavaha Srotas does majority of function with the help of Apana Vayu. So, the Dusti lies at Apana Vayu & Samana Vayu level. The Mansik Bhavas which hamper Agni and Rasavahasrotas, are the main causative factor of IBS

Protein landmarks for diversity assessment in wheat genotypes

Grain proteins from 20 Indian wheat genotypes were evaluated for diversity assessment based seed storage protein profiling on sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE). Genetic diversity was evaluated using Nei’s index, Shannon index and Unweighted pair group method with arithmetic mean (UPGMA) cluster analysis by constructing dendrogram of fractions of proteins, which were used for the calculation of similarity coefficients between these varieties. Diversity analysis attributes exhibited the importance of seed storage as a marker system. The similarity ranged from 32.14% to as high as 100% between genotypes. Adoption of this technology would be useful to plant protection regulatory systems, especially for plant variety identification and registration of new plant varieties, breeding programs and protection purposes.Keywords: Sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE), genetic diversity, population diversity index, coefficient of similarity.African Journal of Biotechnology Vol. 12(29), pp. 4640-464

The physiological study of Twak Upadhatu w.s.r. to Skin

In Samhitas Twak/Twacha is described as outermost protective layer of body as well as largest sensory organ of body. According to Acharya Charaka, Twacha is the Mula of Mansavaha Srotas and Updhatu of Mansadhatu. Acharya Sushrut and Acharya Charak very minutely described its layers according to their functions and also diseases which are related to those layers. Modern health science described skin in detail according to division of cell. Skin, the largest organ of human body, holds significant importance in maintaining normal human physiological condition. The conceptual aspect of skin needs to be understood because skin disorder is outer exhibition of some kind of internal pathology. The ancient science of Ayurveda has noted its features ages back. Ayurveda, the “Science of Life”, is a real wealth of medical sciences. In Ayurvedic oldest text Sushruta Samhita- Shareer sthana, Acharya Sushruta has mentioned five sensory organs i.e. Gyanendriyas. Sparshanendriya is one of them whose Adhishthana is Twacha (skin). As we know, skin is the largest sense organ of the body which sense touch, pain, pressure, temperature etc. It is also known as “The First Line of Defense”. Ayurveda is real wealth of medical sciences which gives preference to prevention of health in healthy person and provides best treatment to diseased one. It believes in complete elimination of root cause of disorder rather than short-term relief. Skin is the largest and first site visible organ of body which acquires 1.5-2 square meter surface area of the body. It is not merely protecting covering but it is reflection of the internal system of the body

The physiological study of Prakopavastha of Shatkriyakala w.s.r. to Seasons (Ritu’s)

The Prayojana of Ayurveda is of two types, maintenance of health a healthy person, by adopting the Ritucharya, Dincharya and Sadvritta and curing of a disease of diseased Person, by adopting therapeutic measures. Kriya means Action or treatment. Kala means time or period. Shatkriyakala means ‘Appropriate time periods to take action/treatment. Acharya Susrutha has narrated detail idea of Shatkriyakala in 21st chapter of Sutrasthana. Shatkriyakala include six stages viz. Sanchaya, Prakopa, Prasara, Sthansamshraya, Vyaktavastha and Bhedavastha. Shatkriyakala is distinctive concept of Ayurveda. By knowing the process of Shatkriyakala the disease process can be arrest at initial stage and avoid the probabilities of complications. Acharya Sushruta already mentions the Kriyakala helps the physician to adopt line of treatment by seeing the vitiated Dosha condition by his intellect and knowledge. So, we can say that the physician who diagnose a disease and treat according to Shatkriyakala will be become a successful Practitioner

Importance of Ghranendriya as explained in Ayurveda with reference to Olfaction

Indriya word is derived from word “Indra” means Prana. Indriya are organ in the body which exhibit the sign of life or vitality. The Panch Gyanendriya is the Sadhan for the perception of Bahygagyana. Each sense is dominated by the 5 different elements according to Ayurveda; earth, water, fire, air and sky. All elements are present in each sensory experience. Indriya is a function that connect the individual with the outside the world, which is the strength of the body. And the power of the senses. The feeling by which the inner ‘I’ gets knowledge about the world around. The nose is considered the doorway to the brain, according to Ayurveda. So, the cleansing and caring for the nose increase the flow of Prana and increases energy to the head and brain

SCIENTIFIC STUDY ON RAKTA DHATU AND ITS RELATED DISORDER AND EFFECT OF VARNYA MAHAKASHAYA GHANVATI AND CHANDRA PRABHA LEPA IN THE MANAGEMENT OF YUVAN PIDIKA (ACNE VULGARIS)

Due to increased competition of earning prosperity in today era human adopted not only lifestyle but also food habits of western culture which is chiefly responsible to derangement in their physiology and responsible to number of skin disorder like Yuvan pidika (acne vulgaris). In Ayurveda vitiation of Vata, Kapha and Rakta are etiological factor that give rise to Yuvan pidika. That is why there is a need of such treatment that contains Vata kapha shamaka and Raktasodhaka property. For this Varnya Mahakashaya Ghanvati and Chandra Prabha lepa were selected for the study on 30 registered patients. Both of these were formulated compound. Varnya Mahakashaya Ghanvati was advocated to patient in a dose of 800 mg twice daily for 60 days while Chandra Prabha lepa was locally applied by making paste with Gulab jala. This study shows highly significant result to ameliorate the symptom of Yuvan pidika especially on Vata dosha pidika as well as Kapha dosha pidika. Both these drugs proved their efficacy to manage Yuvan pidika by making homeostasis of Vata, Kapha and Rakta

Metastatic Signet-Ring Cell Gastric Carcinoma Masquerading as Breast Primary

Metastasis to the breast from an extra-mammary primary is a rare phenomenon; metastasis from gastric carcinoma to the breast is extremely so. We report a case who initially presented as mucin-secreting and signet-ring cell tumor of the ovary, and after an interval of 8 months with breast and chest wall metastatic nodules. The covert gastric primary eluded the oncologists at both presentations

Tumor-induced osteomalacia: experience from three tertiary care centers in India

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by recalcitrant hypophosphatemia. Reports from the Indian subcontinent are scarce, with most being single center experiences involving few patients. Herein, we conducted a retrospective analysis of 30 patients of TIO diagnosed at three tertiary care hospitals in India. Patients with persistent hypophosphatemia (despite correction of hypovitaminosis D), normocalcemia, elevated alkaline phosphatase, low TmP/GFR and elevated or ‘inappropriately normal’ FGF23 levels were labeled as having TIO. They were sequentially subjected to functional followed by anatomical imaging. Patients with a well-localized tumor underwent excision; others were put on phosphorous and calcitriol supplementation. The mean age at presentation was 39.6 years with female:male ratio of 3:2. Bone pain (83.3%) and proximal myopathy (70%) were the chief complaints; 40% of cases had fractures. The mean delay in diagnosis was 3.8 years. Tumors were clinically detectable in four patients (13.3%). The mean serum phosphate was 0.50 mmol/L with a median serum FGF23 level of 518 RU/mL. Somatostatin receptor-based scintigraphy was found to be superior to FDG-PET in tumor localization. Lower extremities were the most common site of the tumor (72%). Tumor size was positively correlated with serum FGF23 levels. Twenty-two patients underwent tumor resection and 16 of them had phosphaturic mesenchymal tumors. Surgical excision led to cure in 72.7% of patients whereas disease persistence and disease recurrence were seen in 18.2% and 9.1% of cases, respectively. At the last follow-up, serum phosphate in the surgically treated group was significantly higher than in the medically managed group

The COVID‐19 Pandemic Not Only Poses Challenges, but Also Opens Opportunities for Sustainable Transformation

The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and “brain gain,” and local governments' exercising authorities