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World Journal of Pharmaceutical and Medical Research

ISSN(p):2455-3301 | ISSN(e):2455-3301
Journal Papers (2177) Details
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Indexed Journal

1 THE RELATIONSHIP WITH BRAIN AND FATTY ACIDS , Aysel Sari
Fatty acids, which are the content of fats, have functions in many syntheses in organs in the body, as well as in synthesis in the brain. These functions are not only high energy sources. It has very important roles in the process of health formation, protection and treatment of discomforts depending on the properties of fatty acids. Briefly, adjuvant and neoadjuvant effects are clearly known. The aim is to emphasize its importance in the light of recent studies on the effects of fatty acids on brain and health.
2 THE RELATIONSHIP WITH BRAIN AND FATTY ACIDS , Aysel Sari
Fatty acids, which are the content of fats, have functions in many syntheses in organs in the body, as well as in synthesis in the brain. These functions are not only high energy sources. It has very important roles in the process of health formation, protection and treatment of discomforts depending on the properties of fatty acids. Briefly, adjuvant and neoadjuvant effects are clearly known. The aim is to emphasize its importance in the light of recent studies on the effects of fatty acids on brain and health.
3 MALE GENITAL MUTILATION: ABOUT 3 OBSERVATIONS , Dr. M. Graiouid*, W. Bai, I. Jandou, M. Gallouo, Y. Larache, Doumer, Elafifi, Abdi, M. Dakir, A. Debbagh and R. Aboutaieb
Male genital mutilation is a rare but serious phenomenon that occurs most often on a psychotic ground. It can be the source of major complications. We report three cases of genital mutilation in patients with schizophrenia.
4 HEALTH FACILITY RELATED MATERNAL SATISFACTION WITH DELIVERY SERVICES AT UDUTH SOKOTO , Yakubu Lawali*, Fatima Muhammad, Zulkiflu Musa A., Aliyu Sokoto Sabo, Abdulrahman S. Maru
Childbirth is a crucial experience in women‟s life as it has a substantial psychological, emotional, and physical impact. Assessment of satisfaction with maternity services is essential and helps in future utilization of the services. The objective of the present investigation was to determine the maternal satisfaction towards delivery services at Usmanu Danfodiyo University Teaching Hospital Sokoto. A cross-sectional descriptive study was used. The study was conducted on a sample of 158 postnatal women at UDUTH. The study participants were selected using convenient method of sampling and the data was collected using self-administrated questionnaires. Most of the respondents are within the age range of 30-39 71(49.3%) and most of which are Hausas by tribe 57(39.6%). The finding of the study shows that majority of the women were satisfied with the structure/health facility related factors affecting mothers satisfaction with delivery services at UDUTH Sokoto except for the condition of toilets and showers in the delivery room. In conclusion there is a high level of maternal satisfaction with delivery services in UDUTH Sokoto. The study recommended that, condition of toilets and shower rooms in the delivery room and postnatal ward should be addressed to ensure the satisfaction of maternity clients. Government should make infrastructural improvements to overcome shortages of water and electricity, toilet and shower supplies.
5 DIRECT OBSERVATION AS A METHOD OF ASSESSMENT AND INSTANT FACE TO FACE FEEDBACK FROM GENERATED AND PRINTED COPY OF BASIC LIFE SUPORT (BLS) DEVICES FOR UNDERGRADUATE PHYSIOTHERAPIST STUDENTS OF CARDIFF UNIVERSITY UNITED KINGDOM. , *Ibrahim M., Yalwa, T., Lawali, Y., Ahmad, S. and Tukur B. M.
For ensuring effective teaching and facilitating learning during students-patient interaction, a valid assessment needs to be adopted. Many assessment mechanisms exist to evaluate students‘ knowledge and skills of Nursing/medical students, including two-way mirrors, close-circuit audio-video and observation. Providing students with instant feedback is a key to successful learning. Level one undergraduate students of Cardiff University, United Kingdom were assigned to carryout basic life support (BLS) procedure using manikin whilst the student-teacher employed direct observation method (DOM) as a tool to evaluating students‘ learning competencies. The supervisor monitored the student-teacher who organized the one-hour task to assess the students. Professional driver‘s guidelines of Quality Assurance Agency, Nursing & Midwifery Council and National Institute for health Care Excellence, together with learning theories including constructivist, behaviouristic and humanistic were considered. The assignment is aimed at examining students‘ competencies using one-hour assessment and BLS generated and printed copy of feedback. The assignment was analysed in three phases viz: direct observation, accuracy and effectiveness of the BLS devices and instant feedback stage. The outcome indicated that DOM is a good assessment tool used in evaluating varying degrees of students‘ Knowledge, Attitude, Motor skills, Structure (logical skills), Novice, Advanced Beginner, Competency, proficiency, and expertise at different stage of learning.
6 BIRD’S NEST HAIR [PLICA NEUROPATHICA]: A CASE REPORT , *Dr. Abdullah Mancy, Dr. Lateef Ahmed Abood and Dr. Nusaiba Al- Dalla Ali
Bird’s nest hair is a rare acquired irreversible condition affecting scalp hair. In which the hair matted together forming a hard mass of tangled hair. It usually happens in those individuals with psychiatric disturbances in whom neglecting of hair care, infections and infestations of the scalp are more common. Also, frequent uses of different shampoos, chemicals, herbal oils and hair cosmetics will lead to plica formation. Because it was rarely reported in the literature, we report a young female, 14 years old, affected with plica neuropathica. The possibility of multifactorial aetiologies such as anxiety, neglected hair care, a combination of herbal oils and long hair were shared in the appearance of this case.
7 PRIMARY CARDIAC BURKITT LYMPHOMA PRESENTING AS A RIGHT ATRIAL MASS: CASE REPORT AND REVIEW OF THE LITERATURE. , Amina Samih*, Hanae Bouhdadi, Sabrine Derqaoui, Bernoussi Zakia, Mohammed Laaroussi and Mohammed Cherti
Primary cardiac lymphoma (PCL) is an uncommon and very rare entity, accounting only for 1% of extra nodal lymphoma with heart involvement. Infections and thrombi account for most non tumoral intracardiac masses. Primary tumors of the heart are rare. Some 75% of the tumors are benign, 25% malignant. Because of the low case numbers, there is an insufficient evidence base to determine the optimal treatment, particularly for malignant tumors. Case Summary: We report the case of a young woman who complained of breathlessness. A transthoracic echocardiography revealed a large mobile homogeneous mass in the apical 4 chamber view, which appeared to be arising from the interatrial septum in the right atrium with tricuspid valve stenosis. The mass impaired right ventricular. Urgent surgery for debulking was indicated. Pathology was a burkitt lymphoma (BL). Discussion: BL causing intracardiac mass is rare. The cardiac symptoms are frequently non-specific and can often be overlooked or underappreciated in the presence of the impressive extra-cardiac disease. This observation is interesting to emphasize the role of early diagnosis that improves the prognosis despite a non-specific clinical presentation.
8 BROWN TUMOR OF THE ORBITAL ROOF, ISOLATED MANIFESTATION OF SECONDARY HYPERPARATHYROIDISM: REPORT OF A CASE , *H. Abourazzek, M. Elanigri, K. Mazouz, Z. Essaadi, M. Derfaoui, I. Lalya, A. Elomrani and M. Khouchani
Introduction: Brown tumor is a non-neoplastic lesion, secondary to disturbance in bone metabolism in the context of the primary or secondary hyperparathyroidism. Subject of the Study: We report a clinical case to illustrate the rarity and highlight the clinical, therapeutic and evolutionary characteristics of this condition. Observation: it’s Mr. AE 34 years old, followed in nephrology for chronic renal failure on hemodialysis, consult in ophthalmology for a progressive instalation of exophthalmia without effects on visual acuity. A cranial ct-scan Shows bone mass on the orbital roof, without optic nerve compression. An excisional biopsy of the mass was conducted. Histological examination was in favor of osteoblastic giant cell tumor. Laboratory tests showed hyperparathyroidism. Discussion and Conclusion: brown tumor is a secondary lesion to primary hyperparathyroidism or most often secondary to chronic renal failure. It mostly affects the ratings, pelvis, femur and mandible. Reaching the roof of the orbit is exceptional. A female predominance is noted. Before the non-specic histology, only the association of osteoclastic giant cells hyperparathyroidism can confirm the diagnosis. treatment of hyperparathyroidism alone can lead to the regression of the expansive process.
9 DIAGNOSTIC UTILITY OF XPERT MTB/RIF ASSAY FOR DETECTION OF MYCOBACTERIUM TUBERCULOSIS AMONG SUSPECTED TUBERCULOUS PLEURAL EFFUSION PATIENTS WHILE TAKING AFB CULTURE AS GOLD STANDARD , Nadeem Sharif*, Gull-e-Rana Khan, Mahmood Ahmad, Muhammad Ahmad Nawaz Ghouri, Abid Ali, Mirza Zaheer Ud Din Babar Baig and Maham Nasrullah
Background and aim of study: Tuberculosis is deadliest communicable disease which infects populations globally and it is most common cause of pleural effusions. The aim of the study is to find diagnostic utility of Gene Xpert among suspected tuberculous pleural effusion patients. Materials: This study was conducted from January 2018 to October, 2019 in Tertiary Care Hospital of Lahore, Pakistan. 200 pleural fluid specimens were processed for AFB smear microscopy (ZN and Auramine stain), AFB cultures (LJ and MGIT), Xpert MTB/RIF assay and Drug Susceptibility Testing. Results: Among 200 pleural effusion patients, 3(1.5%) were positive on AFB smear microscopy, 61(30.5%) were positive on AFB cultures and 17(8.5%) were positive on Gene Xpert. Sensitivity of Gene Xpert and AFB smear was 5% and 20% respectively against AFB culture. 51/200 were positive on liquid culture while 61/200 were positive on solid culture. Contamination rate of liquid culture was more as compared to solid culture. DST was performed on culture positive specimens which was compared with Gene Xpert rifampicin resistance results. Conclusion: Due to pucibacilary nature of pleural effusion specimens, conventional methods like AFB smear and culture have low sensitivity. Gene Xpert can be useful for MDR tuberculosis cases for early, accurate diagnosis and it guide for proper treatment. Both conventional and rapid diagnostic modalities should be performed for best isolation of Mycobacterium tuberculosis.
10 REFLECTIVE AND EVIDENCE-BASED NURSING PRACTICE: TOOLS TO FACILITATING LEARNING AND TEACHING DURING TEACHING A BONE FRACTURE , *Ibrahim M., Yalwa, T., Ahmad, S., Shehu, A. and Anyebe E. E.
Nursing profession has been facing barriers and challenges to learning and teaching particularly in the field of nursing practice and education. To facilitate teaching and learning, nurse-tutors hold the responsibility of providing current educational innovations in order to meet up with professional standard and competencies of feature nurses. Although, several approaches to facilitating learning and teaching exist, but incorporating reflective and evidence-based nursing practice in teaching process is till limited. The study is aimed to facilitate teaching and learning by exposing the student-teacher to in-corporate reflective and evidence-based practice during planning, delivery and evaluation of one-hour teaching session on bone fracture. Demonstration and discussion methods have been used whilst exploring evidence based and comprehensive reflection during planning and delivery of teaching of 30 undergraduate students‟ nurses. Lesson plan has been used to guide the planning, delivery and evaluation of the teaching. The study is underpinned with professional guidelines, policies, learning theories (cognitive, behavioural, constructivist and humanistic), inter-professional issues, systematic search and literatures. The strengths and weaknesses of learning theories, large and small group teaching, teaching plan, methods and strategies as well as other factors facilitating learning and teaching have been explored. Result shows that a cognitive learning theory is a powerful tool to facilitating learning and teaching as deep learning rather than surface learning occurs. In essence, during deep learning, students retained what they have learned into their cognitive structures and apply them later in their daily practices. That justifies why other learning theories contrary to cognitive theories were not emphasized due to their weaknesses.
11 PREVALENCE AND RISK FACTORS OF ACUTE RENAL FAILURE AFTER CARDIAC SURGERY , O. El Allam, Y. El Allam, C. El Kettani, H. Barrou, K. Flayou*, K. Siwane, S. Lyazidi, Y. Ettaoumi
Postoperative renal dysfunction is a serious complication of cardiac Surgery under cardiopulmonary bypass. Even a minor change in serum creatinine are related to an increase morbidity and mortality. A prospective observational study was conducted over a period of eight months from September 2011 to April 2012 including 66 patients. The analysis of the results according to the Software Epi Info 6 allowed to define the main risk factors and outcome of kidney failure. Studies have shown that postoperative renal function deterioration in cardiovascular surgery patients increases in-hospital mortality and adversely affects long-term survival. However, our results do not support the other studies resuming the risk factors of acute renal failure in cardiac surgery because of limited sample based on.
12 LIFESTYLE DISORDERS AND ITS IMPACT ON MAHASHROTAS: A CRITICAL STUDY , Vd. Vaishali Devidas Khadsang* and Dr. Krishna N. Kadam
Background: Lifestyle disorders are the disorders or disease linked with the way people live their life. This is commonly caused by alcohol, drug and smoking abuse as well as lack of physical activity and unhealthy diet. Diseases that impact on our lifestyle are heart disease, obesity, type II diabetes, thyroid diseases etc. The concept of mahashrotas described by charka can be corelate with entire gastrointestinal tract of body .so, functionally the process of digestion is also depend on this. Lifestyle disorders are metabolic diseases in which normal metabolism of body disturbed. According to Ayurveda If Agni (Digestive metabolic activity) is disturbed (Vishma Agni) whatever is eaten is not properly metabolized. This process ultimately leads to lifestyle disorders. Lifestyle disorders Diabetes type II, Obesity, Hypothyroidism, Heart diseases and its impact on mahashrotas will be discuss in present paper.
13 CONCEPT OF EMOTIONAL INTELLIGENCE AND ITS ROLE IN MENTAL HEALTH WITH SPECIAL REFERENCE TO PRAKRITI , *Dr. Shilpa Kantilal Ingle and Dr. Sampada S. Sant
The concept of Prakriti is one of the speciality in Ayurveda. Constitution or configuration is an individual's peculiar set up of body and mind. Every human being is unique in size, shape, physical, psychological, spiritual aspect and is borne with definite genetic constitution determined by Vata, Pitta and Kapha Dosha. Satva, Raja, Tama gunas and its balance is also essential for normal life. Manas Prakriti also has great significance as that of Deha Prakriti. It is a major tool of Physician for the diagnosis and treatment as well as to suggest proper lifestyle. It is also of importance in etiopathogenesis, prognosis and treatment procedures of various ailments. According to one of the pioneer of emotional intelligence –Daniel Goleman, “Emotional Intelligence is the ability to sense, understand, value and effectively apply the power of emotions as a source of human energy, information, trust, creativity and influence” For Personality Development Manas Prakriti is crucial. With the help of this knowledge one can achieve five components of Emotional intelligence - Self-awareness, Self-Regulation, Motivation, Empathy and Social skills. Higher emotional intelligence improves physical, mental, social and spiritual well-being. Emotional Intelligence improvement is necessary to gain health, success and to remain always calm and happy in many areas of life such as Physical Health, Mental Well-being, Relationships Conflict Resolution Success, for therapeutic purpose as well to become mental health Counsellor.
14 ROLE OF RASAYANA CHIKITSA IN THE PREVENTION OF DISEASE AND MAINTENANCE OF HEALTH , Dr. Pooja Sharma*, Dr. Anupam Pathak, Dr. Yogesh and Dr. Anshu Sharma
Ayurveda is a comprehensive medical system of body, mind and spirit. It is a science and art of appropriate living, which helps to achieve better long life. It also guided about the prevention of disease and maintenance of health. Ayurveda is also frequently referred as 'Ashtanga Ayurveda' and Rasayana chikitsa are the part of the it (Ashtanga Ayurveda). It helps a person to maintain good health or to establish impaired or lost physical or mental health. Rasayana therapies are said to revitalize all the seven Dhatus (body elements), therefore, restores equilibrium and health.
15 ROLE OF MAHISHA KSHEERA PAAN IN ANIDRA , Dr. Pooja Sharma*, Dr. AnupamPathak, Dr. Yogesh, Dr. Punam Kumari and Dr. Anshu Sharma
Ayurveda is an ancient science of life, which nearly related to life style. In this way if we do not obey life style, so many problems may develop in human body. Nidra concern as an another term sleep. Sleep is very important phenomenon in an organism and also accepted by modern science because of its restorative function and importance for conservation of energy and growth, so good sleep is best indicator of good health. It affects adversely, if properly not taken by any one and leads to sleep disorders and it is most common complaint in present era. Management of Anidra is been dealt in the form of diet routine i.e., Mahisha Ksheera Paan, medicament and proper life style.
16 ROLE OF AYURVEDA IN PREVENTION OF LIFESTYLE DISEASES , Dr. Anima Kumara*, Dr. Pratibha, Dr. Yogesh and Dr. Anupam Pathak
Ayurveda is the science of life, guiding in maintaining health and curing of diseases by balancing Doshas-Dhatus-Malas and Jatharagni. Ahara, Nidra and Brahmacharya form the pillars of health as per Ayurveda. Lifestyle diseases are those diseases whose occurrence is based on the daily habits of people and are a result of an inappropriate relationship of people with their environment. The main factors contributing to lifestyle diseases include bad food habits, physical inactivity and disturbed biological clock. Occupational lifestyle diseases include those caused by the factors present in the vicinity of pollutants. These factors are also responsible for environmental allergies. So, a healthy lifestyle must be adopted with a proper balanced diet, physical activity and by giving due respect to biological clock. Healthy lifestyle methods are now easily achievable with nutritional counselling, exercise training, deaddiction programmes, regular medical checkups and stress management techniques. Ayurveda provides better solution in the guidelines of proper dietary management, lifestyle advises, Panchakarma procedures like detoxification and bio purification procedures, medicaments and rejuvenation therapies. In this revolutionized era, we cannot stop doing the developmental work, but we can certainly reduce our ailments with simple and effective measures in our lives as suggested in Ayurveda, the science of life.
17 AMLAPITTA W.S.R. TO HYPERACIDITY: A CLASSICAL REVIEW , *Vd. Ganesh Keshaorao Kale and Vd. Vijay R. Potdar
In this modernized and fast life each person is busy and living stressful life. People are unaware to take healthy food and most of them are attracted towards the junk foods and also changing their diet pattern. Amlapitta is a result of inappropriate dietary regimen or stress. Amlapitta is one of the commonest diseases, of annavahasrotas (Gastrointestinal tract) caused by vitiated agni (appetite). Amlapitta is a condition where amlaguna (Sour Taste) of pachak pitta (gastric Juice) increases due to Samata. Amlapitta has been considered as pitta a Trikaphapradhandoshaja Vyadhi (compound disease caused by multiple factors). Aacharya Kashyapa has mentioned as the involvement of three Doshas in Amlapitta while Madhavkara has mentioned that the pitta is dominant in this disease. Aacharya Charaka has not mentioned Amlapitta as a separate disease but as a symptom. The signs and symptoms of Amlapitta are very similar to gastritis or Hyperacidity. According to conventional medical science the most common causes of gastritis are H. pylori infections and prolonged use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS).
18 NIDRA AND NIDRANASHA: A REVIEW ARTICLE , Dr. Khushboo Bishnoi* and Dr. Anupam Pathak
Ayurveda describes the main three pillars of life amongst that Nidra is said to be the very important tripod of life. Nidra is very important regimen of day to day life if not taken properly can cause severe diseased condition, which will affect the physical and mental health as well. Lack of Nidra due to various doshik conditions is called as Nidranasha. In ancient science the detailed study of Nidra and Nidranasha along with the different treatments is given in Samhitas According to modern scientific view, loss of sleep has m any reasons as like illness, stress, elder age, pain, mental illness etc. Ayurveda prescribes several procedures to overcome the situation. Article provides through review of causes, consequences and management of Nidranasha with the perspective of Ayurveda. In this study the attempt of critical review study of Nidra and Nidranasha is done.
19 IMPORTANCE OF SADVRUTTA IN DAILY LIFE: A REVIEW ARTICLE , Dr. Khushboo Bishnoi* and Dr. Anupam Pathak
Rapid economic development and increasing westernization of lifestyle in past few decades, prevalence of Lifestyle Disorders such as Hypertension, DM, Arthritis, Obesity associated with Cardiovascular disorders, PCOD, Cancer etc. have risen alarmingly in recent years due to Stress, Sedentary lifestyle etc. Ayurveda is a life science which describes ways to prevent Lifestyle disorders in the form of proper dietary management, lifestyle advices etc. In cases where already diseases have a taken place various medicinal treatment & Panchakarma are advised in Ayurveda. Ayurveda has explained importance of Sadvrittacharana by following Dinacharya & Rutu-charya which helps in prevention of any kind of diseases which may take place in future Main reason behind any disease in Mithya, Hina or Atiyoga of Kaala, Artha & Karma. Also not following basic rules of Dinacharya, Rutucharya, Vega dharana leads to vishama of Doshas which ultimately results in Roga/Disease. In Brihattarayi, each stage of Dinacharya (Daily regime), their uses etc. Rutucharya i.e rules to be followed according to Rutu (Seasonal regime), Do’s & Don’ts for each Season has been specifically mentioned; also Panchakarma & Rasayana chikitsa for specific disease has been explained.
20 A STUDY ON THE EFFECT OF HEALTHY LIVING IN MODERN ERA: A REVIEW ARTICLE , Dr. Khushboo Bishnoi* and Dr. Anupam Pathak
Health includes one‟s reserve of physical strength and stamina as well as mental steadiness to meet the requirements of the daily life. Only healthy individual of sound body and mind can endure social and cultural pressures. Health not only means freedom from the disease, but the ability to work with the satisfaction and self control. Health is the best root factor in achieving Dharma (attain pious acts), Artha (wealth), Kama (desire) and Moksha (salvation). Lifestyle change, more than any other factor, is considered to be the best way of preventing the disease and early death in our society. When people in western society die before the age of 65, it is considered to be early or premature death. Many factors contribute to early death. The major causes of early death have changed from infectious disease to chronic lifestyle related conditions. The most important is unhealthy lifestyles that contribute to more than half of all early deaths. One who wants to keep fit himself for whole of his life time should also be fit for every day. Health depends on how one spends day. The ideal life style for a day is called as daily regimen (Dinacharya). Daily regimen explains the various duties from one day to the next day.
21 CLASSICAL REVIEW OF PARADA AJEERNA I.E MERCURY TOXICITY , Dr. Ravindra Angadi and Dr. Sangeeta Rao*
Ayurveda has used mineral and herbomineral substances in therapeutics since time immemorial. But with the recent questions raised regarding the safety of these formulations for containing considerable levels of heavy metals like lead, mercury &/ or arsenic etc,there is a need to scientifically evaluate & establish the safety of such preparations. A drug can be a nectar or poison. Classics of Ayurveda do mention the hazards of drugs which are not properly manufactured. Such mentions clearly show that they were fully aware of the hazards of these heavy metals. This article highlights the various methods told to be adopted to prevent any untoward complications and even if in any eventuality, side effects are noticed, the treatments have been mentioned.
22 CONCEPT OF AGNI AND ITS CLINICAL IMPORTANCE , Rahul Panditrao Surnar*, Avinash Deshmukh and Deepali Amle
Ayurveda is the ancient Indian system of life sciences and Medicine, its historicity going back to the Vedas. Ayurveda has described an important factor of digestion and metabolism in our body as Agni. Agni is responsible for strength, health, longevity; vital breath and it determines the quantity of food to be consumed. Ingested food is to be digested, absorbed and assimilated, which is unavoidable for the maintenance of life, and is performed by Agni in Ayurveda. the term “Agni” is used in the sense of digestion of food and metabolic products. According to the functions and sites of action, Agni has been divided into 13 types, i.e. 1 Jatharagni, 5 Bhutagni and 7 Dhatvagni. About the importance of Agni, Acharya charak has mentioned that after stoppage of the function of Agni, the individual dies, and when the Agni of an individual is sama, then that person would be absolutely healthy and would lead a long, happy, healthy life. But, if the Agni of a person is vitiated, the whole metabolism in his body would be disturbed, resulting in ill health and disease. Hence, Agni is said to be the base (mool) of life.
23 IMPORTANCE OF ABHYANGA IN TODAY’S STRESS FULL LIFE: A REVIEW ARTICLE , Dr. Reena*, Dr. Yogesh, Dr. Sunayana Sharma and Dr. Anupam Pathak
Ayurvedic system of medicine approaches in a particular way to prevent and promote a healthy life by following certain methods and therapies in day today activities (dinacharya) which could be considered as a part of a health promotion among the fast moving people of this 21st century. Abhyanga (oil massage) which is one among the dinacharyas, is an ancient Indian approach adopted for healing, relaxation and treating various diseases. It is one of the most important day today activities of life, as how early to bed and early to rise, then brushing of tooth etc. are important. In Ayurveda it is clearly mentioned that the abhyanga controls vata dosha and the person develops strength both physically and mentally. Here an attempt has been made to compile the importance and role of abhyanga in day today life which reduces the stress and keeps the society healthy.
24 IMPORTANCE OF LIFESTYLE MODIFICATION IN DIABETES MELLITUS W.S.R. PRAMEHA: A REVIEW ARTICLE , Dr. Reena*, Dr. Yogesh, Dr. Sunayana Sharma and Dr. Anupam Pathak
Diabetes mellitus (DM) is a progressive chronic metabolic disorder characterized by hyperglycemia associated with long-term micro vascular complications like retinopathy, nephropathy, neuropathy and macro vascular (cardiovascular) complications. Pharmacological interventions i.e. medicines are not always necessary to control diabetes, but emphasis should also be given to non-pharmacological management. Prameha explained in Ayurveda texts bears resemblance to Diabetes. There is detailed explanation in ayurveda texts regarding dietary modification and physical activities for prevention and management of Prameha. This article is compiled with an aim to commemorate various references of lifestyle modification in Ayurveda texts and researches supporting them. Principles of Dinacharya, Aahara, Vihara, Sadvritta, Rasayana when applied in daily routine plays major role in prevention as well as better management of Diabetes.
25 AYURVEDA - STILL MISSING , Dr. Maheshkumar Nilkanth Chaudhari*
Now a days, Ayurveda has most demandable science across the world. The peoples from the abroad are eager to know, what is Ayurveda? Most of the Govt. institutes, Ministry, as well as private NGO introduce / limited Ayurveda only upto herbal medicine. But herbal medicine are one of the part of Ayurveda. Except herbal medicine, there are lot of other ways of living the happy life (Sukhayu). Ayurveda contains Dincharya, Ratricharya, Rutucharya, Pathya-pathya, Mantra-Chikitsa, Age wise, diseasewise suitable rules for the patients that‟s why Ayurveda not only the pathy but also life science. In this article, I explained about the other part which are still missing or we are uses on daily basis but we don‟t know scientific backround behind that like Tandul sevan, Snan, etc. Daily drinking of warm water in winter & rainy season is good for health, quantity of daily drinking water, etc. for this there are a rules in Ayurveda . This is very general statement but very useful for health. We the Vaidyas should literate the other people regarding this. In general, people also understand that Ayurveda means only jadi-buti & nothing else. Actually 75% of Ayurveda science also unknown to the people & Govt. of India too. It‟s our moral duty to propagate proper & real Ayurveda infront of the world. Everyone should avoid malpractice. We have a great science like Ayurveda & we should use that for the welfare of the society. IInd myths regarding Ayurveda that it‟s has late result but that is not so. We Vaidyas should clear this points among the general public. Here, I quoting some points regarding the topic of missing parts of Ayurveda will be helpful for raising the Ayurveda strength & Ayurveda lover.
26 WATERHOUSE – FRIDERICHSEN SYNDROME , T. Merlin Shiba*
There is an increasing number of cases of the waterhouse – Friderichsen syndrome in the literature in recent years, probably due to its more accurate recognition and to the increased incidence of meningococcic infections during the past two years. The condition is believed to be the result of fulminating meningococcemia and shock, and the pathologic findings can be explained on the toxic results of the organisms. Present usage of the term, waterhouse – Friderichsen syndrome, should be confined to those cases exhibiting the fairly typical clinical course as described, and undoubtedly to those patients whose symptomology was confirmed by autopsy. Care should be taken in the early recognition and differentiation of waterhouse – Friderichsen syndrome from acute meningococcemia. The present outline of treatment centers on control of the bacteremia and measures aimed to combat shock, with secondary symptomatic and supportive treatment.
27 GENERAL PERSPECTIVE ON STREE ROGAS; PATHOLOGICAL FACTORS AND AYURVEDA CHIKITSA , Dr. Neeta N. Harale*, Dr. Ujwala Murlidhar Katole, Dr. Dayanand Dattatraya Ovar and Dr. Deepak Yashwantrao Dhoke
The traditional Indian system of health management Ayurveda considered health of woman as prime focus of society. It is believed that at different age of life cycle a female has to face many health events mainly due to the puberty and menopause. The menstrual cycle, hormonal changes and diversified physical stress including sexual activities affects health of genital organs/reproductive system of female therefore prevalence of such types of disorders are very common in women. Gynaecological disorders seeking attentions of medical practitioner towards the finding of new approaches for the management of such types of health issues. Ayurveda also described Gynaecological disorders and their management, present article dealt with some ayurveda perspective of Gynaecological disorders.
28 DISEASES RELATED TO DISTURBANCES OF MENSTRUAL CYCLE; AN AYURVEDA PERSPECTIVE , Dr. Ujwala Murlidhar Katole*, Dr. Neeta N Harale, Dr. Deepak Yashwantrao Dhoke and Dr. Dayanand Dattatraya Ovar
Menstrual abnormalities are very common pathological problems in women of puberty age and current scenario of imbalanced life pattern enhances incidences of such diseases. Delay or absences of menstrual bleeding, painful discharge, cramping and profuse bleeding, etc. are some clinical presentation of menstrual abnormalities. Aggravation of Vata Dosha and Rakta Dhatu along with disturbed functioning of channels can affect menstrual blood flow. Ayurveda mentioned various treatment modalities for the management of menstrual problems including herbs, massage, Yoga and detoxifications measures. The high prevalence of such types of disorders needs special attentions from medical fraternity so that the back bone of society; women protected from undesired health events. Therefore present article explore ayurveda perspective on menstrual disorders.
29 CONSIDERATION OF STREE ROGA AS PER AYURVEDA W.S.R. TO GENITAL PROLAPSES: A REVIEW , Dr. Neeta N. Harale*, Dr. Deepak Yashwantrao Dhoke
Ayurveda the Indian classical science of well being focuses to maintain health of mankind and it encompasses several aspects related to female disorders and their management. The practice based logical reasoning help to establishes basic principles and therapies of ayurveda which not only provides support towards the management of diseases but also enlighten pathway to remain away from diseased conditions. The health problems mainly related to female genital organs or reproductive system are considered as Stree Roga. “Genital Prolapses” is one such type of pathological condition which involves unfavorable displacement or expansion of female genital organs leading to discomfort and other severe health consequences.
30 A COMPARITIVE STUDY OF AGNIKARMA AND KSHAR KARMA IN THE MANAGEMENT OF VRANGRANTHI , Dr. Vivek Kumar Tiwari*, Dr. Rajesh Gupta and Dr. Poonam Rathore
The patient of ulcer who indulges in all the tastes (all types of foods indiscriminately) when the ulcer has not healed or is in the process of healing or when it is still moist (exudative) or when not bandaged or when the body is hit by stones etc. then vata getting aggravated dries up the vitiated blood which has not flown out, and the ulcer give rise to a tumor, having burning sensation and itching. This is known as vrana granthi. The keloid is referred to as vrana ganthi in Auyrveda, Keloid is a result of an overgrowth of granulation tissue at the site of a healed skin injury which is then slowly replaced by collagen fibers.
31 ROLE OF NIRUHA BASTI GIVEN MORE THAN ONE IN A DAY IN NEUROLOGICAL LOW BACK PAIN , *Vd. Minakshi C. Kale and Vd. V. E. Gogate
Background: Low back pain is widely prevalent these days due to living habits and hazardous work pattern. It is very common healthy problem. It can be acute or chronic. At present it is mainly treated with analgesic. Alternate treatment include physical therapy, rehabilitation and spinal manipulation by disc surgery remains last option when all other strategies have failed but outcomes are disappointing.[6] There are many causes of acute low back pain at out of them spinal nerves root injury or compression is one of cause. Also stress factor may cause the low back pain. In ayurveda there is no exact clinical entity mentioned in classics as katishool but it comes under many diseases as a symptom. As the pain that means shool which is exclusively due to vitiation of vata dosha.[9] As per ayurved Samhita samprapti of vatvyadhi has been described in two different types as upstambit and nirupstambit vatvyadhi. Basti is practiced widely in Ayurveda community for different vyadhis but niruha basti is given once a day. Only when Bruhatrayee persistently indicating more than one basti in a day to attain samyaka niruha lakshana.
32 NIDANATMAKA STUDY ON MEDA SANCHAYA IN LIVER W.S.R TO NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) , Dr. Dharmendra Kumar* and Dr. Priyanka Singh
The prevalence of fatty liver disease in India is found to be as high as 24%, which is similar to that reported in some of the Western countries, where it correlates with the prevalence of obesity. Non Alcoholic Fatty Liver Disease (NAFLD) can occur at all ages including childhood, though the highest prevalence is described in those between 35– 45 years of age. With some limitations, both population and hospital-based studies from the West report that around 10–24% of general population, and 57–74% of obese individual may have Non Alcoholic Fatty Liver Disease (NAFLD). The corresponding rates for Non Alcoholic Steato Hepatitis (NASH) are 3–4% and 15–20%, respectively. Survey research is an important form of scientific inquiry that merits rigorous design and analysis. The aim of survey is to gather reliable and unbiased data from a representative sample of respondents. In order to acquire data about people, objects, and events proper data collection tools need to be designed which can measure things of scientific interest. This study was conducted in an individual through survey of Medo Roga patients. The population of 200 subjects of age group more than18yrs.of both sexes was included in the study. Survey was carried out through specially prepared questionnaire which includes both Ayurvedic and Modern science inputs such as anthropometric measurements and Etiological (Nidanatmaka) criteria of Ayurveda. The results of the study are validating the ancient knowledge of Ayurveda in current scenario.
33 SUPERIOR RECTUS MUSCLE OCULAR CYSTICERCOSIS: A CASE REPORT , Saurabh Singh Jareda*, Tanmay Srivastav, Madhvendra Singh Ahirwar and Kirti Verma
Cysticercosis is a systemic parasitic disease caused by the larval form of cestode Taenia solium. It has a worldwide distribution and is potentially harmful with variable clinical manifestations. The most commonly involved sites include eye, brain, bladder wall, and heart. Ocular cysticercosis can be extraocular or intraocular and may present with varied clinical symptoms. We report the condition in a 24 year young male who presented with drooping of right upper lid since 1 year, wherein cysticercus cellulosae cyst was found within the mass of the right superior rectus muscle. It becomes important to report this case because of the relative rarity of the condition these days, unusual site of the cyst and the young age of the patient.
34 STUDY OF TOLERNCE TO NAVAYAS LAUH IN THE PATIENTS OF INTOLERANT TO IRON PREPRATIONS PANDU ROG (W.S.R TO ANAEMIA) --- A CASE STUDY. , Dr. Anil Badhoria*, Ramesh Koundal and Anil Sharma
Anaemia is one of the common manageable problems and roughly one-third world population is affected by it. Half of this total population of Anaemia is suffering from Iron Deficiency (IDA). The management of Anaemia according to modern medicine includes several iron preparations but the side effect of gastric intolerance like nausea, vomiting, epigastria pain; heart burn and constipation are very frequently occurred with these preparations. To overcome from adverse effects caused by these drugs, attempts are being made to explore the ayurvedic literature to develop a suitable remedy for the management of Anaemia. In this series it was decided to use Navayas Lauh 100mg bid for one month with Luke Warm Water in the case of intolerance to Iron preparation of modern medicine. Navayas Lauh contains equal parts of the nine ingredients of Trikatu, Trimada and Triphala with nine parts of lauh churan. The Trikatu, Triphala and Trimada are well known for their properties of correcting the gastric troubles like Nausea, Loss of Appetite, Constipation and Heart Burn. This case study demonstrates that the ayurvedic drug named Navayas Lauh is effective, safer and well tolerable to the patients of Anaemia.
35 HOMOEOPATHIC TREATMENT OF HYPOTHYROIDISM: A CASE REPORT , Dr. S. Karunakara Moorthi, Dr. Raja Manoharan*, Dr. Kumaravel
Hypothyroidism is the most common thyroid dysfunction that affects people globally. At present thyroid disease form the second most common endocrine disorder in India next only to diabetes mellitus. It occurs more in females; and the risk increases with age and those with a family history of thyroid problem. The main line of allopathic system of medicine is to provide thyroid hormone for the rest of life of the patient. Homoeopathy is the best holistic therapy for hypothyroidism. We report a case of 19 year old female presented with enlarged thyroid gland with throat pain occasionally, and irregular menses treated effectively with homoeopathic medicines without any conventional supplement. The TSH report confirmed the diagnosis of hypothyroidism. After case taking, Natrium Muriaticum 200 C was prescribed on the basis of totality of symptoms. TSH reports during follow up visit and the symptomatic improvement provided documentary evidence about the effectiveness of homoeopathic medicines to stimulate thyroid gland to produce normal production of hormone.
36 NATURAL HERBS AND CLASSICAL AYURVEDA FORMULATIONS TOWARDS THE MANAGEMENT OF SEXUAL DISORDERS; A REVIEW , Dr. Dhananjay S. Khot*
Ayurveda is science of healthy living that provides longevity and keeps away from pathological conditions. Ayurveda take care of physical, mental as well as spiritual health therefore establishes balances between body and soul. The ability of Ayurveda principles to combat against many pathological conditions makes it precious for human civilization. The disorders related to physical and mental status can be treated effectively using therapeutic approaches of Ayurveda. The sexual disorders are one such types of health problems that has becomes burning health issue now a days. Ayurveda offer effective management of different sexual problems by virtue of its modalities i.e; Vajikarana or Vrishya chikitsa which produces aphrodisiacs action imparts vitality and enhances chances of healthy progeny, etc. Present article reviewed various Ayurveda aspects towards the management of sexual disorders.
37 HEMOPOIETIC EFFECTS OF SOME HERBAL EXTRACTS USED IN TREATMENT OF INFANTILE ANEMIA IN CAMEROON , Dr. Beack B. S. Suzanne, Fanta Y. S. Adeline, Kopa K. Theodora, Hadidjatou Dairou, Kojom L. Pradel, Kognou M. Aristide, Ndomou Mathieu, Agbor A. Gabriel, Ngono N. R. Anne* and Tchiegang Clerge
The hemopoietic activity of Manihot esculenta, Plastotoma africanum, Ricinodendron heudelotii and Sacoglottis gabonensis extracts used for treatment of infantile anemia were studied on hemolytic anemic rats. Anemia was induced by repeated intraperitoneal injection of phenylhydrazine (40 mg/kg of body weight/day) for two days. A drop in red blood cell count, haemoglobin concentration, and pack cell volume characterized the anemia condition. In addition, the histopathological examination of the bone marrow for blood cells further characterized the anemic condition. Results obtained revealed that oral administration of plant extracts to rats significantly (p<0.05) increased the packed cell volume, haemoglobin, red blood cells and precursors of hematopoietic cell line in bone marrow. Phytochemical analysis of the plants studied revealed the presence of alkaloids, coumarins, flavonoids, phenolic compounds, saponosids, steroids, tannins, terpenoids and triterpenoids. The extracts also contain mineral elements, such as iron, calcium, zinc and copper. The results obtained suggested that the plant extracts studied possess hemopoietic properties, justifying their use in the management of infantile anemia.
38 HOUSEHOLD FORMULATIONS IN AGNIDUSHTI JANYA VIKAAR IN CHILDREN W.S.R PAEDIATRIC GASTRO-INTESTINAL DISORDERS-A STEP TOWARDS PUBLIC HEALTH , *Dr. Sonal D. Wankhede (Kamble) and Dr. Nitesh K. Kamble
Paediatric Gastro-intestinal Disorders, are now-a-days gaining clinical and social importance because of its being the principle cause of morbidity and mortality of children in the developing world.[2] In 1982, on the basis of a review of the active surveillance data from the studies conducted, in 1950’s, 1960’s and 1970’s; it was estimated that, 4.6 million children suffered from Gastro-Intestinal disorders.[2,3] In 1992,a review stated that; in 1980, diarrhoeal mortality has declined to approximately 3.3 million annually. Both the reviews estimated that children in the developing world experienced between 2-3 episodes of GI Disorders. Thus there is a great need of looking into the causes and management of these GI Disorders in order to reduce its morbidity and mortality rates respectively. In Ayurveda, out of the major eight branches, Kaumarbhritya is one of the branch wherein basic concepts of child care commencing from the foetal period to early adulthood are precisely described. Inability of children to express themselves effectively and variations in most of the clinical presentations are the major issues suffered by the clinician in early diagnosis of children. Hence, a lot of children are deprived of proper and timely diagnosis. As stated above, Gastro-enteral disorders named as Agni-Dushti Janya Vikaar in Ayurveda are the most prone disorders in kids due to a number of reasons such as faulty dietary habits, worms, irregular diet, skipping meals and so on. Also, Ayurveda being the ancient Indian science of medicine and herbs, describes various classical fundamental (basic) herbs & formulations , almost some of them are used as kitchen ingredients (in forms of spices, condiments, household items, etc.) but are quite beneficial and capable to cure and prevent diseases at the primary level. Such Ayurvedic formulations in the form of household care are used to cure and prevent peadiatric GI Disorders at the primary level. The whole-sole purpose of this article is to promote and provide the use of such feasible and natural home-based ayurvedic preparations in reducing the morbidity rates of paediatric GI Disorders, which will be definitely a promising step towards public health of children in the near future.
39 ALLERGIC RHINITIS & ITS EFFECT ON THE QUALITY OF LIFE , *Dr. J P Chaudhary, Dr. Yogesh Jakhar and Dr. Anupam Pathak
An allergen is an otherwise harmless substance that causes an allergic reaction. Allergic rhinitis, or hay fever, is an allergic response to specific allergens. Pollen is the most common allergen in seasonal allergic rhinitis. These are allergy symptoms that occur with the change of seasons. Nearly 8 percent of adults are experiencing (are suffering from) allergic rhinitis of some kind. According to the research, between 10 to 30 percent of the worldwide population may also have allergic rhinitis.
40 COST AND OUTCOMES OF DIRECT ACTING ANTIVIRAL THERAPY IN CHRONIC HEPATITIS C PATIENTS WITH GENOTYPE 3 , Anum Hanif, Bazgha Ashfaq, Bushra Ali Sherazi, Dr. Tahir Anwer, Jawad Ashfaq
Context: Hepatitis is derived from Ancient Greek words hepa which means liver and itis which means inflammation. Hepatitis viruses have 5 different types each associated with a different etiology, distribution, mode of transmission and mortality risks. However, the virus of interest here being hepatitis C virus, which transmitted via blood. Aims and Objectives: The objectives of this study are to evaluate the prescription drugs cost of current treatment regimens available for HCV Genotype 3. Design, setting and participants: An observational and cross-sectional study was carried out in the community involving patients with diagnosed Hepatitis C. Data collection, analysis, and interpretation were stretch to a span of 6 months from August 2016 – January 2017. Main outcome Measure: Gender, age, monthly income, awareness and knowledge about HCV, knowledge about cause of HCV, knowledge about medication of HCV, blood profile in last three months, blood profile in last six months. Results: Most of the population in Pakistan belongs from the middle class 55% of the population for this sample size was belonging from middle class while 30% were very poor only 13% from upper middle class. Conclusion: In this, study the assessment of the treatment outcomes for different regimens of Direct Acting Antivirals (DAAs) in terms of patient compliance, relapse rate, improvement in liver architecture, the disability-free period the patient gets using a certain combination of drugs. The entire research directed to figure out the best treatment option for curing genotype 3 infection.
41 FUNGAL SPOILAGE OF BAKERY PRODUCTS AND ITS CONTROL MEASURES , V. S. Patil* and P. D. Kukade
Bakery products are an important part of balanced diet. It is a good source of nutrients, such as macronutrients and micronutrients that are essential for human health. Most common products are breads, bun, cupcakes, cookies, pizza base, toasts etc. These products are subject to fungal spoilage. Many filamentous fungi such as Rhizopus, Mucor, Aspergillus and Fusarium are involved in spoilage of bread due to improper handling and improper sanitation. So its economically important and commercial value is lost due to improper handling. Spoilage of these bakery products may constitute a health risk in food may cause a mild form of food illness. The chemicals are hazardous to the human health so use of natural agents is useful to maintain human health. It is not affect the food flavour. Clove, Lemongrass, Cardamom, Citrus and Edible oil are useally used in food product. These product also acts as controlling measures for these fungi. The present study is focused on the fungal spoilage of bakery products and its control measures.
42 EARLY DETECTION OF SEPTIC SHOCK FOR LIFE SAVING MANAGEMENT IN PATIENTS ADMITTED IN INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL , Nalini Rajapandian* and Karthick R.
Aims And Objectives - Sepsis is a fatal syndrome induced by infection and associated with mortality up to 40%. The barrier for early intervention of sepsis is lack of diagnostic tools. qSOFA was developed to have simple scoring system with few variables that are associated with greater predictive ability. The objective of the study is to evaluate the early detection of septic shock in patients admitted in intensive care unit using risk score for early prompt management to prevent mortality. Materials and Methods: Prospective observational study for a period of one month was conducted in intensive care unit. qSOFA parameters like respiratory rate, systolic blood pressure, mental status were assessed and risk score was calculated. Data collected were statistically analysed using descriptive statistics and expressed in percentage. Results: A total of 51 patients were examined for qSOFA risk score admitted in intensive care unit. The study population consist of 65% males and 35% females. Patients at low risk for septic shock were 26% and patients with high risk for septic shock were 37%. Conclusion: Sepsis and septic shock remains a major health problem with worse prognosis. Early detection and prompt appropriate treatment increases the chance of survival.
43 RESULT OF COLOSTOMY CLOSURE WITHOUT CONVENTIONAL BOWEL PREPARATION , Dr. Ayisha Maqsood*, Dr. Ayesha Gohar, Dr. Mahreen Afzal
Background; Colostomy closure is a routine procedure performed frequently by pediatric surgeons all over the world. It is an elective procedure that is assumed to be easy, yet, the literature indicates that this procedure still may be the source of significant complications, including death. Because of these facts, as well as the very good results encountered in our series, we decided to share our routines and surgical technique that we use during the colostomy closure procedure. Results; Out of these 102 study cases, 66 (64.7%) were boys and 36 (35.3%) were girls while male to female ratio was 1.83:1. Mean age of our study cases was 6.19 ± 2.64 years (with minimum age was 2 years while maximum age was 12 years). Mean duration of surgery in our study cases was 105.88 ± 18.55 minutes (with minimum duration of the surgery was 65 minutes while maximum duration of the surgery was 145 minutes). Obesity was noted in 15 (14.7%) of our study cases. Anastomotic leakage was noted in 10 (9.8%), wound infection in 15 (14.7%) and prolonged hospital stay in 30 (29.4%) of our study cases. Conclusion; The results of this study indicate that colostomy closure without prior conventional bowel preparation is safe, reliable and cost effective mode of treatment. It can be applied to children of different age groups without any significant side effects and it provides less pre-operative hospital stay which is beneficial not only for the parents but also for the hospital authorities. So our study results recommend the use of colostomy closure without prior conventional bowel preparation with desired outcomes.
44 HYPOTHYROIDISM IN WOMEN HAVING MENSTRUAL PROBLEMS , Dr. Ayesha Gohar, Dr. Ayisha Maqsood, Dr. Mahreen Afzal*
Background; Menstrual disorders frequently affect the quality of life of adolescents and young adult women, especially those who suffer dysmenorrhea and heavy menstruation. Different studies have associated thyroid dysfunction with menstrual problems. This study was conducted to document the frequency of hypothyroidism in women with menstrual problems. Objective: To determine frequency of hypothyroidism in women having menstrual problems at a tertiary care hospital. Material and methods; All the study cases (227) who meet inclusion and exclusion criteria of my study were taken from OPD of the Department of Gynecology and Obstetrics, Allied Hospital Faisalabad. Once registered, 5 ml venous blood sample was taken and sent to the central laboratory of the Allied Hospital Faisalabad for serum TSH and T4 levels by a pathologist having minimum 5 year experience after post-graduation. Hypothyroidism was determined on laboratory report after serum analysis for TSH and T4. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was noted to be 24.08± 4.65 years. Of these 227 study cases, 134 (59 %) were married while 93 (41%) were unmarried. Mean body mass index (BMI) of our study cases was 22.31 ± 2.70 kg/m2 , 160 (70.5%) were normal weight, 51 (22.5%) were overweight and 16 (7%) were obese. Secondary amenorrhea was noted in 25 (11%), oligomenorrhea in 42 (18.5%), polymenorrhea in 16 (7%), heavy menstrual bleeding in 59 (26%) and irregular menstrual bleeding in 85 (37.5%). Mean serum TSH level of our study cases was 4.85 ± 0.91 mIU/L while mean T4 level was noted to be 86.90 ± 38.81 nmol/L and hypothyroidism was noted in 176 (77.5%) of our study cases. Overt hypothyroidism was noted in 75 (33 %) and subclinical hypothyroidism in 101 (44.5%) of our study cases. Conclusion; Very high frequency of hypothyroidism was noted in women having menstrual problems in our study. Hypothyroidism was significantly associated with residential status, obesity, poor socioeconomic status, level of education and type of menstrual problem. Subclinical hypothyroidism was more prevalent as compared with over hypothyroidism. Our study results suggest that women presenting with menstrual problems must be screened for thyroid hormones for proper management of these patients.
45 EVALUATION OF ANGIOTENSIN CONVERTING ENZYME GENE POLYMORPHISM AS A RISK FOR MYOCARDIAL INFARCTION WITH / WITHOUT TYPE 2 DIABETIC IRAQI PATIENTS , Raghda N. Hemeed*, Fadhil J. Al-Tu’ma, Heider H. Abbas and Ahmed H. Al-Mayali
Background: Ischemic heart disease (IHD) is the term given to heart problems the lipids in the blood are deposited on the end atrium due to abnormal lipids (metabolism). Due to the higher morbidity rate and mortality rate, IHD has become the most serious cardiovascular disease threatening in Iraqi people. The most common cause of myocardial infarction is atherosclerotic disease of an epicardial coronary artery (or arteries) sufficient to cause a regional reduction in myocardial blood flow and inadequate perfusion of the myocardium supplied by the involved coronary artery. It may affect individuals at any age, the most common risk factors include smoking, family history, hypertension, obesity, diabetes, high alcohol consumption, lack of exercise, stress, and hyperlipidemia. Various studies have shown that the polymorphisms angiotensin-converting enzyme ACE (DD) (rs4646994) associated with various heart diseases. Objective: To study the correlation between ACE (DD) (rs4646994) gene polymorphism with each of lipid profile and troponin I in hypertensive male Iraqi patients of myocardial infarction with / without type 2 diabetes mellitus. Materials and Methods: This case–control study composed of 217 adult males which were classified into three groups: Group I comprised 86 patients with myocardial infarction before catheterization with type 2 diabetes mellitus. Group II comprised 78 patients with myocardial infarction without T2DM which were admitted in Al-Hussein Medical City Teaching Hospitals / Kerbala Health Directorate - Iraq during 1st, Dec. 2018 to 31, July 2019. Group III comprised of 53 apparently healthy individuals as a control group. The risk factors include smoking, family history, hypertension and T2DM. DNA was extracted from whole blood and genotyping was achieved with specific (primers to amplify) the 3 genotypes by using PCR-ARMS techniques. Results: The high frequency of D allele in diabetic group act as independent risk factor. The observed data indicated that ACE-DD homotype was higher in T2DM patients as compared to controls. The genotypes for the ACE (DD)(rs4646994) gene band was observed in (190 pb) which indicate the removal a single nucleotide from gene that called homozygotes. Conclusion: A positive correlation of angiotensin-converting enzyme (DD) (rs4646994) gene polymorphism in myocardial infarction with and without T2DM for in Iraqi patients were observed.
46 AUDIT OF MORTALITY PATTERNS AMONG HOSPITALIZED PATIENTS IN TERTIARY CARE HOSPITALS FAISALABAD , Dr. Maham Arooj*, Dr. Fouzia Batool and Dr. Ayesha Iqbal
Background: In human life, probability of death to occur is 100%. Statistics on patterns and causes of death in a community reflect burden of disease and its related determinants. They are often employed to indicate priorities for health actions and allocation of resources. They also provide basis for further epidemiological research. In many cases the cause of death is predictable and largely preventable through pro- active multi-disciplinary coherent strategies. Objective: To study mortality trends and its determinants in patients admitted in public sector tertiary care hospitals in Faisalabad. Methods: This study is descriptive cross sectional by retrospective examination of medical record of all deaths which occurred in hospitalized patients at DHQ Hospital Faisalabad. Period: 1st January 2018 to 31st December 2018. During this period the record of 7359 expired patients was studied and analyzed. The study variables were socio-demographic, department wise admission and mortality, hospital stay and primary cause of death. Statistical analysis was done in percentages and other relevant tests to know the significance of association among various variables. Results: In total 178290 indoor patient admissions, 7359 patient expired (4.13%). Mortality in hospital admitted children age group was 12.59% while in old age group 5.27%. In study period of one year, number of male deaths were 5154(70.09%) and female were 2205 (29.96 %). Average period of stay in Hospital was 1 to 2 days in acute cases while 1 to 2 weeks in chronic cases. The main killer diseases ranked in order of proportionate death rates, were liver diseases (Hepatitis), Pediatric birth asphyxia & infections, RTA cardiac diseases (MI & CVA) suicidal poisoning, Pulmonary diseases tetanus septicemia/infectious diseases & rest of the other groups. Conclusion: This study concluded mortality prevalence 4.13%% while primary cause of mortality mostly pertained to infectious diseases, accounting for chronic liver disease, pneumonia/respiratory tract diseases, tetanus, septicemia and NCD like cardiovascular diseases, accidental injuries& poisoning. Therefore, we are facing dual burden of diseases CD & NCD. Health policy insight of mortality data and improved health care system can minimize these figures of mortality.
47 AUDIT OF DISEASES IN MEDICAL WARDS OF A TERTIARY CARE HOSPITAL , Dr. Sara Khan*, Dr. Sidra Sadiq and Dr. Muhammad Anees
Objective: - To assess the frequency and pattern of diseases in a medical wards at tertiary care hospital of Southern Punjab. Study design: - Cross-sectional study. Setting:-Medical Units of Nishtar Hospital Multan. Patients and methods: - Patients admitted at different Medical Units of Nishtar Hospital, Multan were included in the study. Specially designed proforma was filled, data were collected and analyzed on SPSS-20. Results: - Total admitted patients in medical units of Nishtar Hospital, Multan from May, 2017 to May, 2018 were 660. Out of these 660, 390 (59.1%) were males and 270 (40.9%) were females. Age ranges from12-70 and above. Mean age was 43.88 years with standard deviation 18.87 years. Mostly (63.5%) patients were from home district. Chief complaints were uncontrolled diabetes mellitus (17.6%), fever (13.6%), weakness of one-half of body (10%), uncontrolled hypertension (9.7%), cough and fever (8.5%), yellowness of eyes (5.8%) and vomiting (4.2%). Most common disease was diabetes mellitus (19.1%) followed by hypertension (17.9%), cerebrovascular accidents (10%), chronic liver diseases (9.7%), acute hepatitis (8.9%), pneumonia (7.4%), meningitis (5.9%), chronic renal failure (3.2%), acid peptic disease (2%) and acute myeloid leukemia (1.5%). Conclusion: - Study revealed diabetes mellitus, hypertension, ischemic heart disease (IHD) and Cerebro-vascular accident (CVA) are most common diseases. Important measure to control diabetes mellitus and hypertension must be adopted. More detailed and large scale study are needed on pattern of diseases at tertiary care hospital so that disease pattern are known and on these basis strategies for control of diseases and patients care can be derived.
48 A CROSS SECTIONAL ON VARIOUS DISEASES IN CASES OF PLEURAL EFFUSION , Dr. Faraz Ali Arshad*, Dr. Fouzia Batool, Dr. Ammad Akbar
Objective: To study the various diseases in cases of pleural effusion presenting at CMH Multan. Material and methods: This cross sectional study was conducted at Department of Medicine, CMH Multan September 2018 to March 2019. Total 100 patients with pleural effusion were selected and different diseases were studded in selected cases. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed by parapneumonic effusion/empyema (25%) and malignant effusion (9%) while congestive cardiac failure (13%) was the most common cause of transudate effusion followed by liver cirrhosis in 8% of cases of all cases of the pleural effusion. Conclusion: Tuberculosis is the most common cause of pleural effusion while infections, malignancies and CCF comprise a significant number of cases.
49 FREQUENCY OF ANEMIA IN CHILDREN SUFFERING FROM PNEUMONIA , Dr. Ayesha Iqbal*, Dr. Faraz Ali Arshad and Dr. Maham Arooj
Objective: To determine the frequency of anemia among hospitalized children suffering from pneumonia in a tertiary care hospital. Material and Methods: Consecutive 145 children were taken in this cross-sectional study from March 2017 to February 2018 from OPD of Jinnah Hospital Lahore. History regarding fever, coughing and tachypnea was taken. Once registered in the study, all the relevant baseline investigations were done including blood tests and chest X-Ray. Venous blood sample (3ml) was drawn and sent to laboratory in EDTA vial for Hb level estimation to determine anemia and all the data was entered and analyzed using SPSS20. Results: Of these 145 study cases, 75 (51.7%) were boys while 70 (48.3%) were girls. Mean age of our study cases was 5.82 ± 2.51 years (with minimum age was 2 years while maximum age was 10 years). Most of our study cases i.e. 75 (51.7%) presented with hospital acquired pneumonia while 70 (48.3%) presented with community acquired pneumonia. Majority of our study cases i.e. 92 (63.4%) were from urban areas and were having poor social background i.e. 98 (67.6%). Mean hemoglobin level of our study cases was noted to be 9.70 ± 1.89 g/dl (with minimum Hb level was 6.5 g/dl while maximum Hb level was 12.6 g/dl). Anemia was present in 91 (62.8%) of our study cases. Conclusion: Very high frequency of anemia is noted in children with pneumonia in our study. Anemia was significantly associated with female gender, hospital acquired pneumonia, mother’s educational level, increasing disease duration and poor socio-economic status. Anemia is generally neglected while treating pediatric pneumonia so pediatricians must check hemoglobin levels on routine basis among this targeted population.
50 MYCOBACTERIUM TUBERCULOSIS SUSCEPTIBILITY TO FIRST LINE ANTI TUBERCULOSIS THERAPY , Dr. Sara Khan*, Dr. Sidra Sadiq and Dr. Muhammad Anees
Objective: To determine the susceptibility pattern of Mycobacterium Tuberculosis (MTB) to 1st line Anti tuberculosis therapy. Study design: Cross sectional study. Study Setting: Department of Biochemistry, Nishtar Medical University, Multan. Study Duration: July 2017 to March 2018. Methodology: This was a cross sectional study carried out at Department of Biochemistry, Nishtar Medical University Multan during July 2018 to March 2019. In this study the cases of both gender with age more than 15 years were included. The cases that have already taken ATT were excluded. Sputum samples were obtained and then processed at solid Lowenstein Jensen (LJ) media for at least 6 weeks, MTB isolated from these sample were then tested for their susceptibility to the 1st line ATT drugs. The MIC of the studied drugs per ml of LJ medium for susceptibility testing were 0.2 mcg for isoniazid, 02 mcg for streptomycin, 05 mcg for Ethambutol, 100 mcg for pyrazinamide and 01 mcg for rifampicin. Results: In this study there were total 115 cases; out of which 72 (62.60%) were males and the mean age of the participants was 35.19±10.67 years. Drug resistance was seen in 36 (32.17%) of cases and few of the cases had more than 1 drug involvement. The most common drug to which was resistance was seen was streptomycin affecting 19 (16.52%) of the cases. it was followed by Isoniazid where it was seen in 17 (14.78%) of the cases. Single drug resistance was seen in 30 (26.08%) of the cases. three and four drug resistance were seen in 2 (1.73%) of cases each. Conclusion: Drug resistance is seen in almost every 3rd case and the most common drug to show resistance is streptomycin.
51 STUDY OF RISK FACTORS ASSOCIATED WITH HYPERTENSION AMONG URBAN AND RURAL COMMUNITIES AT BAHAWALPUR , Dr. Muhammad Ahsan Amin*, Dr. Muhammad Mohsan Amin and Dr. Maria Razzaq
Background: Hypertension may be a longstanding problem in Pakistan, yet little is understood about its prevalence and risk factors, particularly in rural and urban areas. Distinguishing geographical variations in hypertension is vital to reinforce the health of adult Pakistanis no matter where they live. Aim of this study to know risk factors of hypertension among rural and urban population. Methodology: It is a cross sectional study done in which 300 hypertensive persons residing in urban and rural communities of Bahawalpur were enrolled. Data was collected through simple random sampling technique using a questionnaire. Data was collected on risk factors of hypertension. Then collected data was analyzed using SPSS v 20.0. Results: out of 150 participants of urban community, 55 (36.7%) were 46-55 years old while among 150 participants from rural areas, 52 (34%) were 46-55 years old. There were 104 (70.7%) female and 46 (30.6%) male from urban areas. Males from urban and rural areas were 46 (30.6%) and 56 (37.3%) respectively. In urban public 60 (40 %) participants were found illiterate and 70 (46%) rural participants were found illiterate. In current study 30 (20%) participants from urban community and 40 (26.6%) from rural community also had diabetes mellitus as associated disease. It was found that family history and anxiety were the most common risk factors i.e. 105 (70%) and 90 (60%) people from urban community having positive family history of hypertension and stress factor respectively. Similarly among rural respondents 80 (53%) and 95 (63.3%) were having positive family history of hypertension and stress factor respectively. Conclusion: This study showed that there were more hypertensive female as compared to male. Young people of rural areas were more common as compared to young people of urban areas. There were many cases who were unaware of their hypertensive condition, also many were not using proper medicine despite of their acknowledgement. Previous family history, anxiety/stress, high salt intake and smoking were the main risk factors observed.
52 EFFICACY OF AMOXICILLIN-CLAVULANATE AND LEVOFLOXACIN IN THE TREATMENT OF ACUTE BACTERIAL RHINOSINUSITIS , Dr. Maria Razzaq*, Dr. Muhammad Ahsan Amin and Dr. Muhammad Mohsan Amin
Objective: To compare the efficacy of Amoxicillin-Clavulanate and Levofloxacin in the treatment of acute bacterial rhinosinusitis. Materials & Methods: A total of 360 patients with acute bacterial sinusitis of age ranges from 15-55 years of both gender were included. Patients with pneumonia, h/o allergy to allergy to Amoxicillin-Clavulanate or Levofloxacin and diabetes mellitus were excluded. Patients were randomly assigned into two groups based on Lottery method in Group A and Group B. Group A (The Amoxicillin-Clavulanate Group) received oral Amoxicillin-Clavulanate 1 g every 12 hours for 10 days. Group B (The Levofloxacin Group) received Oral Levofloxacin 250 mg every 12 hours for 10 days. Symptoms and signs were recorded at visit one before the start of antibiotics and at day 11 after completion of treatment. Results: The mean age of patients in group A was 35.73 ± 7.31 years and in group B was 35.91 ± 8.24 years. Out of these 360 patients, 143 (39.72%) were male and 217 (60.28%) were females with ratio of 1:1.5. Efficacy was seen as yes in 172 (95.56%) patients in group B (Levofloxacin group) group A (Amoxicillin-Clavulanate group) and 146 (81.11%) patients in with p-value of 0.000. Conclusion: This study concluded that levofloxacin has better efficacy and cost-effective than Amoxicillin-Clavulanate in the treatment of acute bacterial rhinosinusitis in terms of signs and symptoms relief.
53 STUDY OF GESTATIONAL DIABETES IN LOCAL FEMALE POPULATION OF MULTAN , Dr. Anber Rahim*, Dr. Khadija Hussain, Dr. Tooba Inam
Introduction: Gestational Diabetes is defined as onset of glucose intolerance at varying degree or first diagnosed during pregnancy. GDM has a potential risk to the mother as well as the fetus. Obesity has been designated as one of the most important global health threats worldwide, and its prevalence has been increasing among women of reproductive age. Objectives of the study: The main objective of the study is to analyze the gestational weight gain among women with gestational diabetes mellitus in local population of Pakistan. Material and methods: This cross sectional study was conducted at Nishtar hospital, Multan during March 2018 to November 2018. The data was collected from 293 female patients according to the ethical committee of hospital. We designed a study to associate maternal BMI and GWG with pregnancy outcomes in local women of Pakistan with GDM. Demographic profile (name, age, contact no.) was taken. History of related risk factors Physical Examination and investigation included obstetric ultrasound and blood samples were obtained from each subject to know about their clinical parameters like Fasting blood sugar level, random blood sugar level for Screening and diagnosis, HBA1C, Glucose tolerance test of patients was above the normal range. Results: According to the pre-pregnancy BMI, 96 women (11.5%) were underweight, 558 (67.1%) were of normal weight, 134 (16.1%) were overweight and 44 (5.3%) were obese (Table 1). The level of glycosylated hemoglobin was significantly higher in the overweight and obese groups than in normal weight and underweight groups (P < 0.05). In addition, birth weight was significantly higher in overweight or obese women than in underweight women (P < 0.05). There were no significant differences between the four pre-pregnancy BMI categories in maternal age, parity, height and gestational weeks. Conclusion: It is reasoned that high pre-pregnancy BMI and unnecessary GWG are related with higher frequencies of LGA, and in addition other unfavorable results in Pakistani ladies with GDM.
54 FREQUENCY OF MALIGNANT SOLITARY NODULE THYROID AT TERTIARY CARE HOSPITAL , Dr. Tooba Inam*, Dr. Khadija Hussain, Dr. Anber Rahim
Objective: To determine the frequency of malignant solitary nodule thyroid in relation to age and sex at territory care hospital. Material and methods: This cross sectional study was conducted at Department of Surgery Nishtar Hospital Multan from January 2018 to June 2018 over the period of 6 months. Total 100 patients of both sexes, age between 10 and 60 years, clinically detected solitary thyroid nodule and hot, warm and cold nodules on radio isotope (TC99) scan were included in the study. All the patients underwent thyroid surgery and sample was sent to laboratory for histopathology. Results: Total 100 patients with solitary thyroid nodule were selected. Mean age of the patients was 31.58±4.63 years. Colloid goiters were observed in 34 (34%) patients, followed by Nodular goiter in 26 (26%) patients. There were 20 (20%) patients who had Follicular adenoma. Total 20 patients found malignant of which Papillary CA was noted in 18 (18%) and Follicular CA was noted in 2 (2%). Total 28 (28%) patients were male and 72 (72%) patients were female. Conclusion: Results of present study concluded that 20% of solitary thyroid nodules are malignant, malignancy was significantly associated with gender. Papillary carcinoma is the commonest malignancy of Solitary Thyroid nodule.
55 EVALUATION OF THE EFFICACY OF NARIKELA KHANDA AVALEHA IN THE MANAGEMENT OF AMLAPITTA , Dr. Deepika Yadav*
Amlapitta is the diseases caused by unhealthy food habits and lifestyle activities. A clinical trial was conducted to manage the disease through Narikela Khanda Avaleha. 25 patients diagnosed as Amlapitta were selected from OPD and IPD of Ayurveda Mahavidyalaya, Hubli, Karnataka who fulfilled the inclusion criteria. Special clinical proforma, based on criteria of selection and parameter, for assessment of subjects was prepared. All 25 patients were given 25 gms of Narikela Khanda Avaleha along with Sukhoshna Dugdha as anupana for 30 days. Results were statistically significant. Out of 25subjects, 80% subjects showed excellent response. 16% subjects showed good response. Moderate response was shown by 4% subjects. The study revealed that Narikela Khanda Avaleha showed excellent results in the management of Amlapitta.
56 RECURRENT SEIZURES IN PATIENTS SEEKING LOADING DOSE OF MGSO4 IN ECLAMPSIA , Dr. Tayyaba Shakeel*1, Dr. Sana Shakeel2 and Dr. Sidra Hafeez3
Background: Hypertensive disorders such as eclampsia is significant contributor to maternal and perinatal mortality and morbidity worldwide particularly in the developing countries. This study was done to determine the frequency of recurrent seizures in patients seeking loading dose of MgSO4 only in eclampsia. Materials & Method: Pregnant ladies (n = 114) of any parity, 15-35 years old having more than 20 weeks gestational amenorrhea from last menstrual period were included in our study. Patients admitted with eclampsia were examined for recurrent seizures. Frequency of recurrent seizures with loading dose of mgso4 was noted till 48 hours of receiving loading dose of MgSO4. However if there was a repeat fit with loading dose of MgSO4 then an additional 2 gms. MgSO4 was given intravenously and shifted to maintenance regimen. Results; Mean age of our study cases was noted to be 29.75 ± 4.56 years (with minimum age of our patients was 22 years while maximum age was 35 years). Mean parity of our study cases was noted to be 2.03 ± 1.31. Majority of our study cases i.e. 64 (56.1%) had parity less than 3 and gravidity less than 4 was noted in 82 (71.9%) of our study cases. Mean gestational age of our study cases was noted to be 30.80 ± 4.90 weeks (with minimum gestational age was 22 weeks and maximum gestational age was 38 weeks). Mean body mass index (BMI) of our study cases was noted to be 24.67 ± 3.02 kg/m2 and obesity was noted in 25 (21.9%) of our study cases. Mean number of seizures (before start of therapy) was 6.46 ± 3.21 (with minimum no. of seizures was 3 while maximum no. of seizures were noted to be 15). Recurrence of seizures was noted in 11 (9.6%) of our study cases. Conclusion; Our study results have shown that recurrence of seizures was quite low with loading dose of magnesium sulphate. It is safe, effective and reliable therapy in controlling seizures in eclampsia. Provision of loading dose of MgSO4 to these patients will not only reduce painful intramuscular injections but also helpful to reduce related costs. So use of loading dose of MgSO4 regimen is recommended of our group of patients as most of our patients are poor.
57 FREQUENCY OF PREGNANCY INDUCED GESTATIONAL DIABETES MELLITUS AND HYPERTENSION IN OBSTETRICS , Dr. Sidra Hafeez* Dr. Sana Shakeel and Dr. Tayyaba Shakeel
Objective: To find out frequency of pregnancy induced gestational diabetes mellitus and hypertension in obstetrics. Setting and duration: This cross sectional study was conducted at Department of Obstetrics & Gynecology, Nishtar Hospital Multan from April 2018 to October 2018. Results: Total 190 obstetric patients were selected for this study. Mean age of the patients was 30.56 ± 6.718 years and mean gestational age was 23.73 ± 2.945 weeks. Out of 190 obstetric patients, gestational diabetes mellitus was found in 45 (23.7%) patients. Pregnancy induced hypertension was observed in 95 (50%). Minimum gestational age was 20-24 weeks and maximum gestational age was 25-28 weeks. Primigravida were 50 (26.23%) and multigravidas were 140 (73.7%). Conclusion: Results of this study showing a higher rate of pregnancy induced hypertension and gestational diabetes in obese obstetrics. Findings of this study also showed significant association of pregnancy induced hypertension and gestational diabetes with age, area of residence, education and family income.
58 A REVIEW ON RASAYANA; THEIR PHYSIOLOGICAL EFFECTS ON BIOLOGICAL SYSTEM AND THERAPEUTIC IMPORTANCE , Dr. Tushar Kakar, Dr. Shailendra K. Pund* and Dr. Ganesh Belorkar
Rasayan chikitsa is one of the important therapeutic modality of Ayurveda which provides good memory, intelligence, immunity, longevity, complexion and strength, etc. Rasayana not only suppresses pathogenesis of diseases but it also helps to health of healthy person. Physiologically Rasayana drugs pacify Doshas, boost Dhatus, purify blood, eliminates Ama & Mala and improves circulatory process therefore imparts many health benefits. Rasayana therapy helps in physical as well as mental problems and helps to treat mental ailments like; memory loss, mental functioning impairment, depression, stress and anxiety, etc. Mandukparni, Shankhapushpi, Yashtimadhu, Amalaki, Guggul and Guduchi, etc. are some Rasayana drugs used for various therapeutic purposes. Considering importance of Rasayana therapy present article described Ayurveda properties of some common Rasayana drugs in view to explore this area for upcoming researchers.
59 RARE CASE OF GOODHILL SYNDROME , Dr. A. Mennouni*, H. Ngham, H. Ardhaoui, S. Rouadi, R. Abada, M. Roubal and M. Mahtar
The association of otosclerosis with a Malleus ankylosis called goodhill syndrome is very rare, accounting for less than 1% of congenital malformations of the middle ear.[1] We report the case of a 46-year-old woman with no family history of deafness who had been consulting for bilateral deafness, evolving for 10 years, with no associated signs such as vertigo or tinnitus. Otoscopic examination show normal eardrums, The audiogram includes a conductive hearing loss of 60 dB d. Computed tomography is the main examination for the visualization of the ossicular chain and the search for other anomalies. The diagnosis is confirmed during the surgery. We have reported a case of bilateral Malleus ankylosis associated with otosclerosis. This makes our study interesting because it is rarely described in the literature. The objective of this study was to analyze the findings of middle ear exploration and the frequency of ossicular in patients with suspected otosclerosis. bone bridge (Figure 1). The surgery consists of an ossiculoplasty, by section of Malleus's neck with interposition with Incus. We obtained a good result by gain of 20 dB in the main frequency. Our patient is satisfied. The other side will be programmed a year later.
60 PARATESTICULAR RHABDOMYOSARCOMA: WHAT MANAGEMENT? , M. Rachid*, M. Graiouid, I. Jandou, M. Dakir, A. Debbagh and R. Aboutaieb
Paratesticular rhabdomyosarcoma is a rare and aggressive mesenchymal tumor. It is an intrascrotal tumor, localized to the paratesticular structures: vaginal, epididymis or spermatic cord. Genito-urinary localizations are among the most frequent. In light of three observations and a review of the literature, the authors discuss the diagnostic and therapeutic modalities.
61 ADRENAL OLIGOMETASTATIC MALIGNANT PHEOCHROMOCYTOMA , S. Barkiche*, H. Sami, S. Elouarzazi, M. Darfaoui, I. Lalya, A. Elomrani, M. Khouchani
Pheochromocytoma is a neuroendocrine tumor derived from the chromaffin cells of the adrenal medulla. Malignancy is defined by the presence of metastases in non-chromaffin tissue or by the appearance of recurrences. About 40% of cases are genetic. It is therefore important to look for symptoms that suggest a genetic predisposition syndrome, particularly the multiple endocrine neoplasia (MEN). The severity of this cancer is due to its rarity, a common cause of delayed diagnosis. Through the observation of our patient followed for malignant pheochromocytoma for 3 years and became oligometastatic, we would like to present the characteristics of this rare disease and to underline the interest of an optimal as well specific management of the tumor, the oligometastases, and associated complications, passing through experienced multidisciplinary teams.
62 DISINFECTION OF THE ROOT CANAL USING TAP , Assist. Prof. Dr. Baydaa Ali Othman Al – Rawi and Assist. Lect. Huda Raad Awsi
The most important step in regenerative endodontics is the disinfection of the root canal system. Twenty non vital immature permanent incisors were included in this study. All the teeth included in blood clot technique as regenerative endodontics measure. Aims: The present study was carried out to demonstrate the using of triple antibiotic paste for disinfection of the infected root canals of immature non vital permanent incisors. Materials and Methods: Twenty non vital immature permanent incisors were included in this study. All the teeth included in blood clot technique as regenerative endodontics measure.
63 EARLY AND LATE VENOUS THROMBOSIS AFTER PACEMAKER IMPLANTATION , Ivaneta D. Yoncheva*, Denislav E. Biserov and Maria N. Negreva MD
Both early and late complications associated with venous access have been repeatedly reported in scientific literature. Venous thrombosis and stenosis after permanent pacemaker implantation are probably more common than reported incidence in literature due to frequent asymptomatic course. Patients with this complication have a higher potential risk for thrombotic events. Therefore they should be actively screened and the pathogenetic causes for the complication should be clarified. According to the literature, a frequency of 20 to 30% of partial or total thrombosis of the vein used for electrode placement has been reported, and no specific risk factor has been identified for it. At present, the researchers are facing many unclear issues that have yet to be addressed in order to decide on a change in the therapeutic strategy for this group of patients.
64 THE FUTURE OF PSYCHIATRY , Professor Mikhail Reshetnikov, MD, PhD*
In this paper, a number of outdated but still prevailing medical doctrines are critically reviewed, in particular, Hippocrates’s hypothesis of the brain as a repository of all mental processes; I.M. Sechenov’s hypothesis of the psyche as a derivate of the brain reflexes; I.P. Pavlov’s hypothesis of the higher nervous activity as an equivalent of the psyche. In his research, the author refers to studies of feral children, studies of memory and subliminal perception, discovery of mirror neurons and contemporary views of the academic science on information. The author proves the non-materiality of the psyche and the role of the brain as a biological interface between the ideal and the real. The new approach would require changing the traditional paradigm as well as all our approaches to studying the psyche and treating mental disorders.
65 CLEAR CELL ADENOCARCINOMA OF THE CERVIX WITHOUT EXPOSURE TO DIETHYLSTILBESTROL , H. Sami*, H. Eddaoualline, S. Barkiche, S. Elouarzazi, K. Mazouz, M. Darfaoui, A. Elomrani and M. Khouchani
Clear cell adenocarcinoma is a histological type rarely found among cervical cancers. It can be seen in women at all ages and very often mentioned in connection with Diethylstilbestrol (DES) taken by the mother during pregnancy. Its prognosis is severe, requiring early and appropriate management. In front of this rare histological form where the literature still lacks enough examples, we find the interest to report the case of our young patient, where the notion of exposure to DES is absent, and which has been treated with an evolution favorable with no sign of recurrence after 5 years of follow-up. Thus, the objective through our article is to study the characteristics of this type of cancer, in particular its etiopathogenesis, its management and its prognosis.
66 AN AYURVEDIC APPROACH TO UNDERSTAND ENVIRONMENTAL TOXICOLOGY , Dr. Krishna Singh*
Environmental Toxicology is a burning issue of the century. Rachel Carson is the mother of environmental toxicology, as she made it a distinct field in 1962. In the 1970s scientists concerned with this field focused their research on the impacts of agents of biological warfare, industrial pollution, and on discharge from mines. In the next decade; the focus shifted to chemical and radiations associated with radioactive material with the occurrence of Bhopal disaster, in which 45 tons of poisonous methyl isocyanate gas escaped from an insecticide plant, and the Chernobyl accident, in which massive amounts of radioactive material were released into the atmosphere following the explosion of a nuclear reactor. Later in 20th and 21st centuries, the expansion happened with its major concerns as oil spills, the dumping of medical and nuclear waste, air and water pollution, and the impact of substances such as synthetic hormones
67 AN AYURVEDIC APPROACH TO DELAY AGING THROUGH RASAYANA THERAPY , Dr. Krishna Singh*
It is a long time human quest to defeat aging and since time immortal researchers are tirelessly working on it. Several theories have been given to understand this physiological change. Chronological and Biological Aging; are the two components of Aging. The latter one can be reversed or delayed. In Ayurveda, a very unique concept of Rasayana (Rejuvinative Therapy) is mentioned which delays aging and hence is the area of great interest for researchers.
68 IMPORTANCE OF AGNI IN SHALYA TANTRA , Dr. Sucheta Ray* and Dr. Shrikant Patel**
Agni has a special place in Ayurveda. Ayu, varna, bala, swastha, utsaha, budhi, kanti, ojas, teja, agni and prana comes under dehagni. And when dehagni is stable they are also stable. If this agni is destroyed we will die or if it is disturbed we will get diseased. Acharya Sushruta and Acharya Vagbhata both have coated the importance of Agni in poorva karma and pashchaat karma of Shastra karma.
69 A REVIEW ON SOLID DISPERSION METHOD TO INCREASES THE SOLUBILITY OF SCANCY WATER SOLUBLE DRUG , Tikesh Agrawal* and Updesh Lade
Solid dispersion method is the methods, which significantly increases the solubility, dissolution rate and also increases the bioavailability of the poorly soluble drugs. The solid dispersion is based on the concept of kneding method in that the drug is dispersed in an inert water-soluble carrier at solid state. Water soluble carriers such as cyclodextrin, methyl cellulose, urea, lactose, citric acid, polyvinyl pyrrolidone and polyethylene glycols are used as carriers for solid dispersion. This reviews background of solid dispersion technology, limitations, classification and various preparation techniques with its advantages and disadvantages.
70 STUDY OF CORRELATION BETWEEN PITTAVRUTTA APAN AND RAKTAPRADAR WITH SPECIAL REFERANCE TO MENORRHAGIA , Swati Tejrao Deshmukh*, Avinash Deshmukh and Deepali Amle
The concept of Avarana is most unique condition in Ayurveda to understand, analyse, and interprete. The word avarana means avarodha and gatinirodha. There are many types of avarana mentioned in charaka samhita. One of the type is pittavrutta apan, in which pitta dosha is avaraka dosha apan is avrutta, one of the symptoms is Asrukasrava in the form of Raktapradara which may correlated with Menorrhagia which is very common disorder. So if diagnosis and treatment is done in context of avarana then chronicity of disease will be reducd.
71 PROFICIENT CONTRIBUTION OF ACHARYA SUSHRUTA IN THE FIELD OF SHALYA TANTRA – AN AYURVEDIC SURGICAL BRANCH – A LITERARY REVIEW , Dr. Prabhat Kumar Rai*, Dr. Anantkumar V. Shekokar and Dr. Kanchan M. Borkar
Shalya Tantra the ancient Ayurvedic surgical science is one of the most efficient branch in Ashtang Ayurved (among eight major branches) as mentioned in many texts. It is a vital branch of Ayurved deals with the removal of irritating factors causing pain to the body and mind. Sushruta Samhita written by the great Acharya Sushruta, is in-depth treasure-house of surgical knowledge. The contribution of Acharya Sushruta in ancient surgery is long lasting. The concepts and techniques used by Acharya Sushruta in past are even relevant in today’s era with little amendments. There is no denying the fact that modern surgery has its roots or more precisely seeds in Sushruta Samhita. It was Ayurved of ancient India that pioneered the modern concepts of surgery. In this review an effort has been made to draw a special attention on ancient surgical concepts of Sushruta Samhita practicing today with few refinements.
72 REVIEW ARTICLE ON FLEXIBILITY OF JOINTS & ITS IMPORTANCE IN PHYSICAL FITNESS , Suvarna Kakirwar* and Dr. Umesh Lunawat
Flexibility is one of the essential component of physical fitness. In general flexibility means the range movement around the skeletal joint of the body. For a good physical fitness, it is essential that person has quiet flexible joint & is able to maintain his or her body flexibility. Flexibility is the range of motion around joint as determined by the elasticity of the muscles, tendons & ligaments associated with joint under consideration. In order to maintain the natural flexibility of the joints & reduce the risk of injury in, the training program should always contain suitable & correctly executed flexibility exercises. A muscle that is trained for strength becomes shorter. This in turn means that its range of movement is restricted which in practice decreases its ability to utilize its increase force resources correctly. Exercises that are design to train the strength of group of muscles, should always be followed by stretching exercises for the same muscle group. Various Asanas in YogShastra (Branch of Ayurveda) are very useful for stretching. Yoga makes our mind stable and creative & maintains our physical fitness & makes the person energetic.
73 THE PREVALENCE OF VITAMIN D DEFICIENCY AMONG ANTENATAL CASES & ITS CORRELATION WITH ADVERSE PREGNANCY OUTCOME , Reema Kumar Bhatt, Naresh Bansal*, S. Yadav and Dr. Pooja
Background: This study was carried out to Study the prevalence of vitamin D deficiency among antenatal cases & to determine the correlation between vitamin D levels and possibility of adverse pregnancy outcome. Methods: One thousand patients who fulfilled inclusion and exclusion criteria were selected and written consent was taken. The 25- hydroxy vitamin D3 level was estimated twice during the study period first at first trimester and again at the time of delivery. The pregnancy outcome was based on Vit D levels at the time of enrolment in study at first visit. The Vit D levels was grouped into three categories (<10 ng/ml, 10-30ng/ml and 30-100ng/ml). The study subjects were supplemented with Vit D3 (60,000 unit) orally per month till delivery if the Vit D3 level is <30ng/ml. The effect of Vit D3 level on the possibility of adverse pregnancy outcome was observed by Mode of Delivery, Birth weight, IUGR, IUD/Still birth, Anemia, Preeclampsia, Gestational diabetes mellitus (GDM). Results: The prevalence of Vit D deficiency among antenatal mothers was 91% and were supplemented with Vitamin D. In this study, vitamin D levels were significantly associated with parity, gestational age, mode of delivery and occurrence of pre-eclampsia and gestational diabetes mellitus. However, there was no significant association of Vit D levels with age, religion, IUGR, IUD/Still birth and anemia. Conclusion: The Vit D deficiency is widely prevalent and supplementation increases the vitamin D level significantly. In terms of neonatal outcomes, low vitamin D levels at enrollment was associated with low birth weight and IUGR but was not statistically significant. The preeclampsia and gestational diabetes mellitus was significantly more in vitamin D deficient mothers. The vitamin D supplementation during pregnancy might improve the adverse pregnancy and birth outcomes.
74 CLINICAL PROFILE OF PATIENTS WITH VERNAL KERATOCONJUNCTIVITIS , Dr. Dimple Shakeet* and Dr. Shakti Krishan Rajguru
Background: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, recurrent ocular inflammatory condition found in individuals predisposed by their atopic background and associated with secondary keratopathy. Methods: 90 patients with VKC selected at random, who attended the Department of ophthalmology, Barmer Medical College, Barmer (Rajasthan) were the subjects of this study. Results: Major symptoms seen in this study group are itching, watering and photophobia. Congestion was present in 78 patients of VKC and 12 patients had no congestion at presentation. Perilimbal pigmentation was seen in 70 patients out of 90 studied subjects of vernal keratoconjunctivitis. In this study 40 patients had perilimbal conjunctival hypertrophy and 50 patients did not have conjunctival hypertrophy. 12 patients had clinical sign of Horner Trantas dots in this study indicating severity of vernal keratoconjunctivitis. Conclusion: VKC was common in males, during hot climate. Limbal type of VKC was more commonly present.
75 DRY EYE AND ANTIPSYCHOTIC DRUG , Dr. Dimple Shakeet* and Dr. Shakti Krishan Rajguru
Background: Dry eye disease is a well-known side effect of antipsychotic therapy which is often neglected due to nonspecific symptoms. Therefore, this study is to analyse dry eye prevalence in patients on chronic antipsychotic therapy. Methods: This was hospital based cross-sectional study conducted at department of opthalmology. 50 patients who were diagnosed of schizophrenia and have been under anti-pschyotic were included. 50 healthy subjects who have statistically similar demographic features compared with the cases, were involved as a control group. Dry eye was to be diagnosed on the basis of Schirmer's test and TBUT (tearfilm breakup time) Results-16 out of 50 patients on chronic anti-psychotic therapy had dry eye disease. 4 patients were present unilateral dry eye. Maximum 12 (42.86%) eyes out of 28 eyes diagnosed with dry eye had Grade 2 dry eye disease. 50% of the patients found to have dry eye disease were on treatment with anti-psychotic agents for more than 10 years. Prevalence of dry eye was more common (12out of 19 patients) in patients taking two drug combination. The Schirmer test showed thickness of 3.21 ± 0.68 mm and 14.20 ± 1.45 mm in groups cases and control respectively. The blink rate were observed 4-8 per minute in patients on a anti-psychotic therapy. There was a statistically significant difference in the Schirmer test and blink rate between the two groups. Conclusion: Anti psychotic drug may induce dry eye syndrome and thus may lead to morphological alterations in corneal parameters through its anticholinergic and antidopaminergic activities.
76 SYNTHESIS AND BIOLOGICAL EVALUATION OF 1,4 DIHYDROPYRIDINES DERIVATIVES , Pradeep Kumar L.*, Dr. Sangamesh B. Puranik, Dr. Ashok Kumar B. S., Sridhar S. M.
Heterocyclic chemistry is of great importance to the medicinal chemists because of their drug utility. Large number of heterocyclic compounds being used as therapeutic agentsand these compounds are also essential for the human life.1, 4-Dihydropyridines are associated with broad spectrum of biological activities. A series of new Schiff bases containing the Hantzsch 1,4-dihydropyridine skeleton (1a-1g) has been synthesized byreaction of an appropriate aldehyde with 1, 4-dihydro-4-(substituted phenyl)-2,6-dimethylpyridine-3,5-dicarbohydrazide. The synthesized compounds were then characterized by TLC, melting point determination, IR, 1H-NMR.
77 MANAGEMENT OF DRUG INDUCED SEXUAL DYSFUNCTION IN MALE RATS BY SILDINAFIL CITRATE , Sridhar S. M.*, Rohit Saraswat, Ashok Kumar B. S., Pradeep Kumar L., Gopisetty Saran
Sexual dysfunction is a highly prevalent disease associated with aging as well as with several risk factors including hypertension, heart disease diabetes, depression, drug-related. The present study aimed to investigation the effect of phosphodiesterase inhibitors (Sildinafil Citrate) on sexual behavior parameters like: mount latency (ML), mount frequency (MF), intromission latency and frequency (IL & IF), Ejaculatory Latency(EL) and frequency (EF), post ejaculatory Interval (PEI). The result reveals that treatment with Sildinafil Citrate improves sexual behavior in clomipramine induced sexual dysfunction rats.
78 RETROSPECTIVE STUDY ON THE EFFECTIVENESS OF HOMOEOPATHIC MEDICINE IN BIPOLAR AFEECTIVE DISORDER, MANIC TYPE , Dr. S. Karunakara Moorthi M. D. (HOM), Dr. Jaseel Ahammed N. P., Dr. Radhika P. and Ms. Resmy R.
Introduction: Mania can be defined as an abnormally elevated mood characterized by symptoms such as inappropriate elation, increased irritability, insomnia, increased speed and/or volume of speech, disconnected and racing thoughts, markedly increased energy and activity level, poor judgment, and inappropriate social behaviour. There are a number of medicines cited in homoeopathic literature which can be used for treatment of mania. A retrospective study was undertaken to explore usefulness of homeopathic medicines in the treatment of mania. Methodology: Case records of 30 patients were studied retrospectively to assess the symptoms of mania. Young’s Mania Rating Scale was used to assess the response to treatment after 4 weeks of intervention. Results: A Friedmann’s test showed that the YMRS total score has significantly reduced from 37.87±3.58 to 22.30±12.35. (χ2=71.64, p<0.001) over 4 weeks. Post Hoc analysis was done by applying Wilcoxon Signed rank test. Wilcoxon Signed rank test showed that there is significant reduction in the YMRS total score from first week onwards (z=-2.443, p=0.015). Conclusion: The findings are encouraging to open avenues for further studies on mania.
79 RIDGE AUGMENTATION USING MANDIBULAR SYMPHYSEAL BONE GRAFT FOR THE PLACEMENT OF DENTAL IMPLANT – A CASE REPORT , Dr. John Aby*, Dr. Sanjith P. Salim and Dr. Nichu Anna Sunny
Dental implants are artificial tooth root inserted into the jaw to hold a an artificial tooth or bridge for replacing missing teeth. To optimize aesthetic implant placement in the resorbed or damaged ridge, augmentation is required. We are presenting a case report to describe a method and to assess the success of bone reconstruction of atrophic anterior mandibular alveolar ridge utilizing intraoral bone grafts.
80 HYPERTENSION AS A PREDICTOR OF DIABETIC RETINOPATHY AT A TERTIARY CARE HOSPITAL , Background: In the year 2000, there were around 171 million people with diabetes globally, and by 2030, it is estimated that this number would increase to 366 million. These microvascular complications are linked to the duration of diabetes mellitus, poor glycemic control and systolic hypertension. Objective: To determine the frequency diabetic retinopathy (DR) in diabetic patients with hypertension. Subjects and Methods; A total of 365 diabetic patients having hypertension were included in our study using non – probability consecutive sampling technique. These patients were screened for diabetic retinopathy. All the information was recorded in the proforma and data was analyzed by using SPSS version 22. Results; of these 365 study cases, 226 (61.9%) were male patients while 139 (38.1%) were female patients. Mean age of our study cases was 50.92 ± 5.77 years (with minimum age of our study cases was 40 years while maximum age was 60 years). Of these 365 study cases, 127 (34.8%) belonged to rural areas and 238 (65.2%) belonged to urban areas. Monthly family income up to Rs. 25000 was noted in 188 (51.5%) and 177 (48.5%) had monthly family income rupees more than 25000. History of smoking was present in 89 (24.4%) of our study cases. Mean body mass index was 26.32 ± 2.45 kg/m2 and obesity was present in 112 (30.7%) of our study cases. Mean disease duration was 12.35 ± 7.52 years and 239 (65.5%) had duration of illness more than 5 years. Of these 365 study cases, 238 (65.2%) were illiterate and 127 (34.8%) were literate. Controlled diabetes was noted in 75 (20.5%) and 75 (20.5%) were taking proper treatment. Diabetic retinopathy was 151 (41.4%) of our study cases. Conclusion; Very high frequency of diabetic retinopathy was noted in patients with diabetes and hypertension in our study. Diabetic retinopathy was significantly associated with residential status, increasing age, monthly family income, smoking, treatment status, disease duration and obesity. Diabetic retinopathy was not associated with control of diabetes and hypertension. All clinicians treating such patients must educate their patients regarding regular eye check up to decrease disease morbidity.
Diabetic retinopathy, hypertension, frequency.
81 COMPARISON BETWEEN CONVENTIONAL AND HARMONIC TECHNIQUES IN BLEEDING CONTROL DURING THYROIDECTOMY , Dr. Muhammad Saim*, Dr. Anique Ali and Dr. Maham Fatima
Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy. Methodology: This randomized control trial was conducted in Surgery Department, Nishtar Hospital Multan. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant. Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ2=0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion: The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well.
82 VALUATION OF A RETROSPECTIVE ANALYSIS OF SURGICAL TREATMENT OF INFLAMMATORY AND DYSTROPHIC PERIODONTAL LESIONS ACCORDING TO THE EPARTMENT OF SURGICAL DENTISTRY TSDI , Elbek Gaybullaev*, Jasur Rizaev, Shamshod Alovitdinov and Elmurod Dusmukhamedov
This article presents data on a retrospective analysis of the surgical treatment of inflammatory and dystrophic periodontal lesions and the reasons for patients to refuse treatment for the period from 2009-2019, carried out at the Department of Surgical Dentistry TGSI. It is scientifically substantiated that the most common common factors are gastrointestinal diseases, and among local factors, tooth position abnormalities should be indicated. It has been proved that a negative history often forces patients to abandon promising methods of surgical treatment, as many patients are aware of increased sensitivity of the teeth and exposure of the necks of the teeth after the procedure. Therefore, this problem remains relevant today.
83 SUPRAMOLECULAR COMPLEXES OF HETEROCYCLIC AMINES WITH GLYCYRRHIZINIC ACID AND ITS MONOAMMONIC SALT AND THE STUDY OF SOME PHYSICO-CHEMICAL PROPERTIES , *Esanov R. S., Matchanov A. D., Gafurov M. B., Yuldashev Kh. A.
Supramolecular complexes of heterocyclic amines with glycyrrhizic acid and its mono-ammonium salt were obtained. Some physicochemical spectral characteristics of the obtained supramolecular complexes were studied. The stability of the complexes and the Gibbs free energies are determined.
84 CONCEPT OF AUSHAD SEVAN KAAL AND ITS CORRELATION WITH DRUG ACTIONS: AN AYURVEDA REVIEW , Dr. Rahul Sukhdev Bankar* and Dr. Ranjit Maruti Solankar
The treatment of diseases with medicine requires consideration of various factors such as; Desha, Kaala, Pramana, Satmya, Asatmya, Pathya & Apathy. Kaala is one of the concepts which can be elaborated as Aushadha Sevana Kala resembling time of drug administration. The administration of drug at proper time means consideration of concept of “Aushadha Sevana Kala” helps to acquire optimum health benefits of administered drugs. Drug should be administered as per the specific condition of Agni so Dhatu-samyata & balancing of Doshas not get affected. The concepts of Aushadha Sevana Kala help to prevent any adverse food & drug interaction. The consideration of Bhaishajya kaal (time of drug administration) is not only important for treating a disease but it minimizes chances of adverse drug reaction since drug administered at improper time can cause severe side effects. The purpose of present article is to explore concepts of Aushadha Sevana Kala & its relation with pharmacodynamic profile of medicine.
85 BREAST CANCER REVEALED BY PARALYSIS OF THE COMMON OCULOMOTOR NERVE : A CASE REPORT AND REVIEW OF THE LITERATURE , Oubahha Ihsane, Asmouki Hamid*, Ait Souabni Sara, Hajji Ibtissam, Belhaddad Habib, Inzale Nouha, Moutaouakil Abdeljalil and Soummani Abderaouf
The metastatic involvement of the orbit in malignant tumors is a rarely diagnosed condition. Breast cancer accounts for the majority of these cases. Breast cancer can metastasize to many sites, but the orbit is an infrequent location and a comparatively rare site of distribution among the ocular area structures. Longer survival of patients with metastatic disease as well as advances in diagnostic imaging may explain the increasing frequency of ocular involvement[1] that occurs in up to one third of breast cancer patients.[2] Bone metastases as a sole metastatic site in breast cancer portend a good prognosis as opposed to visceral disease and are seen frequently in the ER/PR (+) Her2/Neu (−) subset of the disease. Nevertheless, they may present a particular clinical problem if they are neighboring sensitive structures such as the spine or the eye, as in this case, and may need urgent treatment to preserve patient’s quality of life and function. We report the case of a 50-year-old patient who had orbital metastases of an unknown breast cancer. The commonest clinical sign at diagnosis is exophthalmia. Prognosis is usually pejorative once diagnosis is performed. Standard treatment is radiotherapy and requires a multidisciplinary approach.
86 A REVIEW ON RITU AND RITUCHARYA , Dr. Priyanka*, Dr. Yogesh Jakhar, Dr. Jagmeet Kaur and Dr. Anupam Pathak
Ritu, the season, classified by different features shows different effects on the body as well as the environment. Ayurveda has various rules and regimens (Charya), regarding diet and behavior. Ritu means season and charya means following or discipline. Ritucharya in simple words means seasonal routine, the lifestyle and diet that need to be followed according to the particular seasonal requirement to maintain hormonal balance in our body and to be fit and healthy. The main principle of Ayurvedic system of medicine is preventive aspect, can be achieved by following ritucharya. This is a very important aspect of preventive medicine as mentioned in Ayurvedic texts. In this review article, various ritus and ritucharya,[1] mentioned in the classics of Ayurveda has been discussed.
87 FEATURES OF THE CLINIC AND BLOOD PARAMETERS IN PATIENTS WITH CHRONIC HEPATITIS ON THE BACKGROUND OF RHINOSINUSITIS , Rajabov A. Kh.*
240 children aged 3 to 15 years with chronic hepatitis B in combination with rhinosinusitis were examined. All patients with manifestations of RS and CHB had recurrent sinusitis, sympto RS of General intoxication, dyspeptic phenomena, enlargement and densification of the liver and pronounced biochemical parameters of the blood. The clinical significance of rhinosinusitis in children with chronic hepatitis B is determined by its role in the development of severe for RS of the course, the influence on the rate of progression of the underlying disease and the frequency of adverse outcomes. In children with chronic hepatitis B on the background of chronic rhinosinusitis develop deep clinical and biochemical changes.
88 CONCEPTUAL STUDY OF ASHAYAPKARSHA GATI W.R.T. SAMPRAPTI VIVECHAN OF RUDDHAPATHKAMALA , Dr. Deepali Amale and Dr. Mrunali M. Chavan*
In Ayurveda, the actual intrinsic factors for Samanyaj Vyadhi are Vata, Pitta and Kapha. These Doshas are susceptible to imbalance and vitiation. In this vitiation or imbalance Doshgati plays important and vital role. Gati means movement and the word Doshagati implies movement of Doshas. Types of doshgati are of four types, Koshtha-Shakha-Marmasthisandhi Gati, Vruddhi-Kshaya-Sthana Gati, Urdhwa-Adha-Tiryaka Gati and Ashayapkarsha gati. Here Ashayapakarsha means displacement from original place. In this, the vitiated vata dosha displaces normal pitta or kapha from its place. This displacement of pitta and kapha from its place causes various disorders due to imbalance of pitta and kapha. Kamala is Raktapradoshaj vyadhi, where Bahupittakamala and Ruddhapathkamala are its two types. In Ruddhapatha kamala Aggrevated vata along with kapha obstruct the common bile duct which carries the bile from liver to duodenum i.e Ashayapkarsha Gati. This review of literature highlights study of Ashayapkarsha Gati in Samprapti of Ruddhapathkamala.
89 TARGETED THERAPY FOR RENAL CELL METASTATIC CANCER , M. N. Tillashaykhov and L. T. Gaziev*
Renal cell carcinoma (RCC) accounts for 2-3% of all malignancies in adults, while the incidence increases in most developed countries: the annual increase is 2.3%.[1] In Russia, in 2017, RCC was first diagnosed in 13556 patients. The standardized incidence rate was 16.87 per 100,000 populations, and the increase in incidence over 10 years was 42.63%. In terms of the rate of increase in the incidence of RCC, it is second only to prostate and thyroid tumors.[2] In 2018 in Uzbekistan, RCC was first diagnosed in 717 patients. The standardized incidence rate was 2.2 per 100 thousand populations.[3] Despite the fact that the majority (up to 70%) of patients with RCC are detected at the stage of localized tumor process, more than half of patients develop metastases after surgical treatment.[4]
90 ROLE OF MEAN PLATELETS VOLUME IN NON INSULIN DEPENDENT DIABETES MELLITUS (NIDDM) , Amal Elhassade*, Adham Saad, Monya Azzouz and Ehwida Bukhatwa
Background: Platelets with altered morphology or large size are more thrombogenic and are likely to be associated with increased risk of vascular disease. Platelet parameters especially high mean platelet volume (MPV) has been reported in diabetic patients as major contributing factor. Aim of the study: To determine if platelets were activated in diabetes by measuring the MPV in the diabetics compared to the non diabetics, to see if MPV was influenced in relation HbA1c and total platelet count. Materials and Methods: In the present study 100 were analyzed rand categorized into two groups based on the fasting blood glucose levels as Group I - healthy (non diabetics n= 40) Group II (patients with diabetic mellitus type II n=60), Results: MPV values were 8.97 ± 1.28 fl in diabetic individuals whereas 9.14 ± 1.01 in controls. The mean of total platelet counts in group II and group I were 233.79±85.7 x 109/l and 291.78 ± 97.81, respectively which were statistically significant different, platelets count was lower in uncontrolled diabetics and MPV larger than controlled diabetics. Conclusions: platelets count decrease in diabetics, MPV was larger in uncontrolled diabetics, the parameters still showed progressive decrease and increase with rising sugar levels significant in diabetic group.
91 CRITICAL CARE NURSES' KNOWLEDGE AND PRACTICES REGARDING DYSPHAGIA CARE OF ACUTE ISCHEMIC STROKE PATIENTS , Nahla Shaaban Khalil*, Radwa Muhammad Eissa and Manal Sayed Ismaeel
Background: Dysphagia is a very serious condition that may affect up to 80% of all stroke patients. It can affect hydration and nutritional status of stroke patients delaying their recovery. Also, it can lead to very serious complications such as aspiration pneumonia, choking, and even premature death. Early dysphagia screening and recognition by trained nurses is considered as one of best practices for acute stroke patient to prevent subsequent complications and promote stroke rehabilitation. Objectives: To assess critical care nurse's knowledge and practices regarding dysphagia care of acute ischemic stroke patients. Method: A descriptive exploratory design was utilized and conducted in critical care stroke unit at a teaching university hospital in Eastern Egypt including 30 nurses working in this unit. Nurses' baseline, knowledge questionnaire and observational checklists regarding dysphagia care were utilized. Results: Almost all the studied nurses have got unsatisfactory, knowledge and practices level regarding care of dysphagic patient. Moreover, nurses‟ knowledge was significantly correlated with years of experience in the field of nursing and years of experience in stroke units. Conclusion: It can be concluded that knowledge and practices of critical care stoke unit nurses were inconvenient and need to be improved. As well, enrichment of nurses‟ knowledge and practices regarding dysphagia care of acute ischemic stroke patients is highly recommended with replication of this study on lager samples from the different geographical locations in Egypt.
92 FRACTURES CAPITELLUM TREATED BY SCREWING HERBERT: 2 CASES , Mouad Beqqali Hassani*, Errachid Mohamed Badr, Sekkach Nourdine, Moncef Boufettal, Bassir Reda Allah, Mohamed Kharmaz, Moulay Omar Lamrani, Ahmed Elbardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
The fracture of the capitellum is a rare articular fracture with frontal line, raises essentially the problem of their ignorance and their treatment. Poor results occur after imperfect reduction, late treatment or resection of capitellum. Many treatments have been proposed Our study describes the screw screwing of Herbert practiced in two patients between 2016 and 2019. The diagnosis was oriented by the clinical examination and confirmed on the radiography of face, profile and internal compl complete by a scan of the elbow. The lesions were classified according to Bryan and Morrey. Patients were operated on by emergency external lateral approach, open reduction and stabilization with buried Herbert screws.
93 SCHWANNOMA AT THE DISTAL THIRD OF THE ULNAR NERVE ABOUT A CASE , Mouad Beqqali Hassani*, Errachid Mohamed Badr, M. Zarouf, Moncef Boufettal, Mohamed Kharmaz, Moulay Omar Lamrani, Ahmed Elbardouni, Mustapha Mahfoud and Mohamed Saleh Berrada
Benign schwannomas are the most common nerve tumors. These tumors occur with predilection in the adult of 20 to 50 years, and always indifferently the man and the woman. The time of appearance of the first signs is usually long. Magnetic resonance imaging can guide the diagnosis but it is histology that confirms it. The treatment is essentially based on surgical enucleation. Evolution is generally favorable. We report here an observation of an isolated schwannoma of the ulnar nerve revealed by a subcutaneous mass of the anterior aspect of the left forearm in a patient age of 27 consults for a painless mass of the anterior aspect of the front left arm moving for 2 years. By detailing the diagnostic, therapeutic and evolutionary aspects through a review of the recent literature.
94 THE PREVALENCE OF MALARIA PARASITAEMIA IN CHILDREN 0-11 YEARS IN TWON-BRASS, BAYELSA STATE, NIGERIA , Dotimi Doris Atibinye, Dr. Alex-Hart Balafama Abinye*, Gilbert Preye Clapperton
Background: Malaria is one of the most common deadly parasitic diseases and a public health challenge in Africa. Malaria is a major impediment to health in sub-Saharan Africa, and its greatest toll is found among children and pregnant women. It also remains the single biggest cause of mortality among young children in Africa. The objectives of the study were to identify the prevalence of malaria parasitaemia in children, the susceptible age group and the most affected gender in Twon-Brass, Bayelsa, Nigeria. Method: The cross-sectional study was conducted on 150 asymptomatic children in Twon-Brass between the ages of 0-11yrs. All 150 participants were classified into 5 groups; 0-6 months, 7 months – 2 years, 3-5years, 6-8years and 9-11 years before they were tested for malaria parasite antigens. Data was presented on tables as frequency and percentages. Results: The findings indicated that out of the 150 children tested for malaria parasite, 57 (38%) were positive. The prevalence was highest among children 6-8 years 17(41.1%). More male (30) children had malaria parasites in their blood compared to females (27). Conclusion: The study indicated that the prevalence of malaria parasitaemia among children of 0-11years in Twon community is relatively high 57(38%). It was recommended that children should sleep under Insecticide Treated Nets (ITNs) to protect them from mosquito bites.
95 OGILVIE’S SYNDROME POST CAESAREAN SECTION CASE REPORT AND REVIEW OF LITERATURE , Bassir A., Ouchraa J.*, E. L. Idrissi S., Fakhir B. and Soummani A.
Ogilvie’s syndrome or Acute colonic pseudo-obstruction is a rare condition characterized by symptoms of a large bowel obstruction in the absence of a mechanical cause. The physiopathology of Ogilvie’s syndrome remains unknown. It was associated with some particular conditions including recent surgery especially Caesarean section, infection, or an underlying illness. The diagnostic is confirmed with the combinaison of low intestinal obstruction symptoms , associated with a large caecum without pathological lesion showed by Xray. The diagnosis should be fast to avoid caecal perforation that occurs in 25 to 40 percent of the cases and could be responsible of a significant mortality rate. The treatment is essentielly conservative, but surgical management is necessary in case of a complication. The objective of our study is to identify clinical and radiological signs of the post-caesarean Ogilvie’s syndrome in order to establish the appropriate treatment with no delay. We report a case of Ogilvie’s syndrome after cesarean section, which has been treated by surgery.
96 INFLUENCE OF ATTITUDE ON UTILIZATION OF PERSONAL PROTECTIVE EQUIPMENT AMONG NURSES AT THIKA LEVEL 5 HOSPITAL , Usman Yusuf* and Mwenda S. Catherine
Hospital acquired infections have been recognized as a problem affecting the quality of health care and a principal source of adverse healthcare outcomes globally. Hospital acquired infection occurs due to poor utilization of Personal Protective Equipment (PPE) among healthcare workers. Attitude is one major factor that affects utilization of PPE among healthcare workers. This study examined attitude toward utilization of PPE among nurses at Thika level 5 hospital, Kiambu County, Kenya. The study adopted a cross-sectional descriptive survey design which provided both quantitative and qualitative data. The study population was 246 nurses working in Thika level 5 hospital and with more than 1year experience. Both descriptive and inferential statistics were used in line with the study hypotheses. Qualitative analysis of data revealed that nurses at Thika level 5 hospital have somewhat negative attitude towards use of PPE. The study concludes that, attitude was found to be the most significant predictor of utilization of PPE. Positive attitudes would enhance utilization of PPE. For hospitals aiming to reduce or avoid healthcare worker acquired infections or nurses acquired infections, the management should invest more to develop ways of enhancing positive attitudes among nurses.
97 EFFECTS OF SUB-LETHAL EXPOSURE OF LAMBDA-CYHALOTHRIN ON BIRTH OUTCOME OF FEMALE WISTAR RATS , *Iheanacho J.U.I., Onyeka P.I.K., Udujih, H.I., Udujih O.G. and Iwuala C.C.
Lambda-Cyhalothrin (LCT) is widely used pyrethroid pesticide for pests control in agriculture, home, health and so on. The aim of this study was to investigate toxicity of sub-lethal doses of Lambda-Cyhalothrin on birth outcome of pregnant female wistar rats (Rattus novergicus). Animals were randomly assigned into four equal groups. Group 1 (control) received normal feed and water. Animals in group 2 to 4 were treated with three concentrations of lambda-cyhalothrin 0.2%, 0.4% and 0.8% respectively through feed and drinking water ad libitum from gestation day 1 through to weaning. The results on litter size indicates a significant dose dependent decrease (p<0.05) across treated groups. Total litter birth weight significantly decreased (p<0.05) in a dose dependent manner compared with control. A significant (p<0.05) stillbirth was recorded among treatment groups when compared with that of control. Also, postnatal survival showed a significant (p<0.05) dose dependent lower number of pups survival between parturition and weaning. These results demonstrated that lambda-cyhalothrin has toxic effects on birth outcome in treated rats.
98 USES OF GOMUTRA – HOW & WHEN? , Dr. Himanshu Verma*, Dr. Yogesh Jakhar and Dr. Anupam Pathak
Gomutra plays an important role in mythology as well as in Ayurveda. It is considered as holy and has both spiritual & medicinal benefits. Brihatrayee has mentioned Gomutra at first place among Astamutra Varga. Gomutra is one of the five contents of Panchagavya which obtain from Cow (Urine, Milk, Ghee, Curd & Dung). Cow based treatment is known as Panchagavya Chikitsa. It’s an Important and essential part of Panchagavya Chikitsa. In present era due to improper life-style many life-style disorders and auto-immune disorders are developing. Many researches has been done on Gomutra & it’s effects on the body and curing diseases.Gomutra is scientifically proven to act as an immunomodulatory along with its bacteriostatic action. This work is a conceptual view about Gomutra and its benefits in the maintenance of health and curing auto immune and lifestyle disorders alone and along with other Aushad Dravyas.
99 GRAHNI , *Dr. Pooja Tiwari, Dr. Deepika Anand and Dr. Dinesh Choudhari
The word Grahani can be understood in three ways i.e. grahani avayava, grahani dosha & grahani roga. Any deviation from the status of Samagni i.e. Mandagni, Teekshnagni & Vishamagni are called as Grahani dosha. This impaired agnileads to dooshana i.e. structural defect & functional impairment (vyaapaara vypareetya) of grahani (grahani rupa naadi) resulting in Grahani roga.
100 NEONATAL JAUNDICE , Dr. Neha Patil*, Dr. Nagendra Thakre**, Dr. Megha Agrawal*** and Dr. Ankita Agrawal***
70-80% neonates presentwith some percentage of hyperbilirubinemia, after birth jaundice is the common morbidity in the neonatal, period, however only 7-12% would require therapy to prevent damage or treat the cause of neonatal jaundice. Neonatal jaundice can be mainly classified physiological pathological jaundice. Increased bilirubin production, reduced hepatic clearance and enhanced enterohepatic circulation are the sole causes of increased prevalence of jaundice in new born. Phototherapy is accepted as the primary treatment of Hyper bilirubinaemia. This treatment also puts the baby at risk of important complications including retinal injury, dehydration, diarrhoea and bronze baby syndrome. Therefore, searches in order to reduce the time of phototherapy by a safer treatment have been considered for many years.
101 OPHTHALMIA NEONATORUM & ITS AYURVEDIC TREATMENT , Dr. Vandita Shukla*, Dr. Nagendra Thakre**, Dr. Megha Agrawal*** and Dr. Ankita Agrawal***
It is a type of inflammatory disease usually seen up to the age of 1year, i.e. Ksheerapa Avastha as described by Acharya Kashyap in the pretext of Vayavargikaran Adhyaya. It is caused due to vitiated breast milk as per Sushruta and Kashyapa but Vagbhatta mentioned that it arises during the phase of dentition. Madhav Nidana, Yogaratnakara, Ravanakrita Kumar Tantra had considered it as Ksheer Dosha Janya Vyadhi. Sushruta mentioned it due to Stanyaprakopa including Vata, Pitta, Kapha, Rakta Dushti. Harita mentioned that due to intake of Kshara Dugdha, Netra Roga occurs. In modern, Kukunaka is co-related with Ophthalmia Neonatorum which is also called as Neonatal Conjunctivitis. It usually affects new born babies following birth. Typically due to neonatal bacterial infection, Neisseria gonorrhea or Chlamydia trachomatis this disease may occur during vaginal delivery from exposure to these bacteria from the birth canal. Symptoms includes pain and tenderness in eyeball, purulent, mucoid or mucopurulent conjunctival discharge, conjunctival hypaemia and chemosis.
102 BENEFITS OF SWARNAPRASHANA IN CHILDREN , Dr. Ankita Agrawal*, Dr. Nagendra Thakre**, Prof. Dr. Vijay Chaudhary***, Dr. Sunita Patel***
Ayurveda holds good even today though it was writtenthousands of years ago. Ayurveda mainly helps to maintain the healthy state of mind and body. Swarnaprashana is one of the sixteen Samskaras which were described in ancient scriptures. Kashyapa is described Swarnaprashana in detail with its benefitsto promote immunity and memory of children. Swarnaprashanais very popular in India. It is boost immunity and improvemental, physical and metabolic. Swarnaprashana is administration of processed gold in liquid form with honey, Ghrita and some herbal medicine. Ayurveda recommend only purified and processed form of gold for internal administration Ayurveda explains Swarnaprashana, while modern medicine explained about vaccines. Vaccine produces immunity against specific diseases where as Swarnaprashana produces non specific immunity along with many effects.
103 A REVIEW ON SIRAVARNAN IN SHARIR RACHANA , Dr. Suvarna Kakirwar* and Dr Mrunal Dange
Our ancient acharyas have recommended the thorough structural scientific knowledge of the life. The knowledge of Rachana Sharir is necessary for the students of any system of medicine. Acharya Sushruta is Called as the father of surgery, as in Sushrut Samhita description is available regarding methodology for learning of anatomy, dissection on cadaver, dhamani, sira, marma etc. He has given more emphasis on the practical knowledge. Sushrut Samhita is the bestone for study of rachana sharir. In Sushrut Samhita we get distinguish description among sira, dhamani, srotas we get detail description of sira in Sushrut Samhita Sharirsthan adhyay seven. But regarding sira there is scattered dicription. In one place sira means blood vessels while in one place sira means nerve. So it becomes very difficult to know clear meaning like modern anatomy. So my aim for this literature review article is to study and correlate the tem sira. According to sharir rachana vigyan the circulation of rasa-rakta in the body depends upon sira, dhamani and lasika. While vatavaha sira carry vayu i.e. nerve. We can correlate them with the help of modern anatomy and should understand the text and its importance. So we can study the structure and function of siras by correlating our ayurvedic text and modern text. In conclusion we can say that sira which flow from origin can be called as artery, sira flow towards origin can be called as vein, sira which join artery with vein can be called as capillary, sira carrying lymph(rasa) can be called as lymph vessels, sira (vatavaha) carrying vayu can be called as nerve.
104 STUDY OF PRAMEHA SAMPRAPTI BY EVALUATING BADHATVA AND BAHUTVA OF DUSHYA , Dr. Madhavi Gaikwad, Dr. Komal Kishanrao Patil* and Dr. Deepali Amale
Charaka has explained Prameha in Ashtomahagada. Prameha is a Kulaj Vikar (Hereditary) and Jataj Prameha (Juvenile diabetes) is Incurable. Dosh Dushya Sangraha of Prameha is as- Dosha- Kapha, Pitta, Vata. Involved Dushya are Rasa, Rakta, Mamsa, Meda, Majja, Shukra, Oja, Ambu, Vasa, and Lasiaka. ‘Dosha Dushya Samurchana Janito Vyadhi’. Symptoms of disease are depends up on the involvement of Dushyas. Ten Dushyas are involved in samprapti of Prameha. Symptoms reflecting in patient depend upon how much Dushti occurs. Ex. Prameha Pidaka are not seen in all types of Prameha Rugna. Sandhivishlesh, Sirashyathilya etc. occurre only when Dushya Dushti occurrs. Dosh Sanga occurs at the place of kha vaigunya. Where there is more Kha Vaigunya more symptoms will be expressed in disease. Different type of Lakshana are created by single Dosha by disturbing different types of Dushya.
105 A REVIEW ARTICLE ON TAMAKA SWASA (BRONCHIAL ASTHMA) , Dr. Kaushal Kumar*, Dr. Subhash Upadhyay and Dr. Sakshi
Our ancient acharyas have recommended the thorough structural scientific knowledge of the life. The knowledge of Rachana Sharir is necessary for the students of any system of medicine. Acharya Sushruta is called to be the father of surgery, as in Sushrut Samhita, description is available regarding methodology for learning of anatomy, dissection on cadaver, dhamani, sira, marma etc. He has given more emphasis on the practical knowledge. Sushrut Samhita is the bestone for study of rachana sharir. In Sushrut Samhita we get distinguish description among sira, dhamani, srotas We get detail description of sira in Sushrut Samhita Sharirsthan adhyay seven. But regarding sira there is scattered dicription. In one place sira means blood vessels while in one place sira means nerve. so it becomes very difficult to know clear meaning like modern anatomy. so my aim for this literature review article is to study and correlate the tem sira. According to sharir rachana vigyan the circulation of rasa-rakta in the body depends upon sira, dhamani and lasika. While vatavaha sira carry vayu i.e. nerve. We can correlate them with the help of modern anatomy and should understand the text and its importance so we can study the structure and function of siras by correlating our ayurvedic text and modern text. In conclusion we can say that sira which flow from origin can be called as artery, sira flow towards origin can be called as vein, sira which join artery with vein can be called as capillary, sira carrying lymph(rasa) can be called as lymph vessels, sira (vatavaha) carrying vayu can be called as nerve.
106 AYURVEDA - IN THE PREVENTION AND MANAGEMENT OF OBESITY (REVIEW ARTICLE) , *Dr. Priyanka, Dr. Yogesh Jakhad and Dr. Anupam Pathak
Obesity is a blessing of the Modern age of Machines and Materialism. It occurs as a result of lack of physical activity with increased intake of food. The industrialization, stress during the work. dietary habits, lack of exercise & various varieties among the daily diet e.g. fast food, Freeze fruits, increased amount of soft drinks and beverages, canned foods results into the clinical entity which we can call as Obesity. Obesity is a non communicable disease which becomes a very serious problem in the society. Due to the faulty life style and diet pattern the incidence of Obesity increasing day by day all over the world. Sedentary habits and lack of exercise are also the main reasons behind the increased incidence of Obesity. Obesity can leads to many health problems like Diabetes, Cardiovascular disease and Arthritis. Obesity reduces the average life expectancy and affects the quality of life. Hence, prevention of Obesity during its starting stage should be considered a priority for overcome the risk of Diabetes, Cardiovascular, Arthritis and other serious diseases. There are many drug, medicinal preparations, Yoga and Panchkarma described in the Ayurveda having wonderful preventive and curative effect on the Obesity.
107 A REVIEW ARTICLE ON VAJIKARANA , Dr. Kaushal Kumar*, Subhash Upadhyay, Sakshi and Priyanka
Vajikarana or Vrishya chikitsa is a one of eight major specialty of the Ashtanga Ayurveda - The science of life. It teaches us how to live. In this regard Dinacharya, Ritucharya, Sadvruta, Rasayana, and Vajikarana play an important role. Seven Dhatus are present in the body-Rasa, Rakta, Mansa, Meda, Asthi, Majja and Shukra. The seven Dhatus are the responsible for the development of our body. Shukra is the last Dhatus produced in the body among the all Dhatus. A person who has healthy Shukra has a brightness of confidence, with eyes and skin that seen to radiate light. Shukra Dhatu also conferms strength, wisdom and power of the body. As per Charak Samhita, by proper use of formulations, one becomes endowed with good physique, potency, strength, and complexion and sexually exhilarated and sexually potent. This in turn is helpful in many common sexual dysfunctions, including Infertility, Premature Ejaculation and Erectile dysfunction.. Vajikarana deals with the preservation of sexual potency of a healthy man as well as treatment of defective semen, disturbed sexual potency. Vajikarana promotes the sexual capacity and physical activities.
108 KAYACHIKITSA AN AYURVEDA APPROACH FOR THE MANAGEMENT OF METABOLIC DISORDERS ASSOCIATED WITH MODERN DAY LIFE STYLES , Dr. N. S. Gangasagre* and Dr. Jyotsna N. Gangasagre
Ayurveda the ancient science of health and well being encompasses different branches for specific purposes; Kayachikitsa is one of the branches of Ayurveda science that mainly deals with management of general diseases using internal medicine. Kayachikitsa involves complete treatment (Chikitsa) of body (Kaya) using different approaches. The principles and approaches of Kayachikitsa helps to treat diseases such as; fever, infections, anemia, gastric trouble, diabetes, arthritis and various metabolic disorders, etc. The prevalence of metabolic disorders increases day by day due to the awful conduct of daily regimen. Considering the frequency of metabolic diseases and therapeutic advantages of Kayachikitsa present article summarizes role of internal medicine in the management of metabolic disorders mainly related with disturbed pattern of life style.
109 PRACTICAL APPROACH TO VATAVYADHI SAMPRAPTI & CHIKITSA , Amol D. Adsare* and P. C. Yawatkar
Ayurveda is not only medical science, but also it is a life science, which gives message of health & better living. Disease caused by Vata in its vitiated condition is called “Vatavyadhi”. On the basis of causes, Vatavyadhi can be classified into two types i.e. Dhatukshayajanya & Margavrodhajanya. Hetus of Dhatukshayajanya Vatavyadhi comprises eating less food, dry, cool & light food along with excessive exercise. Food intake leading to formation of Ama causes Margavrodhajanya Vatavyadhi. In samprapti of Dhatukshayajanya Vatavyadhi, Dhatukshaya is filled up with Vata Dosha & produces Vatavyadhi. When Strotas get obstructed, it leads to stoppage of function of organ & produces Margavrodhajanya Vatavyadhi. A sound knowledge of Samprapti plays very important role in diagnosis & treatment of Vatavyadhi. Avastha of Vatavyadhi plays important role in treatment. As the stage of Dosha changes, there is change in treatment modality of particular type of Vatavyadhi, so here an attempt has made for proper understanding of concept of Vatavyadhi Samprapti & Chikitsa.
110 DETAIL STUDY OF PESHI SHARIR & APPLIED ANATOMY OF PESHI , *Dr. Pooja Tiwari and Dr. Dinesh Choudhari
Every concept of Ayurveda has its own importance. There are many concepts mentioned in the classics are scientific and worth understanding in modern words. Among these concepts Acharya Sushruta mentioned Sapta Kalas in the body. While considering upon the Ashaya they had also thought of the linings making internal walls of the Ashaya, designating them as Kala. They presented it in a very silent way. Among the Sapta Kala, Mamsadhara Kala is one described by Sushruta and other Acharyas. There are 3 layers of connective tissue which extended from the deep fascia and protects and give strength to the skeletal muscle. They are epimysium, perimysium and endomysium, they may extend beyond the muscle fiber to form tendons. So by this we can understand. The Mamsadhara Kala in gross anatomy, i.e. fascia or deep fascia and in the histological level it can be taken as Endomysium. So the collection and comprehensive review of information regarding Mamsadhara Kala becomes significant. Hence to unravel and accumulate the hidden scientific information about Mamsadhara Kala, in different resources and its structure and function on common parlon, presents intended research work has been undertaken and planned to carry out.
111 AYURVEDA DRUGS TOWARDS PHYSICAL STRENGTH AND BODY BUILDING W.S.R. TO ASHWAGANDHA AND GOKSHUR , Dr. Yogeshwar Ashok Tikle* and Dr. Bandapalle Dattu Narayanrao
Ayurveda is one of the classical system of Indian health science that provides various approaches towards the healthy well being. The science of ayurveda mainly focuses towards the maintenance of general health by preventing invasion of disease causative factors thus we can say that ayurveda emphasizes concept of disease prevention rather than treatment. Ayurveda suggested concept of Dincharya as a preventive approach that helps to remain healthy and prevent invasion of diseases causative factors. On other hand ayurveda described use of various natural drugs to treat health ailments, these drugs may includes; herbs, plants, classical ayurveda formulations and drugs from animal sources, etc. Moreover Ayurveda enriched with several health supplements that improves general health and helps to maintain physical as well as mental health status. Considering this aspect present article explored role of two ayurveda drugs; Ashwagandha and Gokshur in body building.
112 DEMENTIA: A THREAT TO QUALITY LONGEVITY , Dr. Lakshmy Devi K.* and Dr. Jitendra Kumar Sharma**
Vedic and Ayurvedic term „Ayush‟ implies long & healthy life. Ayurveda, the science of life provides us with the measures that prolong life. Acharya Vagbhat hence quotes thus- “Ayu: kamayamaanena dharmaartha sukha saadhanam / Ayurvedopadesheshu videya: paramadara: //” A.H. Su 1/2 // Ayurveda observes natural dominance of vata dosha in old individuals and so vata dominant diseases are more likely to occur. The classic Sharngadhara Samhita quotes about natural depletion of shareer bhavas with each decade of life. Thus degenerative and debilitating diseases like Dementia, Stroke are commonly seen in older populations. Increasing age is the single strongest risk factor for dementia; a neurodegenerative syndrome characterized by impaired memory and activities of daily living and much more. Dementia is usually progressive and the exact symptoms experienced by a person with dementia depend on the areas of the brain that are damaged. The process of degeneration and wear out increases with age and maintenance of normal function obviously requires special efforts. Ayurveda drugs are helpful in this regard. Dementia being a debilitating disease in later stages, becomes unpleasant influencing the quality of life of the demented person, the dependents as well as the caretaker.
113 REVIEW: SOURCE OF CALCIUM FROM AHARDRAVYA , Vd. Pradnya Bhagwan Wakode*, Vd. Jyotsna V. Kulkarni and Dr. Aparna. M. Ghotankar
Ayurveda is science of life, it has its effect on every aspect of life like in healthy state or in diseased state. Acharya Charaka has explained everything about ahara i.e. diet for maintaining health and prevention for disease. Diet plays an important role in nourishment of body and nourishment of bone depends upon balanced diet. Calcium found in many ahardravya. Body needs calcium to maintain strong bones and to carry out many important function. All most all calcium is stored in bones and teeth, where it supports their structure and hardness.
114 AYURVEDA AND MODERN ASPECTS RELATED TO CONCEPT OF SHATAKRIYAKALA AND ITS IMPORTANCE TOWARDS THE MANAGEMENT OF DISEASES , Dr. Rahul Sukhdev Bankar*
Ayurveda is system of traditional medicine originated from India and practiced globally. Ayurveda mentioned several concepts for the understanding and preventing disease pathogenesis and Shatakriyakala is one of them. The Shatakriyakala related with consecutive stages of disease pathogenesis and considerations of preventive measures according to progression of diseases. Shatakriyakala mainly associated with six stages of disease progression and their possible management through Ayurveda principles. Shatakriyakala not only helps to diagnose diseases in early stage but also helps to suppress their intensity. Considering significance of concept of Shatakriyakala present article summarizes Ayurveda and modern aspects related to concept of Shatakriyakala.
115 MUTRA UTPATTI; AYURVEDA AND MODERN CONSIDERATION: A COMPARATIVE REVIEW , Dr. Rahul Sukhdev Bankar*
Ayurveda is considered as Upanga of Atharvaveda which provides ways of healthy living. Ayurveda encompasses several theories related to the maintenance of human health. Ayurveda not only described concepts of diseases and their prevention but it also elaborated concepts of human anatomy, physiology and pathology. In this regards Ayurveda mentioned anatomical and physiological perspectives related to the various system and Mutravaha Samsthana (urinary system) is one of them. The Mutravaha Samsthana involved in formation and excretion of Mutra (urine) means it is related with excretory system. The understanding of physiology of urine is very important to manage various Mutra Roga, considering this aspect the physiology of urine formation was summarized in present article.
116 ORAL CONDITIONS AND ITS MANAGEMENT DURING PREGNANCY: A REVIEW , Dr. Karanam Apoorva Prakash and Dr. K. Shashikala
Pregnancy brings about various physical, hormonal changes which affects or influences general as well as oral health. Management of the dental conditions is often neglected and ignored due to the lack of awareness among the patients and fear of medicolegal concerns among the medical professionals. This review article provides an insight about the common oral problems that could occur during pregnancy, guidelines for oral health and the management of the oral conditions during pregnancy.
117 A STUDY OF OCULAR MOVEMENTS AND PUPILS IN ACUTE STROKE WITH ITS CLINICAL CORRELATION AND IMAGING , Dr. Arthi P. S. and Dr. E. Dinesh Ragav*
Cerebrovascular disease or stroke rank first in frequency and importance, among all the neurological diseases of adult life. It is the third most common cause of death in the world. Every year there are approximately 700,000 cases of stroke-roughly 600,000 ischemic lesions and 100,000 hemorrhages, intracerebral or subarachnoid-with 1,75,000 fatalities from these causes combined.[¹]
118 JUSTIFICATION FOR NILAVEMBU KUDINEER CHURANAM IN TABLET FORM , Amruthavalli G. V.*, Aruna V. and Gayathri R.
Nilavembu kudineer churanam is well known for its anti-inflammatory, analgesic and anti-pyretic effect in siddha system. It is also proven to have immunomodulatory benefit. This drug will be given as a prophylactic as well as treatment medicine. It is also given during monsoon to prevent the viral diseases even by government of Tamilnadu. Because of its kudineer form, the benefits of it is not reaching to people as it deserved. The question of how to convert this kudineer to a contemporary form i.e tablets requires greater scientific investigations and understanding. We have used the extractive value as the key determining factor to convert Nilavembu kudineer churanam, Sastric Siddha Medicine to tablet dosage form. Details are presented in the paper.
119 FTIR SPECTROSCOPIC STUDIES ON LATEX OF PLUMERIA RUBRA- COMPARATIVE ANALYSIS OF FUNCTIONAL GROUP AFTER EXTRACTION , *Mananki Patel, Sanjukta Rajhans, Himanshu A. Pandya and Archana U. Mankad
FT-IR spectra of Plumeria rubra latex were recorded and from the absorption spectra, the frequency spectrum and intensities were collected. The result shows that both the samples after extraction are abundant in certain constituents. During the study period, the various frequency levels and their functional groups were studied. The results have shown that the biomolecules were rich in the methanolic sample as compared to aqueous sample.
120 RESULTS OF ANALYSIS OF CLINICAL AND MORPHOLOGICAL PROGNOSIS FACTORS FOR RENAL CELL CANCER , M. N. Tillashaykhov*, L. T. Gaziev and A. J. Kakhkharov
In terms of incidence among malignant neoplasm, renal cell cancer (RCC) ranks tenth in the world and firmly holds the third place among malignant neoplasm of the genitourinary system.[1,2] In the structure of cancer incidence in the world population, RCC accounts for 2-3% of all malignant neoplasm, with the highest incidence in developed countries.[3] In Russia, in 2017, RCC was first diagnosed in 13556 patients. The standardized incidence rate was 16.87 per 100,000 populations, and the increase in incidence over 10 years was 42.63%. In terms of the rate of increase in the incidence of RCC, it is second only to prostate and thyroid tumors.[4] In Uzbekistan, the incidence is 2.2 per 100 thousand populations.[5] RCC is characterized by a fairly variable and unpredictable clinical course, which is due to the genetic heterogeneity and morphological diversity of this group of tumors.[6] Despite the fact that in recent years there has been an improvement in the detection of the process, more frequent detection of small tumors and early stages, the mortality rate from RCC has not undergone significant changes.[7] Therefore, the identification of factors that make it possible to make an individual prognosis and determine the optimal treatment strategy for a RCC patient is one of the most important tasks of modern oncourology.[8] Of the many prognostic parameters studied so far, the stage of the tumor when it is detected is the most predictive in relation to the probable course of the disease.[9] In the era of development of minimally invasive and ablative methods of treatment, new forms of targeted therapy and new views on the molecular mechanisms of development and progression of RCC, the identification of factors that make it possible to make an individual prognosis and determine the optimal treatment strategy for a patient with renal cell cancer is one of the most important tasks of modern oncourology.[10] Therefore, it seems relevant to conduct a study aimed at identifying the influence of various clinical and morphological parameters of renal cell cancer on survival rates.
121 CARDIAC REHABILITATION KNOWLEDGE AMONG CORONARY ARTERY DISEASE PATIENTS ATTENDING A TERTIARY LEVEL HOSPITAL, BHARATPUR , *Dr. Rosy Shrestha, Jaya Prasad Singh, Dr. Kshitiz Shrestha and Sirjana Shrestha
Introduction: Coronary artery disease (CAD) is a leading cause of disease burden worldwide. Having Knowledge of the CAD can be considered as the first step to reduce the risk of cardiac complication. Referral to cardiac rehabilitation center (CR) has proved to be effective in improving functional capacity and quality of life. Therefore, the aim of this study was to explore the knowledge regarding CR in patients with CAD attending a tertiary level hospital at Bharatpur, Nepal. Methods: A descriptive cross sectional study design was used to examine 85 CAD patients attending cardiac out-patient departments of Chitwan Medical College and Teaching Hospital, Bharatpur, Nepal. Non-probability, consecutive sampling technique was used for data collection by face to face interview method by using a standard tool, namely CADE-Q. Data was analyzed. Results: Of all 85 respondents mean age was 56.95 ± 15 years. The highest scores of knowledge on CR were in prescription for physical activity based on stress test and persons’ abilities and disabilities (42.4%) and lowest in optimal target value of HDL and LDL cholesterol (2.4%). Level of knowledge was found less than 70%, as 3.5% scored acceptable, 52.9% poor and 43.6% insufficient. Conclusion: The knowledge regarding Cardiac Rehabilitation programs among CAD patients in Bharatpur were found to be sub-optimal. Hence, it is strongly recommended that nurses should frequently organize educational intervention programs on CR and subsequently emphasize on establishing cardiac rehabilitation centers in every tertiary level hospital so as to improve the knowledge on CR among CAD patients.
122 SYNTHESIS AND BIOLOGICAL SCREENING OF SOME SUBSTITUTED BENZIMIDAZOLE DERIVATIVES , Pradeep Kumar L.*, Dr. Sangamesh B. Puranik, Dr. Ashok Kumar B. S.*, Sridhar S. M.*, Gopisetty Saran*
Synthesis of commercially available benzimidazole involves condensation of o-phenylenediamine with formic acid. The most prominent Benzimidazole compound in nature is N-riosyl dimethyl benzimidazole. Benzimidazoles are an important class of compounds with a wide spectrum of biological activity like anti-hypertensive, anti-viral, anti-inflammatory, anti-oxidant, anti-fungal, antitumor and anthelmintic. The five membered heterocyclic moiety with substituted amines, aniline, amides also confers for various biological activity. Hence a series of benzimidazole ethanone derivatives fused with phenylhydrazone ring system have been synthesized, characterized by UV,IR and 1HNMR spectral data and evaluated for their in vitro and in vivo anti-inflammatory and antioxidant activity. The substituted benzimdazoles are summarized in this review to know about the chemistry as well as Pharmacological activity.@2012 Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND licence (http://creativecommons.org/licenses/by-nc-nd/3.0/).
123 THE EFFECT OF LEECH THERAPY IN THE MANAGEMENT OF WRIST TENDINITIS: A CASE STUDY , Bhandare Madhuri Vitthalrao* and Mhatre Sagar Raghunath
Chronic wrist pain can be difficult to manage and the differential diagnosis is extensive. The prevalence rate of wrist tendinitis is 0.5% among men and 1.3% among women. Tendinitis is the inflammation of a tendon .It happens when a person overuses or injures a tendon. Risk factors include high force, repetation & awkward positions. clinical presentation includes localized pain and tenderness. Conventional treatments are generally employed empirically to fight pain & inflammation. However these treatments are not completely satisfactory and the recurrence of symptoms is common. According to Ayurveda sushruta mentioned blood letting in ekadeshaj shotha i.e. inflammation defined to one place. Hence in this case study a patient of wrist tendinitis is treated with leech therapy provided considerable relief of pain.
124 A CASE REPORT OF PEDUNCULAR HALLUCINOSIS SECONDARY TO BRAIN STEM LESION , Dr. N. V. Sundarachary, Dr. G. Evangelin Blessy, Naga Swathi Sree Kavuri*, Dr. G. Rama Krishna and Deepika Kavuri
Peduncular hallucinosis (PH) is a rare complex visual hallucinations often presented as vivid, colorful visions of people, animals and objects. The exact etiology of peduncular hallucinosis is not known but several hypothetical mechanisms were explained by different clinicians. We presented a case of 65-year-old female with visual hallucinations with brain stem lesion in the form of hypertrophic olivary degeneration with the background of diabetes.
125 SPIRONOLACTONE INDUCED GYNECOMASTIA- A CASE REPORT , Palanisamy Sharmila Nirojini*, Maddirevula Maneesh Kumar Reddy, Rama Rao Nadendla and A. Pramila Rani
Gynecomastia is proliferation male breast tissue due to an imbalance in estrogen and androgen action. Though it is rare it causes anxiety, embarrassment and physical discomfort in the affected male. This case report is of a 69-year-old male patient who presented with the symptom of painful swelling in his both breasts. He is suffering from hypothyroidism, type 1 diabetes mellitus and myocardial infarction from past few years and using Eltroxin, Atorvastatin, Aspirin, Clopidogrel, Glimipride and Metformin. He was also diagnosed with clinically controlled Congestive Cardiac Failure (CCF) for which he was prescribed Lasilactone (Furosemide 20mg and Spironolactone 50mg) and developed enlargement of his breast after 9 months of treatment and diagnosed by the physician as bilateral gynecomastia. The physician withdrawn Lasilactone and added Furosemide 40mg. but the poor prognosis of his pedal edema caused by his CCF made the patient to take Lasilactone and the symptoms of gynecomastia recurred again. Diagnosing drug induced gynecomastia and discontinuing the drug causing it will prevent the need of surgery for gynecomastia.
126 ADRENAL GANGLIONEUROBLASTOMA IN ADULTS: RARE CLINICAL CASE , O. Elidrissi*, Y. Ghannam, H. Moudlige, Y. Bencherki, Y. Rachid1, M. Dakir, A. Debbagh, R. Aboutaieb K. Moumna, C. Tolba and F. Marnissi
We report the case of an adrenal ganglioneuroblastoma (GNB) in a 32-year-old patient, incidentally discovered, who underwent a complete surgical excision. The pathology study concluded that a nodular adrenal GNB which is a very rare tumor in adults with an unfavorable prognosis, only 19 cases of adrenal ganglioneuroblastoma in adults have been observed in the literature.
127 THERAPEUTIC USES OF VARAHIKANDA (DIOSCOREA BULBIFERA L.): A REVIEW ARTICLE , Dr. Manisha and Dr. Naresh Kumar Garg*
Traditional medicine forms an integral part of health care system in many countries. According to WHO statistics, about 25% of the medicines are derived from plants. 80% people still depend upon traditional system of medicine. The practice of traditional medicine is based on hundreds of years of belief and observation, which originated much before the development of the modern medicine. The knowledge of traditional medicine throws light on the discovery of new and potent medicine. Systematic documentation is lacking for many medicinal plants in India. Varahikana (Dioscorea bulbifera L.) possesses profound therapeutically potency, belongs to the family Dioscoreaceae which includes 9 genera and 220 species which are distributed in tropical and warm temperate regions. It is attributed with Vrushya (Aphrodisiac), Balya (Strength promoting), Rasayana (Rejuvinative) karmas. Review highlights on all the classical references of Varahikanda.
128 CLINICAL MANIFESTATIONS AND HORMONAL DISORDERS IN CHILDREN WITH PRIMARY HYPERPARATHYREOIDISM COMPLICATED UROLITHIASIS , Abdusattor A. Nosirov*, Fatkhulla F. Bayakhmedov and Izzatullo Z. Sobitov
Hyperparathyroidism (HPT) in children is manifested by nephrolithiasis, nephrocalcinosis, and in 80-100% of cases, recurrence of kidney stones is observed. The aim of this work was to study the effects of calcium and calcium regulatory hormones on the clinical course of urolithiasis of hyperparathyroid genesis in children. From 2010 to 2019, 52 children with urolithiasis were diagnosed with primary hyperparathyroidism based on clinical and biochemical studies. Clinical symptoms and syndromes of the disease depended on the level of calcium and calcium-regulating hormones, and differed from the course of the disease in children with urolithiasis (control). In children of the second age group, the disease was difficult, with pronounced changes in organs and systems, exacerbating the course of the underlying disease. The developed renal failure and sclerotic changes in the renal tissue contributed to the disappearance of the difference in laboratory parameters between age groups.
129 FREQUENCY OF ANXIETY AND DEPRESSION AMONG PATIENTS OF PULMONARY TUBERCULOSIS , Dr. Ramlah Tariq*, Dr. Rabia Khan, Dr. Abeer Raza
Objective: To assess the frequency of anxiety and depression among patients of pulmonary tuberculosis. Material and methods: This was a cross-sectional, observational study conducted at Pulmonology department, Nishtar hospital Multan from March 2018 to May 2018 over the period of 3 months. Total 100 diagnosed cases of TB either male or female having age range from 20-60 years were included in this study and anxiety and depression was assessed in selected patients. Results: Total 130 patients of TB were selected and anxiety and depression was assessed. Mean age of the patients was 43.12 ± 12.009 years. Out of 130 patients, anxiety and depression was noted in 89 (68.5%) patients and 78 (60%) patients respectively. Out 130 TB patients, 40 (31%) patients were normal, mild anxiety was noted in 80 (61%) patients followed by moderate 4 (3%) patients and severe in 6 (5%) patients. Mild depression was found in 60 (46%) patients, moderate in 8 (6%) patients and severe in depression was noted in 8 (6%) patients. Conclusion: Results of present study showed a higher rate of anxiety and depress in TB patients. 41-60 years age group was the most common age group. But age of the TB patients was not significantly associated with development of anxiety and depression. Most of the TB patients were male. Area of residence was significantly associated with development of anxiety and depression.
130 AUDIT OF H. PYLORI INFECTION IN CASES OF DYSPEPSIA , Dr. Abeer Raza*, Dr. Rabia Khan and Dr. Ramlah Tariq
Objective: To determine the frequency of helicobacter pylori among patients with dyspepsia. Material and methods: This cross sectional study was conducted at Department of Pathology, Nishtar Hospital Multan from March 2018 to September over the period of 6 months. Total 289 dyspeptic patients (as per operational definition), either male or female having age 30-70 years and having duration of ≥ 1 month were selected from Medical OPD of Nishtar Hospital Multan. Results: Total 289 patients with dyspepsia were selected in this study. Mean age, weight, height, BMI and duration of symptoms was 44.11 ± 10.492 years, 54.55 ± 13.022 Kg, 63.63 ± 4.230 Inch, 20.52 ± 4.524 and 2.46 ± 1.105 months respectively. Out of 289 patients, H. pylori was found positive in 96 (33%) patients. Male patients were 112 (39%) and female patients were 177 (61%). Conclusion: Results of this study showed a high rate of H. Pylori infection in patients of dyspepsia. Most of the patients belonged to 30-50 years and female patients were more victim of dyspepsia as compared to male. There was insignificant association of H. Pylori infection with age, gender and obesity. But H. Pylori infection was significantly associated with area of residence and duration of symptoms.
131 FREQUENCY OF FACTORS LEADING TO MDR TB , Dr. Talha Bin Yousuf, Dr. Khair Un Nisa, Dr. Qaseem Ali Zaidi*
Objective: The objective of this study is “to determine the frequency of factors leading to Multidrug resistance tuberculosis, in patients presenting at Nishtar Medical University and Hospital Multan”. Material and methods: This cross sectional was conducting at Department of Pulmonology, Nishtar Medical University and Hospital Multan from March 2018 to September 2018. Total 126 patients with MDR-TB were selected for this study. Association of reasons for interruption of ATT course, inadequate chemotherapy, under whose prescription ATT used previously and Previous H/O of taking ATT with gender, age and area of residence was assessed. Results: Total 126 patients with MDR-TB were included in this study. Minimum age of the patients was 20 years and maximum age of the patients was 60 years. Mean age of the patients was 39.44 ± 9.043. Most 65 (51.6%) of the patients with MDR-TB belonged to age group 31-40 years and 74 (58.7%) were male and 52 (41.3%) were female. Conclusion: Results of this study revealed that the most common age group affected with MDR-TB was 31-40 years. Male were more victim as compare to female. Mostly patients reported with MDR-TB have previous history of taking ATT under.
132 AUDIT OF LIPID PROFILE IN CASES OF HYPERTENSION PRESENTING AT TERTIARY CARE HOSPITAL , Dr. Qaseem Ali Zaidi*, Dr. Khair Un Nisa, Dr. Talha Bin Yousuf
Objective: To study lipid profile in cases of hypertension presenting at Sheikh Zayed Hospital Rahim Yar Khan. Material and methods: This descriptive study was conducted at Department of Medicine Sheikh Zayed Hospital Rahim Yar Khan from April 2018 to October 2018. A total of 100 patients admitted with hypertension were the participants of the study. The patients are in the range of 40-80 years. Both known hypertensive patients who were on treatment for a varying period of time and newly diagnosed hypertensive patients were included in the study. Results: Serum TC, TGL, VLDL, LDL, TC/ HDL, LDL/ HDL were significantly elevated in hypertensive group as compared to healthy controls. Serum HDL was low in patients with hypertension as was compared with controls, which was statistically significant. The LDL was raised in obese compared to non-obese patients, which is statistically very significant. TC/ HDL and LDL /HDL were also raised in obese patients which is statistically significant. TC is raised in CVA group, which is statistically highly significant. LDL is raised in CVA group, which is statistically very significant. TC/ HDL and LDL/ HDL are raised in CVA group compared to non-CVA group, which is statistically very significant. TC is raised in IHD group, which is statistically significant. LDL is raised in IHD group, which is statistically very significant. LDL/HDL is raised in men, which is statically significant. Conclusion: There is significant alteration of lipid profile in hypertensive patients as compared to controls. Total cholesterol, LDL cholesterol, triglycerides, VLDL, TC/HDL and LDL/HDL ratios are significantly elevated in patients with hypertension. HDL is significantly reduced in hypertensive patients. Hyperlipidemia is seen in majority of cases of hypertension with Type IIa pattern being the most frequent. Mean TC, LDL, TC /HDL, LDL/ HDL were higher in obese. Mean TC, LDL, TC/ HDL and LDL/ HDL ratios are raised in CVA group. Mean TC and LDL are raised in IHD group.
133 MISUSE OF ANTIBIOTICS IN MANAGEMENT OF DIARRHEA AND COUGH AT PRIMARY HEALTHCARE CENTERS , Dr. Muhammad Waseem Iqbal*, Dr. Badar Iqbal and Dr. Niaz Ahmad
This study is conducted to find out the prescription practices of different broad spectrum antibiotics, being routinely prescribed to children between 2 to 59 months, suffering from cough and diarrhea, in different health facilities of South Punjab districts of Pakistan. A structured questionnaire is provided in various primary health facilities to medical officers, inquiring about details of cough and diarrhea cases visiting these facilities during time period March 2019 to May 2019. The compiled data of 360 children with cough and diarrhea is analyzed using SPSS (20). Descriptive statistics of cough and diarrhea in the given time along with associated symptoms and antibiotics being prescribed are shown in the form of tables and charts. Study infers that the antibiotics prescription rate is significantly high (around 80%) among children between 2-59 months visiting different health facilities for cough and diarrhea. This high rate could be dangerous for young generations in future, therefore, important measures like repeated training sessions for working staff in hospitals, community sessions with media involvement for community awareness, and promotion of related research work are highly recommended to halt the rapid expansion of resistance among young ones caused by these antibiotics.
134 POST-OPERATIVE COMPLICATIONS OBSERVED IN SURGICAL DEPARTMENT AT NISHTAR HOSPITAL , Dr. Badar Iqbal*, Dr. Niaz Ahmad and Dr. Muhammad Waseem
Aim of study: To evaluate post-operative complications during hospital stay of patients in a general surgical ward at a tertiary care teaching hospital of Punjab. Methodology: It is a cross-sectional observational study conducted at a tertiary care center. Duration of the study was 3 months from April 2018 to June 2018. All the patients who underwent surgery due to any reason were included in the study after taking informed consent. Detailed history, examination, treatment and post-operative observed complications were noted on preformed proforma. All the data was analyzed using SPSS version 18.0. Results: Total 342 patients underwent surgical procedures which included 150(43.8%) elective and 192(56.2%) emergency procedures. Most common surgical procedure done was exploratory laparotomies 65(19%). Appendectomy was performed in 56 (16%), hernia repair in 34(9.9%), cholecystectomy including open and laparoscopic in 38 (11.1%), thyroidectomy in 25 (7.3%) and ano-rectal surgery including peri-anal fistula, hemorrhoids and sinuses in 40 (11.6%) of the patients. Complications were found in 198 (57.8%) of the patients. Most of the complications occurred after emergency surgeries in 130 (65.6%) patients as compared to 68 (34.3%) patients in elective procedures. Most common was postoperative pyrexia in 130 (38%) patients followed by postoperative nausea and vomiting in 98 (28.6%), prolonged paralytic ileus 42 (12.2%), intra-abdominal bleeding 33(9.6%) wound infection in 50 (14.6%), respiratory tract infection in 18 (5.2%) and thromboembolism phenomenon was observed in 3 patients. Two patients developed fecal fistula while 3 patients developed wound dehiscence. 8 patients died postoperatively in the hospital during the study period. Conclusion: We found that the most common postoperative complication was fever followed by post-operative nausea/vomiting, spinal headache, wound infection and respiratory tract infection. Post-operative complications are more common in emergency surgery than elective. It is important that the resident staff should be aware of these complications and how to manage them.
135 EVALUATION OF DYSLIPIDEMIA IN CASES OF LIVER CIRRHOSIS , Dr. Aneela Amber*, Dr. Farhana Zafar, Dr. Taimoor Ashraf
Objectives: To evaluate dyslipidemia in cases of liver cirrhosis. Methods: This cross sectional study was conducted at Department of Medicine, Sheikh Zayed Hospital Rahimyarkhan from January 2017 to June 2017. Total 200 cases of liver cirrhosis were selected. Results: In present study, mean age of the patients was 39.65 ± 12.45 years. Dyslipidemia was found in 168/200 (84%) patients. Significant association of dyslipidemia with severity of liver cirrhosis was noted. Conclusion: Results of this study reveals that dyslipidemia was found frequently in patients of liver cirrhosis. Dyslipidemia worsens with severity of liver cirrhosis according to child Pugh classification. But has no statistically significant association with age and gender.
136 FREQUENCY OF DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS PATIENTS , Dr. Farhana Zafar*, Dr. Aneela Amber, Dr. Taimoor Ashraf
Objectives: To determine the frequency of diabetic retinopathy in newly diagnosed type II diabetes patients. Settings: Sheikh Zayed Hospital Rahim Yar Khan. Materials and Methods: Total 113 cases of newly diagnosed type II diabetes mellitus patients with age range from 30-60 years were selected. Patients with type I diabetes, hypertension and h/o previous retinal surgery were excluded. All patients were then undergone fundoscopy and presence or absence of retinopathy and grades of retinopathy were noted. Results: Mean age of patients was 45.46 ± 7.40 years. Out of these 113 patients, 69 (61.06%) were male and 44 (38.94%) were females with male to female ratio of 1.6:1. Results have shown retinopathy present in 18 (15.93%) while 95 (84.07%) patients have shown no retinopathy. Conclusion: This study concluded that the frequency of diabetic retinopathy in newly diagnosed type II diabetes mellitus is 15.93% which is relatively high and emphasizes the detailed ophthalmic examination of each patient at the time of diagnosis of diabetes.
137 AYURVEDA AND MODERN PERSPECTIVE ON SROTAS, THEIR PATHOLOGICAL AND PHYSIOLOGICAL IMPORTANCE: A REVIEW , Dr. Parag Vasudev Yadav*
Srotas are Ayurveda terms resembling minute channels of body which performs various functions including circulation of micronutrients, detoxification and nutritional supply, etc. The specific Srotas perform specific functions depending upon their locations and distribution to the various body parts. The anatomical and physiological perspective of Srotas play vital role towards the normal health status of an individual since disturbed anatomical positioning and improper physiological functioning of Srotas can leads many health issues; Srotas vyadhi such as; infrequent respiration, excessive thirst, anorexia, Adhimamsa, Asthisula and accumulation of toxins, etc. Considering physiological and pathological importance of Srotas present article described Ayurveda and modern perspective on Srotas and diseases related to malfunctioning of Srotas.
138 AYURVEDA SIGNIFICANCE OF AHARA AND CONCEPT OF AHARA VIDHI VISHESHA AYATAN: A REVIEW , Dr. Seema Bahatkar*
Ayurveda the ancient Indian science elaborated various aspects for maintaining normal health including balancing state of Doshas, Dhatus and Agni. Similarly synchronization between Indriyas and Manas provides good health status and social wellbeing. In this regards furthermore ayurveda mentioned that proper nutrition value of consumed foods helps to achieve such types of balances and synchronization. Ahara is very important for maintain good health but rules related to preparation and consumption of food also play vital role. These all aspects greatly emphasized in ayurveda texts and ancient ayurveda literatures presented concept of Ahara Vidhi Vishesha Ayatan, consideration of this concept helps to achieve nutritional value of food and provide all health benefits of ingested food stuffs. Present article emphasized importance of Ahara and concept of Ahara Vidhi Vishesha Ayatan.
139 PREVELANCE OF TUBERCULOSIS IN WARRI SOUTH WEST FROM 2008-2017 , Dotimi Doris Atibinye*, Alex-Hart Balafama and Azah Aloysia
Background: This research project was to assess the prevalence of tuberculosis in Warri South-West, Delta State, from January, 2008 to December, 2017. Method: A retrospective study was carried out consisting of all documented cases of pulmonary tuberculosis in Warri South-West Primary Health Centre DOTs units from January 2008 to December 2017. Analysis was done using SPSS Version 20.0. Result: Findings indicated that out of 280 patients tested, a total of 150 cases of tuberculosis were recorded within the period of the study with a prevalence rate of 53.6%. The prevalence for each year during this study were as follows: 2008 (6%), 2009 (1.2%), 2010 (4.7%), 2011 (1.3%), 2012 (11.3%), 2013 (12.7.%), 2014 (13.3%), 2015 (8.0%), 2016 (16.7%), 2017 (24.7%). The most affected gender was female (77, 51%). The age group mostly affected was between the ages of 41 – 50 years (36%) while the least was 61 and above (2%). The percentage of the infected population that utilized the services rendered in Warri South-West Primary Health Centre DOTs units was 100. Conclusion: The prevalence of pulmonary tuberculosis in Warri South-West LGA within the years under study is on the increase and thus requires prompt measures in combating the situation. It is therefore recommended that Health workers should sensitize the public on how to prevent and control pulmonary tuberculosis. The government should improve the standard of living, Health policies, Human resource and service delivery in the rural areas. There should be a wide coverage of DOTS in all the Local Government Areas to treat identified cases.
140 NOT A DVT – A NOVEL CASE OF SURGICAL EMPHYSEMA , Dr. Lucy Watts and Dr. Carey Girling*
Suspected DVT is a common presentation to acute medical assessment units. Though sometimes obvious, many cases show subtle or non-specific signs and require inpatient laboratory testing for diagnostic confirmation or dismissal. One such patient was seen one day post elective laparoscopic ablation for endometriosis. Examination rapidly identified the source of pain as lower limb surgical emphysema, a rare post-operative complication from surgery of this type. Laboratory testing was reassuring, and radiology identified only subcutaneous gas with no evidence of underlying osteomyelitis. The patient was discharged home. The case is discussed and a literature review is undertaken of this uncommon presentation.
141 Psidium guajava L. AS AN ALTERNATIVE FOR ANTI-INFLUENZA VIRUS: A REVIEW , Yedy Purwandi Sukmawan* and Hendy Suhendy
Background: As of March 11, 2020, the World Health Organization declared COVID-19 pandemic. More than one hundred countries were affected by this virus with 132.758 confirmed and 4955 death as March 13, 2020. Aim of the study: Much research was conducted to discover an effective drug. Lopinavir/ritonavir, ribavirin, interferon-α, chloroquine phosphate, and arbidol have been recommended for the treatment of this virus. However, no verified anti-viral for the treatment of this COVID-19. Psidium guajava L is one of the valuable of herbal medicine for the anti-influenza virus. Materials and Methods We conducted a systematic review with a search strategy involving PubMed and Cochrane. Results: Two article were met the inclusion criteria. This plant showed anti-influenza virus activity through many mechanisms of action. Conclusion: This broad mechanism of action involved in anti-influenza virus activity makes this plant a promising novel for this COVID-19 outbreak treatment.
142 THE RED EYE REFLEX EXAMINATION IN NEONATES OF MONGOLIAN AND NEGROID BREED , Tripaldi Clelia MD*, Grande Elisabetta MD, Annicchiarico Elettra MC and Sannace Carmela MD
The red reflex has in recent years become part of the recommended neurosensory screening of newborns and infants. The ocular objective finding varies depending on the presence of diseases, but also in relation to the ethnicity of the newborn. We performed a retrospective study on all newborns of 2015 and 2016 in our center, examining all those in which the red reflex was altered, recalling them after a week and making a specialist eye assessment. In newborns of the Negroid and Mongolian race there is a greater probability of alteration of the red reflex. This was demonstrated by statistical analysis on our sample examined. The anatomical reason for this alteration, which therefore would have to be considered physiological, would be linked to the different retinal pigmentation in the Negroid and Mongolian races.
143 LITERARY REVIEW OF JALAUKAVACHARAN (LEECH THERAPY) IN THE MANAGEMENT OF DUSHTA VRANA , Dr. Tarun Meena*, Dr. Rajesh Gupta and Dr. Sudesh Rani Gupta
Method of removing blood from the body using jalauka (leech) is considered as the most easy and convenient method. Blood vitiated by vata, pitta and kapha should be removed from the body, by using sringa, jalauka and alabu respectively. Jalauka is ideal to remove blood vititated by pitta. They are of twelve kinds – six are savisa poisonous and the same number Nirvisa – non poisonous Leech sucking capacity is only 1 to 2 gm of blood. It is improper quantity of ‘bloodletting’. Sometimes leech can suck more than capacity. Bloodletting is second one important line of treatment of Vrana-Shotha. Leech saliva contains a chemical which has powerfull antibactirial action. A wound refused to heal or heals very slowly despite of best efforts is known as dushta vrana. Advancement in science, technologies and antibiotics has improved a lot in wound healing process but still understanding its patholoty and management is in phase of evolution. There are so many cause of chronic ulser (dushta-vrana) of the skin some of them are recurrent infection, trauma, poor blood supply, hypoxia, loss of sensation, specific causes like tuberculosis, diabetes, fibrosis etc.A clean wound is normal body heals earlier with minimum scar as compared to contaminated wounds.
144 RISK STRATIFICATION AND PROGNOSIS OF GASTRO-INTESTINAL STROMAL TUMOURS BASED ON IMAGING FINDINGS AND MITOTIC ACTIVITY IN HISTOPATHOLOGY , *Dr. Aarthi Parthasarathy M.D and Dr. Sachin Shatagar M.D
Objective: Aim of the study was to establish any helpful and reproducible parameters to indicate malignant potential and be used practically and objectively in the risk of malignant potential diagnosis of GIST. Materials and Methods: All patients with clinically suspected mass or intestinal obstruction, who are referred to our department for abdominal CT scan for evaluation of obstruction and whose follow up regarding surgical or conservative management is available. CT criteria used included the study of tumours under the following headings necrosis, haemorrhage, ulceration calcifications etc. Involvement of the adjacent in the form of metastasis , lymph node encasement, ascites, peritoneal deposits, exophytic vs endophytic component .CT findings were correlated with HPE – classification of spindle cells and mitotic activity and Immunohistochemistry to prove GIST. No mitosis group, low mitosis group and high mitosis group were defined depending on mitotic rates as described previously, Results: Univariate analysis demonstrated that mitotic count, cellularity, haemorrhage, tumour necrosis and p53 immunostaining were correlated significantly with poor prognosis. On multivariate analysis IHC and cellularity were significant independent prognostic factors, however we failed to obtain a sig p value to indicate a mitotic count a s an independent variable. Conclusions: We concluded that given potential for mitotic count in staging GIST and its prognosis according to various literature cited, a similar study can be continued to see its longterm outcome.
145 A BRIEF REVIEW ON MECHANISM AND ROLE OF HERBAL EXTRACTS IN THE TREATMENT OF CALCIUM OXALATE KIDNEY STONES THROUGH IN-VIVO ANIMAL STUDIES , Arshvir Kaur, Amneet Kaur, Nikhil Saxena, Ashish Kumar, Sujit Bose and Kajol Sharma*
Calcium oxalate stones are the major kidney stones as they are the product of the residue of the urinary contents which got precipitated, crystallized, aggregated and reserved in the kidney. The occurrence of these stones depends on certain factors genetics and age. The major term used for kidney stones is ‘Urolithiasis’ and the main allopathic treatment which is available in the market is Allopurinol, Zonisamide. The allopathic drugs are having certain limitation so herbal plants are good sources to overcome this problem. There are so many herbal treatments available for kidney stones like extracts of tulsi, Foeniculum vulgare, etc. Some of them are also tested in the preclinical trials because they do not cause any allergy and tiredness. The present review gives an idea on the various herbal extract that is tested on the animal model and they elimate the growth of the calcium oxalate stones by the various mechanism. This article gives information about the animal model, model for inducing the stones like ethylene glycol, ammonium chloride, etc in the animal model along with the uses of the model.
146 AYURVEDA AND MODERN PERSPECTIVE ON SROTAS, THEIR PATHOLOGICAL AND PHYSIOLOGICAL IMPORTANCE: A REVIEW , Dr. Parag Vasudev Yadav*
Srotas are Ayurveda terms resembling minute channels of body which performs various functions including circulation of micronutrients, detoxification and nutritional supply, etc. The specific Srotas perform specific functions depending upon their locations and distribution to the various body parts. The anatomical and physiological perspective of Srotas play vital role towards the normal health status of an individual since disturbed anatomical positioning and improper physiological functioning of Srotas can leads many health issues; Srotas vyadhi such as; infrequent respiration, excessive thirst, anorexia, Adhimamsa, Asthisula and accumulation of toxins, etc. Considering physiological and pathological importance of Srotas present article described Ayurveda and modern perspective on Srotas and diseases related to malfunctioning of Srotas.
147 AYURVEDA REVIEW ON INCOMPATIBLE AHARA W.S.R. TO CONCEPT OF SATMYA VIRUDDHA , Dr. Anand Prakash Verma* and Dr Ranjita Naharia
The classic Indian system of medicine Ayurveda described several concepts related to the health management. In this regards Ayurveda mentioned Ahara as one of the Upasthambas amongst three Sthambas which helps to maintain normal health status of body. Ahara resembles quality and quantity of consumed meal which provides basic nutrients and maintain physiological balances of body. The food not only imparts beneficial effects but it also causes many harmful effects if not consumed in proper manner. Unwholesome Ahara (Viruddha Ahara) is one such aspect of Ayurveda which considered harmful effect of incompatible food. The incompatibility of food are several types, considering this in present article various perspectives of Viruddha Ahara are elaborated with special reference to Satmya (wholesome) Viruddha.
148 INNOVATIVE AYURVEDIC VIVECHANA OF VATA-RAKTA - A CONCEPTUAL STUDY , Dr. Savitri Soni*, Dr. Sanjay Shukla and Dr. Rupendra Chandrakar
As per Ayurveda concept, the equilibrium of different fundamental elements in the body is the indication of good health. The imbalance of basic constituents causes different diseases. The joint diseases are emerging main health problem in the present era and the disease of joints which involves rakta, asthi, and dhatus are considered vata-rakta as sandhigat roga. The current life style not only disturb the healthy Ahar (Diet) but Vihar (daily exercise etc.) also. Unhealthy diet like junk food and hectic journey by vehicle etc. overall aggravates disease like vata-rakta. In vata-rakta aggravated vata is obstructed in its passage by aggravated rakta which affect the entire rakta and patient suffer from severe pain.
149 AYURVEDA MANAGEMENT OF MANDAL KUSHTHA (PSORIASIS) W.S.R. TO RASAYANA CHIKITSA: A REVIEW , Dr. Deepti L. Kawale* and Dr. Sharad Durgaprasad Tripathi
Mandala kushta is disease related to skin tissue, predominance of Sleshma and considered as Mahakushta. Red spots, raised patches, itching and burning sensation, etc. are common manifestation of disease. Kledakar Ahar, Dosha vaishamyan, Srotavarodham, Vegadharana, Krimi, Manovikaras and environmental effects, etc. can lead pathogenesis of Mandala kushta. The disease involves vitiation of Tri-dosha, Rakta, Mamsa and Twak thus special approaches requires for managing such disorders. Ayurveda emphasizes various therapies in such conditions and Rasayana Chikitsa is one of them. Considering this aspect present article described ayurveda perspective on Mandala kushta and special reference to Rasayana Chikitsa towards the management of disease.
150 THERAPEUTIC USES OF CHITRAKA (PLUMBAGO ZEYLANICA LINN.) WITH A NOTE ON IT’S PHARMACOLOGICAL ACTIONS. -A REVIEW , Dr. V. G. Mulke* and Dr. A. M. Ghotankar
Traditional system of medicinal plant consists of various medicinal and pharmacological uses. Medical practitioners are using medicinal plant widely for curing various diseases in their day to day practices, Chitraka (Plumbago zeylanica Linn.) is one amongst these, found all over the world, expressed a valuable tank of new bioactive molecules. The present review aimed to compile complete information of pharmacological action of Chitraka (Plumbago zeylanica Linn.) with special emphasis on its various classical and scientifically documents. Plant mainly contains plumbagin, naphthaquinones, alkaloids, glycosides, steroids, triterpenoids, tannins, phenolic compounds, flavanoids, glucopyranoside, sitosterol saponins, coumarins, carbohydrates, fixed oil and fats and proteins compounds. Is commonly used in Ayurvedic Preparations. Different parts of this plant are traditionally used for the treatment of illness including, rheumatic pains, liver diseases, fever, diabetes, kidney disease anti-fungal, anti-tumor, disease of heart.
151 AYURVEDIC MANAGEMENT OF DUCHENNE MUSCULAR DYSTROPHY , Dr. Rahul R. Kuwar* and Dr. K. S. Ratnaparakhi
Duchenne muscular dystrophy is a neuromuscular disorder characterized by deficient dystrophin protein in the muscle. The main symptoms the patient presented were delay in expressive and receptive language development, visual discontent, hyperkinetic behaviour, and inability to initiate and maintain social contact with peers. The data obtained from the family, following clinical examination, laboratory investigation results and assessment of mental status were significant for the diagnosis of Autism Spectrum Disorder, hyperkinetic behaviour and Duchenne Muscular Dystrophy. In Ayurveda it has been classified under Medomamsa dusti further vitiates the Vata doshas occurs due to the Bheejabagahaavyava Dusti. In modern medicine there is no significant treatment available for this diseases while in Ayurvedic panchakrma therapy shows significant results in all signs and symptoms of this diseases.
152 TERMINALIA ARJUNA – AS CARDIOVASCULAR DRUG , Dr. Himani Purohit*, Dr. Omprakash Sharma and Dr. Pratibha
Terminalia arjuna, is the botanical name of arjuna, belongs to the family of Combretaceae. Its bark decoction is used for angina pain, hypertension, congestive heart failure, and dyslipidemia, based on the observations described in sncient samhitas. we will study the utility of arjuna in various cardiovascular diseases. Systematic reviews, meta-analyses, and clinical studies of arjuna were retrieved through the use of, Google Scholar, and Cochrane databases. Most of the studies, both experimental and clinical, have suggested that the drug possesses anti-ischemic, antioxidant, hypolipidemic, and antiatherogenic activities.. The drug has shown promising effect on ischemic cardiomyopathy. So far, no serious side effects have been reported with arjuna therapy. Its useful phytoconstituents are: Triterpenoids, β-sitosterol, flavonoids, and glycosides. Triterpenoids and flavonoids are considered to be responsible for its beneficial antioxidant cardiovascular properties However, its long-term safety still remains to be elucidated. Though there has been seen very fantastic results in angina pectoris, mild hypertension, and dyslipidemia, its exact role in primary/secondary coronary prevention is yet to be explored.
153 AYURVEDA SIGNIFICANCE OF AHARA AND CONCEPT OF AHARA VIDHI VISHESHA AYATAN: A REVIEW , Dr. Seema Bahatkar*
Ayurveda the ancient Indian science elaborated various aspects for maintaining normal health including balancing state of Doshas, Dhatus and Agni. Similarly synchronization between Indriyas and Manas provides good health status and social wellbeing. In this regards furthermore ayurveda mentioned that proper nutrition value of consumed foods helps to achieve such types of balances and synchronization. Ahara is very important for maintain good health but rules related to preparation and consumption of food also play vital role. These all aspects greatly emphasized in ayurveda texts and ancient ayurveda literatures presented concept of Ahara Vidhi Vishesha Ayatan, consideration of this concept helps to achieve nutritional value of food and provide all health benefits of ingested food stuffs. Present article emphasized importance of Ahara and concept of Ahara Vidhi Vishesha Ayatan.
154 CONSERVATIVE MANAGEMENT OF WORM INDUCED INTESTINAL OBSTRUCTION IN CHILDREN USING GASTROGRAFIN – AN OBSERVATIONAL PROSPECTIVE STUDY , Dr. Abdul Hamid Samoon*, Dr. Ashiq Hussain Raina, Dr. Ferkhand Mohi-ud-din, Dr. Ajaz Ahmad Shah, Dr. Irshad Ahmad Kumar
Introduction: Ascaris lumbricoides (AL) is the most prevalent, largest human helminth and the most common cause of small bowel obstruction (SBO) among children in the developing countries. It is manifested in the low socio-economic conditions and poor hygiene. In Kashmir prevalence of AL is found to be 68.30%. Methodology: This study was conducted in the Department of General surgery, Sri Maharaja Hari Singh (SMHS) Hospital an associated hospital with the Government Medical College Srinagar, J&K, India. The prospective study was conducted over a period from October 2017 to September 2018 (One Year) on 186 patients. Gastrografin was given as per weight 2 ml/Kg BW and data was analysed. Results: In our study out of 186 patients 118 were males and 68 were females. The mean age was 8.2 years with most common age group of 5-9 years (Range 2-17years). Mean total duration of symptoms was 12.6 h, with passage of flatus in 10.3 h and passage of stools in 14.9 h. Mean interval between hospital admission and oral intake was 19.5 h. The mean total duration of hospital stay was 26.2 h. 7 (3.8%) patients required laparotomy owing to the failure of conservative treatment for 3 days. Conclusion: In our study we concluded that Gastrografin is an effective worm obstruction reliever in small children, decreasing the morbidity associated with it.
155 HYPOTHYROIDISM IN HEAD AND NECK CANCER PATIENTS AFTER RADIATION TREATMENT A TERTIARY CANCER CENTRE STUDY , Dr. Aravindh Sivanandan Anand, Dr. Vipin George Kuriakose, *Dr. Ciniraj Raveendran and Dr. Suma Susan Meloot
Background: Head and neck cancers is one of the most common malignancy in India. Radiation treatment is an integral part in the treatment of these patients. Hypothyroidism is a major radiation toxicity among these patients. But studies focusing on this are less in Indian population. Objectives: Primary objective of the study is to estimate the proportion of hypothyroidism in head and neck cancer patients after radiation treatment. Materials and Methods: This is an observational study of biopsy proved head and neck cancer patients who are selected either for definite or adjuvant radiation or chemoradiation. Baseline thyroid function test (TFT) prior to radiation treatment must be normal and the patients are monitored for TFT at three monthly intervals. Patients were treated with radiation treatment with radical radiation doses of 66Gy/33 fr, 66Gy/30fr or 60 Gy/30 fr based on the clinical scenario. Some patients received concurrent chemo radiation while others received neo adjuvant chemotherapy. Results: 61 patients were recruited for the study. Laryngeal cancers (39.3%) formed the most common subsite followed by oral cavity cancers (23%). Total incidence of hypothyroidism was 26.3%. Median time to development of hypothyroidism was 47 months (95% CI 28.87-65.121months).
156 A STUDY TO EVALUATE THE KNOWLEDGE, ATTITUDE AND PRACTICE OF PHARMACOVIGILANCE AMONG DENTAL PRACTITIONERS IN A DENTAL COLLEGE IN GREATER NOIDA , *Dr. Rajeshwari Gore, Nidhi Arora, Nimisha Aggarwal, Nisha Gupta and Nidhi Priya
Aim: To evaluate the knowledge, attitude and practice of Pharmacovigilance among dentists in a teaching dental college in Greater Noida. Material and Methods: - We conducted a cross-sectional questionnaire based study among 82 dentists working in a dental college. The questionnaire was validated first by conducting a pilot study among 10 subjects. Written consent was obtained from the participants before initiating the study. Result: We found that 70.73% of the subjects were aware about Pharmacovigilance, while 41.4% exactly knew what PVG consists of. 90.62% people thought that reporting to ADR is necessary and 76.82% thought that AMC (Adverse reaction Monitoring Centre) should be established in every health institute. 35.36% of people had gone through the articles of pharmacovigilance and almost 29.26% of the subjects had come across an adverse drug reaction. Conclusion: We have come a long way from were we initially started in the field of pharmacovigilance but underrepoting remains an important problem area which need to be addressed and taken care of.
157 A PRELIMINARY STUDY ON THE EFFICACY AND SAFETY OF TWO UNANI PHARMACOPOEIAL FORMULATIONS (Iá¹­rÄ«falShāhtarah AND Sharbat-i-‘Unnāb) IN ADOLESCENT AND YOUNG ADULTS CASES OF ACNE VULGARIS (BusÅ«rLabaniyyah): SINGLE ARMED OPEN LABELLED CLINICAL STUDY , *Mahboobus Salam, Qutubuddin Khan, Najmus Sehar, Mohammad Ishtiyaque Alam, MD Hashmat Imam, Md Manzar Alam, Anirban Goswami, Mohd. Waseem Ahmad, Tasleem Ahmad, Mohd Mumtaz, Rajesh, Jamal Akhtar
Acne vulgaris (BusÅ«rLabaniyyah) is an easily recognizable and very common dermatological disease, most often in adolescents. A clinical trial was conducted to assess the safety and efficacy of two Unani Pharmacopoeial formulations Iá¹­rÄ«falShāhtarah and Sharbat-i-‘Unnāb in the management of Acne vulgaris. Thirty-six diagnosed patients with acne, were included in the study, clinically assessed and diagnosed on the basis of history and dermatological examination, test drugs were administered orally for 21 days. The severity of acne and efficacy of treatment was assessed by Grading and Visual Analogue Scale (VAS). The results showed significant reduction in the grading and VAS scores of post-treatment group (P<0.01) as compared to pre-treatment scores. The test drugs had not any adverse side-effects and compliance was also good. So we concluded that the test drugs are safe and very effective in the management of Acne vulgaris (BusÅ«rLabaniyyah).
158 ARE PREDICTIVE FACTORS FOR SUCCESSFUL NON-OPERATIVE MANAGEMENT OF SPLENIC TRAUMA IN ADULTS STILL UNPREDICTABLE? , Naveed Nabi*, Ajaz Ahmad Malik, Munir Ahmad Wani, Irshad Ahmad, Beigh Firdous, Mir Showkat
Background: Recognition of spleen as a vital organ of reticulo-endothelial system with some important immunological functions has changed the management strategy of blunt splenic trauma from splenectomy to non-operative techniques with greater emphasis on splenic preservation. After considerable success in pediatric population non-operative management of splenic trauma is frequently employed in adults as well, with commendable success rates. However, keeping in view the increased mortality and morbidity associated with failure of non-operative strategy, there is a need to identify positive predictors of successful non-operative management of splenic trauma in adults which are still a matter of debate. Objectives: The principal objective of our study was to study the predictive factors for successful non-operative management of splenic trauma in adults. Materials and Methods: It was an observational prospective and retrospective study conducted in Sheri-Kashmir Institute of Medical Sciences Srinagar India. All patients who met our inclusion criteria were monitored in HDUs (High Dependency Units) and all clinical and laboratory parameters were recorded on predesigned proforma. Collected data was finally analysed using SPSS v 20.0. Results: Among 44 patients included in our study, more than two-third (34;77.3%) were <40 years of age. Males were affected more commonly (84.1%) than females (15.9%). Most common mode of trauma was Road traffic accidents (52.3%) followed by fall from height (43.2%). In our study, 90.9% patients were successfully managed conservatively and only 9.1% underwent splenectomy. On CT scan grading, majority of patients (59%) had Grade III injuries. Conservatively managed patients had stable hemodynamic parameters on admission (mean PR of 88.7 bpm and mean Blood pressure of 112/71 mm of Hg). Initial mean Hemoglobin concentration and Hematocrit levels were 10.43g/dl (10.43+2.45) and 31.55% (31.55¬+7.39) respectively, in the conservative group, and the mean number of blood transfusions required in this group was <1 (0.78+1.09) in comparison to >2 transfusions required in splenectomy group. Number of days of hospital stay was 6.30(6.30+1.91) in conseravtively managed patients as opposed to 8 days (8.00+2.70) in splenectomised patients. Conclusion: Splenic Injuries are mostly seen in the age group of <40 years (77.3%) which represents the young and economically productive group. Parameters depicting stable hemodynamics are strong positive predictive factors for successful NOM. Better oxygenation at the cellular level (like Hemoglobin, pH and lactate levels) also help in predicting a successful outcome of conservative management.
159 MORPHOLOGICAL AND MICROSCOPIC STUDIES OF AERIAL PARTS OF INDIAN FIG TREE , Dr. Tanvi Sood*, Dr. Vikrant Arya, Dr. Ashwani Upadhaya, Dr. Navneet Sharma
Ficus racemosa Roxb. is a deciduous tree comes under the category of Angiosperm commonly known as Indian fig tree, cluster fig tree, Goolar belonging to family Moraceae. In Indian System of Medicine i.e. Ayurveda, Ficus racemosa belongs to Panchavalkal group i.e combination of five herbs having properties like Shodhana (cleaning) and Ropana (healing) of wounds. It is used as ingredient in various formulations as an effective anti-microbial, anti-bacterial, anti-ulcer, anti – tussive activity. The present investigation deals with morphology and microscopy of aerial parts of Indian fig tree.Morphological study of fruits revealed the insect enters through ostiole in syconium for pollination. Microscopic study of leaves, fruit, bark shows identifying characteristics which are helpful in further standardization of this plant.
160 FACTORS AFFECTING THE ETIOLOGY OF PREMENSTRUAL SYNDROME IN YOUNG GIRLS OF BAHAWALPUR REGION , *Dr. Mavra Naz, Dr. Sana Ujala and Dr. Ammad Masood
Objectives: ï‚· To study the phenomenon of premenstrual syndrome. ï‚· To see the relationship of PMS with age of menarche. Design of Study: Cross sectional study (An observational study). Settings: The Department of Obstetrics & Gynaecology, Bahawal Victoria Hospital, Bahawalpur. Duration: 3 months from october 2019 to december 2019. Methodology: The study groups included 50 controls and 31 patients of the age group 18-28 years. Their symptoms of PMS were noted by questionnaire. Data related to age of menarche was also recorded. Results: The T-test was used to assess the relationship of premenstrual syndrome and age of menarche. While considering age of menarche with PMS in cases and controls, P value is non-significant. Conclusion: It suggests that in our study groups age of menarche does not affect the symptomology of PMS. There may be other factors responsible for the symptoms in our subjects such as life style, dietary habits or genetics.
161 PHALPRASHAN AND ANNAPRASHAN SANSKARA W.R.T TO COMPLIMENTARY FEEDING – A REVIEW , Dr. Shubhangi K. Thakur*
Sanskara (Sacraments) are a religious customs (rite), rituals sacrifices a religious ceremony. Sanskara also build a wakefulness of the attainment of social status and rights for the individual. In Ayurveda, the word sanskara also introduced as “Samskarao hi Gunaantradhyanum” means qualitative improvement is carried out by incorporating the specific qualities. Hindu mythology describes various Sanskaras (sacraments/religious rites) outlined from birth to death of an individual. Out of the sixteen Sanskaras described, eight are for children. This article analyzed „‟phalprashan and annaprashan Sanskaras’ in detail and gives a critical approach to their relevance in light of modern scientific knowledge. They were significant in context of child health and provided opportunity for routine examination of child at regular intervals. Samskara developed proper feeding habits, providing strong digestive system, ensured adequate nutrition, prevented diseases and malnutrition. Sanskara took care of not only physical but also mental, social and spiritual growth and development of child.
162 BILATERAL VESTIBULAR SCHWANNOMA, ABOUT A CASE , Dr. Samuel Villeda Bojorque*, Martha Elena Rodriguez Borjas, Jose Carlos Echeverria Solis and Mary Coti de Xicara
Vestibular schwannoma is a slow-growing benign tumor that develops in the vestibulocochlear nerve. It was first described by E. Sandifort in 1777. It affects 1 per 100,000 people, is more frequent between the fourth and sixth decade of life, occupies between 80 and 90% of all tumors of the cerebellopontine angle. In cases of bilateral schwannomas, its prevalence ranges from 1: 210,000. In the event that the tumor is presented bilaterally, it is consitence with neurofibromatosis type II.
163 AYURVEDA PERSPECTIVE ON CONCEPT OF TRAYOSTAMBH, CORRELATION WITH DISEASES AND THEIR MANAGEMENT , Dr. Ashwini B. Jaiswal*
Ayurveda is a science which aims to live healthy life and curing of ailments. In this modern era, due to pollution, excessive work pressure, faulty eating habits, improper lifestyle, prevalence of many diseases is increasing in the population. According to Ayurveda our Swasthya depends on three Upsthambas i.e. Ahara, Nidra and Brahmacharya. Ayurveda emphasizes on Ahara and believes that healthy nutrition nourishes the mind and soul while Nidra affects physical as well as mental state. Brahmacharya helps to retain disease resistance, mental and physical strength.
164 AYURVEDIC APPROACH TO MANAGE ANIDRA (INSOMNIA) – A REVIEW , Dr. Savitri Soni*
The natural phenomenon of giving adequate rest to the body (Sharir) and mind (Man) is sleep and anidra (Insomnia) is a condition in which patient is unable to sleep properly which adversely affects his daily activities. An improper diet and irregular lifestyle (Aahar and Vihar) develop cause of vata prakopa that travels through manovahi srotas causing sleeplessness (Anidra). Ayurvedic management works on by addressing root causes of disease. Ayurvedic herbals like Bramhi, Aswagandha, Jatamansi etc are very useful to balance vata and pitta dosha and strengthen the nervous system. Panchkarma therapies like padabhyanga, shirodhara, and shirobasti etc. are used for internal and external oiling.
165 EFFECT OF SILVER NANOCOMPOSITES TREATMENT ON FEMALE REPRODUCTIVE FUNCTION , Blashkiv Taras*, Sribna Valentyna, Kutsevol Natalia, Kaleinikova Oksana, Kuziv Yulia, Voznesenskaya Tetiana
Recently, it has been proved that polymers with a dextran core and grafted polyacrylamide chains (D-g-PAA) were effective nanoplatform for creation of nanocomposites for chemotherapy and photodynamic therapy. Also, these polymers can be like a matrix for stable silver sol synthesis, that gives confidence in the prospect of silver-based nanosystems for biomedical application. An animal studies are becoming more relevant to determine the effect of the treatment of nanosilver on female reproductive function in particular. In this work for the first time we have obtained data about the influence of star-like D70-g-PAA polymers on somatic, germenative cells, embryos and live newborns (pups) in mammals, which had not previously been investigated. No significant changes in meiotic maturation of such ovarian oocytes in vitro, the number of living cells of FEO and the number of such cells with morphological signs of apoptosis and necrosis, pre- and post-implantation mortality rates of embryos and the number of live newborns (pups) have been established under conditions of one-time treatment with D70g-PAA and D70-g-PAA(PE) at doses of 0,39 mg/kg and 3,90 mg/kg and AgNPs/D-g-PAA and AgNPs/D-g-PAA(PE) at doses of 0,20 mg/kg and 2,00 mg/kg. The effect of AgNPs/D-g-PAA(PE) at a dose of 2,00 mg/kg on oocytes is inhibitory (reduces the number of oocytes in the ovary). The inhibitory effect of such polymer D70-g-PAA (PE) at a dose of 3,90 mg/kg on oocytes was also established. However, there is no additional effect of AgNPs/D70-g-PAA(PE) on oocytes compared to the effect of the polymer itself (D70-g-PAA(PE). The inhibitory effect of AgNPs/D70-g-PAA and AgNPs/D70-g-PAA(PE) on cells of ILN has been established. However, the effect of D70-g-PAA and D70-g-PAA(PE) on cells of ILN is not suppressive. An additional effect of AgNPs/D70-g-PAA(PE) (2.00 mg/kg) on cells of ILN was also compared with the effect of D70-g-PAA(PE) polymer itself.
166 HARMONIZING AND MERGING CHANGE MANAGEMENT AND DRUG DEVELOPMENT , Anne Jeanne Barzyk and François-Xavier Lacasse*
Successful drug development requires an integrated approach. Over the past few decades, there have been considerable changes to the ways drug development has been conducted. To increase efficiency and to comply with the requirements of regulatory agencies,[1] many companies have chosen to apply the Six Sigma method,[2] implement new project management strategies,[3] to avoid pitfalls and be more efficient, and follow the Quality by Design approach.[4] However, the reality shows that it has been mainly large companies that have applied these improvement methods, which are costly in terms of both expenses and human resources and which pose enormous challenges for biotechnology and start-up firms. It should also be kept in mind that the Six Sigma and project management areas of expertise were not originally intended for drug development. Finally, many achievements have highlighted the scientific skills of those involved in drug development and project management. However, few articles or testimonials have mentioned (1) the challenge of implementing project and operational management in drug development; (2) the dependence of scientific and pharmaceutical discoveries on regulatory requirements, which have changed and become more stringent over time; or in particular, (3) the importance of the human element — of bridging gaps between people from very different fields (such as science, management, and government) in order to streamline the path to an effective drug launch as much as possible.
167 A REVIEW ON JANAPADODDHVAMSA WITH SPECIAL REFRENCE TO COVID-19 , Dr. Tanvi Sood*, Dr. Mohit Pathak and Dr. Surinder Mohan Pathak
Covid-19 is new pandemic diseases caused by virus knows as Corona virus known as SARS-CoV-2. Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. It is communicable diseases. In Ayurvedic literatures the communicable diseases are mentioned under the Janapadoddhvamsa and Aupasargik Rogas. Its causative agents, method of prevention has been clearly explained. To manage Janapadoddhvamsa it is advised to include the usage of Rasayana therapy, Panchkarama procedures, Sadvrit Paalan (code of right conducts) and Aachara Rasyana i.e behavioural therapy, Dhupan Karma (Fumigation) and Vaad Chikitsa (Sound therapy). An effort has been made to find possible ayurvedic comparison to current outbreak COVID-19. It can be classified under Pranavaha Srotasa (respiratory system) diseases based on the particular signs and symptoms and the system involved. Also aims to provide information among the Rasayana Aushadi which can be in cooperated in day to day life as immunomodulator along with Vyadhi Hara Chikitsa. So effort is made to compile the knowledge of Janapadoddhvamsa so that it should be applied for bettering the human life and may provide answer to the challenge of COVID-19.
168 THERAPEUTIC INDICATIONS AND GENERAL ASPECTS OF STHANIC CHIKITSA IN YONI ROGA: AN AYURVEDA REVIEW , Dr. Ajayraj Vishwanath Bal* and Dr. Vikas Vallabha Kasture
The health of women is very important not only for her family but for whole society and in this regard ayurveda mentioned various approaches for the management of health of female. Sthanik Chikitsa is one such approach of ayurveda which helps in the management of various Stree Rogas especially disorders belonging from female genital organs. Sthanik Chikitsa means local therapies such as; Yonidhawan, Uttar –Basti, Yoni-Pichudharan, Yoni –Dhupan, Yoni-Puran, Yoni-Lepan, Yoni-Varti and Yoni-Parisheka can be utilizes for the management of various Yoni-Roga. Sthanik Chikitsa play vital role towards the management of various diseases like; Yoni Strava, Yoni Kleda, Yoni Arsha and Yoni Paicchilya, etc. Present article explore some important aspects of Sthanik Chikitsa.
169 A CASE REPORT ON ANTI -TUBERCULAR THERAPY INDUCED HEPATITIS , Bandi Aiswarya*, Kedem Asha and Dr. K. Thirumala Naik
Modern day drug therapy for the control of pain has made great strides in the recent past. Nevertheless, adverse drug reactions, although rare, still remain a major threat to the patient welfare. The drugs involved in the DOT’S therapy (Isoniazid, Rifampicin, Pyrazinamide & Ethambutol) are the most commonly used agents to treat Tuberculosis. But Adverse drug reactions caused by these agents is one of the major concern. It possesses a formidable socio-economic burden on the individual and on the society. Among all ADRS 75 to 80% are classified into type A (predictable) where as 20-25% as type B (unpredictable). I here present a case of 32 years old female patient who was alleged with anti tubercular therapy and presented with complaints of Loss of appetite, Itchy skin, Facial edema and Fever with jaundice, the patient went to local hospital and was further referred to Tertiary Care Teaching Hospital and was diagnosed as Drug induced Hepatitis (Anti Tubercular Therapy) and further management was given to the patient and her condition was improved at the time of discharge .The ultimate goal is always to discontinue the offending medication if possible. Once the offending drug has been identified, it should be promptly discontinued.
170 THE INTEREST OF THE SHORT TELEGRAPH NAIL IN THE TREATMENT OF FRACTURES OF THE UPPER EXTREMITY OF THE HUMERUS: ABOUT 27 CASES , Mouad Beqqali Hassani*, Dahmani Youness, Sekkach Nourdine, Moncef Boufettal, Bassir Reda Allah, Mohamed Kharmaz, Moulay Omar Lamrani, Ahmed Elbardouni, Mustapha Mahfoud and Mohamed Saleh Berrada
Fractures of the upper end of the humerus occupy the third fracture site in people over 65 years of age after the wrist and the upper end of the femur, preferentially affecting the osteoporotic elderly subject after a low energy trauma or more rarely the young subject after a high energy trauma. the Telegraph nail covers a wide range of applications for the treatment of simple and complex fractures of the upper extremity of the humerus allowing a rehabilitation protocol in the immediate intervention. It is a straight intramedullary nail made of stainless steel, 15 cm long, locked proximally and distally, the proximal locking is ensured by 4 cancellous screws, of long thread, the distal locking is ensured by one or two transverse screws at the level of the deltoid V. we report 27 observations of fracture of the upper extremity of the treated humerus Tee by short Telegraph nail collected between 2014 and 2017. The aim of our work is to analyze the radio-clinical results and assess the impact of this technique on the function of the shoulder. Osteosynthesis by Telegraph nail allows very effectively treat fractures of type 2 and 3 but also fractures impacted in valgus with 4 fragments, it is an effective and reproducible solution valid even for complex fractures of the proximal humerus and allows rapid recovery of mobility of the shoulder
171 BENIGN SCHWANNOMA OF THE INTERNAL POPLITEAL SCIATIC NERVE, ABOUT A CASE , Mouad Beqqali Hassni*, Dahmani Youness, Kadiri Mohamed, Moncef Boufettal, Bassir Reda Allah, Mohamed Kharmaz, Moulay Omar Lamrani, Ahmed Elbardouni, Mustapha Mahfoud and Mohamed Saleh Berrada
Schwannomas are tumors of the peripheral nerves, developed from of the nerve sheath. Schwannomas of the sciatic nerve are rare. Their symptomatology is usually close to sciatica by herniated disc, which can delay their diagnosis. MRI helps guide the diagnosis by highlighting a tumor with the same signal as muscle tissue. The ideal treatment for these tumors is surgical enucleation with careful dissection of the surrounding nerve bundles. We report the case of a benign schwannoma developed at the expense of the internal popliteal sciatic nerve.
172 EFFICIENCY OF MATRA BASTI WITH BALA TAILA IN JANU SANDHIGATA VATA WITH W.S.R. TO OSTEOARTHRITIS , Dr. Pramod Suryawanshi*
With changing trends to food and lifestyle there is increasing the to Vatavyadh’s. Ayurveda considers aggravated Vata as the main contributory factor for many disorders. Whole world is witnessing a surge in the elderly population. The people of geriatric age group are vulnerable to many elements. degenerative changes are accounted as a primary case for disease of senility. osteoarthritis (Sandhi Gata Vata) is a common manifestation presenting with pain and stiffness in effect joints. Knee joint suffer most bear to maximum load of the body weight. Sandhi Gatavata is describe under the Vatavyadhis on all Sanhitas and Sangraha Granthas.Sndhi Gata Vata is one of such disorder in which there is Sandhi Shola (joint pain) Sandhi Sotha (joint swelling) Sandhi Graha (joint stiffness).Matra basti is the type of Sneha Basti .these therapy is indicated in all age group.it is very unique therapeutic procedure because is prevent, curative properties, and pramotive.it used in all kind of Vata Vayadis.
173 ARTERIAL THROMBOSIS AND NEPHROTIC SYNDROME: ABOUT A CASE , Ingrid Avome Mba*, D. Hamssili, A. Benjafaar, L. Benamar, N. Ouzzedoun, R. Bayahia and T. Bouattar
Hypercoagulability, resulting in thromboembolic events, can be a life-threatening complication of nephrotic syndrome. Many factors expose to hypercoaguability: the leakage of coagulation inhibitors in the urine, imbalance in the fibrinolytic system, hyperlipidemia, as well as genetic predisposition. Arterial thrombosis is less frequent than venous thrombosis, however it poses a diagnostic and therapeutic problem, and continues to compromise the vital and functional prognosis.[1] We report the observation of arterial thrombosis of the lower limb in a patient with nephrotic syndrome.
174 LOBULAR NEOPLASIA: ATYPICAL HYPERPLASIA AND LOBULAR CARCINOMA IN SITU: LITERATURE REVIEW , *Meriem Nadi, Hanane Ouhame, F. Z. Belkouchi, Samir Bargach and Mounia Malki Yousfi
Lobular neoplasia pathology is a rare proliferative breast lesion, includes atypical hyperplasia and lobular carcinoma in situ, growing inside ducts and terminal ductolobular units. It represents a marker of increased risk for breast cancer and a non-obligate precursor of malignancy. Evidence available on diagnosis and management is scarce. It is frequently found incidentally associated with other lesions, but can be visible through mammography, ultrasound or magnetic resonance. Due to the risk of underestimation, surgical excision is often performed. The analysis of imaging and histopathological characteristics could help identifying low-risk cases, for which surgery is not necessary. Chemopreventive agents can be used for risk reduction.
175 OVARIAN CARCINOSARCOMA: ABOUT A CASE AND REVIEW OF LITERATURE , *Meriem Nadi, Hanane Ouhame, Charaf Fourati, Mounia Malki Yousfi and Samir Bargach
Ovarian carcinosarcoma is one of the rarest histological subtypes of ovarian cancer. There are approximately 1-4% of all ovarian cancers. Given the rarity of this histological type, management is often extrapolated from the experience of ovarian adenocarcinoma. The prognosis seems to be more dismal than adenocarcinomas, with a median survival of less than 18 months, very variable according to the studies and the stages of the disease. The histological, homologous or heterologous subtype is not associated with a change in prognosis. On the other hand, the stage of the disease at diagnosis, the age of the patient, the complete surgery, seem to affect survival. Response rate to chemotherapy is approximately 20%. We report a case of 73-year-old female patient, with an ovarian carcinosarcoma stage IIIC.
176 MAYER ROKITANSKY-KUSTER-HAUSER SYNDROME: 3 CASES STUDY , *Hanane Ouhame, Fatima Zahra Belkouchi, Samir Bargach and Mounia Yousfi
Mayer Rokitansky-Kuster-Hauser syndrome or utero-vaginal aplasia syndrome is a very rare birth defect. It is characterized by an absence of the uterus or a rudimentary uterus when the ovaries are normal. This anomaly is mainly represented by primary amenorrhea as well as unsatisfactory or even impossible sexual intercourse. The external genitalia and secondary sexual characteristics are normally developed, in particular breast growth and pubic hair growth. The karyotype is 46 XX, with no clearly visible chromosomal anomaly, and the hormonal balance is considered normal. The diagnosis is confirmed by imaging. This syndrome can be isolated (Type I) or associated with other renal, skeletal, auditory or cardiac malformations (Type II). The therapeutic attitude is very complicated, and should always start with non-surgical methods; it is only after failure that the surgical methods are indicated and requires an experienced medical team without forgetting the psychological support of the patient. Through our 3 cases, we will study Mayer Rokitansky-Kuster-Hauser syndrome with a review of the literature.
177 TECHNOLOGY OF OBTAINING DRY EXTRACT FROM GROUND PART OF PULICARIA GNAPHALODES L. BY PERCOLATING EXTRACTION METHOD , Zokirova Sh. O., Yunusxodjaeva N. A.*, Eshbakova K. A., Poyonov M. M. and Uzokboev Sh. N.
This article describes the role and advantages of the pharmaceutical forms of dry extracts obtained on the basis of medicinal plants. Based on this, the development of technology for obtaining a dry extract from the ground part of Pulicaria gnaphalodes L. was presented. Аccording to the requirements of the State Pharmacopeia, qualitative indicators of the resulted dry extract were studied. In accordance with the requirements of dry extracts, the indicators such as description, authenticity, pH value (4,30), moisture (4,95%) and heavy metals were studied (0,01 %).
178 IMMUNOMODULATORY EFFICIENCY OF TINOSPORA CORDIFOLIA AGAINST VIRAL INFECTIONS , *K. G. C. Dissanayake, W. P. R. T. Perera and N. Premasinghe
Most of the cases, viral infected patients are suffering from secondary infections. Apart from that, due to the exhausted immune system patients more vulnerable to secondary infections and various diseases. Dysfunction of the immune system is responsible for multiple illnesses, such as arthritis, ulcerative colitis, asthma, allergies, parasites, cancer, and infectious diseases. So, medicinal plants and their active components are becoming increasingly relevant as a source of immunomodulatory agents. T. cordifolia stem extracts or the isolated compounds of the plant exhibits amazing immune stimulatory effects in various ways. Isolated compounds of T. cordifolia such as N-methyl-2-pyrrolidone and 11-hydroxymustakone, Magnoflorine and Tinocordiside shows immunomodulatory effects by enhancing Reactive Oxygen Species (ROS) generation which causes to augment the immune response. T. cordifolia extract exhibits a considerable effect of the immunostimulation in HIV positive patients and, increases the phagocytosis and intercellular killing capacity by increasing the survival rate and polymorphonuclear leucocyte function. In addition to that, a novel (1,4)-α-D-glucan from T. Cordifolia activates the immune system by activating macrophages via of TLR6 signaling and NF-κB activation mechanism, leading to cytokine and chemokine production. Immunoductatory protein (ImP) obtained from the dry stem powder of Tinospora cordifolia is significant for augmenting the various immunological activities in the human body. Hence, more attention should be focused on the phytochemistry and their applications of the Tinospora cordifolia for immune enhancements as well as reduce secondary infections risks along with the viral infections.
179 GESTATIONAL HYPERTENSION: ABOUT 59 CASES , M. Sebti*, M. C Fourati, F. Zidane, PR M. Yousfi, PR S. Bargach
Gestational hypertension (GH) is a heterogeneous group of pathological conditions whose common denominator is an increase in blood pressure with a systolic pressure greater than or equal to 140mm-Hg and/or a diastolic pressure greater than or equal to 90mm-Hg, obtained on two occasions separated by at least 4 hours. It is a major health problem of global proportions, firstly because of its frequency, which can reach up to 15% of pregnancies, and secondly because of the high maternal and foetal morbidity and mortality for which it is responsible. The pathophysiology of this condition remains poorly defined despite the numerous studies on it.
180 PAEDERUS DERMATITIS , *Dr. Zahoor Hussain Daraz, Dr. Berkheez Shabir, Dr. Rehana Afshan, Dr. Pramesh Kumar Yadav and Dr. Adnan Bacha
Paederus dermatitis is a distinct, inflammatory contact dermatitis characterized by a quick onset of maculoerythemobullous rash on exposed parts of the body. The disease is caused by a beetle of the genus Paederus. This insect beetle usually does not bite, but accidental crushing of the beetle over the skin brings about the release of its haemolymph, which contains a strong blistering agent called paederin. This article describes few cases of such dermatitis encountered in our OPD causing distress to many children and their parents. Proper identification of the condition, treatment and counseling about absence of systemic disease of parents play a pivotal role in management.
181 THE ROLE OF ACALYPHA INDICA LINN EXTRACT ON EXPRESSION OF ACETYLCHOLINE RECEPTOR IN NEUROMUSCULAR JUNCTIONS WITH MYASTHENIA GRAVIS RAT MODEL , Rani Wardani Hakim, Desak Gede Budi Krisnamurti, Radiana Dhewayani Antarianto, Siti Farida, Erni Hernawati Purwaningsih, Jan Sudir Purba*
Objectives: Myasthenia gravis (MG) is one of the autoimmune disease for which the target autoantigen, the nicotinic acetylcholine receptor (AChR) of the neuromuscular junctions (NMJ). A number of molecules, including ion channels and other proteins at the neuromuscular junction, may be targeted by autoantibodies leading to abnormal neuromuscular transmission and produces symptomatic weakness that predominates in certain muscle groups and typically fluctuates in response to effort and rest. Treatment of MG involves the use of drugs standards for MG can only last for short time, and enormously high cost of treatment. By most ethnicities and cultures plants have been used as medicines throughout recorded human history. For this study of experimental autoimmune myasthenia gravis (EAMG) is used rocuronium, prostigmine and Acalypha indica Linn (AI) compared with expression of AchR. Results: Results of this study found that induction by rocuronium injection to animal model MG as competitive antagonist for acetylcholine receptor showed reduction of AChR expression in comparison to normal group. Preventive treatment with prostigmine showed increased AChR expression in comparison to MG induction group. Curative treatment with prostigmine showed decreased AChR expression in comparison to MG induction group and is lower than the normal group. Preventive treatment with Al extract showed comparable level of AChR expression as MG induction group. Curative treatment with Al extract showed decreased AChR expression in comparison to MG induction group as well as normal group. However, AChR expression by curative Al extract is at comparable level as curative prostigmine. Conclusion: Results of this study used prostigmine as a preventive therapy which afterwards given rocuronium, amount of AChR did not differ significantly. Likewise, AI given as a curative therapy is also not significantly different from the effect of prostigmine. As a conclution the use of AI as a preventive or curative therapy indicates that AI has an effect similar to the effect prostigmine which can prevent a decrease in AChR in rats induced by rocuronium. Our results clearly demonstrate Acalypha indica Linn as a promising candidate for the new drug for myasthenia gravis.
182 CONTRACEPTIVE USE AND COUNSELING IN YOUNG WOMEN WITH BREAST CANCER , Dr. Sara Daoudi*, Imane Adrif, Sihame Lkhoyaali, Ibrahim El Ghissassi, Hind Mrabti and Hassan Errihani
Background: Contraception is very challenging for reproductive-aged breast cancer patients, due to limitation in nonhormonal options. Contraceptive methods used by this population are very heterogeneous and may be insufficient, resulting in an increased risk for unwanted pregnancy. Methods: This is a survey conducted in reproductive-aged breast cancer patients at the Department of Medical Oncology at the National Institute of Oncology of Rabat - Morocco. It is an analytical study of contraceptive methods used before diagnosis, during and after cancer treatment, what identifies the level of contraceptive counseling. Results: 104 young patients with breast cancer respond to the survey. The mean age was 39 years. 78% of the cases had a localized disease and 22% were metastatic. 87% had received treatment and 13% were under surveillance. Sexual activity was maintained in 62% of the cases. 91% used contraception before the diagnosis of breast cancer. After the diagnosis was announced, 67% used contraception. 74% of patients were informed that hormonal contraception is not recommended. This information was received from medical staff in 89% of cases. 48% were informed when the diagnosis was announced, 29% before the start of chemotherapy, 15% during chemotherapy and 8% at the end of treatment. Conclusion: Reproductive-aged patients require contraceptive counseling after newly diagnosed breast cancer. Contraceptive counseling should be tailored to the needs, concerns, and history of cancer for each patient. Given the lack of information regarding contraception for these patients, oncologists in collaboration with gynecologists should ensure proper contraceptive counseling for better quality of care.
183 PATTERN OF DIABETIC FOOT AND ITS MANAGEMENT AT A TERTIARY CARE SURGICAL UNIT , Dr. Nayyab Mujahid*, Dr. Hajra Iqbal Alvi, Dr. Shiza Tanveer
Background: In diabetes mellitus involvement of foot with infection, neuropathy and vascular involvement is a diabetic foot. It is a common problem. Objective: To find the pattern of diabetic foot infection in a tertiary care unit and its surgical solution. Methodology: This was a descriptive study conducted at a surgical unit in Sheikh Zayed Medical College, Rahim Yar Khan. It included 32 patients suffering “diabetic foot” admitted from June 2019 to December 2019. All adult patients regardless of sex were included in the study. Data was analyzed by using SPSS version 20. Results: There were 32 patients presented with diabetic foot and 29 (90.6%) were male. Only eighteen were known diabetic. Smokers were 11 (34.4%). The right foot was involved in 19 (59.4%). The disease was advance as Wagner Grade 1, in 3 (9.4%), Grade 2, 5 (15.4%) Grade 3, 16 (50%) and beyond the grade were eight patients. Ulcer size was less than 4 cm in 2 (6.25%). The infection was superficial in 2 (6.25%), subcutaneous in 13 (40.6%) and deep in 23 (71.9%) patients. In 5 patients Ray’s amputation was done, forefoot amputations in 2, below knee amputations in 11, above knee amputation in five patients. Two patients were managed conservatively, and eight were subjected to significant debridement of leg and/ thigh and submitted to the Plastic Surgery department for plastic procedures. Conclusion: In conclusion, infection is the major cause of infected foot in our study. The below knee amputations, above knee amputations and Rays' amputations, were the most common type of amputations performed in this study.
184 OCCURRENCE OF NAFLD IN THE PATIENTS SUFFERING FROM TYPE II DIABETES MELLITUS , Dr. Shiza Tanveer, Dr. Nayyab Mujahid, Dr. Hajra Iqbal Alvi*
Objective: To assess the prevalence of non-alcoholic fatty liver disease in type II diabetes mellitus patients. Study Design: A Prospective Observational Study. Place and Duration: Department of Medicine Sheikh Zayed Hospital Rahim Yar, from June 2018 to January 2019. Methodology: Patients presenting with diabetes mellitus type II were divided into two equal groups on the basis of presence or absence of non-alcoholic fatty liver disease. Age, gender, BMI, Plasma aspartate aminotransferase, Plasma alanine aminotransferase, Plasma alkaline phosphatase, duration of type II diabetes mellitus, fasting plasma glucose, serum albumin, plasma cholesterol, plasma triglycerides, Plasma LDL-C, Plasma HDL-C and HbA1c were the variables calculated. Results: The mean age was 59.15±5.63 years, BMI 32.03±5.32 kg/m2, Plasma AST 19.68±2.22, Plasma ALT 19.87±1.71, Plasma ALP 62.32±12.84, duration of type 2 DM was 8.40±3.71 years and fasting plasma glucose of non NAFLD patients was 124.57±5.66 mg/dl. While, the mean age was 61.55±8.00 years, BMI 32.05±6.24 kg/m2, plasma AST 23.03±2.56, plasma ALT 27.28±1.94, plasma ALP 75.19±21.30, duration of type 2 DM 8.12±1.28 years and fasting plasma glucose of NAFLD patients was 137.45±5.07 mg/dl. The mean albumin (g/dl) was 4.20±0.64 g/dl, plasma cholesterol was 150.65±28.44, plasma triglyceride 114.04±5.99, plasma LDL-C 87.25±18.16 and plasma HDL-C of non NAFLD patients was 42.97±11.40. HbA1c in non NAFLD was 9.1%. While, the mean albumin was (g/dl) 3.80±0.69 g/dl, plasma cholesterol 158.62±42.02, plasma triglyceride 150.07±9.03, plasma LDL-C 87.0±27.89 and plasma HDL-C of NAFLD patients was 40.76±10.46. HbA1c of NAFLD patients was 6.8%. Conclusion: Non Alcoholic Fatty Liver Disease has a high prevalence in patients with type II diabetes mellitus having normal aminotransferases.
185 RISK FACTORS OF DRUG-INDUCED HEPATITIS IN TB PATIENTS , Dr. Alveena Butt*, Dr. Shanza Ahmad, Dr. Kaynat Hassan
Objectives: The aim of this research study is to diagnose various factors of risks of ATDH (Anti-TB Drug-induced Hepatitis) in the patients suffering from the disease of TB (Tuberculosis). Methodology: In this retroactive research work, we reviewed that clinical records of 194 diagnosed patients of TB in the Nishtar Hospital Multan. We also analyzed the data about the ATDH. The duration of this research was five years from January 2019 to June 2019. The patients of TB who were fulfilling the standard of NTP (National Tuberculosis Program) were the part of this research study. SPSS V.16 was in use for the statistical analysis of the research work. We also used Chi-square and Exact Fisher tests in this research work. Results: There were total 194 registered patients of ATDH during treatment and the follow up duration in which 30.78% (n: 63) were female & 65.18% (n: 131) were male patients with an average age of 41.18 years were the participants of this research work. There were statistically significant disparities between the infection of HIV and drug injections in vessels in the patients of ATDH & non-ATDH patients. Conclusion: All the previous recognized risk factors for the incidence of ATDH, infection of HIV& IVDU were available with high significance.
186 FREQUENCY OF VARIOUS DISEASE IN PATIENT WITH PLEURAL EFFUSION , Dr. Kaynat Hassan*, Dr. Shanza Ahmad and Dr. Alveena Butt
Objective: To study the various diseases in cases of pleural effusion presenting at CMH Multan. Material and Methods: This cross sectional study was conducted at Department of Medicine, CMH Multan September 2018 to March 2019. Total 100 patients with pleural effusion were selected and different diseases were studded in selected cases. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed by parapneumonic effusion/empyema (25%) and malignant effusion (9%) while congestive cardiac failure (13%) was the most common cause of transudate effusion followed by liver cirrhosis in 8% of cases of all cases of the pleural effusion. Conclusion: Tuberculosis is the most common cause of pleural effusion while infections, malignancies and CCF comprise a significant number of cases.
187 ATTITUDE OF MEDICAL STUDENTS TOWARDS PSYCHIATRY IN A TERTIARY CARE HOSPITAL , Dr. Tayaba Shahid Khan*, Dr. Javeria Afzal and Dr. Hareem Tariq
Background: Dearth of psychiatrist specialists is evident worldwide. Awareness of undergraduate students towards mental illness has an important role in affecting the quality of care the patient receives and in choosing psychiatry as a career. Decision to specialize in psychiatry based on many factors, however attitude of undergraduates towards career choice play most important role in this aspect. Objective: This study aims to explore attitude and towards psychiatry among medical undergraduates in tertiary care hospital and factors influencing this decision. Methodology: It was Descriptive cross sectional study done at Nishtar medical University, Multan, from June to November 2019. The total 384 students from first to final year were enrolled by non-probability convenient sampling technique. Participation was voluntary and ensured that response would be kept anonymous. ATP-30 (Attitude towards Psychiatry) a 30 item self- administered questionnaire was used to measure the attitude of medical students. Data collected on a pre-defined questionnaire was analyzed using SPSS version 23. Results pertaining to rates were reported as frequencies and percentages. Result: 47.4% of study respondents were male and 52.6 % were female. 52.3% of our study respondents strongly agree that psychiatry was respected branch of medicine and 56.7% strongly agree that psychiatry should be an important part of medical curriculum. 19.4% of study respondents consider it in the list of the carrier choice while majority didn’t think that it should be in their career list options. Conclusion: Majority of students shows positive attitude. Mostly found it as respected and essential field of medicine. However insufficient knowledge and awareness can also be observed in responses pertaining to available treatment and advancement in the field. There is a need to revise the curriculum and clinical rotation schedule to raise interest of students regarding mental health issues of their community and ease their decision in choosing it as a career.
188 TREATMENT OF RECURRENT INTRANASAL POLYPS WITH INTRANASAL POLYPECTOMY VERSUS STEROID THERAPY , Dr. Saba Sarfraz, Dr. Javeria Afzal*, Dr. Tayaba Shahid Khan
Objective: To compare recurrence of intranasal polyps treated with intranasal polypectomy versus steroid use. Study Settings and Duration: ENT department Nishtar hospital Multan from January 2018 to July 2019. Study design: randomized controlled trial. Material and Methods: All 50 cases were divided in two groups M and S. Group M were given oral prednisone (30-60 mg) for 15-20 days in tapering regimen while patients in S group, intranasal polypectomy done. Information was collected through pre-designed Performa. Mean and standard deviation was calculated for quantitative variables such as age. Frequencies and percentages were calculated for qualitative variables such as gender and outcome variable i.e. recurrence. Chi-square test was applied to compare recurrence in both groups and P ≤ 0.05 was considered as significant. Results: The mean age of patients in group A was 34.49 ± 6.51years and in group B was 34.15 ± 6.97years. Male were 64.44% and 35.56% were females with ratio of 1.81:1. The mean duration of disease in group A was 5.81 ± 4.33 days and in group B was 5.75 ± 4.56 days. Recurrence rate in Group A (steroid group) was 57.78% while in Group B (intranasal polypectomy group) was 22.22% (p =0.001). Conclusion: Intranasal polypectomy is more effective in terms of non-recurrence of nasal polyps as compared to steroid use in the management of nasal polyps.
189 CAUSES OF UPPER GI BLEEDING AT TERTIARY CARE HOSPITAL , Dr. Samra Khan*, Dr. Sana Javed, Dr. Aqsa Tahir
Aim of study: The aim of this study was to determine the common etiologies of upper gastrointestinal among patients of different age groups and gender that mostly present in medical emergency of our hospital. Place and Duration: The study was done in 6 months duration from July 2018 to January 2019 at Nishtar hospital Multan, Punjab. Methodology: It was a single centered descriptive cross-sectional study. Total 120 patients were enrolled in this study. Patient presented to us in emergency with upper gastrointestinal bleeding got initial resuscitation and then followed up throughout the hospital stay. Complete history, examination and relevant investigations were noted by author on a “patients detail form”. Causes of upper gastrointestinal bleeding were identified by endoscopy. Patients with recurrent history of UGIB and end stage disease patients were not included in the study. Non-probability method of sampling was used. Results: Total one hundred and twenty patients were selected in the study. Out of 120 patients, 81 were male and 39 were female. Most common cause of upper gastrointestinal bleeding was variceal cause with 47.5% (57/120) followed by peptic ulcer 23.33% (28/120) and NSAID induced gastritis 13.33% (16/120). At first presentation, 68 patients presented with melena, 31 with hematemesis and 19 with both melena and hematemesis. In this area variceal cause is more common due to high prevalence of hepatitis infection. The most common age group was 36-50 years. In 5 patients the result of endoscopy was normal, no pathology seen. Mean hemoglobin value at presentation was 6.9±1.2, mean pints of blood transfused were 2.3±1.1 and mean duration of hospital stay was 8.5±4.6 days. 4 patients died during hospital stay. Conclusion: According to this study due to high prevalence of infectious disease like hepatitis C and B, esophageal varices is the most common cause of upper gastrointestinal bleeding in this area followed by peptic ulcer and NSAID induced gastritis.
190 CLINICAL PROFILE OF PATIENTS WITH DIABETIC KETOACIDOSIS , Dr. Mahrukh Javed Khan*, Dr. Nimra Khan and Dr. Nabeel Ahmad
Objectives: The aims of this study were to assess the frequency of clinical characteristics of patients with severe Diabetic ketoacidosis (DKA) who were admitted to the intensive care unit (ICU) and investigating the relationship between para-clinical (glucose, anion gap, and serum bicarbonate) and clinical parameters in patients with severe DKA. Method: A retrospective chart review of all adult patients with DKA who were admitted to the ICU at Nishtar hospital, Multan, between January 2019 and December 2019. The data collected include the demographic data, clinical presentation, precipitating factors, duration of hospital stay and mortality rate. The data were analyzed using STAT software. Results: A total of 60 patients were included. Of these, 50 were men (83.3%). The median age was 23 years (ranging 18-29 years). Newly diagnosed diabetics accounted for 15 (25%) of the cases; the remainder was previously known patients of type1 diabetes on treatment. The main precipitating factors of DKA were insulin treatment cessation (87.5%) and infection/sepsis (39.6%). Serum blood glucose, serum bicarbonate level, and the calculated anion gap did not significantly correlate with clinical parameters of severe DKA. Conclusion: Most patients with severe DKA who were admitted to the ICU of our institution presented with gastrointestinal symptoms. Non-compliance to insulin therapy was the main precipitating factor of DKA.
191 KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING FOOT CARE IN DIABETIC PATIENTS , Dr. Aqsa Tahir*, Dr. Sana Javed, Dr. Samra Khan
Background: Diabetes mellitus is multifarious illness and foot ulceration is one among its common complication. Diabetic foot lesion is calculable to impact 15 to 25th of individuals with diabetes at some time in their lives and it precedes 25% to 90% of all amputations. Objective: Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients’ knowledge and compliance of diabetic foot care. Material and Methodology: A cross sectional study was conducted at public diabetic clinic in Ibne-Seina hospital, Multan. A sample of 300 patients were chosen using nonprobability convenient sampling in the duration of one month. A questionnaire which included demographic details, knowledge and practice of functional foot care was administered. Data was compiled in SPSS V20 software and later analyzed in Community Medicine department, Multan Medical and College. Results: out of total of 300 diabetic patients studied, 182 patients (60.66%) had good knowledge regarding prevention of diabetic foot while total of only 110 patients (36.66%) were found to have a good level of practice. Poor educational status and long duration of diabetes was significantly associated with poor knowledge and poor practice of functional foot care. 250 (83.33%) diabetics knew the importance of taking anti diabetic drugs to prevent complications. 68 (22%) knew the warning signs regarding diabetic foot to consult the doctor. 182 patients (60.66%) knew the Importance of keeping feet dry to avoid foot complications. Regarding practices, 156 (52%) patients inspected their feet and toes regularly. 202 (67.3%) washed their feet regularly. 108 (36%) trimmed their nails in time properly. 136 (45%) had a habit of walking bare foot. 128 (42.66%) inspected the inside of the shoes they wore. 104 (34.66%) wore shoes with socks. Conclusion: Result demonstrate satisfactory data on diabetic foot care however practices of preventive techniques are extremely unsatisfying. The study has highlighted the gap in data and observe of foot care in DM patient. The majority of the patients collaborating in the study didn't have higher education and were of low socioeconomic standing. Only a few individuals knew the warning signs concerning diabetic foot to consult the doctor. Practices of correct timely trimming of nails, regular review of feet, carrying socks were found to be terribly poor. But regular feet washing and knowledge of the importance of taking anti diabetic medicine as safety measure was satisfactory.
192 MORBIDITY PATTERN OF PATIENTS WITH ISCHEMIC STROKE AT TERTIARY CARE UNIT , Dr. Hareem Tariq, Dr. Amara Malik, Dr. Saba Sarfraz*
Background: Stroke is an important morbidity for low and middle income countries like Pakistan. This study was conducted to note the frequency of complications in ischemic stroke patients to determine magnitude of the problem in our local population. Objective: To determine the morbidity pattern in patients with ischemic stroke at a tertiary care hospital. Material and Methods: All the cases of ischemic stroke (170), fulfilling inclusion criteria were recruited in this cross – sectional study. Once registered these study cases was assessed for different complications (UTI, shoulder pain, arrhythmia, pneumonia and hyponatremia) after undergoing baseline investigations like urine test, blood tests and ECG. Data was entered and analyzed by computer program SPSS-18. Results: Of these 170 study cases, 95 (55.8%) were male patients while 75 (44.2%) were female patients. Mean age of our studied cases was 48.6± 8.18 years. Out of these 170 cases, 70 (41.2%) were from rural area while 100 (58.8%) from urban areas, 112 (65.8%) were hypertensive and 40 (23.8%) were diabetic. Mean body mass index (BMI) of our study cases was 23.58 ± 3.29 kg/m2 and obesity was present in 35 (20.5%). Previous history of stroke was present in 18 (10.5%) while family history of stroke was noted in 41 (24.1%) of our study cases and 118 (69.4%) were illiterate and 52 (30.6%) were literate. History of smoking was present in 54 (31.7%) of our study cases. Mean serum sodium level was noted to 135.9 ± 2.03 mEq/L, shoulder pain in 65 (38.2%), pneumonia in 45 (26.4%), arrhythmia in 58 (34.1%) urinary tract infection (UTI) was noted in 86 (50.5%), and hyponatremia in 48 (28.2%) of our cases. Conclusion: The results of our study showed that there is very high ratio of medical complications in ischemic stroke patient. We found that urinary tract infection was the most common complication followed by shoulder pain, arrhythmia, pneumonia and hyponatremia. All clinicians treating such patients should carefully monitor such patients to take preventive measure against these complications, this will decrease disease morbidity and hospitalizations in these patients.
193 STROKE ASSOCIATED PNEUMONIA IN STROKE PATIENTS , Dr. Nabeel Ahmad*, Dr. Nimra Khan and Dr. Mahrukh Javed Khan
Objective: The objective of the study was to: Determine the frequency of stroke associated pneumonia in stroke patients. Study Design: Descriptive case series. Setting: This study was carried out in Department of Nishtar Hospital Multan. Methodology: A total of 285 cases fulfilling the inclusion/exclusion criteria recruited from Department of Medicine, Nishtar Hospital Multan were enrolled in the study after taking an informed consent from the patients to include their data in the study with the assurance of confidentiality of their record. History and complete examination of the patients were done. All diagnosed cases of stroke were followed till 30 days (either in medical ward/outdoor) for stroke associated pneumonia, with positive finding in chest X-ray and culture of tracheal aspiration (as per operational definition) by the researcher herself. Results: In our study, out of 100 cases 21.05%(n=60) were between 30-50 years of age while 78.95%(n=225) were between 51-70 years of age, mean+sd was calculated as 56.86+6.81 years, 51.58%(n=147) were male and 48.42%(n=138) were females. Frequency of stroke associated pneumonia in patients with stroke was recorded in 17.89% (n=51). Conclusion: We concluded that the frequency of stroke associated pneumonia is quite high among stroke patients. However, these cases should be diagnosed early managed accordingly.
194 REVIEW: CELOSIA ARGENTEA LINN. AND ITS PHYTOCHEMICAL ACTIVITY , *Dr. Vd. Gajanan Shankarrao Patil, Vd. Pankaj P. Surve and Dr. Aparna M. Ghotankar
Since ancient time in India. Celosia argentea linn. Is widely used in traditional medicine, to cure several disorders such as fever, diarrhea, mouth sores, itching wound, jaundice, gonorrhea and inflammation. Literaterature survey from books and journal of traditional Indian medicine revealed that celosia argentia linn. has a lot of medicinal properties. Leaves, stem and root have been reported for medicinal activity, the plant has pharmacologically been studied for various cativities like anti-cancer ,hepatoprotection, anti-dibetes etc. However too many scientific studies have been carried out on this plant. For exploring these traditional uses. The present report is deals with traditional uses and pharmacological activity of celosia argentea linn. In the treatment of various diseases.
195 CLINICAL APPROACH OF AVARANJANYA SAMPRAPATI IN KASAVYADHI , Dr. Shilpa Kishor Chatre*, Dr. Madhavi D. Gaikwad and Dr. Deepali J. Amale
Avarana is one of the mechanism mentioned in the science of Ayurveda to explain the pathogenesis of disease, peculiarly due to the vitiation of Vata .Avarana is the disturbed movement of Vata due to obstruction by other factor in the body. There are two pathological conditions or factors for vitiation of Vata out of which one is Avarana. Charaka described the Avarana topic in which he mentioned ParasparAvaran and its different types .One of the type is Udhanavarut Apan which leads to Kasa Vaydhi Udan Vayu Avrut the Apan Vayu obstructing the path and leading the Kasa Vyadhi.If it recognized early and properly that pathogenesis of Kasa Vyadhi is due to Parasparavaran then it will be helpful for Clinical Management.
196 REVIEW ON LEKHANIYA DRAVYA BY ACHARYA CHARAK , *Vd. Neha Vishnu Kakde, Vd. Jyotsna Kulkarni and Dr. Aparna M. Ghotankar
‘Lekhana’ means that which has the ability to scrap out the excess tissues from the area where it is located. Such drugs are indeed essential to decrease the body weight. In recent decades, because of the changed life style, daily routine, food habits and environmental changes, the population of unhealthy people is increasing even in developed countries, which made them victim of many diseases. Sthaulya (obesity) is one of them. Obesity has become major health problemover the world affecting people of all ages, sex and ethinicities. Acharya charak has mentioned ‘lekhaniya dravya’,[1] which do scraping by absorbing fluid part from dhatu and mala. It includes 10 drugs which are mainly made with the combination of Vayu and Agni mahabhuta.
197 CONCEPT OF AGNI - A CONCEPTUAL STUDY , Dr. Gupta Deepak* and Asthana Alok
In Ayurveda, the term Agni is used in the sense of power which converts ingested substances from one form to another. Agni converts food in the form of substances which are acceptable by body. Ayurveda considers that Dehagni is the fundamental cause of life, complexion, strength, health, nourishment, lusture, Oja, Teja and Prana. Agni as pondered upon in Ayurveda is related with digestion, metabolism, assimilation & thermoregulation. All the metabolic processes leading to genesis of body tissues are the outcome of Agni. The balanced state of agni is a prime factor of health. The derangement of agni leads to production of diseases of nutrition, digestion and metabolism. The of Agni is associated with health of an individual as well as closely related with formation of diseases. The improper diet or faulty life style causes agni Dushti which causes abnormality of Dhatus and ultimately results in various diseases.
198 NORO VIRUS INFECTION: A BRIEF REVIEW , Ch. Sreenivasulu, Ch. Sekhar, Gunji Venkata Lokesh, Dr. Sarad Pawar Naik B.* and Mungara Sree Pavani
Noro virus also called as winter vomiting bug. This is a positive single stranded RNA virus belongs to family of calciviridae. It is the main causative agent for gastroenteritis. This virus can cause sudden onset of diarrhoea and vomiting. It spreads through contaminated water and food. Infection begins in 12-48 hrs after exposure. Symptoms lost within a few days. Histological changes occur in intestine after infection. Epithelial cells of intestine mostly affected. Control measures including anti-microbial agents are used. Infants require proper medical care and attention.
199 HETU AND SAMPRAPTI OF AMAVATA (RHEUMATOID ARTHRITIS) - A SYSTEMATIC REVIEW , Dr. Savitri Soni*
According to ayurveda concept, the inequity of basic constituents causes different diseases. The balance of different fundamental elements in the body (sharir) is the sign of good health. Ayurvedic remedies are found very effective and useful to sustain the equilibrium. Amavata, vatarakta, sandhivata, etc are few vata related diseases. Among these amavata is a chronic joint and body pain disease accompanied by a swelling of some or all of the synovial joints which involve ama and vata. It is a disease of madhyam roga marga as it affects sandhi and hridaya marma. The present life style not only disturb the healthy ahar (diet) but vihar (daily exercise etc.) also. Whenever the function of agni is disturbed in the body, ama is produced. Such produced ama is slimy in nature, this ama gets together with dushit vata / prakopit vata and circulates all over the body through shira and dhamani and gets stuck in kaphasthana i.e. sandhi because shleshak kapha is located in sandhi and amavata is developed resulting patient suffer from lifelong joint deformities and acute condition.
200 THEORETICAL ESTABLISHMENT OF MAINTENANCE OF HEALTH OF SUTIKA THROUGH BIOACTIVE INGREDIENTS OF SAUBHAGYA SUNTHI PAK , *Kamde Rahulkumar R. and Mohite Swati S.
Delivery of a baby is considered as rebirth of the female. Recovery from the stress and strain of labor is a process which takes some period of time. This period of 6 weeks post natal is regarded as (puerperium) sutikawastha. Wound healing, start of lactation and involution of reproductive system are major events during sutikawastha. Saubhagya Sunthi Pak is one classical multi herbal Ayurvedic preparation which take care of needs in sutika (puerperal phase woman). This article review bioactive compounds in the herbal ingredients of saubhagya sunthi pak. The desirable effect and contributing bioactive component are compared to conclude that most of the needs of a puerperal woman can be fulfilled by consuming Saubhagya sunthi pak as a dietary supplement.
201 REVIEW ARTICLE ON PATHOPHYSIOLOGY OF PCOD AND LABORATORY DIAGNOSIS , Dr. Vrushalee Dodke* and Dr Neha Milind Sahare
Polycystic Ovarian Syndrome (PCOS) affects women of reproductive age groups and it is considered as most common endocrine disorder which affects more than 10% women world widely. It has a spectrum of symptoms like Asrikdosha, Anartava, Alpa artava, Medovriddhi, Granthi Vikara and Prameha. Ayurveda classified PCOS in the combined category of Yonivyapadas and Aartavadushti. It is considered as a disorder of Dhatus leading to imbalance in the functioning of hormonal system and reproductive system. There are no single criteria sufficient for clinical diagnosis because of multiple etiologies and presentations. Thus sonography and multiple hormonal tests are required for the investigation.
202 MEDICINAL CONSIDERATIONS, THERAPEUTIC UTILITY AND SAFETY CONCERN OF RASASHASTRA: A REVIEW , Dr. Vandana N. Hirudkar*
The classical text of Indian medicinal system mentioned concept of Rasashastra as one of the significant aspect of Ayurveda. The Rasashastra involves uses of different ayurveda formulations for the management of various diseases and these formulations mainly prepared using classical procedures of Marana, Putta and Sodhana, etc. The Rasashastra deals with preparations and uses of Rasa Dravyas or mercurial (Rasa) formulations. Rasashastra utilizes metal, mineral or herbomineral based formulations. The drugs prepared from the principles and theories of Rasashastra offers many health effects including rejuvenating, anti-stress, anti-depressant, anti-oxidant, aphrodisiac, analgesic, hepato-protective and anti-ulcers effects, etc. Present article deals with general considerations, therapeutic utility and precautions related to the Rasashastra.
203 MEDICATION ADHERENCE: AN OVERVIEW , Sharon Ann Varghese*, Jasmy E. S., Megha Anna Varghese, Anjana Baby and Sara Yeldhos
Medication non-adherence is an unforeseen, emerging problem of the health care system. According to WHO any increasing the effectiveness of medication adherence have greater impact on clinical outcome than any other improvement made in medical treatment. Patient‘s medication behavior is hindered by various factors such as socioeconomic factors, patient related factors, physician related factors and health care system related factors. Poor medication adherence can lead to unforeseen medical complication, reduced quality of life, increased medical cost, frequent physician visit, medication changes etc. Various methods for measuring medication adherence are available such as subjective measures and objective measures like pill counting, electronic monitoring of medication adherence shown promising and validated measurement of any non-adherence. Barriers to medication adherence can be improved only by complete cooperation from patient, physician and other healthcare provider to follow some basic policies to improve adherence rate in patient. Using latest technologies such as e-health, reminders set in cell phone, watches, MEMS etc. can also improve rate of adherence. Soon, non-adherence would be a leading factor for decreased clinical outcome and can affect the growth of healthcare sector in a country.
204 PRACTICAL APPROACH TO AMAVATA SAMPRAPTI AND CHIKITSA , Hemant D. Patel* and D. S. Swami
Ayurveda- the Great Healer Science of ancient as well as modern era which give message of health & better living. Amavata term derived from words as “ama” & “ vata”. The word ama is the condition in which various ailments in system creates toxic effect. Such ama when combines with vatadosha & occupies sheshmasthana results in painful disease “amavata”. In modern science Rheumatological disorder called Rheumatoid Arthritis is similar to amavata on the basis of their clinical features like pain, swelling, stiffness, fever, redness, fatigue etc. Amavata is such disease not dealt with important in ancient classics. It is well described in 7century by Aacharya Madhav in Madhav nidan under the category of vatakaphaj disorders. Hetu of amavata as said by madhavkara are viruddhahara, mandagni, Exercise after heavy meal etc. The treatment procedure described are Langhan, Swedan, Tikta-katu dipan, Virechan, Basti etc. so in the present study we have practical approach to amavata samprapti and chikitsa.
205 CLINICAL IMPORTANCE OF NADI PARIKSHA (PULSE EXAMINATION): AN AYURVEDIC DIAGNOSTIC METHOD , Dr Savitri Soni*
Ashtavidha rogi pariksha is one of the main diagnostic tool prescribed in Ayurveda. Acharya Yogaratnakara described eight varieties of rogi pariksha, namely nadi, mutra, mala, jivha, shabda, sparsha and drik for the diagnosis of diseases. Among them, nadi pariksha is necessary to diagnose altered condition of doshas like diminished functions or hyper functions or mixed or normal function of doshas. Nadi pariksha throw light to entire condition of diseases. In current paper attempts are made to study the relation of nadi pariksha (pulse examination) among ashtasthana pariksha in therapeutics with special emphasis and its applicability in medical practice.
206 AYURVEDIC APPROACH TO MANAGE STHAULYA (OBESITY): A REVIEW , Dr. Savitri Soni*
The worldwide percentage of non-communicable diseases is increasing and now becoming the chief cause of the death in all over the world. There are many non-communicable diseases among of them, obesity (Sthaulya) are vastly increasing in the world due to the change in the life style (Ahar, Vihar and Manasika) and working conditions. Sitting habits and lack of exercise are also the main reasons behind the higher prevalence of Obesity. Obesity lead to many diseases like Diabetes, Cardiovascular disease and Arthritis. Obesity also reduces the average life span and decreases the quality of life. Therefore, prevention of Obesity during its starting stage may overcome the risk of Diabetes, Cardiovascular, Arthritis and other serious diseases. In Ayurveda, Sthaulya (Obesity) belong to Santarpanajanya Vyadhi and fully described by acharyas. Accordingly, there are a number of drugs, medicinal preparations, Pathya - Apathya, Dinachrya and diverse techniques of Yoga and so on, which have wonderful preventive and curative effect on obesity.
207 ROLE OF AYURVEDA IN PREVENTION AND CURE OF MADHUMEHA , Dr. Vilas S. Kad, Dr. Mahadev B. Tupe, Dr. Namrata V. Kore*
In Ayurveda, Madhumeha is described as one of the type of Vataj Prameha and it is compared with Diabetes mellitus because of having similarities of disease in respect to etiopathogenesis, clinical features and prognosis. WHO list of most common lifestyle disorders is as CVD's, Diabetes mellitus, COPD, Cancer, Asthama, Diseases of digestive system like peptic ulcers, GERD etc, Genitourinary conditions like Nephritis, CKD etc, Neuropsychiatric disorders like depression, anxiety, stress etc. Lifestyle disorders are those who’s occurrence is based on the daily habits of people and are a result of an inappropriate relationship of people with their environment.[1] The main factors contributing to lifestyle disorders include bad food habits, physical inactivity, wrong body posture and disturbed biological clock. Now a days due to changing lifestyle, urbanization and fascination of western culture there is noticeable change in food habits and preparatory methods between early time and in present era. Ayurveda is age old, time tested and holistic science. It offers various methods to manage Madhumeha by following Pathyapathya, Dincharya, Ratricharya, Rituchratya,Panchakarma and also by including Rasayana therapy. This type of ayurvedic lifestyle promotes physical, mental as well as social health and ultimately leads to symptomatic improvement also improvement in the quality of life and thus help in the prevention and management of Madhumeha.
208 HINGULA (RED SULPHIDE OF MERCURY): A CONCEPTUAL REVIEW , Jolly Saxena, Vinita* and Ankur Saxena
Hingula is described as the cheapest and easiest source of Parada (Mercury). It is classified under both Maharasa and Sadharanarasa Varga. In ancient time it was used in the incineration procedures of gold, silver and other metals. Best quality of Hingula colour is like Japa-pushpa or Gudhal pushpa (shoe flower). Chemically it is Red sulphide of mercury (HgS) and called Cinnabar. It is considered as the most popular mineral for obtaining mercury across the world. Purified Hingula is useful in the treatment of all types of eye diseases (Netra Roga). It is therapeutically used in various disease conditions of liver, pancreas, skin and rheumatoid arthritis (Amavata), diabetes mellitus (Prameha), fever (Jwara), spermatorrhoea (Sukrameha) and leprosy (Kustha). Hingula has been used in many formulations.
209 CLINICAL STUDY TO EVALUATE THE EFFECT OF VAMANA KARMA AND VIDANGADI MODAKA IN THE MANAGEMENT OF EKAKUSTHA WSR PSORIASIS , Dr. Priyanka Ahitan and *Dr. Anil Bhardwaj
Every scientific investigation in the field of medical science on drug evaluation has to pass the stage of clinical study, before being declared to be therapeutically valuable. In-vitro and in-vivo experimental studies cannot establish their effectiveness unless and until they can cure the diseased man for which they have been tested. This is only possible by scientific clinical study. Among various skin diseases one soul harrowing disease is Ekakushtha. Ekakustha can be correlated with Psoriasis on the basis of similarity in symptomatology. Psoriasis is a non infectious, chronic inflammatory disease of skin. Remission, relapse and seasonal variation are seen in Ekakustha which are also present in psoriasis. In modern medicine there is no definite treatment for this disease. The unique treatment modality of Ayurveda provides long lasting results and better life to patients through its three basic principles of treatment i.e Shodana, Shaman and Nidanparivarjan. Current treatment modalities have their own limitations and the drugs have considerable side effects when used for a longer period. Hence it is time to find out safe and effective treatment for Psoriasis and here Ayurveda plays an important role. The present abstract reviews the concept of psoriasis in Ayurveda and role of Panchkarma in the management of psoriasis.
210 REVIEW ON HEAVY METAL TOXICITY MODERN AND AYURVEDIC ASPECT , Dr. Vd. Jaiprakash S. Ukey*
Heavy metals are nothing but naturally occurring elements having high atomic weight and density and are toxic in low concentration. The most commonly found heavy metals include arsenic, cadmium, chromium, copper, lead, nikel and zinc. These metals gets accumulated in body through food, water chemicals present in industries etc. Metal poisioning mostly occurs due to occupational exposure, accidents and environmental factors. . Metal toxicity mostly depends upon the absorbed dose, the route of exposure, i.e acute and chronic. Heavy metal toxicity proved to be a major threat and there are several health risks that are associated with it. Some of the metals, such as aluminium, can be removed through elimination process, while some metals get deposited in the body producing acute and chronic symptoms.various public health measures undertaken for control, prevention and treatment of metal toxicity occurring at various levels, such as occupational exposure, accidents and environmental factors.
211 CLINICAL STUDY ON DASHMOOLA TAIL KATIBASTI IN THE MANAGEMENT OF KATISHOOLA W.S.R TO LOW BACK ACHE , Dr. Gitanjali Aher* and Dr. Vilas Kad
Katishoola is common disorder involving the muscles and bones of lower back, which reduces the day-to-day activities considerably. In Ayurveda Katishoola comes under Vatavyadhi. Management for this is Katibasti as mentioned in the Ayurvedic Texts. Katibasti is one of the popular Panchkarma therapy described as Bahi Parimarjan Chikitsa (external procedure) in Ayurveda. In this clinical study an attempt has been made to trace out the references pertaining to the Katishoola from the Ayurvedic Texts. The study was conducted in 10 patients of Katishoola. Patients were treated with Dashmoola Tail Katibasti for 8 days. Observations and results obtained were statistically computed and appropriate conclusions were drawn. Katibasti with Dashmoola Tail proved to be the highly beneficial Ayurvedic Oil pooling treatment in the management of Katishoola.
212 STUDY OF ANTIPYRETIC ACTIVITY OF TRIBHUVANKIRTI RASA IN THE MANAGEMENT OF SANNIPATIK JAWAR: A CASE STUDY , Vd. Ganesh Sakharam Deshmukh* and Vd. Sunil Manikprabhu Pimple
There are various drugs in Ayurveda which can be helpful in Fever but effectiveness of Tribhuvankirti Rasa is nevertheless because Tribhuvankirti Rasa is one of the Rasaoshadis which acts rapidly and requires in low dose which is helpful to actual relief of Fever in small period of time. Tribhuvankirti Rasa balances Vata-Pitta-Kapha and hence it is very helpful in Sannipatik Jawara. The aim of this study was to evaluate the role of Tribhuvankirti Rasa in the treatment of Sannipatik Jawara. It is a single observational innovative case study. A female aged 40 years presented with a non-healing fever along with some other symptoms with a history of 2 weeks. On examination, patient was moderately febrile, general condition was weak, P.R 80/min; R.R. 18/min B.P. 130/90 mm of Hg and Ayurvedic findings was Daourbalya, Aasyavairasyata, Samata & Daha. The routine laboratory investigations were within normal limit except Hb count which was decreased and TLC count which was raised. Blood Smear test and Widal Test both was negative. This case study showed effective antipyretic activity of Tribhuvankirti Rasa.
213 EFFECT OF ANTIDIABETIC ACTIVITY OF GYMNOSPORIA MONTANA LEAVES ON DIABETIC RATS , Sandip Agrawal, Dr. Anil Chandewar, Rakesh Tiwle, Dr. Nitin Kochar*
Gymnosporia montana (GM) belonging to the family Celastraceae commonly known as Bharatti and Vikalo. It is a shrub or tree growing wild in dry areas and is commonly found in Maharashtra, Gujarat and other part of India. It is widely used in treating sore, ulcer, gastro-intestinal disorders, toothache, and dysentery. The dried powder of leaf of Gymnosporia montana was subjected to the phytochemical screening for the presence of various phytoconstituents like alkaloids, flavonoids, saponins, tannins, anthraquinones, and carbohydrates, etc. Effectiveness of different extracts of leaf of Gymnosporia montana was evaluated (100 and 200 mg/kg; p.o.) against Streptozotocin (STZ) induced diabetes mellitus in rat for blood glucose level and blood parameters. Further, ethanolic extract of the plant was also evaluated (200 mg/kg; p.o.) for glycosylated haemoglobion study. The result of study show ethanol and aqueous extract powder of Gymnosporia montana, an popular herbal drugs, appears to be a safe alternative to reducing blood glucose.
214 COMMUNITY-BASED ACTIVE TUBERCULOSIS CASE FINDING IN RURAL POPULATION OF AMRAVATI DISTRICT: A FEASIBLE AND EFFECTIVE STRATEGY , *Dr. Vishal Samadhan Dhande, Dr. Jyoti Khadse, Dr. Dilip Nikose, Dr. Manoj Barai, Dr. Amol V. Mankar and Dr. Anita Gopal Ambhore
Introduction: In light of the limitations of the current case finding strategies and the global urgency to improve tuberculosis (TB) case-detection, a renewed interest in active case finding (ACF) has risen. The WHO calls for more evidence on innovative ways of TB screening, especially from low-income countries, to inform global guideline development. We aimed to assess the effectiveness of community-based ACF for TB among the rural population of Amravati district and determine its impact on case detection and treatment uptake. Materials and methods: Present study was done during 13- 28 September 2019 by public health department of Government of Maharashtra. Active case finding strategies was applied for early detection and diagnosis of high risk population in Amravati rural area. Among 15 Tuberculosis Units in Amravati district, out of 2150364 target population, 1968617 populations were screened out for tuberculosis. Results: Among the screened population, Number of Presumptive TB Cases Identified was 4733 (0.24%). Out of 4733 presumptive TB cases, total 203 (4.2%) patients were diagnosed as tuberculosis. And all 203 (100%) were put on Antikoch’s treatment. Conclusion: ACF could supplement current strategies to yield additional TB cases, lead to early diagnosis and better treatment.
215 STRUCTURAL COMPOSITON OF KURPAR MARMA- A CADAVERIC STUDY , Shubham R. Nikam* and Dr. B. C. Vikhe
Marmas is the vital organ/ vital parts of the body where trauma/injury may be cause sudden death and may be deformity in the body. Total no of marmas is 107. Shushrutacharya have mentioned marma concept in sharirsthan 6th adhyaya. Vaghbhatacharya have also elaborated the concept of marma in asthang Hridaya sharirsthan 4th adhyaya. Marma is formed by mans(muscle), sira(artery/vein/capillary), Snayu(ligament), asthi(bones) and sandhi (joints). The classification of marma is based on four types by shushrutacharya. It is given as marmabhed as per shadanga, rachana, parinam and pariman. Kurpar marma is present in the urdhwashakha of sharir in between arm and forearm. So, it is necessary to see structural composition with the help of cadaveric dissection method.
216 THE EFFECT OF AMRUTADYAM CHURNA IN AMAVATA W.S.R. TO RHEUMATOID ARTHRITIS: A CASE STUDY , Hemant D. Patel* and Dr. D. S. Swami
Ayurveda deals with holistic approach of life and treatment of disease i.e. balance of body mind. The changes in life style & food habit often leads to vitiation in dosha, dhatu and mala creating vyadhi (disease) in the body. Ayurveda has since long time provided answer to the problem arising due to life style disorder. Rheumatoid arthritis is a disorder with varies clinical sign & symptoms related to multiple organ system. On the basis of clinical presentation, it is close to amavata. A disease described in madhavnidan samhita by aacharya madhav. In modern science Non steroidal anti-inflammatory drugs (NSAIDs) are the treatment in this condition. Which have limitation for long term therapy so there is need for drugs having good efficacy with low toxicity. In this disorder the whole treatment includes deepana, pachana. Drugs like Amrutadyam churna with kanji possess the deepana & pachana properties. Thus case described in this article was treated with the same guidelines of amavata chikitsa in ayurveda and results were obtained. Though a single case is not enough to prove the efficacy, author has tried to share his experience through this article to state that ayurvedic treatment for Rheumatoid arthritis is very effective & enhances the quality of life of patient without creating any side effects.
217 INCIDENCE OF ORAL STRESS ULC ERS AMONG DENTISTRY STUDENTS , Charanya S. and *Dr. Vasugi Suresh
Introduction: Mouth ulcers are small, painful lesions that develop in the mouth or at the base of gums. They can make eating, drinking and talking painful. Stress, anxiety and depression are the most common causes of oral ulcers among dentistry students as they more likely tend to bite their cheeks and lips when anxious or stressed causing trauma to mouth and eventually leading to the development of oral stress ulcers. Aim: To evaluate the occurrence of oral stress ulcers among dentistry students during their course tenure. Materials and Methods: An online survey was conducted among dentistry students across various dental colleges using a questionnaire. The questions were related to the frequency of occurrence of oral stress ulcers during their course tenure. A total of 15 questions were included. Results: 86.8% of the students have experienced the occurrence of oral stress ulcers more than twice during their course tenure, 10.2% of the students have experienced the occurrence of oral stress ulcers only twice during their course tenure and 2.68% of the students have experienced the occurrence of oral stress ulcers only once during their course tenure and 0.32% of the students seem to have not experienced the occurrence of oral stress at all. Conclusion: The high occurrence of oral stress ulcers among dentistry students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions.
218 SYNTHESIS AND ANTIMICROBIAL STUDIES OF MANGANESE COMPLEXES WITH ORTHO VANILINE OXIME AND SUBSTITUTED BENZOIC ACID , Reena* and Dr. Biju A. R.
Two complexes of Manganese with ortho vaniline oxime and substituted Benzoic acid were prepared by solvent based synthesis method. Its application as antimicrobial agent was tested on the basis of its activity against gram positive bacteria Staphylococcus aureus, gram negative bacteria Pseudomonas aeroginosa (ATCC 27853) and E.Coli and fungi Candida albicans.
219 EFFECT OF SUNBATH ON AUTONOMIC VARIABLES IN HYPERTENSIVE INDIVIDUALS , *Dr. Deeksha Shenoy G., Dr. Ganesh Prasad B., Dr. Prashanth Shetty, Ananth Prabhu and Dr. Sujatha K. J.
Background & Objectives: Sunbath is a cost-effective, efficient treatment modality used in the field of Naturopathy. Sunbath produces different physiological responses among individuals. Seasonal variations in blood pressure and cardiovascular mortality and morbidity are always encountered across the globe. Ultraviolet component of sunrays shows significant benefits on Blood Pressure. Present study aims to evaluate the effect of sunbath on various autonomic variables, to substantiate the clinical understanding of its effect, and to know its role in clinical application on hypertensive individuals. Methods: 60 subjects with hypertension between 30 to 50 years (40.08±5.58) were recruited, and were randomly allocated into case (Sunbath) and control groups (without sunbath). Blood Pressure, Heart rate, Heart Rate Variability, Respiratory Rate, Digit pulse volume, Body temperatures were assessed before, immediately after and an hour after the insolation. Results: The data analysis showed significant reduction in SBP (p=0.0060), DBP (p=0.0002) and MAP (p=0.0002). In time domain of HRV, there was significant increase in Mean RR (p=0.0052), RMSSD (p=0.0039), NN50 (p=0.0042), pNN50 (p= <0.0001) and significant reduction in HR (p=0.0005) were noted. In frequency domain, significant increase in HF (p=0.0049) and a significant decrease in VLF (p=0.0003), LF (p=0.0001) and LF/HF ratio (p=0.0013) were noted. Even after 1 hour, changes were sustained. No significant changes were observed in Pulse rate and Temperature. Interpretation & Conclusion: The present study reported that sunbath reduces the sympathetic tone and shifts the sympathovagal balance in favor of parasympathetic dominance and claims that it can be effectively used in managing hypertension.
220 PARENTAL PERCEPTION REGARDING ANTIBIOTIC USE IN CHILDREN- A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL, ODISHA , Sristi Ganguly*, Kiran C. Pankaj and Saroj K. Satpathy
Background: Antimicrobial resistance is one of the top ten threats to public health worldwide, in which society plays a pivotal role. Irrational prescribing trends by doctors and easy availability of antimicrobials over the counter, and parents’ attitudes and beliefs regarding antibiotics, assume prime importance. This study attempts to understand the parenteral perception of antibiotics use in children, and the factors responsible for a favourable attitude towards the same. Methodology: This is a hospital based cross-sectional study, enrolling parents of children aged upto 14 years, in SCBMCH and SVPPGIP, Cuttack, during March 2019 to September 2019. A structured questionnaire was administered, including socio-demographic details and twenty statements to assess their attitude. A scoring system employed with +1 and -1 for favourable and unfavourable response, and 0 for uncertain. A total score >0 was considered favourable attitude. Data was analysed with Chi- square test and percentages, using SPSS 18. Results: 30.7% and 26.3% felt antibiotics were needed to cure fever and cold respectively. 38.7% were unaware of side-effects of antibiotics and 42.3% refuted the phenomenon of resistance.55% found using antibiotics without consulting a doctor to be acceptable. 33% even requested the doctor for antibiotics. 37% admitted discontinuing the antibiotics upon recovery. 53.3% had an overall favourable attitude towards antibiotic use. Child’s age (p 0.003), mother’s education (p 0.036), income (p 0.009), socioeconomic status (p<0.001), self-medication (p<0.001) were significantly associated with the same. Conclusion: The poor parenteral perception regarding antimicrobials mandates an urgent need to improve doctor-patient relationship, and create awareness among the public about the correct antibiotic practices.
221 EVALUATION OF EFFICACY OF UNANI PHARMACOPOEIAL FORMULATION DABIDULWARD IN TASHHAMUL KABID (NAFLD) - A PRELIMINARY STUDY , Maqbool Ahmad Khan, *Najmus Sehar, Mohammad Naime and Jamal Akhtar
Fatty liver is acknowledged as fatty liver disease or hepatic steatosis. It is a reversible condition wherein large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e abnormal retention of lipids within a cell). It is normal to have some fat in liver but in the condition of fatty liver more than 5-10% of liver weight is fat. NAFLD is a spectrum of liver disease that ranges from simple fatty infiltration of the liver parenchyma (steatosis) to fat with inflammation (nonalcoholic steatohepatitis; NASH). The term Tashhamul Kabid is used for fatty lever disease in Unani System of Medicine. The objective of the present study was to evaluate the efficacy and safety of Unani pharmacopoeial formulation „Majoon Dabidulward‟ in the treatment of NAFLD. Patients were advised to take orally 7 grams of Majoon Dabidulward with water twice daily before the meal for 21 days. After treatment, it was observed that associated symptoms of fatty liver including abdominal tenderness, nausea, anorexia, general weakness and ultrasonography report were significantly reduced (p<0.05). The percentage reduction in abdominal tenderness, nausea, anorexia, general weakness and report of ultrasonography were 42.98%, 81.57%, 73.68%, 47.38% and 30.70% respectively as compared to base line. No adverse effect of the drug was found. Highly significant improvements in all associate symptoms of the fatty liver suggest that the results are really due to the therapy. On the ground of above result, it can be concluded that Majoon Dabidulward is very effective and safe in the treatment of Tashhamul Kabid.
222 MESSAGES, PLANNING AND ACTIVITIES BY ASHA & RDW DURING PREGNANCY OF RECENTLY DELIVERED WOMEN IN UTTAR PRADESH, INDIA , *Dr. Tridibesh Tripathy and Dr. Umakant Prusty
The current study explores some of the messages given by ASHAs to RDWs while including the planning and activities done by both the ASHAs & RDWs regarding the antenatal care of the RDWs. The study also describes the details on the components of Ante Natal Care (ANC) status and the role of ASHAs in availing these ANC components provided to the Recently Delivered Women (RDW) or mothers in four selected districts of UP. From the catchment area of each ASHA, two RDWs were selected who had a child in the age group of 3 to 6 months. Through this profile, the ANC components of RDWs such as measurement of weight, blood pressure, testing of blood and urine, examination of abdomen, knowledge on expected date of delivery and advice on place of delivery including nutrition during pregnancy. Receiving and consumption of Iron and Folic Acid tablets or bottles of syrup, deworming medicines by the RDWs are the other aspects mentioned in the study. Frequency of Tetanus Toxoid injections taken by the RDWs is the other area dealt in the study. All these aspects by the RDWs are reflected upon to give a picture that represents the entire state of UP. The relevance of the study assumes significance as data on the activities and planning of RDWs on their pregnancy is not at all reflected in many surveys. Usually, health workers are interviewed on their knowledge and messages or services they provide for ANCs of recently delivered mothers but data as actually told by RDWs are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The coverage for the four ANCs along with other services related to ANC are given for the state and district level in many surveys but there is a significant difference between the services or indicators mentioned in the current study and large-scale surveys like NFHS 4. The current study also gives the data regarding actual activity done by the RDWs (like buying of IFA tablets/bottles of iron syrup) on ANC. All these reasons are attributed to increased MMR in UP. It is noteworthy to mention here that the Maternal Mortality Ratio (MMR) of UP was 201 as per the MMR bulletin of Sample Registration System of May 2018 but currently it is 216 in UP as per the MMR bulletin of SRS in November, 2019 (SRS, 2018 & 2019). A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study. The results showed that the performance of ASHAs in Barabanki and Gonda districts regarding disseminating ANC messages was poor among the four districts. Less importance was given to the message on nutrition during pregnancy. The ASHAs were not distributing the iron tablets to all the pregnant women in the four districts. Regarding iron tablets, the study elicited that 3% of RDWs in Banda and 1% each in the other 3 districts said that they cannot recall how many tablets or syrups they received. None of the districts also showed that all pregnant women consumed IFA tablets. The study also reflected that the ASHAs were not following up the pregnant women properly for the TT shots as part of ANC. The study also showed that the ASHAs had not ensured availability of mother child cards with all the RDWs in all the 4 districts. It also emergeds that in Gonda district, only 51% of RDWs and in Barabanki district, 67% of RDWs received deworming medicines but 96% in Banda district and 93% in Saharanpur district received deworming medicines.
223 NEW PROPHYLACTIC MEASURES IN PREVENTING COMPLICATIONS OF VIRUS INFECTION COVID-19 , Dr. Ivan Minić*
Background: Coronavirus Disease 2019 (COVID-19) is a respiratory disease caused by a new virus that first emerged in December 2019 and has since spread to many countries. In the current situation where COVID-19 is rapidly spreading worldwide and the number of cases in Europe is rising with increasing pace in several affected areas, there is a need for immediate targeted action. There were strong evidences of human-to-human transmission of 2019-nCoV among the close contacts of infected patients. The most common symptoms at onset of COVID-19 illness are fever, cough, and fatigue, while other symptoms include sputum production, headache, haemoptysis, diarrhoea, dyspnoea, and lymphopenia. The virus lingers on the mucous membranes of the nose and in the oral cavity before being transmitted to the lungs. Method: The aim of this paper is to consider additional measures for the prevention of viral infection. Steam inhalation is one of the most widely used home remedies to soothe and open the nasal passages and get relief from the symptoms of a cold or sinus infection. Also called steam therapy, it involves the inhalation of water vapor. The introduction of water vapor into the nasal spaces and sinuses can also affect viruses and in this situation the virus COVID -19. Sodium hypochlorite (NaOCI), commonly known as 'bleach," is widely accepted as being a safe and effective antiseptic against bacteria, fungi, and viruses. The author's recommendation is that each person uses NaOCl at a concentration of 0.05% or 0.1% 2 times a day after contact with another person and after spending time outside the home. It is thought that mouthwashing alone will contribute to the reduced concentration of viruses in the oral cavity and NaOCl will also exert its antiviral effect. Result: The result of this research could be to prevent the spread of the virus into the deeper parts of the airways, which is an important prevention of the complication of viral infection. Conclusion: Based on available data on the virus COVID-19, its transmission, retention in the nasal mucosa and oral cavity the application of water vapor to the nasal cavities and the application of a solution of NaOCl could contribute to the reduction of virus activity in the indicated regions of the body and thus reduce the possibility of virus transmission in deeper parts of the airways. These preventive measures have been used in medicine for many years, have no negative effects on health and can be applied in the situation of a pandemic virus COVID-19.
224 CLASSICAL STUDY OF “VIKAR VIGHATKAR BHAVA ABHAVA PRATIVISHESHA IN PROCESS OF DISEASE MANIFESTATION , *Vd. Devanand R. Pawar and Dr. Vijay R. Potdar
According to concept of Ayurveda Cause of disease, Dosha and Dushya factors are the specific factors responsible for disease and disorders. Manifestation of disease depends How quality of Dosha and Dushya component.It means imbalanced Dosha and Dushya(Serum,Blood,Muscles etc) may initiate the manifestation of disease. Human body and natural physiology itself Physician of human being, which face initially against pathogenesis of disease. In other words nature is the first doctor of human being. Physiacian Factors which assist for disease manifestation are the vikarvighatkara abhava. Factors which hinders disease manifestation are vikarvighatkar bhava.Visheshas are the specific factors like nidana,dosha,and dushya. Prativishesha are the outcome of the interaction between the vishesha. Anubadhnati ,bala, kala, are the three main factors responsible for the changes in samprati of diseases. As above said the concept of vikarvighatkar bhava abhav prativishesha will be presented in brief.
225 IMPORTANCE OF YOGA AND DIET IN INFERTILITY , Dr. Priti Kumari*, Dr. Deepak Kumar, Dr. Anupam Pathak and Dr. Yogesh Jakhar
Infertility is the most common gynecological problem which many couples in 21st century are facing. According to mayo clinic USA about 20% of cases of infertility are due to the problems in the men. About 40 to 50% of the cases of the infertility are due to problems in both men & women. Increasing rate of infertility has become challenging for gynecologists. As the allopathic treatment developed upon hormone supplementation, surgical procedure & artificial reproductive technique, it‟s the turn of ayurved & yog to give solution & active conception by natural method to give healthy offspring. Yoga is one among oldest system of health care in the world which uniquely perceived an intimate relationship between lifestyle of an individual to its health & disease. In Yogsutra, Achary Patanjali explained various asanas. These asanas are very helpful in controlling the mind as well as other element of the body. By the regular practicing the asanas the reproductive organs get strengthen & the neuro-mascular co-ordination improve. Also hormonal imbalance gets corrected. Nitya sevaneya aharas are mentioned for daily dietary consumption in Ayurveda. It includes food items which can promote the health and fertility and maintain the balance of sevaneeya ahara make a balanced diet.
226 AN OBSERVATIONAL STUDY ON USE OF ANTIEPILEPTIC DRUGS IN PEDIATRIC WARD AT GMERS HOSPITAL, GANDHINAGAR , Parin Patel*, Neil Modi, Krupa Patel, Shrikalp Deshpande, Janki Patel and Seema Shah
Drug utilization study (DUS) is stepping stone to conduct drug use evaluation so that error in drug use can be observed and resources can be put to use in proper fashion. Seizure disorder is a generalized term which includes epilepsy, febrile seizure, single seizure all associated with excessive or uncontrolled discharge of neurons. Around 4-10% children suffer at least one seizure in first 16 years of life leading to prescription of Anti-epileptic drugs (AED’s). The pharmacokinetics of AED’s differs between pediatric and adults, 90% of people are not receiving AED’s treatment due to various factors. Results: 132 pediatric patients prescribed with single or multiple doses of AED’s. Midazolam (41%) was the most commonly prescribed Benzodiazepine, Phenytoin (25%) most commonly prescribed AED. Conventional AED’s (95%) are more commonly prescribed in our study than Newer AED’s (5%). Conclusion: Our study concluded that boys were more prone to seizure episode than girls. Phenytoin was the most used AED and Midazolam was most commonly used BZD. Midazolam monotherapy was used as first line of drug for management of seizure episode. Thus concluding study shows conventional AED’s were still safe and effective in achieving seizure control.
227 LOCATION OF SHAT CHAKRAS AND CO-RELATION WITH ENDOCRINE GLAND IN THE HUMAN BODY , Dr. Deepak Kumar*, Dr. Priti Kumari, Dr. Sakshi and Dr, Subhash Upadhayay
The Chakra has its own importance in Ayurveda. They are considered loci of life energy, or Prana (Shakti), which is thought to flow among them along pathways called Nadis. There are six primary Chakras namely Muladhara, Svadhisthan, Manipura Anahat Vishuddha and Agya Chakra. The endocrine system maintains homeostasis by controlling hormones The endocrines system produces hormones from glands and homeostasis is the maintenance of the internal environment by keeping your hormones constant. In some Indian religions, a chakra (Sanskrit cakra, "wheel") is thought to be an energy point or node in the subtle body. Chakras are believed to be part of the subtle body, not the physical body. More importance is given to Shatchakra in Yoga vigyan .Now a days, there is need to establish the relation between modern science, Yoga and Ayurved for maintaining good health of an individual .Ayurved and Yoga are interdependent science which are already being used in day today practice .Its true need to interpret both sciences with modern science which will really show magical results.Endocrine disorder is commonly seen in the present era. So, to improve the function of endocrine glands, we may follow the knowledge Shatchakra described in Ayurved samhitas which actually works together as a system to balance physical and mental health of an individual. The effort is made to establish interrelationship of endocrine glands with Shatchakra in Ayurved.
228 FIBROIDS AND FERTILITY: A LITERATURE REVIEW , *M. Sebti, M. C. Fourati, F. Zidane, P. R. M. Yousfi and P. R S. Bargach
Leiomyoma, more commonly known as uterine myoma or fibroma, is a benign tumor of the human uterus that grows at the expense of smooth muscle cells. These tumors consist of smooth muscle fibers with elongated nuclei, surrounded by collagen fibers and a pseudocapsule formed by smooth muscle cells, and are poorly vascularized. Myomas are extremely variable in form, each characterized by their size, consistency and position relative to the myometrium, and are mostly multiple within the same uterus. Fibroids are classified ultrasonographically into different types based on the position of their largest transverse diameter according to the FIGO classification. Fibroids are the most common uterine tumors in women of childbearing age and are present in 20% to 50% of these women, and their controversial relationship to infertility remains a matter of debate. The management of a woman with a fibroid and a desire for pregnancy is discussed. It is reported that 5% to 10% of infertility cases prior to medical management are associated with the presence of uterine fibroids. Uterine fibroids are considered to be the sole infertility factor in only 1-3% of cases.
229 EFFECT OF PANCHKARMA IN PAKSHAGHATA: A CASE STUDY , Dr. Diksha Sharma*, Dr. Himanshu and Dr. Charu Supriya
Pakshaghat is made up of two words Paksha (half part of body) and aghat (loss of function). Ayurvedic literature is full of textual references where Pakshaghat is described extensively. It is considered as vata dosha predominant vyadhi. Patient usually presents with loss of function of a half of body or weakness of one half. Face may or may not be involved .Prognosis depends on many factors including vaya, bala, dosha involvement etc. In modern science all the motor activities are controlled by brain. Cerebrovascular accidents are mainly responsible for loss of function in body and due to maximal similarity they can be correlated with Pakshaghat. In modern science there is usually treatment of symptoms but when it comes to Ayurveda there is treatment of root cause along with symptoms. In Ayurveda treatment of diseases is divided in to two parts Samshodhana and Samshamana. Panchkarma is shodhana pradhana therapy, which includes five major procedures for shodhana of body . Along with it there are many allied processes which helps in symptomatic relief by directly acting on the part being affected. Pakshaghat is best treated with mridu samshodhana and vata shamaak snehana chikitsa. In the present case patient presented with right side Pakshaghat and treated with Panchkarma therapy, which included Nasya, Vasti and Akshitarpana. Initially Nasya and Akshitarpana given for 15 days .Patient was called for second sitting after 15 days and given Yapna vasti in kala vasti karma. After treatment patient was 100 % cured.[1]
230 A CASE STUDY ON EFFECT OF JANU DHARA IN SANDHIGATA VATA W.S.R TO OA , Dr. Himanshu Sharma*, Dr. Diksha Vashisht and Dr. Charu Supriya
Sandhigata Vata is the commonest disorder which mainly occurs due to Dhatukashya and other Vata Prakopaka Nidan, which limits daily life activities such as walking, standing, personal care etc. Janu Sandhigata vata can be correlated with osteoarthritis (OA) of the joint is degenerative disease which affects mostly knee joint. In OA pain, swelling, restricted movements of the joint are common clinical features.
231 ETIOLOGY OF ILEAL PERFORATION AT TERTIARY CARE HOSPITAL , Dr. Maria Irshad Chohan*, Dr. Tahreem Afzal and Dr. Seemab Ara
Objective: The aim of this study is to determine the incidence of ileal perforation on its etiological basis. Study design: The data is collected prospectively and the patients are selected by consecutive sampling technique. Sample size: 119 patients. Place and duration: The study is conducted at Surgical Emergency of Sheikh Zayed Hospital, Rahim Yar Khan from July, 2019 to 1st January, 2020, over the period of 6 months. Results: Out of 119 patients, 86 are male and 33 are female with male to female ratio of 2.61. According to the results of the study, the order of etiologies of ileal perforation is as follows: Nonspecific 66 (55.5%), Traumatic 34 (28.6%), Typhoid 14 (11.8%), Intestinal Tuberculosis 3 (2.5%), and Iatrogenic 2 (1.7%). Conclusion: Typhoid and Tuberculous perforation are the third and fourth most common cause of ileal perforation, respectively. Ileal perforations are more common in males.
232 SUSCEPTIBILITY PATTERN OF MYCOBACTERIUM TUBERCULOSIS TO 1ST LINE ANTI TUBERCULOSIS THERAPY , Dr. Seemab Ara*, Dr. Tahreem Afzal and Dr. Maria Irshad Chohan
Objective: To determine the susceptibility pattern of Mycobacterium Tuberculosis (MTB) to 1st line Anti tuberculosis therapy. Study design: Cross sectional study. Study Setting: Department of Biochemistry, Sheikh Zayed Hospital, Rahim Yar Khan. Study Duration: March 2019 to November 2019. Methodology: This was a cross sectional study carried out at Department of Biochemistry, Sheikh Zayed Hospital Rahim Yar Khan during March 2019 to November 2019. In this study the cases of both gender with age more than 15 years were included. The cases that have already taken ATT were excluded. Sputum samples were obtained and then processed at solid Lowenstein Jensen (LJ) media for at least 6 weeks, MTB isolated from these sample were then tested for their susceptibility to the 1st line ATT drugs. The MIC of the studied drugs per ml of LJ medium for susceptibility testing were 0.2 mcg for isoniazid, 02 mcg for streptomycin, 05 mcg for Ethambutol, 100 mcg for pyrazinamide and 01 mcg for rifampicin. Results: In this study there were total 115 cases; out of which 72 (62.60%) were males and the mean age of the participants was 35.19±10.67 years. Drug resistance was seen in 36 (32.17%) of cases and few of the cases had more than 1 drug involvement. The most common drug to which was resistance was seen was streptomycin affecting 19 (16.52%) of the cases. it was followed by Isoniazid where it was seen in 17 (14.78%) of the cases. Single drug resistance was seen in 30 (26.08%) of the cases. three and four drug resistance were seen in 2 (1.73%) of cases each. Conclusion: Drug resistance is seen in almost every 3rd case and the most common drug to show resistance is streptomycin.
233 ESSENTIAL STUDY OF RASA SHASTRA FOUNDAMENTAL CONCEPTS , Dr. Gaurav G. Shanbhogue* and Dr. M. V. Sobagin
Indian Ancient Pharmaceuticals deals in spices, medicinal minerals and animal productsIn ancient India, metals / minerals were the primary resources used for civilizational and medicinal purposes. Parada is the primary element, both for alchemy and medicinal purposes, while other minerals (e.g. Abhraka, makshika, hingula), metals (e.g. gold, copper, lead), along with certain non-metals such as gandhaka, also played an auxiliary function for these purposes.All raw materials shall be processed in general or in a particular way as specified for that reason in order to produce the required finished product. Ancient therapies used for medicinal purposes include Murchhanaa, shodhana, jarana, marana, amritikarana, sattvapatana, etc. and 18 sanskara is the primary method used for alchemy.Both procedures are performed in a single or numerous method, with their own value for the finished result and the work. During the processing of the finished goods, their quality assurance, dosage fixation with the law of regulation, allergic reactions and their treatments are the essential needs of the subject.In the present essay the inevitability of basic values such as Paribhasa, mana, yantra, puta, sanskara, shodhana, marana, amritikarana, dosage assessment, control of harmful effects, etc.The goal is to address the topic in a concise and structured way for a deeper comprehension of the topic by ordinary citizens and to discuss the issue with cross-disciplinary knowledge and discussion on study activities.
234 CAUSATIVE FACTORS OF DIABETES MELLITUSACCORDING TO AYURVED , Dr. Ankita Vashist*
Diabetes mellitus is the world’s largest silent killer. India has been projected by WHO as the country with the fastest growing population of Diabetic patients. It is estimated that between 1995 to 2025 diabetic patients in India will increase by 195%. The problem with diabetes mellitus is that it is very difficult to diagnose in the early stages.
235 ASSESSMENT OF NUTRITION EDUCATION ON DIET AND NUTRITIONAL STATUS OF PREGNANT WOMEN , *Dr. Mahnoor Ishtiaq, Dr. Maryam Sana and Dr. Hafsa Ahtesham
Objective: To assess the effects of nutrition education intervention on dietary practices and nutritional status of pregnant women. Methods: In this quasi-experimental study, 215 pregnant women were enrolled from Gynae OPD, Sir Ganga Ram Hospital, Lahore, Pakistan during 2017-18. Dietary practices were assessed using the usual intake form and scoring was done against food guide pyramid. Nutritional status was evaluated by anthropometric measurements and biochemical estimation. In addition to nutrition counselling, each woman was prescribed with supplements commonly used during pregnancy. Dietary habits and nutritional status were reassessed after two months. The women lost to follow up were 21 (9.8%) therefore data obtained from 194 women were subjected to final analysis by using SPSS 20. Results: The age of women ranged between 18 and 38 years. Those who never attended a school were 14.4%; poor 46.0%; and working 3.7%. The comparison between pre- and post-counselling dietary practices showed improvement in the numbers of women taking recommended portions of bread & cereals (79.4% vs. 95.9%, p = <0.001); vegetables (50.5% vs. 64.9%, p = 0.004); milk & dairy products (38.1% vs. 81.4%, p = <0.001); and a reduction in the numbers of women taking recommended portions of meat & bean (100.0% vs. 94.8%, p = 0.002). The frequency of women taking recommended diet as per food guide pyramid improved from 3.1% to 37.1%. Vitamin D status also showed improvement in the numbers of women with normal levels of serum vitamin D (7.1% vs. 33.3%, p = 0.079). Conclusions: Overall, nutrition counseling showed positive effects on nutritional status of pregnant women. Thus, the nutrition counseling must be an essential part of antenatal care for all pregnant women in the setting.
236 AWARENESS AND PREVALENCE OF NON-COMMUNICABLE DISEASES AMONG UNIVERSITY STUDENTS IN PAKISTAN , Dr. Maha Jamil, *Dr. Zara Tahir and Dr. Nosheen Tariq
Background and Objective: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality in developed countries. This study has evaluated the frequency of the risk factors of NCDs and its awareness among students in a University in Pakistan. Methods: This cross-sectional study was conducted among 374 female students of University of Lahore, Lahore. The study was carried out for a duration of six months, from August 2019 to January 2020. Standard self-administered questionnaire, anthropometric and biochemical parameters were used for data collection, analysed through SPSS version 20.0. Results: The mean age of the students was 20.6 years. The results showed that 64.7% of students were physically inactive, 52.4% spend more than two hours watching TV. The intake of adequate amount of fruits (14%) and vegetables (6.8%) was very little. Junk food was consumed >11 times per week by 37.1%. The prevalence of overweight and severe obesity was 25.9% and 5.1% respectively. Blood sugar analysis showed 1.1% had pre-diabetes and 0.8% had diabetes. About 56.2% of students had no knowledge about NCDs and their risk factors. Conclusion: A high prevalence of risk factors for NCDs was found among students. Awareness programs about healthy lifestyle practices; periodic screening of school and college students at regular intervals with appropriate advice are warranted to control the rising epidemic of NCDs.
237 EFFICACY OF DIAGNOSING URINARY TRACT INFECTIONS BY ROUTINE CULTURE SENSITIVITY TEST AND MOLECULAR METHODS , Dr. Waseem Ahmad, Dr. Adeela Yasmeen, *Dr. Hafiz Aaqib Mehboob
Objectives: Urinary tract infections are the second most common bacterial infections occurring at all ages and both sexes. The increasing rate of antibiotic resistance is a global concern. The use of routinely used antibiotics is resulting in treatment failure. The objective of this study was to diagnose the urinary tract infections by routine culture sensitivity test and by molecular methods. Methods: This study was conducted in Microbiology laboratory, DHQ Teaching Hospital, Sargodha, from July 1st to 31st March 2019. Isolates were identified biochemically by API20E & API20NE. Antibiogram was performed using disc diffusion Kirby Bauer technique. The 16S rDNA gene approach was used for molecular identification of bacterial isolates. The presence of the blaNDM-1 gene was identified by polymerase chain reaction (PCR). Results: We isolated 146 bacterial isolates namely Escherichia coli (n=99) 67.80%, Klebsiella pneumoniae (n=33) 22.60%, Pseudomonas aeruginosa (n=11) 7.53% and Proteus mirabilis (n=3) 2.05% from 2032 urine samples. The resistance pattern was dominated by Multi Drug Resistance (MDR). Remarkably, four isolates of Escherichia coli (n=3) and Klebsiella pneumoniae (n=1) were displaying resistance against a range of antibiotics used in the study, including carbapenems but sensitive to tigecycline and polymyxins only, suggesting extensive drug resistance having blaNDM-1 gene. Conclusion: This is the first report on direct molecular detection of bacterial pathogens from urinary tract infected patients in Punjab. The presence of blaNDM-1 in different bacterial species and their extensive drug resistance pattern poses a significant clinical threat. Molecular detection of bacteria and resistant gene may reduce the diagnostic time of patients.
238 PHARMACEUTICAL EFFICACY AND LIFE STYLE MODIFICATIONS IN THE TREATMENT OF ASTHMATIC BRONCHITIS , Dr. Nosheen Tariq, Dr. Zara Tahir and *Dr. Maha Jamil
Objective: To investigate the clinical effect of ambroxol in the treatment of asthmatic bronchitis. Methods: One hundred and twenty patients with asthmatic bronchitis who were admitted to our hospital from June 2017 to August 2018 were selected as the research subjects and divided into a control group and an observation group according to random number table method, 60 in each group. The control group was treated with conventional treatment, while the observation group was treated with ambroxol in addition to conventional treatment. The therapeutic effect, disappearance time of symptoms andsigns and the recovery of pulmonary function were compared between the two groups. Results: The total effective rate of the observation group was 96.7%, and that of the control group was 73.3%. The control effect of the observation group was significantly better than that of the control group, showing a significant difference (P<0.05). The disappearance time of symptoms of the observation group was shorter than that of the control group, and the recovery of pulmonary function was better; the differences were statistically significant (P<0.05). Conclusion: For asthmatic bronchitis patients, addition ofambroxol to conventional treatment can improve the therapeutic effect, shorten the disappearance time of clinical signs and symptoms, and promote the recovery of patients, which is worth clinical application.
239 PREVALENCE OF NON ALCOHOLIC FATTY LIVER IN RHEUMATOID ARTHRITIS PATIENTS , Dr. Hafsa Ahtesham*, Dr. Maryam Sana and Dr. Mahnoor Ishtiaq
Objective: To determine the frequency of fatty liver (non-alcoholic) disease, Framingham 10-year cardiovascular risk score in rheumatoid arthritis patients. Methods: This study was conducted from September 1st to March 19, 2019, at Rheumatology OPD, Services Hospital, Lahore. One hundred ninety two seropositive rheumatoid arthritis patients were recruited. Demographic details were noted, BP, BMI, smoking habits, and waist circumference were noted, then sent to radiology department for ultrasound scan of abdomen by an expert radiologist. On next day 10 ml blood was taken by phlebotomist for lipid profile and fasting blood sugar levels, after availability of results 10-years Framingham cardiovascular risk score was calculated. Results: Females were (81.3%) mean age of (45.4) years, fatty liver was present in n=39 (20.3%). In positive cases comorbid like metabolic syndrome was present (71.8%), diabetes mellitus (33.3%), hypertension (59%) FRS score (intermediate to high in (33.3%), history of hakeem/desi medication use (51.3%), while on regression analysis all study parameters except DMARD’s had significant association with fatty liver (p<0.05). Conclusion: Nonalcoholic fatty liver disease is very widely prevalent in rheumatoid arthritis patients. As in general population, it is multifactorial in origin and needs careful monitoring and treatment.
240 SIGNIFICANCE OF ASPHYXIA AND SEPSIS IN ACUTE KIDNEY DAMAGE AMONG NEWBORNS , Dr. Hafiz Aaqib Mehboob, Dr. Muhammad Tauseem and *Dr. Adeela Yasmeen
Objective: To determine association of in-hospital outcome of AKI with etiology in newborns at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted at Department of Pediatric Neonatology, Services Hospital, Lahore by using non-probability purposive sampling technique from June 2016 to June 2017. A total of 101 newborns diagnosed with acute kidney injury were registered. Etiological factors were assessed and these patients were followed till discharge to monitor in-hospital outcomes. Results: Of these 101 newborns, 75 (74.3%) were boys while 26 (25.7%) were girls. Mean age of these newborns was 7.59 ± 6.13 days (range; 1 day to 28 days). Mean age of the boys was 5.73 ± 7.20 days while that of girls was 6.77 ± 6.16 days. (p=0.515). Mean weight of these neonates was 2545.05 ± 600.42 grams (range; 1000 grams to 4000 grams). Mean serum potassium level was 4.94 ± 0.92 mgEq/L ranging from 3.1 mgEq/L to 7.0 mgEq/L. Mean urea level was 73.35 ± 27.65 mg/dl ranging from 18 mg/dl to 206 mg/ dl. Mean serum creatinine level was 1.98 ± 0.27 mg/dl, ranging from 1.6 mg/dl to 2.8 mg/dl. Mean serum sodium level was 145.72 ± 12.64 mgEq/L ranging from 126 to 166 mEq/L. Eighty one (80.2%) were term babies while 20 (19.8%) were pre-term babies. Of these 101 study cases, 29 (28.7%) delivered vaginally while 72 (71.3%) through cesarean section. Delayed crying was noted in 48 (47.5%), dehydration 13 (12.9%), sepsis in 36 (35.6%) and renal malformation in only 4%. Neonatal mortality in these patients was 15 (14.9%) while 86 (85.1%) were discharged from hospital after recovery. Conclusion: Acute kidney disease in newborns is associated with significant disease morbidity and mortality with asphyxia and sepsis are the main etiological factors responsible. It is predominantly more common in boys compared with girls. Mortality rate was high in our study and it was significantly associated with female gender. Mortality was also associated with elevated serum sodium and urea level.
241 SELECTION OF CONTRACEPTIVE METHODS AMONG MARRIED WOMEN OF RURAL AREA OF RAHIM YAR KHAN , Dr. Hira Iqbal*, Dr. Aneela Munawar and Dr. Munazza Azhar
Objectives: To get information regarding the most preferred contraceptive method used by married women of rural area of Rural Health Center of Rahim Yar Khan. Method: The cross-sectional study was conducted on 300 married women of rural areas with different socio-demographic factors, age groups, & family backgrounds. A structured questionnaire consisting of open ended and close ended questions was made, and pre-tested. Face to face interviews of those willing women were done at their residence with the help of a trained Lady Health Workers (LHWs) and the 100% response rate achieved. Non-probability sampling (convenient) was adopted to include willing married female. Statistical Package for the Social Sciencesp-19 was used for analysis & descriptive statistics were calculated. Results: Out of 300 participants majority of women 129 (43%) are using Combined Oral Contraceptive Pills (OCP) followed by condoms 65(21.6%) and natural method (exclusive breast feeding) 40(13.6%). Majority of women 125(41.6%) have been taking contraception for 1-2 years. Most participants 217(90.3%) were of age 27-36 years along with majority of participants were having gravidity and parity of 4-6 each. Opinion of better family well-being was given by 110(36.6%) women after taking contraception for family planning. Major side effect of nausea and vomiting noticed among 35(11.6%) user of oral contraceptive methods. Conclusion: Oral contraceptive pills are the most commonly used contraceptive method among married women. The reason of this preference is availability of combined oral contraceptive pills at basic health units. These OCP delivered through lady health workers increased the number of women taking contraception for family planning. It is also related with increased awareness about family wellbeing and health of mother.
242 KAP STUDY AMONG WOMEN TOWARDS BREAST SELF-EXAMINATION , Dr. Munazza Azhar*, Dr. Rabia Pervaiz and Dr. Hira Iqbal
Introduction: A breast self-exam is the routine examination done by females of their own breasts to find any abnormal growth or changes that are alarming and need medical consultation to treat. It is seen that more than 10% to20% breast cancer is detected by breast self-examination. It is important for females to do BSE regularly to prevent breast cancer. Setting: Study was conducted in a rural area of Lahore, Pakistan. Study design: Cross sectional descriptive study was conducted. Population: Data was collected from 135 women of rural area of Lahore. Sampling: Data was collected from convenient selected sample of 135women of rural area of Lahore. Methodology: The instrument use for the data collection was adopted questioner and convenient sampling technique was used. Results: 19.3% of the study participants knew about the Breast self-examination while 28.9% have knowledge about breast cancer. Only 24.4% knew about the Breast self-examination whereas 35.6% know that only doctors can examine the breast. As regard interval of breast self-examination, 34.1% of the study participants had knowledge, while 46% were not having knowledge. On other question that BSE must be done between days 7 until day 10 after menstrual cycle 20% of the study participants had knowledge, while 80% were not aware of this. BSE should be done in front of a mirror 40% had knowledge and 60% had no knowledge. The above table reveals that only 19.3% study participants had knowledge regarding Breast self-examination, while 80.7%% were not aware of it. Similarly, need to assess any changes in color, size and shape of Breast only 24.4% had knowledge and 75.6% had no knowledge about it. The knowledge of breast self-examination was also very low among the participants and only 19.3%had knowledge about it. Conclusions: knowledge, attitudes, and practices towards breast self-examination are poor among the women of child bearing age in the rural area of Lahore.
243 ROLE OF BRANCHED CHAIN AMINO ACIDS IN THE MANAGEMENT OF HEPATIC ENCEPHALOPATHY , Dr. Saif Ullah Khalid*, Dr. Rabia Pervaiz, Dr. Umair Younas
Introduction: Hepatic encephalopathy (HE) or portosystemic encephalopathy is a state characterized by disordered central nervous system functions because of failure of liver to detoxify nitrogenous agents originating from gut because of dysfunction of hepatocytes and portosystemic shunting. Patients with Hepatic encephalopathy (HE) often present alteration of mental status varying from minor psychological abnormalities to deep coma. Multiple studies conducted worldwide suggest that the branched chain amino acids (BCAAs) leucine, isoleucine, and valine may be useful in improving survival and reducing morbidity in patients with HE. Objectives: To compare the efficacy of branched chain amino acids in reversal of hepatic encephalopathy in patients with cirrhosis of liver with placebo. Study Design: Randomized control trial Setting: Medical Unit, Nishtar Hospital, Multan Duration: Study was carried out over a period of 6 months from July 2019 to December 2019 Results: A total of 60 patients (30 in each group) were enrolled, majority of the patients were between 41-50 years in both groups, 36.67% (n=11) in Study and 43.33% (n=13) control group, mean and standard deviation of age was calculated as 43.56+5.21 in study and 45.78+4.98 years in control group, 70% (n=21)patients were male in study group and 63.33% (n=19) in the control group, 30% (n=9) patients in study group and 36.67% (n=11) in control group were females, comparison of efficacy of BCAAs in reversal of HE with placebo reveals 63.33% (n=19) patients in study group showed reversal of HE and 26.67% (n=8) patients in control group. Conclusion: The results of the study conclude that branched chain amino acids are significantly effective in reversal of hepatic encephalopathy when compared with placebo.
244 OCCURRENCE OF HYPERURICEMIA AMONG PATIENTS WITH BACKACHE IN GENERAL POPULATION , Dr. Umair Younas, Dr. Aneela Munawar*, Dr. Saif Ullah Khalid
Objective: To determine frequency of Hyperuricemia in patients with backache in general population and to compare the results with international studies. Study Design: cross sectional Descriptive Case Series. Place and Duration: In outdoor patients of medicine department, Sheikh Zayed Hospital, Rahim Yar Khan from August 2018 to January 2019. Methodology: Adult patients of either gender with low backache were Included in the study. Patients of chronic renal failure and osteomalacia patients were excluded. Nonprobability consecutive sampling technique was used. After enrolment of patients according to criterion an informed consent was taken. Uric acid level was checked in all patients. Uric acid level 4 to 5.7mg/dl for females and 47.0mg/dl for males were taken as normal. Results: We included 100 patients. Age ranged from 12-80 years (mean =40.50±15.2years). Out of these100 patients 17% patients were having Hyperuricemia. Among patients regarding age distribution 57% were below age 40 and 43% were above age 40. In above 40 years age group Hyperuricemia was seen in 76.47 %( 13pts) in below age 40 years group 23.53% (4pt) had Hyperuricemia. The p value is (.002) significant indicating an important relationship between age above 40 and Hyperuricemia. Out of 100 patients regarding gender distribution 54 %were females and 46 % were males. Amongst 17%patients having Hyperuricemia 64.7 %( 11pt) were female and 35.3 % (6pt) were male and P value regarding gender distribution was 0.331. Conclusion: Hyperuricemia is common in Pakistani population and needs to be considered in most of patients with backache especially females who are more predispose to this condition.
245 ASYMPTOMATIC SPONTANEOUS BACTERIAL PERITONITIS IN PATIENTS WITH LIVER CIRRHOSIS , Dr. Marzia Ali*, Dr. Tooba Bukhari and Dr. Omer Qasim
Objectives: Investigate the incidence of asymptomatic spontaneous bacterial peritonitis in patients with liver cirrhosis. Study Design: Prospective study. Place and Duration of Study: This study was conducted at the Gastroenterology Department of Sheikh Zayed Hospital Rahim Yar Khan from July 2018 to July 2019. Materials and Methods: Eighty six patients of liver cirrhosis were included in the study. Main variables were serum albumin, prothrombin time, ascitic fluid protein, serum bilirubin, child class B, child class C. SPSS version 23 was used for data analysis. Test of significance student t-test and chi square test were applied. P value ≤0.05 was taken as significant. Result: S. Albumin, PT (s), Ascitic Fluid Proteins, S. Bilirubin, TLC, ESR and CRP of SBP negative patients was 29.55±2.95 (g/dL), 28.97±1.25, 1.87±0.22 (g/dL), 54.21±2.15mMol/L, 11.91±2.21 (x109 /L), 34.37±2.18 (mm/h) and 56.47±2.33 (mg/ L), respectively. Child class C and child class B was observed as 64.5% and 31.6%, respectively. Conclusion: High frequency of spontaneous bacterial peritonitis is associated with liver cirrhosis; early diagnostic parenthesis should be performed in all outdoor patients for detection of silent cases of peritonitis. Antibiotic prophylaxis reduces the incidence of SBP.
246 CLINICAL PRESENTATION OF MYOCARDIAL INFARCTION AMONG HOSPITALIZED PATIENTS , Dr. Omer Qasim*, Dr. Aimen Qureshi and Dr. Marzia Ali
Objective: To determine the clinical features, characteristics, presentation patterns, and acute MI triggers. Study Design: A Case series. Place and duration: In the Cardiology department of Sheikh Zayed Hospital Rahim Yar Khan for Six months duration from March 2019 to September 2019. Methods: This study included 1,500 patients admitted for acute myocardial infarction. The acute myocardial infarction diagnosis was based on ECG findings, cardiac enzymes and characteristic clinical after other possible alternative diagnosis exclusion. Results: Men were dominant in the study (n = 1080, 72%). The 53 ± 11 years was the mean age at admission. The majority of patients (90%) had typical chest pain and only 10% had atypical symptoms. During the presentation, 81% of the patients had normal examination and only 19% had left ventricular failure (basal crepts, S3 gallop). During the presentation, normal electrographic rhythms were observed in 95% of the patients. Conclusion: Most patients with myocardial infarction are male. Smoking is the main risk factor. Most patients showed typical symptoms over a sufficient period of time.
247 FREQUENCY OF COMPLICATIONS AFTER PROLONGED USE OF STEROIDS IN PATIENTS WITH NEPHROTIC SYNDROME , Dr. Anum Qureshi*, Dr. Tabassum Rasul and Dr. Zoha Hashmi
Introduction: Nephrotic syndrome is one of the most common glomerular diseases that affect pediatric age group. Corticosteroid is first line treatment in patients of nephrotic syndrome but they are associated with wide variety of side effects. Children with nephrotic syndrome can develop growth retardation due to malnutrition caused by prolonged use of corticosteroids. This study described the burden of major side effects as well as data for rationale use of alternative treatment modalities instead of prolonged use of steroids. Objective: To determine the frequency of various complications after prolonged use of steroids in pediatric patients with nephrotic syndrome. Study Design: Descriptive cross sectional study. Place & Duration of Study: Department of Pediatrics, Nishtar Hospital, Multan over a period of six months i.e. March 2019 to September 2019. Subjects and Methods: A total of 100 patients of nephrotic syndrome taking steroids for more than six months were enrolled in study. All patients underwent detailed medical history and physical examination followed by required investigations. Data were analyzed in SPSS version 20. Age & disease duration was presented as mean and standard deviation while complications of the treatment were presented as frequency and percentage. Results: The mean age of children was 7.14±3.34years. Among 100 patients, 66 were male and 34 were female. Regarding complications, 8 patients had pancreatitis, 11 had liver disease, 68 had Cushing like features, 35 patients had posterior subcapsular cataract, 7 patients had raised intraocular pressure, 19 patients had osteoporosis, and 46 patients had hypertension. Conclusion: Most common complication of long term steroids use in children was Cushing features followed by hypertension and posterior subcapsular cataract.
248 STUDY OF COMMONLY ISOLATED UROPATHOGENS AND THEIR ANTIMICROBIAL PROFILE AT A TERTIARY CARE CENTER , Dr. Zoha Hashmi*, Dr. Tabassum Rasul and Dr. Anum Qureshi
Background: Urinary tract infection is common in all age groups. It is more common in females, immunocompromised patients and those who have been catheterized or had some other invasive procedure of urinary tract. Gram negative and gram positive microorganisms are responsible for UTI. Sensitivity of uropathogens to antimicrobial drugs has changed over the past many years. Objective: The present study was planned to determine the common uropathogens, their antimicrobial sensitivity and clinical profile at a tertiary level health facility. Material & Methods: In this cross sectional study, urine samples of two hundred symptomatic patients were studied and the underlying pathogens were identified by appropriate methods. The present study was conducted from January 2019 to July 2019 in Nishtar Medical University and Hospital, Multan. Subsequently their sensitivity to antibiotics was determined by the recommended method. The data was entered and analyzed in SPSS 15. Results: Female patients were more than males. Increased frequency and dysuria were observed in all patients. E.coli was the commonest pathogen identified, followed by Klebsiella, Staphylococcus and Pseudomonas species. E.coli was sensitive to aminoglycosides, carbapenem and quinolones in decreasing order of frequency. Klebseilla and pseudomonas are sensitive to norfloxacin, whereas, staphylococcus are sensitive to quinolones. Conclusion: E.coli remains the most common uropathogen. Antimicrobial sensitivity of uropathogens showed a changing pattern.
249 A COMPREHENSIVE REVIEW KRUCHCHARTAVA W.S.R. DYSMENORRHOEAA  , Dr. Swati Garg*, Dr. Trupti Gupta and Dr. Arun Kumar Gupta
Dysmenorrhoea literally means painful menstruation. But a more realistic and practical definition includes cases of painful menstruation of sufficient magnitude so as to incapacitate day to day activities.[1] Dysmenorrhoea is a very common complains, experienced by 45-95% of woman of reproductive age.[2] In true Dysmenorrhoea the pain sensation arises in the Uterus and is related to muscles contractions. It is experienced a few hours before and after the onset of menstruation and rarely lasts in a severe form longer than 12 hours. It is colicky in type, although the patient does not always recognize. The periodic exacerbation and may describe a constant ache which causes her to ‘double up’. The pain is felt mainly in the hypogastrium and is often referred to the inner and front aspect of the thighs it never extends below the level of the knee and is never experienced in the back of the leg. There may be some low backache as well but this is not the dominant sensation. Menstruation is a normal physiological process. Accompanied with pain, it is called as Dysmenorrhoea. In Ayurveda texts, though various conditions are described in which menstruation occurs with pain, Dysmenorrhoea is not mentioned specifically. The terms as Kashtartava or kruchchartava are also for Dysmenorrhoea. Classically defined Udavarta Yoni Vyapat counterparts with the all types of Dysmenorrhoea. Charaka has defined that the Pain symptom is instantly relieved after discharge of menstrual blood in Udavarta Yoni Vyapat which resembles to Spasmodic or true Dysmenorrhoea. Panchakarma Uttar Basti, Aasthapana Basti, Anuvasan Basti & Virechana are best treatment modality of Krucachartava. We can use oral Ayurvedic medicines like Ashokarista, Kaumaryasava, Patrangasava, Kanchanarguggulu, Rajahpravartanivati and Ashoka powder. Yogasanas, meditation, regular exercises help in maintaining weight. Walking for half an hour daily for 5 days is adequate to maintain weight.
250 PENILE GANGRENE COMPLICATING A URETHRAL STENOSIS: EXCEPTIONAL MODE OF REVELATION , Dr. O. Elidrissi*, Y. Larrache, Y. Ghannam, M. Dakir, A. Debbagh and R. Aboutaieb
Penile gangrene is a rare and serious pathology, the etiologies are multiple. We report the case of an 82-year-old patient, with no particular pathological history, who presented with necrosis of the penis on a stenosis of the urethra discovered intraoperatively treated by total amputation of the penis and a perineostomy diversion. The post-operative suites were satisfactory.
251 PHYTOTHERAPEUTIC APPROACHES TO MANAGE/TREAT OBESITY , Charitha Gangadharan, Alben Sigamani and Mohammed Rahmatullah*
Obesity is labeled as the disorder of this century as it forms the first step of other serious diseases. Therefore, World Health Organization (WHO) suggests that management of obesity is the most important for healthy living. Obesity can be controlled either through a healthy lifestyle or regulated eating habits. Alternatively, chemically synthesized medicines are also marketed for weight loss programs. However, the application of drugs is mostly disadvantageous as there are many adverse effects associated with their usage. Therefore, the solution lies in finding healthier alternatives developed from plant origins. To assess the alternates, a thorough screening of medicinal plants for anti-obesity properties is mandated. The prime goal of our review was to understand the efficiency of the selected plants, namely, Amaranthus spinosus, Capsicum annuum, Caralluma fimbriata, Cinnamomum verum, Garcinia cambogia, Hoodia gordonii, Moringa oleifera, Phaseolus vulgaris, Lagenaria siceraria, and Ziziphus jujuba against obesity through secondary research methods. Based on the available literature, our study showed that even though most of the plants are traditionally known for their anti-obesity characteristics, not much published information is available at the clinical level. Moreover, our review highlights the requirement of in vitro, experimental, preclinical and clinical methods to develop alternate plant-based formulations. In addition, there is a huge gap in research for most of the plants in terms of phytochemistry and their mechanism of action. It was also observed that majority of the studies did not test any associated complications. Therefore, there is a lot of scope of research in this field.
252 THE STUDY OF THE IMPORTANCE ACCORDED TO PERINATAL ASPHYXIA PATHOLOGY IN THE TRAINING COURSES OF HEALTH PROFESSIONALS , *Asmaa Barkat, Khalid. Barkat, Aicha Kharbach and Amina Barkat
Study’s aim: The aim of this research was to study the teaching of perinatal asphyxia’s pathology in the basic and continuing education courses of midwives, nurses and, general doctors involved in the care of asphyxic newborns. Materials and Methods: This is a quantitative prospective study, carried out at the level of all birthing centers and maternities of the Rabat-Salé-Kenitra region. It targeted all midwives, nurses and general doctors who meet the inclusion criteria of this study. On the basis of an exhaustive sampling, the mother population was 307 health professionals, and with a response rate of 83.67% the number of respondents was 251. Results: This study showed that 64.54% of the health professionals benefited from a course on perinatal asphyxia as part of their basic training. This course includes practical and theoretical aspects in 37%. It was theoretical in 59.9% and only practical in 3.1%. Likewise, she attested that 69% of health professionals who had received a course on perinatal asphyxia stated that the course did not provide them with the necessary knowledge to manage an asphyxiated newborn baby. As she illustrated, 55.7% did not receive any further training related to perinatal asphyxia. And that, 96.2%, of the participated in the continuing education sessions organized in the field of this pathology, declared that these training sessions enabled them to develop their skills relating to the management of asphyxic newborns. Conclusion: This study has shown the importance of evaluating the training programs in order to review the teaching of perinatal asphyxia’s pathology for the benefit of these health professionals. Also, this study attested the importance to integrate this pathology in the plans of continuing education Of the Ministry of Health, in order to improve health professionals’ skills about asphyxiated newborns’ care.
253 PROBLEM-BASED LEARNING INTO THE FUTURE E-LEARNING , Hala Moustafa Ahmed*, Nashwa A. Ahmed and Kemenada everard
In applied medical sciences related multi disciplines the theoretical and mathematical knowledge is first taught to the students. The main drawbacks of this approach are lack of motivation and high drop-out and failure rates. This case study uses the Problem Based Learning (PBL) approach in introductory courses of medical biophysics, and microbiology to overcome the main drawbacks of more traditional teaching schemes. A learning method based on the principle medical sciences of using problems as a starting point for the acquisition and integration of new knowledge intellectual and professional skills. The students and the teachers have assessed the experience and the results are very satisfactory in both cases.
254 ROLE OF MEDICAL BIOPHYSICS MRI IMAGING IN DETECTION OF MASSES IN BREAST CANCER , Hala Moustafa*, Metwally Kotb and Diana El-Sherif
Objective: As artificial intelligence methods for the diagnosis of disease advance, we aimed to evaluate machine learning in the predictive task of distinguishing between malignant and benign breast lesions on an independent clinical magnetic resonance imaging (MRI) dataset within a single institution for subsequent use as a computer aid for radiologists. Methods: Between December 2015 and December 2019, 60 female breast patients were enrolled in this study, in addition to 10 control female with a confirmed diagnosis of breast cancer and dense breasts underwent bilateral breast magnetic resonance imaging. In the physics MRI, is effective in the identification of additional masses in dense breasts that are not visualized on mammography. The results: Sensitivity and specificity are the two most important indicators in selection of medical imaging devices for cancer screening. Breast images taken by mammography, and MRI were collected from patients. The statistical features extracted from the histograms of the regions of interest revealed that MRI modality registered the highest scores, and ended with mammography, in the differentiation between normal, benign, and malignant breast tissues. They were then studied and compared for sensitivity and specificity results. The sensitivity and specificity, it is clear that, sensitivity increases on the expense of specificity, and vice versa. The data of this study, revealed that, both mammography and MRI has high sensitivity. In conclusion: The behavior and the general shape of the gray-level histogram describe specific behavior with each category of tissue, namely; normal, benign and malignant, because each modality gives specific shape for each imaged ROI of each tissue category.
255 YOUTH FRIENDLY HEALTH CARE SERVICES UTILIZATION AND ASSOCIATED FACTORS AMONG HIGH SCHOOL STUDENTS IN BOSSAT DISTRICT, OROMIA REGION, ETHIOPIA , Natinael Bogale and Gebi Agero*
Background: Globally young people are faced with immense reproductive health problems; they have limited access to quality reproductive health. In Ethiopia, about 63% of the total population is below the age of 25 years. Nationwide 13% of teenagers have started childbearing, unwanted sex or marriage, putting them at risk of unwanted pregnancies, unsafe abortions and sexually transmitted infections. Objectives: The objective of this study was to assess utilization of youth-friendly reproductive health service among high school students in Bosset Woreda, Ethiopia, May 2018. Methods and Materials: Institutional based cross-sectional study was used and a total of 360 study participants were selected from three randomly selected high schools. Simple random sampling technique was used to select study participants. Dgaruata was entered into EPI-INFO Version -7 and analyzed using SPSS version 20. Odds ratios, along with 95% confidence interval was calculated using bivariable and multivariable logistic regression; p-value less than 0.05 was considered as statistically significant. Results: This study indicates that, 187(51.9%) were female and 34.4% of youth's utilized youth reproductive health service. More than half 224(62.2%) of the respondents were knowledgeable about reproductive health service. Females were 1.76 times more likely to use reproductive health services than male respondents (AOR = 1.76, (95% CI 1.12-2.78)). Youth who are near to health facility in less than 30-minute travel or those who pay two birr for transport cost were 2.6 times more likely to utilize reproductive health service than those who take more than 30-minute walking distance (AOR=2.6 (95% CI 1.2-5.99). Conclusion: The level of youth-friendly reproductive health service utilization was very low; there need to be great effort and attention of all concerned bodies to design and implement appropriate youth reproductive health strategies in schools to influence the knowledge, attitudes and practice of youths to increase the service utilization.
256 LIVER SUBCAPSULAR HEMATOMA: ABOUT A CASE , *Dr. Ouhame Hanane, Nadi Meriem, Bargach Samir and Yousfi Mounia
Liver subcapsular hematoma represents a rare and a serious complication of preeclampsia and HELLP syndrome. Hepatic capsular rupture is responsible for high maternal and fetal mortality; hence the importance of quick diagnosis and adequate multidisciplinary medical intervention. In this article we report a case of cracked subcapsular hematoma of the liver with satisfying results.
257 THE RELATIONSHIP BETWEEN GHRELIN AND FATTY ACIDS , Aysel Sari*
Ghrelin stimulates food intake, initiating a feeling of hunger. In order to regulate the energy balance, the role of ghrelin is important in food intake and regulation of energy balance. Lipids, fatty acids and triglycerides are the primary fuel source for energy in many organisms. Lipids are esters of fatty acids, or compounds that can be esterified; The main building blocks are fatty acids. Fatty acids are the body's energy regulators, and the functional relationship with ghrelin is very important. Approach: It is aimed to summarize the recent information about Ghrelin and fatty acids and their functions in biochemistry and clinical chemistry in body energy regulation and the importance of fatty acids related to ghrelin.
258 HERD IMMUNITY ACQUIREMENT FOR COVID 19 PREVENTION , Dr. Yongxin Zhang* and Ying Wang
COVID 19 is one of the most severe infectious diseases in human history because of its world-wide pandemic, rapid spreading, high mortality and lack of effective vaccine, and therefore the studies on herd immunity for COVID 19 are needed urgently. Natural infection, vaccination and artificial small-amount pathogen infection (ASAPI) are three potential strategies for establishing herd immunity against COVID 19. The features and feasibility of these strategies are discussed in this review.
259 AMOEBIASIS LEVELS IN RELATION TO SANITATION AND PERSONAL HYGIENE AMONG PATIENTS ATTENDING KAUWI AND MUTHALE HOSPITALS IN KITUI COUNTY, KENYA , Mung’ang’a EM., Kamau LM. and Maingi JM.
Background: Entamoeba histolytica, an intestinal protozoan parasite, is the causative agent of amoebiasis which is the third leading parasitic disease causing deaths in humans after malaria and schistosomiasis. Globally, it is responsible for 40,000 to 100,000 deaths annually. Objective: To determine the occurrence levels of E. histolytica infection among persons of various age groups attending Muthale mission and Kauwi sub-district hospitals in Kitui west district. Materials and methods: The study involved observation of clinical signs and symptoms as well as microscopic examination of E. histolytica trophozoites and cysts in stool samples from randomly selected individuals attending the two hospitals where 119 were males and 158 females. Formal-ether concentration technique was done for each sample that tested negative under direct smear and examined at low (20x) and high (40x) magnifications. The study collected data on personal hygiene and sanitation level as well as sources of water for domestic use and boiling habits of the residents by use of questionnaires. Data on level of sanitation and infection by E. histolytica in different sexes and age groups were analyzed using Mean square contingency coefficient, Cramer’s V and Chi-square. Results: The study revealed that 81 (29.2%) of the patients suffered from amoebiasis of which 10.8% were males while females were nearly double at 18.4%. The most affected age group was the under five years at 58.8% and the least infected was 26 to 35 years at 20.6%. River water had significant relationship with infection by Entamoeba histolytica. Washing of hands, fruits and vegetables had no significance since the water used was from unsafe sources highly likely to be contaminated with E. histolytica. Conclusion: Although over 90% of patients practised hygiene habits such as hand washing with soap and latrine use, these practices did not seem to reduce the infection. This could be attributed to use of unsafe water or poor storage leading to contamination. It was apparent that the lack of properly treated water neutralizes any effort by the residents using other hygienic practices. This is in agreement with previous research that 94% of the population in Kitui west district had no access to safe drinking water.
260 DRUG PRESCRIPTION PATTERN OF ANTI-MALARIALS AND THE USE OF LABORATORY DIAGNOSIS BY MEDICAL PRACTISIONERS FOR TREATMENT OF CHILDHOOD (<5YEARS) MALARIA IN IMO STATE, NIGERIA , Udujih O. G.*, Ukaga C. N., Udujih H. I., Iwuala C. C. and Udujih O. S.
A retrospective study on drug prescription pattern of anti-malarials and the use of laboratory diagnosis by medical practitioners was carried out in Owerri municipal and Orlu both in Imo State using medical records of both in-patients and out-patients between the March 2004 and June 2007. Overall, the result showed that out of 510 medical records of childhood malaria, 59.9% were sent for laboratory diagnosis by medical personnels before commencement of treatment. The prescription pattern by medical practitioners in the treatment of childhood malaria varied significantly (P<0.05) between the two local government areas. In Owerri municipal, montherapy was the most prescribed antimalarial drugs among in-patients (57.6%) while Artemisinin Combination therapy (42.8%) was prescribed most for out- patients. In Orlu, monotherapy was the common prescription for both in-patients (57.6%) and out- patients (74.3%). This study therefore can be used as a baseline to assess future trends in prescription patterns of medical personnels in Imo State.
261 PERICARDIAL EFFUSION IN AN ANTICOAGULATED PATIENT: CASE REPORT FROM A REMOTE LOCALITY , Dr. Winston Low and Dr. Carey Girling*
Pericardial effusion is a potentially life-threatening condition, often requiring urgent specialist intervention before progression to cardiac tamponade and subsequent cardiac arrest. One such case was seen in Lorne and the Islands emergency department one week post pulmonary endarterectomy for severe pulmonary hypertension. Imaging identified a 35ml effusion with significant chamber compression. This presented a challenging management and retrieval case which was complicated by the patient’s concomitant use of apixaban and remote location. The case is discussed, and a literature review undertaken.
262 PANDUROGA IN CHILDERN , Dr. Sunita Patel* and Dr. Ankita Agarwal**
Anemia is common micronutrients disease affects health status of very large population of whole world. Iron deficiency is the most common causes of anemia. Ayurveda described Pandu Roga which correlated with anemia. Ayurveda mentioned causes, symptoms and treatments of Pandu. The Pandu Roga involves lack of haemoglobin due to poor intake of iron through dietary sources, poor absorption and digestive problems may also leads Anemia. The characteristic features of diseases involve discoloration of skin, pita and presence of Ketaki dhuli nibha chaya. Ayurveda described it as “Varnopalakshita roga” which indicates change in the color. The clinical symptoms involve loss of appetite, palpitations, Pandutwa and fatigue.) Ayurveda is the most ancient system of medicine among the different system of medicine existing in the world. In the classification the disease Pandu felt in the group of Varna in which there are significant change in the normal colour of the body. The detail description of Pandu Roga and its classification starts form Ayurvedic Samhitas only .Pandu roga is one of the diseases mentioned in Ayurveda characterized by the whitish discoloration of the skin due to the loss of blood. The disease is comparable with Anemia in the modern medical literature. The incidence of the problem is high in school going children, adolescents and pregnant women.
263 UNDERSTANDING THE ‘PESHI’ ON THE BASIS OF LITERARY AND CADAVERIC STUDY: A REVIEW ARTICLE , Dr. Vikash*, Dr. Sakshi and Dr. Subhash Upadhyay
The concept of Snayu and Peshi is in controversy. Most of scholars consider Peshi as a muscle and Snayu as ligament, tendon, sphincter, aponerosis etc. Some consider Peshi as fascia, intermuscular septum etc and Snayu as muscle. Hence to understand about concept of Peshi, it becomes necessary for a scholar to understand what actually Peshi means. For this purpose literature and cadaveric study was done. Most of people consider Peshi as Muscle. The reason may be Peshi covers Sira, Snayu, Asthi etc. If we consider Peshi as Muscle. The reason may be Pesshi covers Sira, Snayu, Asthi etc. If we consider it as the covering to all the structures then it indicates muscle, which most of the experts might have considered. But if we consider it as individual covering then Peshi may be fascia, intermuscular septum, adventia of artery and vein, epineurium of nerve, periosteum, fibrous capsule etc. when we conduct region wise dissection, the number of muscles and tendons are fairly similar to number of Snayu than the Peshi.
264 A REVIEW ON SAMPRAPTI OF DHATUKSHAYJANYA JANU SANDHIGAT VATA , *Vd. Mayuri N. Manwatkar and Vd. S. V. Suryavanshi
Janu sandhigat vata comes under the broad umbrella of Vatvyadhi mentioned in Ayurveda classics i.e. it is caused by vitiation of Vata. This vitiation of Vata can be basically because of 2 reasons – Dhatukshaya (emaciation of dhatus) or Marga avarodha (obstruction to normal pathway by other entities). Physiologically, in old age there is predominance of Vata and dhatukshay. So it is obvious that the dhatukshayjanya vatvyadhis are mainly seen in them. But due to faulty eating habits like having wafers, cold drinks, less amount of food than required, faulty manners of behaviour like excess bike travelling, prolonged standing, not having enough sleep at night time, psychological factors like excessive stress are all leading to the dhatukshaya and vitiation of Vata at early age now a days. Patients of young, middle and old age groups may suffer from the complaints of dhatukshay janya vatvyadhi like Janu sandhigat vata. Samprapti analysis is the most important tool for diagnosis and treatment of any kind of disease. So the present article focusses on the review of samprapti of dhatukshayajanya janu sandhigat vata.
265 CONCEPTUAL STUDY OF SAAMA AND NIRAMA SANDHIGATA VATA – A REVIEW STYUDY , *Vd. Ashwini Balasaheb Galande and Vd. Ujwala V. Pawar
AS being a life science, main motto of Ayurveda is prevention of disease by maintaining the health of healthy person and to treat the disease of diseased one. For maintaining the health, equilibrium of tridosha in the body is very important. Among the tridoshas vata has prime important and considered as Ayu and Bala, because without vata the other two doshas have been unable to work separately. Disease caused by vitiated vata dosha is called as vatavyadhi. Disease Sandhigata vata is explained under vatavyadhi in all Samhita granthas. Sandhigata vata is one of the chronic, degenerative, inflammatory disease which has great impact on quality of life of an individual. So, that Ayurveda has been given different treatment modalities to tackle the condition effectively. But before applying any treatment, it is very important to understand the detail samprapti (pathogenesis) of disease to diagnose the proper awastha because in case of sandhigata vata it can be occurred by two ways of samprapti i.e. Dhatukshya and Margavarodha. Dhatukshya can be correlated with Niramavastha because it is caused due to vitiation of pure vata and Margavarodhajanya can be correlated with Samavastha caused due to vitiation of vata by the obstruction of Aama. Causative factors responsible for disease, sign and symptoms occurred in disease and treatment modalities applied for Sandhigata vata changes according to awastha, so it is very important to confirm the awastha for further management.
266 REVIEW ARTICLE ON VIBANDHA , Dr. Rajeev Kumar Sharma*, Dr. Nagendra Thakre and Dr. Dinesh Ram
Constipation is a disease condition resembling to Vibandha described in Ayurveda. Vibandha or Badhapurisha means obstruction or constipation i.e. sanga and which indicates one of the state of srotodushti especially in purishavaha srotas. It refers to bowel movements that are infrequent or hard to pass and is a general term used to indicate fewer bowel movements, solidified hard stools, painful defecation and feeling of bloating, abdominal discomfort or incomplete elimination. Constipation may be the end result of many gastrointestinal and other medical disorders. Constipation is easier to prevent than to treat. Following the relief of constipation, maintenance with adequate exercise, fluid intake and high fiber diet is recommended.
267 SHOULD ACE INHIBITORS AND ARBS BE PRESCRIBED OR PROSCRIBED IN COVID-19? , Ravi Kant* and Dr. Mahendra Kumar Meena
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which have been responsible for current pandemic COVID – 19 disease. This virus competes with the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme2 (ACE2), an enzyme that play an important role not only in activation of RAAS but also act as a receptor for virus entry point. This interaction between ACE2 and COVID-19 viruses has been considered as a potential factor in their infectivity, and it is a matter of great concerns about the use of ACEIs/ARBs that might alter ACE2 and may be responsible for vivid outcomes in ongoing COVID-19 pandemic.
268 MANAGEMENT OF AMLAPITTA AN EMERZING LIFE STYLE DISORDER THROUGH AVIPATTIKAR CHURNA AND KAMDUDHA RAS , Neha Uniyal*, Dr. Kimmi Seth and Dr. Dhruv Mishra
Agnimandya leads to the utpatti of almost all vyadhis in the body particularly vyadhis of annavaha and rasvaha srotasa, as agni is prana and oja(immunity) depends upon prana (agni). Therefore, one should regulate and protect the agni by all means. Nevertheless, disturbed life style with derailed eating habits, sleep, anxiety and stress with cumulative negative thoughts are some common factors that negatively affect the metabolic rate of the body. It causes formation of ama in body, the vitiated pitta due to ama formation leads to mandagni. Tryopstambha (ahara, nidra, bhramcharya) plays a major role in maintaining the swasthawastha of the body in both sharirika as well as mansika level, thus disturbed life style causes the vikriti of tryopstambha leading to agnimandya all these factors accomplished into amlapitta. In modern it involves a bundle of various Acid peptic disorders like dyspepsia, hyperacidity, GERD, acute and chronic gastritis which further leads to ulcers in later stages. The drugs used in the treatment regimen of the disease in modern are quiet helpful in reducing symptoms but arouses various other pathologies like GI mucosa lining degeneration due to vitamin c reduction, calcium deficiency in the body leading to osteoporosis. Thus here is my humble approach to explain the probable mode of action of avipattikar churna and kamdudha ras in the management of amlapitta. These shamana drugs plays a great role in breaking etiopathogenesis of amlapita. As these drugs are commonly deepniye, pachniye, agnivardhaka, vibandhanashaka, triptighna, jwarhara and trishnanigrahana in properties.
269 AYURVEDIC CONCEPT OF ANUKTA VYADHI: A REVIEW ARTICLE , *Vd. Devanand R. Pawar and Dr. Vijay R. Potdar
Prayojana of Ayurveda is to maintain the health and to cure the diseases.[1] An Ayurveda is science of life. In today’s era due to sedentary lifestyle new diseases which was not explained in Ayurveda put challenge to Ayurveda Vaidyas. Tantrayukti Vedanga, Kalpana, Tacchilya these are the unique technologies of Ayurveda to narrate and understood the principles of Ayurveda. Anukta concept is one such type of principle which is helpful to understand the new diseases,drug formulations. At present era due to new viruses and bacteria causes new diseases which is not explain any ayurvedi texts called Anukta Vyadhi. Atidesh Tantrayukti is helpful to understand the concept of Anukta[2] Acharya Charak explain the concept of Anukta in Sutrasthan of Charaksamhita[3] In this article concept of Anukta and its clinical aplication is narrated.
270 A COMPARATIVE CLINICAL TRIAL OF YASTYADI KWATHA AND DURVADI LEPA ON SHEETAPITTA / URTICARIA , Dr. Pushpa Markam* and Dr. Nikhila Ranjan Nayak
Sheetapitta is a disease caused when a human being is exposed to cold breeze. Due to this, there will be vitiation of kapha and vata. These two combine with pitta and circulate all over the body producing the sign and symptoms over the skin. In the present study, Yastyadi Kwatha and Durvadi Lepa an effective safe treatment modality in Ayurveda was planned. A clinical trial was carried out on 40 patients of Sheetapitta were selected from OPD and IPD of Khudadag dunga Govt. Ayurvedic hospital Raipur (c.g.). The assessment of therapy was done by suitable scrolling methods which were critically analyzed. The results thus obtained were subject to statistical analysis by paired ‘t’ test. The end results which were obtained were interpreted and graded according various grades. The study showed Yastyadi Kwatha and Durvadi lepa treatment as highly effective of Sheetapitta.
271 RECENT ADVANCEMENT IN THE MANAGEMENT OF ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) , Amala Boban*, Bincy T. Abraham, Dr. K. Krishnakumar, Lincy George and Jibin K. Joy
Heart Attack or Myocardial Infarction is a medical emergency caused by the blockage of blood flow to the heart. Without sufficient blood flow, the myocardial cells become deprived of oxygen and get infarcted and eventually death of myocardial cells occurs. Later it can lead to heart failure and life threatening condition. ST- elevation myocardial infarction (STEMI) is more dangerous than Non ST-elevation myocardial infarction as it is caused by complete occlusion of coronary artery. Therefore the management of STEMI is very important. The treatment procedure includes Fibrinolysis, Percutaneous Coronary Intervention (PCI), Coronary Artery Bypass Grafting (CABG) and these primary preventive methods followed by secondary preventive methods.
272 REVIEW ARTICLE OF ORTHOKERATOLOGY , *Kuldeep Kumar Dixit M. Optom
Purpose: Review the published evidence to evaluate the ability of orthokeratology treatment for reduce myopia progression in children's and adolescents compared with the use of spectacles or contact lenses.
273 KARNAPOORANA: ARTICLE REVIEW , Dr. Sandeep Purohit* and Dr. Diksha
Ayurved a rich science with different kinds of management techniques. karnapoorana means filling the ear with medicated Taila or other substances. It not only used to cure the disease but a part of healthy living according to Ayurveda. Diseases of ear, nose, and throat are categorized in Urdhavajatrugata Vikara in Ayurveda and different treatment modalities are described for them. It includes surgical procedures, drugs, and different procedures like Karnapoorana, Akshitarpana, Nasya, etc. Karnapoorana not only cures the ailments but also helpful in maintaining well being of ear, neck, and head. Ayurveda treats diseases based on Doshik parameters which are influenced by many factors like Kala, Vaya, Desha, Ahara-Vihara, etc. Due to this variety of factors treatment should also be of different kinds. In Ayurveda, Vata is considered important among three basic Dosha. Vata is best treated with Snehana processes. This Snehana grossly divided into Bahya and Abhyantara. Karnapoorana is a type of Bahya Snehana. Drugs used for Karnapoorana are selected according to disease, Dosha, Prakriti, Awastha, and Desha. Karnapoorana is very important in healthy individuals as it is described as part of Dinacharya. Time and duration are also according to Dravya and Vyadhi.
274 THERAPEUTIC USES OF KHEJRI (PROSOPIS CINERARIA): A REVIEW ARTICLE , Dr. Manisha* and Dr. Naresh Kumar Garg
Prosopis cineraria (L.) Druce. (Family Leguminosae, subfamily Mimosoideae), is locally known as Ghaf. The plant effects socially, ethnologically, traditionally and remedially in the life of the people. The proposition is to summarize the current studies on up-to-date and comprehensive information, highlighting bioactive potential of the plant. The review aimed to revise the information available regarding the therapeutic activities published in scientific journals and to provide a comprehensive tabulated data in such a way that it is useful for academic researcher. A through scientific search of P. cineraria (L.) was carried out on phytochemical constituent’s viz. leaf, stem, pod, bark, and their pharmacological data and safety. The review is helpful in utilizing abridged scientific knowledge of the P. cineraria (L.), identifying gaps in, and future possibilities to work with.
275 COVID-19 IN PREGNANCY, AYURVEDIC CORRELATION AND PREVENTION PROTOCOL: REVIEW STUDY , Vd. Swapnali B. Bari*, Vd. Chetna J. Kulkarni, Vd. Madhuri S. Bhalgat
The outbreak of COVID-19 infection has become a major epidemic threat all over the globe since December 2019. COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It typically presents with respiratory and systematic manifestations. High risk population are elderly persons and people having DM and HTN. Similarly pregnant women are more susceptible to respiratory pathogens and to the development of severe pneumonia which makes them more prone to COVID-19 infection than the general population. It can cause adverse pregnancy outcomes. Consequences of infection with SARS-CoV-2 for pregnancy are very few with no evidence so far of severe outcomes however the possibility should be considered. Therefore pregnant women should be considered as high risk populations in strategies focusing on prevention and management of COVID-19 infection. No effective treatment or vaccine exists currently (April 2020). In Ayurveda symptoms of COVID-19 can be considered as sannipata jwara with dominance of kapha dosha. To combat the infection many researches are going on. To date we can take precautions only to prevent COVID-19. An attempt is made to focus on its precautions in pregnant women according to swasthavritta mentioned in Ayurveda. Some therapies and preventive protocols published by AYUSH ministry are also added.
276 PERTUSSOID ILLNES IN SEVEN INFANTS TREATED IN A SECONDARY CARE CENTRE IN NORTH EAST INDIA , *Dr. (Colonel) Mahendra Narain Mishra, Dr. Murugan Timri Palani, Dr. Bianchi Sangma, Dr. Pallavi Mishra and Dr. Divya M. George
Introduction Bordetalla pertussis infections are underreported in India due to paucity of advanced diagnostic facilities and lack of clinical suspicion. A presumptive diagnosis is therefore often based on clinical and haematological profile without confirmation by culture or polymerase chain reaction. In this paper we present laboratory and clinical profile of seven infants with pertussoid illness treated in a secondary care centre in Assam of which three had leukemoid counts. Case Series Description Seven infants aged two -five months were brought with variable symptoms including paroxysmal cough, fever, rapid breathing and feeding difficulty. Investigations included complete blood counts (CBC), C reactive proteins, serum creatinine, Blood culture, Plain X –Ray chest and blood gas analysis for two patients. Leukocytosis with increased absolute lymphocyte count, and raised C -reactive protein, normal serum creatinine was present. A probable diagnosis of Pertussoid illness was made and aggressive indoor treatment was administered resulting in a successful outcome in five infants in spite of limited resources. Conclusion In resource poor settings it is possible to manage pertussoid illness successfully with limited laboratory facilities. High ALC and thrombocytosis were useful in prognostication.
277 NON COMMUNICABLE DISEASES IN CHILDREN: AYURVEDIC PERSPECTIVE , *Dr. Jyoti Kaushik and Prof. Rakesh Sharma
Non-communicable diseases are the group of diseases which do not transmit from person to person. They tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors. Children are vulnerable to the risk factors contributing, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke or harmful use of alcohol. The global disease burden affecting children in childhood and later in life is rapidly increasing, even though many of the risk factors can be prevented (WHO, 2016). Approximately 13 % of all NCD deaths occur among children under 20 years. Majority of NCDs which develop later in adulthood have their origin in early life even before the conception. Ayurveda represents the oldest complex medical system about healthy lifestyle principles. The establishment of these disorders can be prevented by various measures depicted in Ayurveda before conception, during pregnancy, during childhood and adolescence, which should influence global health and socioeconomic development.
278 OVERVIEW ON COVID 19: A REVIEW , Dr. Juluri Krishna Dutta Tejaswi*
Corona viruses (CoV) were family of viruses that cause a wide range of illness to various infections. Corona viruses had the spikes that protrude from their membranes, like the sun‟s corona. According to the WHO, common signs include respiratory difficulties in breathing, fever and cough. Serious cases could lead to kidney failure and even death. Social distancing and other methods specified by WHO was being hampered to stop spreading of virus. Novel corona virus (nCoV) was a different strain and newly discovered in humans which means that they spread between animals and then to humans. The 4C‟s by WHO were no cases, first cases, first clusters, and community transmission and spread.
279 AYURVEDA PERSPECTIVE ON INFECTIOUS DISEASE AND THEIR MANAGEMENT THROUGH AYURVEDA DRAVYA (NATURAL DRUGS) , Dr. Pradyumna M. Pasarkar*, Dr. Shailendra K. Pund and Dr. Khemraj V. Pawar
Sankramaka Roga and communicable disease are very common now a day’s which arises due to the microbial transmissions. The infectious diseases can transmit from one to another person through various mode of transmission including biological, physical and chemical means, etc. These microbial agents affect specific tissues of body and utilize biological system of host for their multiplication; this way induces pathogenesis of specific diseases. The microbial toxins; endotoxins or exotoxins contribute significantly towards the pathological manifestations of diseases. Ayurveda mentioned various approaches for the management of such diseases including uses of antibiotics, enhancing fluid intake, lifestyle modification, uses of immune booster and purification measures; Raktmokshana as Shodhanupkramas etc. The concept of Dravyaguna provides way for the management of various diseases including infections.
280 SCIENCE RACING WITH THE TIME TO INVENT COVID-19 VACCINE FOR FIGHTING WITH ITS PANDEMIC , Rajeev Shah* and Reena Mehta
Covid-19 pandemic shocks and locks whole world in year 2019 and 2020. Maximum death occurred in USA followed by Italy and Spain. Here discussion and analysis have been focused on various types of vaccines of Corona virus on basis of its spike antigen S and its corresponding ACE2 receptors on certain type of human cells. The ultimate target of all types of vaccines is to prevent binding of ACE2 receptor to S antigen of corona. The main sources of the latest information of Covid 19 vaccination has been internet websites and social net working like whatsApp and facebook etc. Recently on 28th April, there is a video on facebook that Oxford University, London claimed of finding out live attenuated vaccine which had been on trial basis on 800 human volunteers and they ordered Serum India company, which have the capacity of producing 1.5 billion vaccines every year, expected to be ready by September 2020. If this vaccine will found satisfactory, it would be the fastest vaccine invented ever, as usually five to six years are required in such invention, The cost wise also it will be also very cheap, it will cost about 0.5 cent per vaccine, should be consider ahead of others followed by claim of Germany and UK, the vaccine developed from chimpanzee’s Corona virus is ahead of other type as now they got permission of even testing on human volunteers. Israeli defense lab claimed totally new approach of vaccine, in which rather than injecting a pathogen’s antigen into human body, body has been given genetic code needed to produce that antigen itself. Israel claims this unique vaccine production requires minimum of nine months. The report of Arab news, quoting Italian news agency ANSA, claimed that company Takis isolated antibodies in mice which blocked virus from infecting human cells, which according to us should be not consider as vaccine but is the method of passive immunization and will be useful only in treatment but not for prophylaxis. Australia also claimed to develop monoclonal antibodies but by different technique but is also not vaccine candidate like Italian. Even though whole world community of scientists are working on the finding out of treatment as well as vaccine against Covid 19, till that time social distancing and lockdown only can break the chain of transmission which in turn reduces number of infected patients along with morbidity and mortality in the whole globe.
281 ACUTE ORAL TOXICITY OF RHUMAVIN TABLET (POLY HERBAL FORMULATION) WITH ITS EFFECT AGAINST RHEUMATOID ARTHRITIS , Nilesh Patel, Dr. Janmejay Patel*, Achal Patel, Dr. Ankitkumar M. Paneliya*
Introduction: World Health Organization estimated that 80% of the world's population still depend on traditional medicines for their health care despite the availability of advanced medicinal systems. The toxicological evaluation of herbal formulation is necessary as it is in use for wide variety of clinical applications. Aim: To evaluate Rhumavin Tablet for its acute oral toxicity on Swiss albino mice and efficacy with anti-oxidant properties on arthritic rats. Method: The study protocol was approved by IAEC (SKPCPER/IAEC/2016-02/05) as per the CPCSEA. The acute oral toxicity was assessed by following OECD guideline AOT-425 to know single dose (2000 mg/kg) toxicity of test drug. Animals were periodically observed individually for 14 days for any clinical signs of toxicity or mortality after administration of test drug. Bovine serum denaturation assay (In-vitro) was done to examine effectiveness of test drug on arthritis. FCA induced arthritis animal model (In-vivo) was adopted to assess effectiveness of test drugin arthritis. FCA was challenged to sub plantar region after treatment in Rats and various parameter such as paw volume, arthritic index, hematological and radiological parameterswere measured. Different assay analysis (total protein, SOD activity, Catalase activity, Lipid peroxidation) were done to establish its anti-oxidant properties. Results: There were no any physical as well as behavioral changes and mortality observed in any animal during study period. Body weight of all animals did not reveal any significant change as compared to vehicle control group. Rhumavin Tablet has significantly decreased paw volume, arthritic index, hematological parameters compared to disease control group. The significant increase in SOD and calalase level was observed in test drug treated group. Conclusion: The No-Observed-Adverse-Effect-Level (NOAEL) of Rhumavin Tablet is 2000 mg/kg. The obtained results advocate anti- inflammatory, anti-arthritic and antioxidant effect of Rhumavin Tablet.
282 ANTIVIRAL-COVID-19 POTENTIALS OF NOVEL INDOLE AND CEFETAROLINE FOSAMIL ANALOGUES FOR INHIBITION OF 3-CL PROTEASE-SARS/COV-2; BASED ON ANALYSIS OF MOLECULAR DOCKING , Rajaganapathy Kaliyaperumal*, Ramalingam Sathiyasundar, Dharman Suresh Lingam and Chidambaram Ganapathy
The current work focuses on drug development of known approved antibiotics such as Ceftaroline fosamil was modified its structural core to obtain a novel ceftaroline fosamil analogues library and also a certain novel indole library for the inhibition of SARS-CoV-2, 3CL-Proteases enzyme for against COVID-19, it’s a urgent to generate new chemical entities against this virus. As a key enzyme in the life-cycle of corona-virus, the 3C-like main protease (3CLpro or Mpro) is the most attractive for antiviral drug design. Based on a recently solved structure (PDB ID: 6LU7, SARS/CoV-2 3CL Pro, its 99% identical of COVID-19), Reported as., Yu-Chuan Chang et.al.,2020, we were developed the preliminary work of Structure-based drug design for generating potential lead compounds for targeting against the SARS-CoV-2 3CLpro resulted in the, archived three series of derivatives from those library by our structure-based optimization. These three compounds can be used as potential lead candidates for future drug development of the pharmacological interventions against COVID-19.
283 EVALUATION OF PLANTS LEACHATES AS PHYTO-STIMULATORS THROUGH SEED PRIMING , S. Lokesh*
Phytoleachates obtained from culinary items exhibits the phyto stimulatory activity in enhancing the seed germination in paddy, sunflower and green gram seed samples. Out of the selected culinary items rose, fava bean, avacado, apple and manihot plants extract favoured the seed germinaiton followed by increased seedling growth. Apart from these parameters, the same plants items leachates also showed high activity of alpha amylase in the germlings of all the selected crop species (paddy, sunflower and green gram). The promising phytoleachates also resulted in the high phenolics accumulation proved the resistance to the seed borne pathogenic fungi. The seed borne pathogens like Alternaria padwikii, Fusarium oxysporum, F. moniliforme, in paddy, Alternaria zinniae, Macrophomina phaseolina in sunflower in sunflower and M. phaseolina in green gram compared to their control. The incidence of these fungal species was diminished to a greater extent over control; hence possibly strengthen the seedlings growth. The IAA level was also found to be more in seedlings of respected phyto leachates, which might be the probable role of phyto leachates in triggering the early growth leads to escape from the action of pathogens.
284 EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF ORAL CANCERS AMONG THE ADULTS OF MYLAI BALAJI NAGAR, PALLIKARANAI, CHENNAI , *K. Mageswari Mohanram
Oral cancer is the major health problem in India. Squamous cell carcinoma of the oral cavity has the highest incidence in India. Most of the public is not aware of health hazards due to tobacco use, excessive alcohol intake and poor oral hygiene. This study aims to assess the level of knowledge of adults on prevention of oral cancer after giving the structured teaching programme. Quantitative Pre-experimental one group pretest-posttest design was selected. The study was conducted at Mylai Balaji Nagar, Pallikaranai, Chennai. The investigator selected 50 adults with non- probability convenient sampling technique. Pretest was collected by using Self Structured Questionnaire, followed by Structured teaching were given on prevention of oral cancer for 45 minutes on the same day itself. Then posttest was done after 7 days. The study revealed that there is a highly significant difference in the level of knowledge of adults with pretest and posttest after the structured teaching programme (P<0.01). The study concluded that structured teaching programme was very effective in improving the knowledge of adults on prevention of oral cancers.
285 FORMULATION, DEVELOPMENT AND EVALUATION OF DUAL-PURPOSE ANTIMICROBIAL POLYHERBAL GEL: FACEWASH AND HANDWASH , *Sachin Jalindar Fartade, Aniket Balaprasad Dode, Mahesh Arjun Garje, Pratima Santoshkumar Ladda, Vaibhav Murlidhar Kewatkar and Shubhangi Sharadrao Wayal
Nosocomial infection has emerged as a critical issue in hospital care outcome, resulting in substantial morbidity and mortality. The hands of healthcare workers are the primary routes of transmission of infection to patients. Hence it brings up the use of antiseptic for handwashing purposes. Many of the antiseptic available in market are alcohol-based sanitizers which have some shortcomings or adverse effects and their frequent use can lead to skin irritation. Carica papaya is one of the most widely used and well documented medicinal plant in the world. This study is aimed to formulate effective herbal handwash using Manilkara zapota, Trigonella foenum-graecum and Carica papaya seed extracts with emphasis on safety and efficacy and to avoid risk occurred by synthetic antimicrobials. Evaluation of antimicrobial activity of prepared polyherbal gel was performed against skin pathogens using disc diffusion method. Its efficacy was checked and compared with commercial product. Results of this study revealed that formulated gel as a skin cleanser was more efficient in reducing the number of microorganisms from human skin than the commercial antiseptic soaps, so it can be used as an antiseptic with less or no side effects. Also some of the in vitro evaluations tests were also performed on prepared formulation and this study was compared with some marketed herbal formulations.
286 PREVALENCE AND PATTERN OF ANAEMIA IN NON PREGNANT HYPOTHYROID WOMEN , Dr. Susan D. P.*, Dr. K. R. Mukilarasi and Dr. Mary Lilly
Anaemia is an important, common clinical condition in which the number of red blood cells or the hemoglobin concentration within them is lower than normal. It is often seen accompanying thyroid diseases. It is diagnosed in patients with hypothyroidism and it is often the first sign. In this study, the Hb level of 63 women with hypothyroidism will be investigated to study the prevelance of anaemia and its morphological pattern in hypothyroid women.
287 A CASE STUDY ON AVASTHIKA CHIKITSA IN JWARA , Vd. Mayuri N. Manwatkar*, Vd. S. V. Suryavanshi and Vd. P. V. Kulkarni
For the therapy to be effective it is important to examine the 10 factors mentioned in classics which are dosha, aushadha, desha, kala, satmya, agni, satva, oka, vaya, bala. Kala is one of these factors which means the vyadhi avastha. Jwara is one of the diseases which has been given prime importance in the Ayurveda classical texts. The basic chikitsa siddhantas explained in Jwara chikitsa are applicable to each and every disease where the avastha is analysed priorly and properly. So along with proper diagnosis of disease it is important to analyse the precise avastha for the correct treatment. This case study is an attempt where sadya vamana and kashaya pana was carried as avasthika chikitsa in patient of Jwara after analysis of avastha.
288 EFFECT OF NASYA IN TRIGEMINAL NEURALGIA (A CASE STUDY) , Dr. Diksha*, Dr. Himanshu and Dr. Sandeep Purohit
Trigeminal[1] neuralgia is a long term pain disorder that effects the trigeminal nerve. Severe and recurrent pain in the distribution of one or more branches of Trigeminal Nerve is called trigeminal neuralgia. Trigeminal nerve supplies face with its three branches. Any pathology leading to compression or demyelination of nerve causes pain. Patient usually complain of severe episodic pain leads to depression and many times leads to suicidal tendency. In modern science no effective treatment is available and also has many side effects. Ayurvedic literature full of references where management of various diseases explained with minimal adverse effects. Ayurveda therapy is based on tridosha and all treatments are based on dosha involvement in diseases.[2] Anantavata a disease explained under urdhava jatrugata vikara has maximal similarity with Trigeminal neuralgia.Treatment modalities explained for it are diet management and Panchkarma. Panchkarma is Shodhana pradhan chikitsa.[3] Nasya is one of procedures explained under it for management of Anantavata. It specially acts on diseases related to brain. Along with it lepa,[4] raktamokshana, snehapan also indicated in Anantavata. In the present case female patient presented with typical symptoms of trigeminal neuralgia. She was treated with Nasya for 15 days and she recovered fully with decreases recurrence.
289 THE EFFECT OF NASYA IN THE MANAGEMENT OF ARDIT- A SINGLE CASE STUDY , Vd. Bhaumik Suthar*, Vd. Ram Shukla and Vd. Vibhuti Chaudhari
In this modern era, due to recent life style, anxiety, stress etc reasons incidence of vat vyadhi pakshaghata, ardit etc. Ardit is considered as one of the vata nanatmaja vyadhis described in our ayurvedic classics. It can be correlated with bells palsy in modern science. The present case study was conducted with an objective to find out the effective ayurvedic management in bells palsy. For present case study 35 years old female having history of dakshina netra ashru strava, mukh vakrata , dakshina hasta evam pada pradeshe alpa karmanyata since 10 days registered in our OPD. History and examination reveals to facial paralysis .i.e. bells palsy. On examination the patient was treated on the lines of ardit chikitsa mentioned in ayurvedic classics.
290 A SINGLE CASE STUDY ON THE ROLE OF TIKTA KSHEER BASTI IN THE MANAGEMENT OF AVASCULAR NECROSIS OF HEAD OF FEMUR , Vd. Vibhuti Chaudhari*, Vd. Ram Shukla and Vd. Bhaumik Suthar
Avascular necrosis (AVN) is death of bone tissue due to interruption of the blood supply. Without treatment, the process is almost always progressive and joint pain may develop which may limit the ability to move. Complications may include collapse of the bone and nearby joint surface. Treatments may include medication, not walking on the affected leg, stretching, or surgery. A diagnosed case of AVN - male patient came with complaint of severe pain in both hip joints and both thighs, difficulty in prolonged standing, walking, sitting, restricted movement of both hip joints and disturbed sleep due to pain. It was correlated with Vatavyadhi and treated accordingly. A little effort has been made in this study to evaluate the effect of Tiktaksheer basti in the management of AVN of the femoral head. Patient had been administered Dipana – Pachana and Vata shamaka Aushadhi along with Tikta ksheer Basti (3 cycles of 15-15 days with interval of 15 days) There was moderate improvement found in all signs and symptoms. This case study suggests that Tikta ksheer basti karma provide a significant result in Vatavyadhi and so it can be a better option instead of surgery in AVN.
291 PRIMARY NEUROENDOCRINE TUMOUR OF MANDIBLE: A CASE REPORT WITH RADIOLOGICAL AND HISTOPATHOLOGICAL FINDING , Monika Gupta*, Virendra Singh, Anjali Narwal and Rajeev Sen
Neuroendocrine tumours (NETs) in the oral and maxillofacial region are extremely rare and accounts for only 4% of all cases. As per literature, 46 cases of NETs of maxillofacial region are reported till date. A sixty-four old male presented with swelling right side of face. Clinical examination revealed expansile swelling in the right mandibular region with intraoral extension causing restriction of jaw movement. Biopsy was performed. Microscopic examination revealed monotonous round to oval cells with hyperchromatic nuclei and scanty eosinophilic cytoplasm, infiltrating the fibrocollagenous connective tissue. Immunohistochemistry was performed. Although of uncommon occurrence, with poor prognosis, histopathology and immunohistochemistry is important and most significant tool in differentiating this tumour from other round cell tumours of this area in view of therapeutic connotation. The present case is one of the rarest possibilities as the provisional diagnosis was completely different to the histopathological diagnosis.
292 INTUSSUSCEPTION DUE TO CAECAL ADENOCARCINOMA - A CASE REPORT AND REVIEW OF THE LITERATURE , Ken Udoji, James Lucocq and Darren J. Porter*
Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non - specific symptoms and most cases are diagnosed at emergency laparotomy. With more frequent use of computed tomography (CT) in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment involves simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. Surgery is the mainstay of treatment in adult intussusception. This paper discusses the clinical presentation, investigations and management of an adult patient with intussusception of the caecum, and ascending colon into the transverse colon secondary to a caecal adenocarcinoma.
293 A CASE REPORT OF VITILIGO AND ITS PSYCHOLOGICAL IMPACT MANAGED WITH HOMOEOPATHY , *Dr. Hanuman Ram, Dr. Anuradha Singh, Dr. Navita Bagdi and Dr. Prasoon Choudhary
Vitiligo is a common dermatological disorder of chronic depigmentation on the skin caused as a result of the systematic destruction of functional melanocytes and is cosmetically and psychologically devastating. Currently, the available treatment options have limited effectiveness, particularly when acral areas are involved and sometimes follow with relapse and side effects which impels the patient to approach alternative therapy. The homoeopathic literature shows that cases of Vitiligo have been treated successfully with homoeopathic medicines. Here, a diagnosed case of Vitiligo of an 11 year old female presented with a history of 2 years of depigmented patch over right upper eyelid with associated symptoms of loss of confidence, fear of crowd and timidity in nature. On consideration of the totality of symptoms, Sulphur 200C was prescribed with repetition as per requirement. When complaints came to standstill complementary medicine Cal.carb 200C was prescribed to complete the cure. There was significant improvement seen in the domain of sign and symptoms in the context of the whole person physically, mentally and emotionally, and halt the progress of the disease with repigmentation of the white patch over affected part by the end of 10 months, which is evident from the photographs and improvement in baseline Vitiligo Symptom Score of the presentation of the case. Definite causal attribution of changes was explicitly depicted by modified Naranjo Criteria. This case report evidently suggests individualized approach widens the scope of homoeopathy in the management of vitiligo and reducing the psychological impact of disease on patient.
294 INCIDENTAL FINDING OF CASTLEMAN'S DISEASE IN AN INGUINAL HERNIAL SAC LYMPH NODE - A CASE STUDY , Dr. K. R. Mukilarasi M.D., Dr. Mary Lilly
Castleman’s disease (CD) is characterized clinically by lymph node hypertrophy, and histologically by angiofollicular lymphnode hyperplasia. Castleman et al first described it in 1956 in a group of patients with localized benign lymphadenopathy. This disease has two clinical types: Unicentric CD or localized and multicentric CD or systemic. It also has three histological types: hyaline-vascular variant, plasma-type variant, and mixed type. Castleman’s disease in an inguinal lymph node is quite a rare location which is discussed in this case report.
295 HOMEOPATHIC MANAGEMENT OF PSORIASIS – A CASE STUDY , Dr. Yogendra Bhadoriya*
Psoriasis is a chronic autoimmune disorder of the skin. Psoriasis can have physical, emotional, social and psychological impacts on patient’s life. There are several types of Psoriasis including plaque and erythematous psoriasis. According to recent studies, the Psoriasis prevalence in India is approximately ranging from 0.42 to 2.28% and it commonly occurs more in males than females. The onset of Psoriasis may occur at any age but mostly it appears in adults under the age of 40 years. The exact cause of Psoriasis is unknown but stress plays a major role in psoriasis. Homeopathy can helps to treat Psoriasis without any side effect. This article presented a case study on Homeopathic management of Psoriasis.
296 CLIMATE CHANGE, INFRARED ENERGY, ORBITAL VARIATION AND THEIR IMPACTS , Dr. D. K. Awasthi* and Gyanendra Awasthi
Climate change occurs when changes in earth’s climate system result in new weather patterns that last for at least a new decades ,may be for millions of years. come a widespread topic in recent years. This problem that resulted from the emission of greenhouse gases that affected our environment. Therefore, it raises question on whether the problem is caused by human activities or it’s just a part of nature’s cycle. The climate system receives nearly all of its energy from the sun, with a relatively tiny amount from earth’s interior The balance of incoming and outgoing energy ,the passage of the energy through the climate system, determines Earth’s Energy Budget. When the incoming energy is greater than the outgoing energy, earth’s energy budget is positive and the climate system is warming .if more energy goes out, the energy budget is negative and earth experience cooling .climate can be measured at many geographic scales for example cities, countries, or the entire globe—by such statistics as average temperature, average number of rainy days, and the frequency of droughts .climate change refers to changes in these statics over years, decades, or even centuries. The overwhelming majority of climate scientists agree that human activities, especially the burning of fossil fuels (coal ,oil and gas),are responsible for most of the climate change currently being observed. Scientists have given information for more than century that emissions from the burning of fossil fuel could lead to increase in the Earth’s average surface temperature .NASA’S Global surface temperature Record estimate that Earth’s average surface temperature has increased by more than1.40F(0.80C)over the past 100 years ,with much of this increase taking place over the past 35 years. The green house gases are carbon dioxide(CO2),Methan (CH4),Nitrous oxide(N2O),and water vapour .Human activities---especially burning fossil fuel---are increasing the concentrations of many of these gases, amplifying the natural greenhouse effect .Swedish scientist Svante Areehenius predicted that if human activities increased co2 levels in the atmosphere, a warming treand would result.Green house gases trap more infrared energy in the atmosphere than occurs naturally .Heat(infrared energy)radiates out ward from the warmed surface of the surface of the Earth.
297 APPLICATION OF GOLD NANOPARTICLE IN MEDICAL FIELD , Prof. D. K. Awasthi*, Gyanendra Awasthi and Kritika Verma
Gold is a Block D, Period 6 element. It is a soft metal that is often alloyed to give it more strength. It is a good conductor of heat and electricity. It is a good reflector of infrared and is chemically inert. The versatile surface chemistry of gold nanoparticles allows them to be coated with small molecules, polymers, and biological recognition molecules, thereby extending their range of application. The morphology of gold nanoparticles is spherical, and they appear as a brown powder. Gold nanoparticles are versatile materials with a broad range of applications in a variety of fields. Researchers have coated gold particles with DNA and injected them into plant embryos or plant cells. This will ensure that some genetic material will enter the cells and transform them. This method enhances plant plastids. The targeted delivery of drugs is one of the most promising and actively developing directions in the medicinal use of GNPs. The options of using GNP conjugated with the following antitumor agents were proposed: paclitaxel, methotrexate, daunorubicine, hemcytabin, 6-mercaptopurine, dodecylcysteine, sulfonamide, 5-fluorouracil, platinum complexes, kahalalide, tamoxifen, herceptin, doxorubicin, prospidin etc. The conjugation was carried out either by simple physical adsorption of the drugs onto GNPs or via the use of alkanethiol linkers. The effect of conjugates was assessed both (chiefly) on in vitro models, using tumor cell cultures, and in vivo, in mice with induced tumors of different natures and localizations (Lewis lung carcinoma, pancreatic adenocarcinoma, etc.).
298 CLINICAL BIOTECHNOLOGICAL DETECTION OF SOME PARASITES , S. I. Shalaby*, Mona A. Awad and Devendra Kumar Awasthi
Molecular testing is increasingly used to supplement or replace conventional microscopy-based methods of parasite identification. Potential benefits of molecular methods such as nucleic acid amplification tests include increased sensitivity, ability to differentiate morphologically similar organisms. A variety of technologies have been applied, and some specific and general pitfalls and limitations have been identified. This review provides an overview of the multitude of methods that have been reported for the detection of blood and intestinal parasites and offers some guidance in applying these methods in the clinical laboratory and in epidemiological studies.
299 COVID-19 (CORONA VIRUS DISEASE-2019) , Pavithran G., Anusha V. H. and Praveena B.*
The world has been battling Coronavirus since months. Since the first case originated in late 2019 In the city of Wuhan, China. The virus has made its way across the globe causing economic decline, quarantine and death. The World Health Organisation has officially raised the Global alert to the highest possible level. This Novel Corona Virus is a cause for global concern because how little we know about it and how quickly it is spreading. Tait- Burkard, associated Professor at the Roslin Institute of Edinburgh, said that what makes this Novel Coronavirus Unique is that it is much severe than SARS and MERS viruses, it also means that a lot of people remain undetected as its looks like a normal common cold and they don‟t develop very severe symptoms and infected people are already sharing the virus while they look health.
300 MORINGA OLIFERA EXTRACT AS A HEPATOPROTECTIVE AGENT AGAINST RIMACTAZID-INDUCED HEPATOTOXICTY IN RATS , Hanan A. Mohalhal*, Khaled G. Abdel-Wahhab, Abdel-Rahman B. Abdel-Ghaffar and Magdy M. Mohammad
Hepatotoxicty, the most important problem worldwide gets the most attention from scientists as it considered a lethal disease. It arises as a side effect of many drugs, Alcohol abuse, liver malfunction and others. RimactazidR (RimR) is the first line drug for tuberculosis causes hepatotoxicity. Our study asses the hepatoprotective effect of Moringa olifera leaves water extract (MO) towards the hepatotoxicity induced by RimR in rats. Seventy – four rats (130-170g) were divided into 8 groups(7 rats for normal and drug groups and 10 rats for Moringa extract for each group). Co-administration of Moringa oleifera with RimR reduced the elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total protein, total bilirubin levels, malondialdehyde (MDA) and total antioxidant capacity (T.A.C). However, it elevated the reduced albumin. Hitopathological examination of MO extract groups showed the reduction in liver damage happened by RimR adminstration. From this study, we concluded that MO might be considered as hepatoprotective therapy with anti-tubercular drugs.
301 TOTAL EYE HEALTH , Dr. Rajshree B. Bomnale, Dr. Mehetre D.P.
As the sun is an important entity of universe similarly eyes are prime sensory organ of human body. One can see this beautiful world with eyes as well as can express feelings like love, affection, hate, anger etc. through eyes. Poets and writers have described eyes in many words like Meenakshi, Harinakshi etc. in their literature. Hence eyes are one of the important sensory organ.
302 REMOTE TELE-DENTISTRY VERSUS IN-PERSON ORTHODONTICS: DO PATIENTS PERCEIVE ANY DIFFERENCES? , *Aalok Y. Shukla, Dr. Rodrigo Sousa Uva, Hiten RH Patel
Telemedicine has emerged in mainstream clinical practice across multiple disciplines including general practice, dermatology and physiotherapy, due to the availability of economically acceptable technologies. As a branch of Telemedicine, Teledentistry services have sought to shift from Teleconsultation alone to Teleconsultation plus Remote treatment models, due to perceived costs and time saving possibilities for the consumer and health care provider. This is mostly applied in Orthodontics, the branch of dentistry concerned with the alignment of teeth. As so, a new commercially available Teleorthodontic platform was developed with the aim of increasing patient access with these treatments. Aim: to compare the patients’ perceived quality of care for remote orthodontic service (ROS) versus traditional in clinic orthodontic (TICO). Material and Methods: In this study, we evaluated the patient perceived quality of a remote orthodontic service (ROS) with clear aligners versus traditional in clinic orthodontic (TICO) care using accepted fixed appliances requiring manual adjustments. Both groups were surveyed to evaluate their perception of quality of care by evaluating the patients’ orthodontic treatment related responses (confidence, assessment, plan, design and treatment) by means of a questionnaire (Appendix I). Results: 21 ROS and 21 TICO patients were evaluated. The ROS group responded with higher satisfaction scores across all four categories measured compared to the TICO group. 76.2% (n=16) of the remote group and 47.6% (n=10) of in-clinic patients were confident that the respective type of approach would work for them, showing a marginally statistically significant association. Conclusions: Our study suggests patient acceptance and satisfaction for ROS, may be related to the increased involvement of the remote patient in the therapeutic process, with a more patient centred model. More investigation is needed to evaluate this further across to determine optimal parameters for this new model.
303 THE CROSS-SECTIONAL STUDY REGARDING FREQUENCY OF CHRONIC NEUROPATHIC PAIN AND ITS ASSOCIATION WITH DEPRESSION , Dr. Urooj Mehtab Raina*, Dr. Aimen Qureshi, Dr. Aniqa Ayaz
Chronic neuropathic pain is secondary to other musculoskeletal pain. The following study aimed to determine the frequency of chronic neuropathic pain and its association with depression in the elderly. A crosssectional survey was carried out on 306 participants at the Pain management center, Nishtar Hospital Multan over a period of 6 months from September 2018 to February 2019. Population of 60 years of age with chronic pain for >6 months were included, whereas patients with malignant origin of pain, intermittent pain and psychological pain were excluded. Data was collected by using DN4 and DASS Questionnaires were analysed by SPSS. Of the 271 participants with the mean age of 66 ± 5.8 years, 216 (79.9%) were male. The frequency of patients suffering from chronic neuropathic pain was 53.9%. Data showed among the elderly a strong association of chronic neuropathic pain with anxiety and stress (P<0.05), but not with depression (P>0.05).
304 FREQUENCY OF H. PYLORI INFECTION IN CHILDREN PRESENTING WITH RECURRENT ABDOMINAL PAIN , Dr. Aniqa Ayaz, Dr. Urooj Mehtab Raina*, Dr. Rana Zeshan
Objective: To determine the frequency of helicobacter pylori among children presenting with recurrent abdominal pain. Study Design: Descriptive / Cross-sectional study. Study and Duration of Study: This study was conducted in the in the Department of Pediatrics, Sheikh Zayed Hospital, Rahim Yar khan from August 2018 to January 2019. Materials and Methods: Sample size was 177 using 8% proportion of H.Pylori among children with Recurrent Abdominal Pain. Results: The mean age group of our sample was 11.29 ± 2.74 years of which 75.1% were male and 24.9% were female children. Most of the sampled children were in the age group between 8-16 years. The mean duration of abdominal pain was 4.86 ± 1.14 months. On ELISA, H. Pylori was detected in 24.9% of patients. Conclusion: H. Pylori is quite common in our pediatric population presenting with recurrent abdominal pain. It is a serious calamity in children and we recommend more research to find out risk factors related to this high burden of H. Pylori.
305 CONCEPTUAL STUDY OF IMPORTANCE OF LOCAL TREATMENT METHODOLOGIES IN SHALAKYATANTRA WITH SPECIAL REFERENCE TO ANJANA , *Dr. Rujuta Prakash Chandanshive, Dr. Virkar Chandana, Dr. Darunde Sandeep and Dr. Khole Shraddha
Local treatment methodologies in shalakyatanra refers to the Kriyakalpa, where kriya means unique therapeutic method and Kalpa means medicinal formulation such as Swaras, Kwatha, Kalka used in the treatment. Among the various contributions of Ayurveda, Netra kriyakalpa Anjana holds the specific status in special local treatment done for eye disorders. Anjana is a medicinal preparation which is applied on lower palpabral conjunctiva or cul-de-sac with the help special applicator known as Shalaka for specific time as mentioned in samhitas. There are various types of anjanas based on the formulation or medicinal form and detailed explanation such as indication, contraindication, selection of drug according to dosha, the main procedure, paschatkarma are seen in the samhitas. They are modulated to suit the structural peculiarities and different disease conditions.
306 SYSTEMIC EFFECTS OF LOCAL ANAESTHESIA IN HYPERTENSIVE PATIENTS , Dr. Wajeeha Zareen*, Dr. Hira Anmol and Dr. Tahreem Zahid
The aim of this study was to review the literature to assess any scientific basis for the limited use of dental anesthesia with a vasoconstrictor agent in hypertensive patients. This stratified randomized control study was carried out at the department of Oral and Maxillofacial Surgery in Nishtar Institute of Dentistry from August 2018 to January 2019. The total numbers of patients were 75; age range from 25 to 70 years. The patients were characterized by the JNC-8 report for hypertension patients i.e. normotensive with <120/180mmHg and hypertensive with >140/90mmHg. Patients were clinically evaluated and were divided into three groups, each groups comprises of 25 patients. Group A: Hypertensive patients who were administered 2% lignocaine. Group B: Hypertensive patients administered 2% lignocaine with epinephrine 1:100,000 and Group C: Normotensive patients who were administered 2% lignocaine with epinephrine 1:100,000. The mean age of the study sample was 46.62±13.81. These three groups were further stratified into three categories on the basis of age i.e. young patients’ age 25 to 35 years, middle age 36-55 years and old age 56-70 years respectively, to check the relation of hypertension with age. The mean B.P increased in all groups after two minutes of administration, which maintained even after 5 minutes of administration, while after extraction it returned to the observed baseline values in each group. When including age as a co-variable in the multivariate analysis, no statistically significant differences was observed between groups and did not show any adverse effects of epinephrine.
307 CAUSES AND PATTERN OF IMPACTED MANDIBULAR THIRD MOLARS , Dr. Tahreem Zahid*, Dr. Hira Anmol and Dr. Wajeeha Zareen
Mandibular third molar are the most commonly occurring impacted teeth. The reason for impaction can be lack of space, decreased skeletal growth and disproportionate crown size. Various symptoms can be associated with impacted third molars such as, pain, caries, pericoronitis, periodontal problems and root resorption. A descriptive cross sectional study was carried out on a total of 89 patients and on 100 mandibular impacted teeth over a period of 12 months. The age range was from 15 to 44 years mean age 25.7 years SD + 5.79 impacted teeth were more common in males than females. Mesioangular impaction was the most common angulation of impacted mandibular third molar and class II A was most common pattern according to Winter’s and Pell and Gregory classification. The most common presenting complaint was pain and caries of second and third molars followed by periodontal disease and pericoronitis.
308 AYURVEDIC OVERVIEW ON PANCHAKARMA IN PEDIATRIC PATIENT , Dr. Dipak P. Chaudhari* and Dr. Rajanish Meti
Ayurveda is the science of life in this treatment is branched into two types namely; shodhana chikitsa and shaman chikitsa. Shaman therapy includes deepan (appetizer), pachana (digestive) etc. and in shodhana therapy includes panchakarma. Shodhana is one among the two modalities of treatment which is best for uprooting the disease from the root itself. This Principle also holds good for a child an irrespective of the age as basic constituents of the body are same in all age group. Panchakarma incluided five therapies delineate mainly for cleansing the body toxins to achieve balanced state of body. Ayurveda considers that the purification of the body is important before the commencement of any other therapy. Routinely raised question of benefits and contraindications of Panchakarma are needed to be answered. In paediatric patients, panchakarma procedures are equally effective as they are in adult, but In present situation, there is difficulty in administering panchakarma in children because of lack of knowledge of the doses, methodology and complications.
309 CONCEPTUAL STUDYIMPORTANCE OF KAVALAGRAHA IN MUKHAROGA , Vd. Pratima Kale*, Dr. Chandana Virkar, Dr. Darunde Sandeep and Dr. Khole Shraddha
The aim and objectives of Ayurveda is to preserve the health of a healthy and normal person and also to treat and cure the sick person in such a way that the disease does not appear again. Oral health plays an important role in every individual. According to Ayurveda Mukh is one of the complex structure which consists of 7 different parts like Oshtha, Dantamoola, Danta, Jivha, Talu, Gala&Sarvasara(complete Mukha). Due to so many vitiating factors like tobacco chewing, smoking, stress, vitamin deficiency, allergies and trauma enhances imbalance in VatadiDosha & produce 67 Mukharogas. Among the different treatments of Ayurveda, Panchkarma&Upkarma or Kriyakalpa are effectively employed for promotion of health, prevention of ill health as well as eradication of the disease. Among these Kriyakalpa, Kavala & Gandush are used for achieving both the aims i.e. for prevention of Mukhrogas and also to preserve oral health and to maintain oral hygiene. In present paper an attempt is made to review the Kavala technique and its benefits as well as mode of action in diseases of oral cavity.
310 ORGAN DONATION , Dr. Tanvi Singh*
The organ donor can be anyone of which the organ can be transplanted to the patient urgently require. The organ donated by the normal human being is saved properly to transplant into the patient whenever he or she require. One can get the new life through the organ transplantation donated by donor.
311 SOME INDICATORS OF PHARMACOKINETICS OF SODIUM DICLOFENAC IN PATIENTS WITH RHEUMATOID ARTHRITIS TAKING INTO ACCOUNT COMORBIDE CONDITIONS , N. X. Tukhtaeva*, M. Sh. Karimov and G. X. Khasanova
The aim of the study was to study in a comparative aspect some of the pharmacokinetics of Diclofenac sodium in patients with rheumatoid arthritis with impaired gastric microbiocenosis (gastric dysbiosis) and without disturbance (without dysbiosis). Material and methods: We examined 38 patients aged 18 to 60 years, with I-II-III degree of disease activity. In addition to general clinical examination conductedenzyme immunoassay and urease test to determine Helicobacter pylori andhigh performance liquid chromatography to determine the pharmacokinetics of diclofenac. Results: studies and analysis of their results indicate that in conditions of rheumatoid arthritis, in particular, in the presence of comorbid conditions, there is a decrease in the metabolic rate and lengthening the half-life of NSAIDs, which increases the risk of side effects, especially from the gastrointestinal tract and significantly affects the course of the disease and treatment results.
312 SPECTRAL PROPERTIES AND CHARACTERIZATION OF SOME PYRIMIDINE AND PURINE COMPLEXES , Prof. Dr. M. S. Masoud*, M. Sh. Ramadan, A. M. Sweyllam and M. H. Al-Saify
The metal complexes of ligands Adenine, Adenine-Cytosine, Barbituric acid, Thiobarbituric acid and 2-Thiouracil were synthesized. The infrared spectral measurements assigned the characteristic bands and mode of bonding. The electronic absorption spectra and magnetic properties of the complexes revealed the tetrahedral, square pyramidal and octahedral geometries. The Mössbauer spectra for Fe(Adenine)3 complex proved a high spin FeIII complex .
313 BIOLOGICALLY ACTIVE COMPOUNDS BASED ON OROTIC ACID , *Ubaydulla Baltabaev, Abdukakhkhor Juraev, Abdugafur Khajimetov, Jahongir Abduvakilov, Nusrat Akhmadaliev and Feruzbek Ubaydullaev
In this paper, it was of interest to synthesize derivatives of 1,3-bis (aroylthiocarbamoyl) -orotic acid in order to increase the arsenal of biologically active compounds. By the interaction of chloro-, bromo-, iodo- and nitro-substituted benzoyl-isothiocyanates with orotic acid in the environment of pyridine and dimethylformamide, at a temperature of 100-1050С and a reaction time of 5 hours, derivatives of 1,3-bis (aroylthiocarbamoyl) -orotic acid were synthesized. Among the synthesized compounds, effective anti-inflammatory drugs were identified, as well as substances with bactericidal and fungicidal properties, which are of undoubted practical interest.
314 ASSESMENT OF THE PASSIVE HIP JOINT FLEXION, EXTENSION AND ABDUCTION; A COMPARISON BETWEEN THE ELECTRONIC AND UNIVERSAL GONIOMETER AMONG THE HEALTHY UNDERGRADUATE STUDENTS OF IPRS LUMHS, JAMSHORO, PAKISTAN , Aadil Ameer Ali*, Ahmed Ali, Shahnila Shaikh, Noman-Haq, Amjad Hussain, Taufiq Ahmad, Muhammad Umair, Muhammad Kumail, Shivam Sachdev, Sakshi Kumari and Muhammad Ishaque M. R.
Objective: To compare the passive range of motion (flexion, extension and abduction) of hip joint by using electronic and universal goniometer among healthy undergraduates students of iprs Lumhs, Jamshoro, Pakistan. Methodology: A cross sectional survey was conducted in institute of physiotherapy & rehabilitation sciences, Liaquat university of medical & health sciences, Jamshoro Pakistan from February to August 2018. Flexion, extension and abduction of hip joint was measured by the electronic and universal goniometer among 200 participants and SPSS version 23 was used to analyze the data. Results: The majority were (n=157, 78.5%) female and having mean age of 21.4 + 1.6 years. By using the electronic goniometer the mean scores were hip flexion were 122+1.50, extension 112.9+1.43 and abduction 44.1+1.20, while measuring with universal goniometer the mean scores were hip flexion were 120+1.42, extension 110.7+1.08 and abduction 43.0+1.77. The correlation between the electronic and universal goniometer in hip flexion were (flexion=0.300, extension=0.184, abduction=0.189). Conclusion: This Study concluded that both the electronic and universal goniometer are equally valid and reliable in order to measure the passive flexion, extension and abduction of hip joint.
315 SIGNIFICANT METABOLOMIC DIFFERENCES BETWEEN THE TUMOR AND NON-TUMOR ADJACENT MUCOSA IN COLORECTAL CANCER - A TARGETED MASS-SPECTROMETRY-BASED STUDY TO IDENTIFY POTENTIAL BIOMARKERS , Marcos Vinicius ARAUJO Denadai*, Carlos Augusto Rodrigues Veo, Sandra Morini Silva,M. Gordian Adam, Udo Muller, Simon Schafferer, Ismael D C G Da Silva, Isabella Alves Brunetti and Delcio Matos
Metabolomics is an emerging analytical tool that has allowed cancer research to elucidate specific biomarkers and helped improve clinical outcomes. The aim of the project was to identify metabolic conditions in patients with colorectal cancer. A targeted metabolomic approach with the Biocrates Absolute IDQ® p180 Kit was used to quantify metabolites of various biochemical classes. The samples comprised 85 human cancer tissue and 85 cancer-surrounding tissue samples from the same patients. Classes of amino acids, biogenic amines, acylcarnitines, glycerophospholipids, sphingolipids and monosaccharides were analyzed. The statistical analysis included data normalization and quality control, Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA), univariate statistics with significance testing, and analysis of fold changes. The main biochemical pathways affected were also analyzed. Univariate statistical analysis by comparing tumor and tumor-surrounding tissue found a total of 118 significantly altered metabolites. Tumor tissue samples displayed severely altered metabolomic features, which affected different pathophysiological pathways ranging from energy to lipid metabolism. Metabolomic reprogramming, glutaminolysis, prominent Warburg Effect, and increased IDO activity, which all have been described for cancer cells, could be conclusively observed in this analysis. The importance of lipid alterations occurring in tumor cells were also confirmed with this study. In colorectal cancer, the tumor and tumor-surrounding tissue present distinct metabolomic states and dramatic metabolomic reprogramming. Especially the role of sphingomyelins and lysophosphatidylcholines (lysoPCs) as potential tissue biomarkers for colorectal cancer needs further investigation.
316 COMPARISON PLATELETS COUNT BY AUTOMATED AND MANUAL HAEMOCYTOMRTER METHODS , Amal Elhassade*, Mahbuba Hassan, Hajir Geryat, Boshra Elkelani and Salma Aljbali
Background: Manual platelet counting in the Neubauer chamber, by means of a phase-contrast microscope, has been recommended as the reference method for assessing the platelet number by the International Committee for Standardization in Hematology (ICSH -1984). platelet counts as a reference for the calibration of hematology analyzers has been a continuing problem due to varying results. Methods: Fifty-Five blood samples in EDTA-anticoagulant vacutainer tubes were obtained and randomly divided into 3 group; Group A-normal control (n =34), Group b thrombocytopenia (n = 14) and Group C high platelets count thrombocytosis (n = 6). Each blood sample were analyzed for platelet count by manual microscopy, and automated hematology analyzer. The agreement between the two methodologies were assessed using the paired t-test and correlation coefficient analyses. Results: The coefficient of variation values significantly differed in Group A and were high for Automated cell counter. High positive correlation was also observed between Automated cell counter values and manual method (r=0.935, p=0.001) in group b was not significantly correlated. Conclusion: Based on the results observed in thrombocytopenia, manual platelet count using by haemocytometry may be promising if platelets are very low and giant platelets.
317 EVALUATION OF MYRICA SALICIFOLIA AND PENTAS LONGIFLORA EXTRACTS FOR THE CONTROL OF COFFEE LEAF RUST (HEMILEIA VASTATRIX BERKELEY AND BROOME) AT LWIRO, PROVINCE OF SOUTH KIVU, EASTERN OF DR. CONGO , Bagalwa M.*, Rubabura K., Lorena A. C., Masunga L. and Mugisho L.
Coffee leaf rust caused by the fungus Hemileia vastatrix is present in the great lake country of Central Africa and in the eastern part of Democratic Republic of Congo. It caused several damages on the coffee production. The phytochemical screening of Myrica salicifolia and Pentas longiflora show secondary metabolites which have fungicidal activity. Experiments were conducted in vivo and in vitro on extract of plants against coffee leaf rust. The spraying of extract of Pentas longiflora and Myrica salicifolia were effective against coffee leaf rust respectively at 100 g/mL in vivo for both extract plants and 50 g/mL for field experiments. Results confirmed that plant extracts such as the extract of Myrica salicifolia and Pentas longiflora can be used as natural fungicides to control Hemileia vastatrix and thus reduce the dependence on the synthetic fungicides such as copper sulfate.
318 DETERMINATION OF ULTRASONOGRAPHIC MEAN FETAL KIDNEY LENGTH AT DIFFERENT GESTATIONAL AGES IN A PUBLIC SECTOR HOSPITAL OF PAKISTAN , Dr. Mahnaz Gondal*, Dr. Amna Ahsan, Dr. Tayyaba Tahira, Dr. Saira Fayyaz, Dr. Rabia Wajid, Dr. Hina Munir and Dr. Rabia Javed
BACKGROUND: The determination of exact gestational age (GA) has been a challenge for managing obstetricians always. It has gained importance in managing pregnancies with different risk factors. Fetal kidney length together with routine fetal biometric parameters can help in predicting gestational age in a precise manner. The purpose of this study was to determine the ultrasonographic mean fetal renal length at different stages of gestation and find its correlation with maternal age, BMI and parity in female population presenting at a teaching hospital in Punjab. MATERIAL AND METHODS: It was a six months observational descriptive case series carried out in Gynecology Unit-IV, Sir Ganga Ram Hospital, and Lahore from August 8, 2019 till Feb 8, 2020. Two hundred women presenting to the Outdoor of Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital, Lahore were enrolled into this study after fulfilling the inclusion criteria. Detailed history was taken from the patients who consented to participate in the study. The pregnant females underwent ultrasonographic assessment and the fetal kidney length was measured for both kidneys. Mean of the two lengths was calculated and noted into the specially designed proforma along with gestational age and demographic details. All the ultrasonographic measurements were performed by a single radiologist on a single machine to eliminate bias. The collected data was analyzed by SPSS version 20. P- Value of ≤ 0.05 was considered to be statistically significant. RESULTS: The patients’ mean age was 26.24 ± 5.53 years. At 24th week the mean length of left kidney, right kidney and overall length of kidney were 30.45 ± 0.26 mm, 30.49 ±0.29 mm and 30.47 ± 0.27 mm respectively. At 28th week the mean length of left kidney, right kidney and overall length of kidney were 35.09 ± 0.58mm, 35.62 ± 0.87 mm and 35.35 ± 0.72 mm respectively. At 32nd week the mean length of left kidney, right kidney and overall length of kidney were 35.72 ±0.40 mm, 36.25±0.79mm and 35.99 ±0.66 mm respectively. At 36th week the mean length of left kidney, right kidney and overall length of kidney were 41.51 ± 0.27 mm, 41.56 ± 0.32 mm and 41.53 ± 0.31 mm respectively. A p -value of 0.05 was obtained when the fetal kidney lengths were correlated with age, parity and BMI of the female. CONCLUSION: This study reached to the conclusion that the length of kidney increased as the gestational age advanced. No statistical correlation of fetal kidney length with maternal age, BMI and parity was seen in female population presenting at a teaching hospital in Punjab. So, prediction of fetal gestational age can be done in a better manner complimenting fetal kidney length with other routine parameters.
319 PREVALENCE OF PLASMODIUM INFECTION IN HUMANS PRESENTING WITH SYMPTOMS OF MALARIA IN SOME HEALTH FACILITIES IN ENUGU METROPOLIS , Esimai Bessie Nonyelum* and Obeagu Emmanuel Ifeanyi
A parasitological evaluation of blood samples of 2000 symptomatic malaria patients (1000 males and 1000 females) in some health facilities of Enugu metropolis was conducted to determine the prevalence of Plasmodium (P) species. Plasmodium species encountered in patients showed significant difference (P<0.05) in the distribution P. malariae P. falcparum. A prevalence of 880 (88.0 percent) was recorded in males and 340 (34.0--percent) in females.
320 EVALUATION OF MEAN MALARIA PARASITAEMIA BEFORE AND AFTER TREATMENT IN MICE , Esimai Bessie Nonyelum*, Obeagu Emmanuel Ifeanyi and Njoku O. O.
Holistic management of malaria with Antioxidant Vitamins A.C.E'. In animal model was employed. Gnotobiotcally reared male Swiss albino mice were inoculated with a standard dose of p. berghei, about 107 parasitized erythrocytes through intrapertional route. Treatment was administered according to body weight of mouse through intrperitoneal route, observing the lethal dose of Vitamins through the route. The blood was evaluated parasitologically. There was a highly significant decrease (p<0.0001) in parasitaemia, consequent to total clearance in all mice treated with antioxidant vitamin. A hundred (100 percent) mortality was recorded in positive untreated control group. Post mortem examinations revealed haemorrhagic lesions at the lower part of the brain. There was an effective treatment by orthomolecular approach.
321 NON-ADHERENCE – A CHALLENGE IN HEALTH MANAGEMENT , *Syed Ahmed Arshad and Prof. Jamal Ara
Aim; To determine the frequency of non-adherence to diet, medication and physical activity as a factor in the management of diabetic and hypertensive adult patients. Methodology; Cross sectional, observational one month study conducted on 100 adults who were diagnosed with diabetes, hypertension or both at Creek General Hospital, Karachi, Pakistan from December 2018 to January 2019. Non adherence to diet, physical activity and prescribed medicines was noted. A reason of non-compliance was explored. Results: Out of 100 subjects 44 were male (44%) and 56 consisted of females (56%). The results showed that 26 (26%) of the adults were diagnosed with diabetes, 39 (39%) of the patients were hypertensive and 35(35%) of the adults were diagnosed with both. Noncompliance to physical activity was 59%, to diet it was 42% and to medicine it was 36%. Males were more non-compliant to diet and medicines, while females were to physical activity. Regarding age groups, the elderly were most noncompliant to diet and medicine, while the middle age were to physical activity. Among reasons of noncompliance to any of the modality, being busy/lack of time was most prevalent (21%), followed by the lack of financial means (21%). Conclusion: Non-adherence to diet, medication and physical activity is a challenging factor in the management of diabetic and hypertensive patients.
322 VARIOUS MOLECULAR ASSAYS LABORATORY TESTS FOR COVID 19 , Rajeev Shah*, Reena Mehta and Aarjav R. Shah
Background: Commercially available COVID-19 tests currently fall into two major categories. The first category includes molecular assays for detection of SARS-CoV-2 viral RNA using polymerase chain reaction (PCR)-based techniques or nucleic acid hybridization-related strategies. The second category includes serological and immunological assays that largely rely on detecting antibodies produced by individuals as a result of exposure to the virus or on detection of antigenic proteins in infected individuals. It is important to reemphasize that these two categories of tests serve overlapping purposes in management of the COVID-19 pandemic. Testing for SARS-CoV-2 viral RNA identifies SARS-CoV-2-infected individuals during the acute phase of infection. Serological testing subsequently identifies individuals who have developed antibodies to the virus and could be potential convalescent plasma donors. It also furthers the ability to conduct contact tracing and monitor the immune status of individuals and groups over time. Timely diagnosis, effective treatment, and future prevention are key to management of COVID-19. The current race to develop cost-effective point-of-contact test kits and efficient laboratory techniques for confirmation of SARS-CoV-2 infection has fueled a new frontier of diagnostic innovation.
323 CIPROFLOXACIN INDUCED HYPOGLYCAEMIA-A RARE CLINICAL ENTITY , Ravi Kant* Prakash Tendulkar and Mahendra Kumar Meena
Numerous pharmacological agents have been commonly used in diabetes mellitus patients, with the potential to alter serum glucose levels. Some of these commonly used drugs associated with hypoglycaemia, other than anti diabetic drugs, like ACE inhibitors, β-blockers, Quinolones; Salicylates etc.[1,2] This is a case report of drug-induced hypoglycaemia due to quinolones. Ciprofloxacin (Quinolones) is a very common antibiotic prescribed by clinicians in day-to-day practice; however, awareness about the uncommon side effects like hypoglycaemia is poor.[2] This is case of a 42-year-old female who is a known case of DM for last 12 years on basal bolus insulin regimen with normal renal function and hypothyroidism. She had no prior episodes of hypoglycaemia while taking the same Insulin doses. She underwent a cataract surgery after which she was started on tab ciprofloxacin 500mg BD along with other symptomatic eye drops. On the 3rd day after discharge, she developed symptomatic severe hypoglycaemia (58mg/dl). Next day she herself reduced the dose of insulin which again leads to a similar episode of severe hypoglycaemia. After her OPD visit next day, a careful review of medications was done at diabetic clinic and Ciprofloxacin was stopped.
324 COMPARISON OF EFFECT OF DIABETIC MELITUS, HYPRTENSION AND DISLIPIDEMIA ON COGNITIVE FUNCTION-A SYSTEMIC REVIEW , Alfy O. O.*, Lincy George and K. Krishna Kumar
Vascular risk factors such as type 2 diabetic mellitus, hypertension and dyslipidemia have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this review was to compare the risk factors with regarding cognitive decrements. Cross sectional study and longitudinal studies assessed cognitive functioning in person related to diabetes, hypertension and dyslipidemia and that adjusted or matched for age, gender and education were included. Diabetes and hypertension were clearly associated with cognitive decrements, the results for dyslipidemia were less consistent.
325 A REVIEW ON ASSOCIATION OF CD14 WITH INCIDENT DEMENTIA AND MARKERS OF BRAIN AGEING AND INJURY , *Jesna Jose, Lincy George and K. Krishnakumar
The soluble cluster of differentiation 14 is a type of CD14 which is a glycoprotein expressed on monocytes and neutrophils. CD14 is involved in the innate immunity and facilitate pro-inflammatory and anti-inflammatory cytokines. Current researchers found that CD14 is a key component of incident dementia and also involved as a marker of brain aging and injury. Usually, the dementia forms such as Alzheimer’s are diagnosed in later stages after sufficient damage to the brain had occurred. So, a marker like CD14can plays a vital role by the light of current researches that it could help in early detection and less costly. With this key component the detection of damage and injury can be including cognitive decline can be identified.
326 COVID-19 AND AYURVEDA , Tanvi Nagpal*, Swapnil Saini, Akhilesh Kumar Srivastava, Rajesh Manglesh and Dalip Sharma
Ayurveda is the “The Science of Life”. It is the oldest traditional system of medicine .Ayurveda lay emphasis on prevention and encourages the maintenance of health of an individual through balanced diet, lifestyle, positive attitude and the use of herbs .Ayurveda has the remedy or cure for those diseases also where ever other stream of medicine fails. losZ jksx% vfi eUnkfXu ewya –means that the root cause of all the diseases is Mandagni. Agnivishmata cause disturbances in the metabolism thus weaken the immune system of the body. As a result of this person gets prone to various infections. Now, in the present scenario Covid-19 is spreading like wildfire across the world. The first cases were seen in Wuhan, China in late December 2019 before spreading globally.Covid-19 outbreak was declared as a pandemic on 11 March 2020. In the present era, bad food habits, sedentary lifestyle, lack of exercise and over stress is the main cause of the spread and virulence this deadly disease. It is because of today’s lifestyle only that person’s immune system is so low that he gets easily infected by microorganisms. Ayurveda is ancient in origin but its concept like Aupasargika Roga (communicable diseases) and Janpadodhavansa (epidemics) still holds importance in the present era.
327 MEDICINAL EFFICACY OF GREEN TEA: A MINI REVIEW , Prof. Ravinder Kumar*, Shruti Sharma and Priyanshi Sood
Tea is among the world’s most commonly consumed beverages and its constituents are known to possess medicinal efficacies. Since ancient times, regular tea consumption is considered as health-promoting habit. The most commonly consumed tea varieties are -green, black, and oolong; based on the amount of antioxidants present and the degree of fermentation. Tea is obtained from the leaves, buds, or delicate stems of the Camellia sinensis plant which belongs to the family Theaceae. Recently, the medicinal properties related with daily green tea intake have become well recognized. Green tea or Extract of Green Tea contains catechins that have antioxidant, antiangiogenesis and antiproliferative activities. Green Tea is loaded with more antioxidants than other kinds of tea. Tea contains caffeine, minerals and trace amounts of vitamins, amino acids and carbohydrates. The phytoconstituents present in Green tea stimulate central nervous system and improve overall health.
328 ACHIEVING HEALTH AND WELLNESS , S. I. Shalaby*, Mona A. M. Awad, Sawsan I. Shalaby and Dvendra Kumar Awasthi
Wellness is an active process of becoming aware of and making choices toward a healthy and fulfilling life. It is a state of complete physical, mental, and social well-being, and not merely the absence of disease. The social, economic, cultural and physical environment in which people live their lives has a significant effect on their health and wellbeing. Although genetics and personal behaviour play a strong part in determining an individual's health, good health starts where we live, where we work and learn, and where we play. We are dealing with 5 components of health and wellness, 8 dimensions of wellness, 5 areas of health related to wellness, 4 components of holestic health and 3 parts of Mental/emotional wellness. Moreover. How to achieve health and wellness ,improve mind and body wellness, methods to improve mental health and have better energy build mental and emotional strength and get stronger brain. The final aim is to be healthy naturally.
329 CLINICAL STUDY TO EVALUATE THE EFFICACY OF ASHWAGANDHA MODAKA IN KARSHYA , Dr. Dinesh Ram*, Dr. Rajeev Kumar Sharma and Dr. Ashutosh Kumar Yadav
Swasthavritta is a science of Health, which prescribes the theory, and practice of the maintenance of public and private health. Swasthavritta in Ayurveda means maintenance of the health of an individual. Malnutrition is a term which is defines as deficiency of nutrition, generally consists of both the terms under-nutrition and over nutrition. Karshya is a clinical condition that can be correlated with under nutrition in which body gets emaciated gradually. Among the eight socially undesirable physical state mentioned by Charaka, Karshya has been categorised under nutritional deficiency. Altered function of Vayu and Agni leads to insufficient production of Rasa Dhatu. Uposhoshan of Rasa Dhatu takes place leading to Dhatu Kshaya chronologically. Hence the patient of Karshaya suffers from indigestion, malabsorption, defective metabolism. So, the purpose of my study is to provide an Ayurvedic management and prove the efficacy of Ashwagandha Modaka in the management of Karshaya.
330 ROLE OF UTTARBASTI IN THE MANAGEMENT OF YONIVYAPADA: REVIEW , Madhuri Bhalgat* and Karishma Bilade
In the Ayurveda, Tridosha have more importance because without them not a single disease can manifest. Among the Tridosha, Kapha and Pitta are nonmotile whereas vatadosha have motility. So to get vitiate Kapha and Pitta mostly requires an initiation from Vata Dosha. As per the therapeutic approach Basti have good efficacy to normalise the vitiated Vata. Vitiated Vata mainly responsible for all Yonivyapada. Yonivyapada described under Striroga covers almost all the diseases of women. Uttarbasti found very effective in Yonigat vata shamana. Uttarbasti having both the effects of Shamana as well as the Shodhana effect. This study aimed to find out role of uttarbasti in yonivyapada and why the drugs used in uttarbasti mostly prepare with oil based.
331 THERAPEUTIC USES OF RASNA (PLUCHEA LANCEOLATA): A REVIEW ARTICLE , Dr. Manisha and Dr. Naresh Kumar Garg
Medicinal plants like eg. Pluchea lanceolata etc. have been a major source of treatment for human diseases since time immemorial. They are the richest biosource of drugs of traditional system of medicine, modern medicines, food supplements, folk medicines, pharmaceutical intermediates and chemical interties for synthetic drugs. Plant products still remain the principle source of pharmaceutical agents used in traditional medicine. In recent years, there has been a great demand for plant derived products in developed countries. These products are increasingly being sought out as medicinal products, neutraceuticals and cosmetics. The increasing knowledge of metabolic process and the effect of plants on human physiology have enlarged the range of application of medicinal plants.
332 A REVIEW ON SENNA: AN EXCELLENT PROPHETIC HERBAL MEDICINE , Mohammad Sadat A. Khan*
It is evident from the literature that 80% of the world’s population depends on herbal drugs. Now-a-days, the herbs and herbal medicines are much effective for the treatment of varied disorders as they have minimal side effects as compared to the allopathic medicines. Cassia leaves and pods have been used in traditional or herbal medicine since ancient times. Ibn al-Qayyim described the plant Senna (ال س نا ) as an excellent medicine in his work on Prophetic Medicine. There are a number of species of Senna used throughout the world for medicinal purposes. The pods and leaves contain anthraquinone glycosides that have a big laxative effect. Cassia angustifolia, which is commonly called Senna belongs to the family Leguminosae. It is a well-known laxative throughout the planet. It is an ayurvedic herb more popularly known as swarnapatri in Sanskrit. Senna is widely used for its numerous benefits. The plant is mainly valued for its cathartic properties and is especially useful in habitual constipation. The laxative principles sennoside A and sennoside B are isolated from leaves and pods of senna, which constitute important ingredients in purgative medicines. This prophetic herb is very beneficial for numerous health issues. The plant has been investigated for its various chemical constituents and pharmacological properties. The distribution, medicinal applications, chemical constituents and various aspects of senna are reviewed in this paper.
333 SURGICAL INTERVENTIONS IN GYNAECOLOGY & OBSTETRICS: AN AYURVEDA REVIEW , Dr. Trushna Tembhekar*, Dr. Neha Milind Sahare, Dr. Vrushalee Dodke
The renowned physicians of ancient time developed many branches of medical science and Shalya Chikitsa is one of the important branches of Ayurveda. Shalya Tantra possesses great utility for the management of many medical emergencies where minor or major surgical intervention needed. The gynecological problems many times need special surgical interventions therefore it is required to explore the role of Shalya Chikitsa in Prasuti Tantra and Stree Roga. Considering this present article emphasizes various aspects of Shalya Chikitsa utilized for Prasuti Tantra and Stree Roga.
334 AYURVEDA AND MODERN PERSPECTIVES ON CONCEPT OF DINCHARYA; A REVIEW , Dr. Lokesh Chandra Sharma*, Dr. Ravi Prakash Sharma
Dincharya means daily routine and ayurveda classic suggest some rules to be followed for good conduction of daily regimen. The concept of Dincharya (disciplinary conduction of daily routine) not only helps to restore normal health status but also resist disease pathogenesis. Dincharya encompasses routine practices to be followed like; eating at appropriate times, time of sleep and rising, exercise, avoidance of day time sleep and avoidance of late night awakening. The improper conduction of Dincharya may leads several health problems including; diabetes, fatty liver, obesity, anorexia, stress, insomnia and hypertension, etc. Therefore ayurveda strongly recommended that one should follow all suggested rules of daily regimen (Dincharya). Present article emphasizes ayurveda and modern view on concept of Dincharya.
335 CHEMISTRY GOES GREEN: A REVIEW ON CURRENT AND FUTURE PERSPECTIVES OF PHARMACEUTICAL GREEN CHEMISTRY , Mona Patel*, Harsha Patel, Shweta Mevada and Ojash Patel
Over the past few decades, the chemistry community has been mobilized to develop a new chemistry that is less hazardous to the environment as well as human health. This new approach has received extensive attention and nominated by many names including Green Chemistry, Environmentally Benign Chemistry, Clean Chemistry, Atom Economy and Benign by Design Chemistry. Below all of these different designations there is a movement toward pursuing chemistry with the knowledge that the consequences of chemistry do not stop with the properties of the target molecule or the efficacy of a particular reagent. The practice of chemistry in a manner that maximizes its benefits while eliminating or at least greatly reducing its adverse impacts has come to be known as green chemistry. It focuses on a process (whether carried out in industry or a chemical laboratory) that reduces the use and generation of hazardous substances or by-products. As on today, maximum pollution to the environment is caused by numerous chemical industries. Therefore, attempts have been made to design synthesis for manufacturing processes in such a way that the waste products are minimum, they have no effect on the environment and their disposal is convenient. In pharmaceutical industry, some drugs generate large amount of waste as byproducts during their synthesis which results the low yield in the final products. For carrying out reactions it is necessary that the starting materials, solvents and catalysts should be carefully chosen. Green chemistry play important role in pharmaceutical in developing innovatory drug delivery methods which are less toxic and more useful, effective with minimum side effects and could help millions of patients. In this review, we will also be looking ahead at the immediate and longer-term challenges and opportunities as I now see them in research and in industrial application and also in education and promotion.
336 ATIVISHA AS A DRUG OF CHOICE IN PEDIATRIC AILMENTS , Dr. Rashi Jaiswal*, Dr. Jyoti Kaushik and Prof. Rakesh Sharma
Ayurveda aims at prolongation of healthy life in terms of mental, physical, spiritual and social health and prevention of diseases hence, maintaining the senility of a person. When we talk of Ayurveda, we need to give credit to those innumerable plants and herbs in nature’s lap used for medicinal reasons that are serving its very purpose. Phytomedicine had its genesis in India from time immemorial. Today, a number of plants are used in different Indian system of medicine. The conventional medicine is also using a lot of plant derived chemicals as therapeutic agents but there is a need to further evaluate different uses of these medicinal plants which are concealed in Ayurveda treatise. The aim of this study is to collect and evaluate different medicinal properties of Ativisha with special reference to its importance in childhood ailments. It is a highly valuable drug and is mentioned in different Ayurvedic literatures like Brihadtrayee, Laghutrayee, Chikitsagrantha and Nighantus. Ativisha is also referred as “Sishubhaishjaya” in classical texts, which means it is best remedy for children.
337 REVIEW ARTICLE ON KARSHYA AND PEM IN AYURVEDA , Dr. Aayushi Tiwari*, Dr. Nagendra Thakre and Dr. Aashutosh Kumar Jain
Ayurveda is mainly based on preventive aspect first rather than curative. Ayurveda believe that many health problems can be prevented through nutritious diet. Food is importrant as a nutritional source also therapeutic importance. Karshya is disease a similar to under nutrition. PEM (protein energy malnutrition) is one of the diseases related to Annavaha Srotas. It is a type of malnutrition resulting from deficiency of proteins and calories in food over a long period of time. It is very common among young children (usually below 5 years). PEM is not only important cause of childhood morbidity and mortality but also leads to permanent impairment of physical and possibly of mental growth of those who survive. Disease such as Parigarbhika, Phakka, Balashosha and Karshya describe by various author of Ayurveda can also co related to malnutrition based on the clinical features these diseases are related to each other. This article highlights the Ayurvedic view of nutritional disorder like protein energy malnutrition.
338 AYURVEDIC ASPECTS OF SHAYYAMUTRA- A REVIEW ARTICLE , Dr. Aayushi Tiwari*, Dr. Nagendra Thakre and Dr. Aashutosh Kumar Jain
Nocturnal enuresis i.e Shayyamutra though not physically very harmful but negatively affects child psychology and is assign of delayed neurological development. Ayurveda considers this problem as a Kaphaavrit Vata condition along with Tama involvement. The description regarding Shayyamutra is found in Sharangadhara and Vangasen Samhita Review of the literature and reported studies in Ayurvedic parlance states importance of certain Kaphaghna/Pramehaghna drugs (like Marich, Bimbi, Vangabhasma, Khadira, Shilajit, ChandraprabhaVati), Nervine tonics (like Brahmi, Giloy, Yashtimadhu, Shankhpushpi), Panchakarma therapies (especially Nasya and Shirodhara) and most important Sattvavajaya Chikitsa. Thus Considering pathology of the Shayyamutra, treatment should be planned in a multi dimensional approach including all components of management than merely choosing single drug or Kalpa.
339 AYURVEDIC ASPECTS OF SHAYYAMUTRA- A REVIEW ARTICLE , Dr. Aayushi Tiwari*, Dr. Nagendra Thakre and Dr. Aashutosh Kumar Jain
Nocturnal enuresis i.e Shayyamutra though not physically very harmful but negatively affects child psychology and is assign of delayed neurological development. Ayurveda considers this problem as a Kaphaavrit Vata condition along with Tama involvement. The description regarding Shayyamutra is found in Sharangadhara and Vangasen Samhita Review of the literature and reported studies in Ayurvedic parlance states importance of certain Kaphaghna/Pramehaghna drugs (like Marich, Bimbi, Vangabhasma, Khadira, Shilajit, ChandraprabhaVati), Nervine tonics (like Brahmi, Giloy, Yashtimadhu, Shankhpushpi), Panchakarma therapies (especially Nasya and Shirodhara) and most important Sattvavajaya Chikitsa. Thus Considering pathology of the Shayyamutra, treatment should be planned in a multi dimensional approach including all components of management than merely choosing single drug or Kalpa.
340 IMPORTANCE OF PATHYA- APATHYA IN DAY TO DAY LIFE – A REVIEW ARTICLE , *Dr. Sudhir Dhone
The aims & objectives of Ayurveda are to maintain the health of a healthy person & to cure the diseases of the patients. To maintain the health, Ayurveda laid many basic principles like Ritucharya (seasonal regime), Dincharya (diurnal regime) etc. The word Pathya, derives its origin from root word Patha which literally means a way or channel. Pathya & Apathya are defined as the substance or regime which do not adversely affect the body & mind are regarded as Pathya, those which adversely affect them are considered to be Apathya. Apart from being a part of regime of healthy living in day to day life. This indicates the importance of Pathya and Apathaya in Ayurveda. The concept of Pathya and Apathya is the peculiarity of Ayurveda.
341 SWASTHVARITHA FOR THE MANAGEMENT OF METABOLIC DISORDERS; AN AYURVEDA APPROACH , Dr. Vipul C. Patil*
The metabolic disorders are burning health issues now a day’s and present pattern of living enhances incidences of such problems therefore it is require to pay attentions for curing metabolic disorders. Ayurveda mentioned term “Santarpanjanya Vikaras” for diseases which may occurs due to the defect in tissue metabolism. The sedentary life style, genetic factors, environmental conditions and improper dietary habits, etc. can cause metabolic disorders. The ayurveda concept of Swasthvaritha helps to prevent consequences of improper daily and dietary regimen thus conduction of rules of Swasthvaritha can prevent initial pathogenesis of such types of disorders. Considering this aspect present article summarizes role of Swasthvaritha towards the management of metabolic disorders.
342 FORMULATION AND EVALUATION OF FAST DISSOLVING TABLETS OF PHENYTOIN SODIUM , Korem Raju*, MD Rehana Begum, B. Prashanth, G. Manirathnam, D. Chandrashekhar, K. Shashidhar Reddy
Fast dissolving tablet of phenytoin sodium was design with a view to provide a quick onset of action. The main objective of the study was to formulate fast dissolving tablets of phenytoin to achieve a better dissolution rate and further improving the bioavailability of the drug. Here Fast dissolving tablets were prepared by direct compression by using super disintegrants such as SSG,MCC and sodium alginates etc. Before preparing evaluated pre-compression parameters that results found to be within I.P limits. Among the all the 6 formulations F4 formulation containing SSG,MCC as super disintegrants considered to be best formulation which shows 98.7% drug release.
343 FORMULATION AND EVALUATION OF POLYHERBAL FACE PACK , Swati Siddheshwar Londhe*, Mangesh Gautam Bhosale and Amol Arun Joshi
The aim of this work is to formulate and evaluate an herbal face pack for glowing skin by using natural herbal ingredients. The natural herbal ingredients such as Gram Flour, Rice flour, charcoal powder, Arjuna Powder, Lemon peel Powder, Nutmeg, Manjishta, saffron, Turmeric, Aloe Vera were purchased from local market in the form of dried powder. All powdered natural ingredients were sieved using #120 mesh, weighed accurately and mixed geometrically for uniform formulation and then evaluated for parameters including Organoleptic, physicochemical, physical, phytochemical, irritancy along with stability examination. The dried powder of combined form had passable flow property which is suitable for a face pack. Herbal face packs or masks are used to stimulate blood circulation, rejuvenates the muscles and help to maintain the elasticity of the skin and remove dirt from skin pores. In this study it is concluded that all the formulations of face packs found to be good in physical parameters, free from skin irritations so we found good properties for the face packs and further optimization studies are required on this study to find the useful benefits of face packs on human use as cosmetic product.
344 EVALUATION OF ANTIFUNGAL ACTIVITY OF AQUEOUS AND ALCOHOLIC EXTRACT OF BILWADI AGAD AGAINST SOME FUNGAL STRAINS , Kumari Anupama*, Tiwari R. C., Sharma Ved Bhushan, Tiwari Shashikant
This study was carried out with an objective to investigate the antifungal potentials of aqueous and alcoholic extract of bilwadi agad .The aim of the study is to assess the antifungal activity and to determine the zone of inhibition of extracts on some fungal strains. In the present study, the antifungal activity of aqueous and alcoholic extracts of of bilwadi agad was evaluated against medically important fungal strains. The antifungal activity was determined in the extracts using well diffusion method. The antifungal activities of aqueous and alcoholic extracts (5, 10, 15 % concentration) of bilwadi agad were tested against Candida albicans, Microsporum canis, Microsporum fulvum, Trichophyton rubrum. Zone of inhibition of extracts were compared with Ketoconazole .The results showed that the remarkable inhibition of the fungal growth was shown against the tested organisms. We conclude from this that these extracts exhibit amazing fungicidal properties that support their traditional use as antiseptics Hence, bilwadi agad can be used as natural products to fight with fungal infections.
345 VALIDATED SPECTROPHOTOMETRIC METHOD FOR SIMULTANEOUS ESTIMATION OF FENOFIBRATE AND ATORVASTATIN IN SYNTHETIC MIXTURE AND IN BULK TABLET DOSAGE FORM , *Godge Ganesh Raosaheb, Garje Mahesh Arjun, Dode Aniket Balaprasad, Dhaygude Anil Machindra, Wagh Divya Vinayak and Fartade Sachin Jalindar
A simple, accurate, sensitive, precise and rapid UV- Spectrophotometric simultaneous equation method have been developed for the simultaneous analysis and estimation of Fenofibrate and atorvastatin in bulk and combined tablet dosage form formulation. To determine the absorption maximum, each drug Fenofibrate and atorvastatin were scanned in wavelength range of 200-400 nm in spectra measurement mode using the double beam UV- Spectrophotometer (Jasco). 287 nm (λmax for fenofibrate) and 249 nm (λmax for atorvastatin) respectively were selected as a sampling wavelengths in methanol as solvent. Beer’s limit were obeyed in the range of 5-30 μg/ml for both Fenofibrate and atorvastatin. The correlation Coefficients for both drugs found to be satisfactory. Validation parameter such as its accuracy, linearity, precision, limit of detection (LOD), limit of quantitation (LOQ) were studied for proposed method according to the ICH guidelines. Results of all parameters were found to be satisfactory. The proposed method can be used effectively for routine analysis and estimation of fenofibrate and atorvastatin in combined synthetic mixture and bulk dosage form.
346 OUTCOMES OF A PHARMACIST-LED ANTICOAGULATION EDUCATION PROGRAM AMONG PATIENTS ON LONG-TERM WARFARIN THERAPY IN A KENYAN REFERRAL HOSPITAL , Dr. Sakina I. Mamdani*, David G. Nyamu and Tom B. Menge
Background: Warfarin is widely used for long-term anticoagulation management in low resource health settings but it has a narrow therapeutic index. Patients’ knowledge on warfarin use promotes optimal anticoagulation and adherence. Objective: To evaluate the effect of a designed warfarin based patient education program on oral anticoagulation knowledge, adherence and level of control among adult outpatients on warfarin therapy at Kenyatta National Hospital. Methodology: A pre-test/post-test single group quasi study. Participants: forty-five outpatients aged ≥ 18 years at anticoagulation clinics. Main outcome measures: Level of knowledge, adherence and anticoagulation control. Methods: Ethical approvals were sought from institutional review board (reference KNH/ERC/A/151) and study sites. Eligible participants were enrolled during clinic appointments. A predesigned data collection tool was used to collect information on sociodemographics, baseline oral anticoagulation knowledge, adherence and the most recent international normalized ratios, after which a designed warfarin based education program was provided to participants. Patients were given a warfarin education booklet for further reference.The effect of the designed education program on knowledge of anticoagulation, level of adherence and anticoagulation control was assessed thirty days post the intervention using the the same tools administered at baseline data. Data was analyzed using Statistical Package for Social Sciences version 21 software at 95% confidence level. Results: The mean participants’ age was 42.9(±13.7) years and majority were females (86.7%). There was a significant improvement between the pre-test and post-test anticoagulation knowledge mean scores (p<0.001) as well as adherence (p<0.001). Conclusion: Pharmacist-led warfarin based education program improves patient knowledge and adherence in warfarin anticoagulation therapy. Future studies should correlate patients’ knowledge with adverse drug reactions.
347 A CASE REPORT ON ENDODNTIC MANAGEMENT OF MANDIBULAR CANINE WITH 2 ROOT CANALS , Manju Krishna E. M.*, Asha Pius and Robin Theruvil
Endodontic therapy may sometimes fail because morphological features of the tooth adversely affect the treatment procedures. Many investigators have reported the anatomical variations associated with mandibular canines. The root canal anatomy of permanent mandibular canines varied widely in an Indian population. Mandibular canines are recognized as usually having one root and one root canal in most cases., but it may possess two canals and even less frequently two roots and two or three canals. This case report describes a clinical case of mandibular canine with two canals. Human mandibular canines do not present internal anatomy as simple as could be expected. The existence of mandibular canines with more than one root canal is a fact that clinicians thought to keep in mind, in order to avoid failure during endodontic treatment. The presence of a second canal in these teeth leads to difficulties in endodontic treatment. The precise knowledge of the dental root canal system’s anatomy is essential in the success of the root canal therapy, because the failure to detect the accessories canals and the incomplete radicular obturation leads to the infection of the periapical space, which will ultimately result in the loss of the tooth.
348 ESTHETIC MANAGEMENT OF DISCOLOURED PREVIOUSLY TREATED MAXILLARY INCISOR USING INTRACORONAL BLEACHING TECHNIQUE-A CASE REPORT , *Dr. Asha Pius BDS, Dr. Jain Mathew MDS, Dr. Robin Theruvil MDS and Dr. Manju Krishna E.M. BDS
Introduction: Discoloration of the anterior tooth due to trauma or endodontic treatment can cause considerable esthetic compromise to patients. The discoloured anterior teeth can cause significant esthetic concerns. The walking bleach technique is a relatively reliable, fairly simple technique for management of discolouration. Aim: The aim of this report is to depict the successful management of a discoloured central incisor subsequent to endodontic treatment by intracoronal bleaching. Method: Management of the discoloured endodontically treated tooth was performed using sodium perborate (SP).A 30‑year‑old female who had undergone endodontic treatment of the central incisor reported with discoloured maxillary central incisor tooth. The case was managed with “walking bleach technique” using Sodium perborate and water. Results: Proper selection of bleaching agent and technique had resulted in the conservative and successful management of the case. Conclusion: Walking bleaching technique using Sodium perborate can be used as a treatment of choice for nonvital, discoloured endodontically treated cases.
349 NON-AUTOIMMUNE HEMOLYTIC ANEMIA –A RARE COMPLICATION OF ACUTE HEPATITIS B INFECTION , Megha K. Mukundan, Sukdev Manna, Minakshi Dhar* and Rohit Gupta
Hepatitis B infection is quite common infection in this part of North India. The clinical presentation and complications of acute hepatitis B are related to onset and extent of liver failure. Here we report a very rare complication of acute hepatitis B in 61-year-old male patient. He was admitted with features of acute hepatic failure with grade 1 encephalopathy and coagulopathy. Patient was started on Tab Tenofovir 300 mg/day along with supportive and symptomatic treatment. Patient was improving clinically and laboratory parameters also showed improving trend. On day 8 of admission patient had a syncopal attack. Investigations revealed significant drop in haemoglobin level from 15.8 gm/dl to 5.8 gm/dl. Liver function showed improvement except increase in serum bilirubin. Other investigations revealed high LDH, haemoglobinuria, low haptoglobin with peripheral blood smear suggestive of acute haemolysis. Direct Coomb’s test was negative. G6PD values were normal limits. Diagnosis of non-haemolytic anaemia secondary to acute hepatitis B infection was made. Patient was transfused 8 units of packed red blood cells in between in view of low haemoglobin. He was started on oral steroids in view of rapid fall in haemoglobin level despite blood transfusion. Haemoglobin improved over two weeks to 10.7 mg/dl. He is doing well with steady rise in haemoglobin level even after stopping of steroid after gradual tapering over a period of 1 month. According to previously published data acute viral hepatitis especially A, B, E mono or co-infection decreases lifespan of RBCs, but rarely results in severe life threatening haemolytic anaemia and that too in absence of pre-existing blood cell and liver pathology.
350 AUDIT OF DOG BITE AMONG CHILDREN AT A TERTIARY CARE HOSPITAL , Dr. Aabid Raza Ullah*, Dr. Lariab Fatima Dr. Saba Maryam
Background: Animal injuries are common throughout the world. Dog bite injuries stand at the top. Children are the most common victims of dog bites due to limited self-protection and more outdoor activities and mischievous behavior. Objectives: To determine the outcome of dog bite in children. Methodology: This was a cross sectional study that was performed on patients referred or brought to our department directly with serious dog bite injuries. Overall, 26 patients were enrolled during the period of September 2017 to October 2019, admitted in the department of pediatric surgery. Wound management including irrigation, and debridement were done. Antibiotics were given and anti-rabies vaccination was carried out. Skin grafting was done in 4 patients who got full thickness skin loss from scalp due to degloving injury. The outcome was noted. Results: Results were compiled on 26 patients. Most of the patients were males (69.2%), and 5-10 years was the commonest age group, and 46.5% of the patients were having 3-5 wounds and head and neck was the most common area injured, 14 (53.84%) patients presented with punctured and lacerated wounds. Management varied case to case. One patient died due to septicemia. Conclusion: Most of the children with dog bite have age less than 10 years and few results in complications as well. Children should be educated about dog behavior. There should be strict legislation about dog keeping and management including antirabies vaccination. More and more dog centres should be established and stray dogs wiped out.
351 OUTCOME OF DIAGNOSTIC LAPAROSCOPY IN UNEXPLAINED ACUTE ABDOMINAL CONDITIONS , Dr. Saba Maryam*, Dr. Lariab Fatima and Dr. Smavia Aslam
Background: Acute abdomen is a surgical emergency and sometimes portrays a challenge as its cause remains unexplained unless explored. Recently, trend of diagnostic laparoscopy in acute abdominal conditions is growing among surgeons due to its benefits of establishing diagnosis and provision of therapy with minimal invasive approach. Objective: To assess the diagnostic and therapeutic utility of laparoscopic surgery in unexplained acute abdominal conditions. Methodology: Fifty three patients, from September 2018 to June 2019, with unexplained acute abdominal conditions on clinical and radiological assessments were subjected to diagnostic laparoscopy. Therapeutic laparoscopic surgery was offered to all diagnosed cases. Resected specimens were directed for histopathological analysis to confirm diagnosis. All patients were followed up to 3 months. The data was entered and analysis by using SPSS version 20. Results: Accurate diagnosis was established successfully in all patients. The outcome of diagnostic laparoscopy was: uncomplicated acute appendicitis in 31(58.49%) patients, complicated acute appendicitis in 5(9.43%) patients, acute cholecystitis in 1(1.88%) patients, pancreatic necrosis in 1(1.88%) patients, mesenteric adenitis in 2(3.77%) patients, caecal mass in 2(3.77%) patients, dual pathologies in 5(9.43%) patients, and gynaecological emergencies in 6(11.32%) patients. We did not need to convert to open surgery for diagnostic or therapeutic purpose in any case. No significant intraoperative and postoperative complications were observed. All patients were discharged within 2 days after surgery except three cases. There was no mortality. Conclusion: Our initial experience showed that diagnostic laparoscopy in acute abdomen is useful in establishing diagnosis, safe to perform and achieves therapeutic goals in almost all patients.
352 ROUTINE SCREENING OF ACUTE SURGICAL ADMISSIONS FOR COVID-19 AT A SCOTTISH TEACHING HOSPITAL , *Darren J. Porter and Afshin Alijani
The coronavirus pandemic is a global emergency that has led to significant changes in the provision of both elective and emergency surgical care.[1] To-date, Tayside region has had a total of 1470 confirmed cases of COVID-19 in a population of 417470 people (0.35%).[2]
353 SARS CoV 2: THE NEW DISEASE WITHOUT PROPHYLAXIS & TREATMENT , Rajeev Shah*, Reena Mehta, Shaista Saiyad, Parul Sharma, Ashish Mittal and Ramesh Chavada
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1] It was first identified in December 2019 in Wuhan, China, and since spread globally, resulting in an ongoing pandemic.[2,3] The first case may be traced back to 17 November 2019.[4] Common symptoms include fever, cough, fatigue, shortness of breath, and loss of smell and taste.[5,6,7] While the majority of cases result in mild symptoms, some progress to acute respiratory distress syndrome (ARDS) likely precipitated by a cytokine storm, multi-organ failure, septic shock, and blood clots.[8,9,10] The time from exposure to onset of symptoms is typically around five days but may range from two to fourteen days.[511] The virus is primarily spread between people during close contact,most often via small droplets produced by coughing, sneezing, and talking.[5,12,15] The droplets usually fall to the ground or onto surfaces rather than travelling through air over long distances.[6] Less commonly, people may become infected by touching a contaminated surface and then touching their face.[6,12] It is most contagious during the first three days after the onset of symptoms, although spread is possible before symptoms appear, and from people who do not show symptoms.[512] The standard method of diagnosis is by real-time reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab.[16] Chest CT imaging may also be helpful for diagnosis in individuals where there is a high suspicion of infection based on symptoms and risk factors; however, guidelines do not recommend using CT imaging for routine screening.[17,18]
354 INFLUENCE OF TRIGUNATAMAKA AHARA ON MENTAL HEALTH , Dr. Priya Pathak*, Dr. Umesh Shukla, Dr. Rajika Gupta and Prof. T. C. Thakur
Ayurveda the most ancient science of life, practiced in India for thousands of years based on its own unique fundamental principles such as prevention of disease, maintenance of health and promotion of health. Trayopasthamba consists of Ahara (food), Nidra (Sleep) and Brahmacarya (good conducts). Each Upasthamba has its own importance in prevention of disease. Aahara has been considered as the first one which shows its prime importance. Ahara stands for balanced diet and is the first and foremost pillar of Ayurveda. Acharya Charaka has clearly stated, that a daily diet should be of such quality, which not only helps to maintain present well- being but serves as a prophylactic against upcoming disease. This is a very important aspect of preventive medicine as mentioned in Ayurvedic classics. Diseases are mainly result from unhealthy diet and faulty dietary habits, lack of physical activity and lack of awareness. Triguna represents essential energies of the mind. Individual’s personality is genetically determined and dependent on dominance of Triguna. According to Triguna Theory it is hard to change physical constitution, but mental attitude can be molded through the choice of food. Ancient Yogic science classified food in to three basic categories called the Satvik Ahara, Rajasic Ahara and Tamasic Ahara based on their influence on Triguna of mind. Through this paper the effect of Trigunas on mental health is explained and classics will be reviewed. An attempt has been made to explain them in terms of scientific terminology and their relation with Ahara.
355 ESTHETIC MANAGEMENT OF DISCOLOURED PREVIOUSLY TREATED MAXILLARY INCISOR USING INTRACORONAL BLEACHING TECHNIQUE- A CASE REPORT , Dr. Asha Pius*, Dr. Jain Mathew, Dr. Robin Theruvil and Dr. Manju Krishna
Introduction: Discoloration of the anterior tooth due to trauma or endodontic treatment can cause considerable esthetic compromise to patients. The discoloured anterior teeth can cause significant esthetic concerns. The walking bleach technique is a relatively reliable, fairly simple technique for management of discolouration. Aim: The aim of this report is to depict the successful management of a discoloured central incisor subsequent to endodontic treatment by intracoronal bleaching. Method: Management of the discoloured endodontically treated tooth was performed using sodium perborate (SP). A 30‑year‑old female who had undergone endodontic treatment of the central incisor reported with discoloured maxillary central incisor tooth. The case was managed with “walking bleach technique” using Sodium perborate and water. Results: Proper selection of bleaching agent and technique had resulted in the conservative and successful management of the case. Conclusion: Walking bleaching technique using Sodium perborate can be used as a treatment of choice for nonvital, discoloured endodontically treated cases.
356 ROLE OF AGNI IN STHAULYA (OBESITY) – A REVIEW ARTICLE , *Vd. Komal Wasudevrao Bele and Vd. Anil Pansambal
Obesity is one among the major diseases of modern era, increasing in prevalence. Sthaulya (Obesity) is well known from the Samhita period and is considered to be one of the eight undesirable conditions (Ashtau Nindita). It can be caused due to Mandagni as Agni is considered to be responsible for metabolism. Thus, a formed moves within body, further causing Medovruddhi, which produces excessive stoutness. According to modern science, among the many causes one of the causes for obesity is sedentary lifestyle, where there is more intake of fast food and less physical activity as compare to intake. Agni is sole cause for existence of life and its extinction leads to death; its proper maintenance helps to live a long life. It is also cause for colour, strength, health, enthusiasm, plumpness, complexion ojus tejus and various verities of agni and pran. There are four different states of jatharagni .Visham (irregular), teekshna (intenese), Manda (weak or less powered) and Sama (well maintained and regular) states. Among the four different states of Agni Smagni is considerd as normal one, all others are considered as abnormal. Ashtau Ahara Vidhi Vishesh Ayatanas (eight rules for eating) explained in Ayurveda, is only carried out by Samagni. Agni is one of the important and basic phenomena of the life. It should be maintained at any cost to live a disease free life. State of Agni is having dominant role in the manifestation of lifestyle disorders as obesity is considerd as one of the life style disorder. Maintenance of Smagni is essential for the disease free life especially for diseases associated with lifestyle such as sthaulya.
357 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF ABACAVIR, LAMIVUDINE & DOLUTEGRAVIR BY RP-HPLC METHOD , Ponnamalla Jasmine Carey*, Dr. Devanaboyina Narendra and Gadi Vijaya Lakshmi
A simple, Accurate, precise method was developed for the simultaneous estimation of the abacavir, lamivudine and dolutegravir tablet dosage form. Chromatogram was run through STD Agilent C18 150 x 4.6 mm, 5. Mobile phase containing Water: Acetonitrile taken in the ratio 60:40 was pumped through column at a flow rate of 0.8 ml/min. Buffer used in this method was milli-Q Water. Temperature was maintained at 30°C. Optimized wavelength selected was 284 nm. Retention time of Abacavir/Lamivudine/ Dolutegravir were found to be 2.233 min and 2.700,3.426. %RSD of the Abacavir/Lamivudine/ Dolutegravir were and found to be 0.4,0.5 and 0.3 respectively. %Recovery was obtained as 99.89%, 100.0.4%and 100.35% for abacavir/Lamivudine/ dolutegravir respectively. LOD, LOQ values obtained from regression equations of Abacavir/Lamivudine/ dolutegravir were 0.04, 0.11,0.08 and 0.13, 0.33,0.24respectively. Regression equation of Abacavir is y = 37926x + 8085.1, y = 38697x + 13271 of Lamivudine and dolutegravir is y= 4326.9x+194.59. Retention times were decreased and that run time was decreased, so the method developed was simple and economical that can be adopted in regular quality control test in Industries.
358 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF BETAMETHASONE, GENTAMICIN & MICONAZOLE BY RP-HPLC METHOD , Sangaru Madhava Rao*, Dr. Devanaboyina Narendra, Gadi Vijaya Lakshmi and P. Venkata Kishore
A simple, Accurate, precise method was developed for the simultaneous estimation of the Betamethasone, Gentamicin and Miconazole in liquid dosage form. Chromatogram was run through Phenomenex C18 150 4.6 mm, 5. Mobile phase containing Buffer and Acetonitrile in the ratio of 35:65 A was pumped through column at a flow rate of 1ml/min. Buffer used in this method was Water at Temperature was maintained at 30°C. Optimized wavelength for Betamethasone, Gentamicin and Miconazole was 240 nm. Retention time of Betamethasone, Gentamicin and Miconazole were found to be 2.177min, 3.321 min and 2.634 min %RSD of system precision for Betamethasone, Gentamicin and Miconazole. were and found to be 0.8, 0.8 and 0.7 respectively. %RSD of method precision for Betamethasone, Gentamicin and Miconazole. were and found to be 0.4, 0.5 and 0.3respectively. % recovery was Obtained as 99.56%,99.37%,99.16% for Betamethasone, Gentamicin and Miconazole. Respectively. LOD values are obtained from regression equations of Betamethasone, Gentamicin and Miconazole were 0.09ppm, 0.04ppm, 1.96ppm. LOQ Values 0.28ppm and 0.12ppm, 5.93ppm respectively. Regression equation of Betamethasone was y =3415.x + 485.6, Gentamicin was y = 5211.x +876.6 and of Miconazole was y =4497 .x + 7864.
359 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF BETAMETHASONE, GENTAMICIN & MICONAZOLE BY RP-HPLC METHOD , Sangaru Madhava Rao*, Dr. Devanaboyina Narendra, Gadi Vijaya Lakshmi and P. Venkata Kishore
A simple, Accurate, precise method was developed for the simultaneous estimation of the Betamethasone, Gentamicin and Miconazole in liquid dosage form. Chromatogram was run through Phenomenex C18 150 4.6 mm, 5. Mobile phase containing Buffer and Acetonitrile in the ratio of 35:65 A was pumped through column at a flow rate of 1ml/min. Buffer used in this method was Water at Temperature was maintained at 30°C. Optimized wavelength for Betamethasone, Gentamicin and Miconazole was 240 nm. Retention time of Betamethasone, Gentamicin and Miconazole were found to be 2.177min, 3.321 min and 2.634 min %RSD of system precision for Betamethasone, Gentamicin and Miconazole. were and found to be 0.8, 0.8 and 0.7 respectively. %RSD of method precision for Betamethasone, Gentamicin and Miconazole. were and found to be 0.4, 0.5 and 0.3respectively. % recovery was Obtained as 99.56%,99.37%,99.16% for Betamethasone, Gentamicin and Miconazole. Respectively. LOD values are obtained from regression equations of Betamethasone, Gentamicin and Miconazole were 0.09ppm, 0.04ppm, 1.96ppm. LOQ Values 0.28ppm and 0.12ppm, 5.93ppm respectively. Regression equation of Betamethasone was y =3415.x + 485.6, Gentamicin was y = 5211.x +876.6 and of Miconazole was y =4497 .x + 7864.
360 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF DAPAGLIFLOZIN & SAXAGLIPTIN BY RP-HPLC METHOD , Gadi Vijaya Lakshmi* and Dr. Devanaboyina Narendra
A simple, Accurate, precise method was developed for the simultaneous estimation of the Dapagliflozin and Saxagliptin in Tablet dosage form. Chromatogram was run through Std BDS 150 x 4.6 mm, 5. Mobile phase containing Buffer Perchloric acid: Acetonitrile taken in the ratio 50:50 was pumped through column at a flow rate of 1 ml/min. Buffer used in this method was 0.1% OPA. Temperature was maintained at 30°C. Optimized wavelength selected was 220 nm. Retention time of Dapagliflozin and Saxagliptin were found to be 2.266min and 2.805min. %RSD of the Dapagliflozin and Saxagliptin were and found to be 0.9 and 0.6 respectively. %Recovery was obtained as 99.72% and 99.60% for Dapagliflozin and Saxagliptin respectively. LOD, LOQ values obtained from regression equations of Dapagliflozin and Saxagliptin were 0.12, 0.36 and 0.02, 0.06 respectively. Regression equation of Dapagliflozin is y = 20173x + 18271, and y = 4124x + 2572 of Saxagliptin. Retention times were decreased and run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.
361 ASSOCIATION BETWEEN VITAMIN D3 LEVELS AND INSULIN RESISTANCE IN GESTATIONAL DIABETIC PATIENTS OF KERBALA PROVINCE: IRAQ , Hashim Fadhil Al-Tu'ma*, Sura Mohammed Ridha Al-Fakhry, Taha Emad Fadhil Al-Saidey, Zahraa Abdul Kareem Mohammed and Eman Hussein Nasir
Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable severity that occurs during pregnancy. Women with GDM represent a heterogeneous group and are characterized by pancreatic β cell function that is insufficient to meet body insulin needs, probably due to autoimmune diseases, insulin resistance or genetic abnormalities. Objectives: This study aims to examine the levels of 25(OH)D3 in Iraqi women with normal pregnancies and pregnancies complicated with GDM and then to see its association with insulin, insulin resistance and HbA1c levels. Materials and Methods: This cross-sectional study includes three groups: Group I include 25 pregnant gestational diabetes mellitus (GDM) with age range between 24-43 years. Group II include 23 non-pregnant with type II diabetes mellitus (T2DM) with age ranged between 30 – 39 years. Group III include 29 normal pregnant without GDM and T2DM as control group whose age ranged between 20 – 37 years. All these samples were obtained from gynecology and obstetrics teaching hospital / Kerbala health directorates between Sep., 2019 and June, 2020. The body mass index (BMI), fasting blood glucose, insulin, HbA1c% and 25(OH)D3 were measured immediately, while HOMA-IR was calculated from the resultant data. Results: The mean ± SD value of age of GDM group (34.28 ± 6.44) years was significantly higher than that found in group III and less than that found in group II which contain only T2DM (41.65 ± 6.73) years and for BMI group I was non-significantly higher than that found in group II and significantly higher than that found in group III. Fasting blood glucose, glycated hemoglobin, insulin hormone and insulin resistance was obviously higher in GDM group as compared with normal pregnancy group. Serum insulin levels was higher in GDM group (16.78 ± 7.23) μIU/mL as compared with both normal pregnant group III (13.05 ± 4.1) μIU/mL and T2DM group II (14.29 ± 7.68) μIU/mL. Homeostatic model assessment insulin resistance (HOMA- IR) was found of significantly higher in gestational diabetes mellitus (6.06 ± 2.98) as compared with normal pregnancy group (3.11 ± 0.99) and lower that found in T2DM group (6.97 ± 4.55). In our study we have found a high prevalence of deficiency of 25(OH)D3 in overall study sample. The higher deficiency was found in 56% group I followed by T2DM group II which was present in 65% as compared with normal pregnant group III. The serum 25-(OH)D3 levels obtained were lower in patients who were overweight as compared with other individuals of normal pregnancy group. Conclusion: The diagnosis of GDM usually may occurs after the age of 30 years. The observed data indicated that 25(OH)D3 deficiency or insufficiency status was associated with an increased risk of diabetes mellitus and gestational diabetes and higher insulin and insulin resistance as compared with normal pregnancy.
362 MODERN VIEWS ON CORRECTION OF BODY WEIGHT IN PATIENTS OF REPRODUCTIVE AGE WITH OBESITY ANNOTATION , *Umida Musaevna Boborakhimova, Dildora Rakhimovna Khudoyarova and Lola Mirzatullaevna Abdullaeva
Obesity is a serious medical and social problem. Women of reproductive age with obesity and overweight have impaired reproductive system function, complicated pregnancy, childbirth and the postpartum period. These patients have risks of developing somatic and gynecological pathology. Reproductive health in obese women is an urgent problem. Weight loss and metabolic correction have a positive effect on the restoration of ovulatory function in 40% of patients who are overweight. The article presents the recommended methods of treating obesity in women of reproductive age.
363 PHYTOCHEMICAL AND PHARMACOLOGICAL OF RASONA (ALLIUM SATIVUM LINN.): A REVIEW ARTICLE , Dr. Manisha and Dr. Naresh Kumar Garg
Rasona (Allium sativum Linn.) commonly known as ‘garlic’ has been used safely since ancient time as both food and medicine. It is a rich source of several phytochemical and recognised to have significant & wide range of biological activities. The active constituent of garlic includes several sulphur containing compounds (principally thiosulfinate) which, are rapidly absorbed, transformed and metabolized. Thiosulfinate, volatile sulphur compound is responsible for its pungent smell and different biological action. Since centuries garlic has been used traditionally for the management of different disorders. In Ayurveda the garlic is considered as ‘Rasayana’, an important class of drugs reputed to promote health & longevity and therefore, it can be used for the prevention as well as for the management of different disorders. In the United States and Western Europe, garlic is one of the most popular remedies used to reduce various risks associated with cardiovascular disease. Several clinical & experimental studies validated its potential uses in the pathological conditions related to the cardiovascular system, respiratory system, genito-urinary system, gastrointestinal system, hematopoietic system and skin. Garlic can be used in different forms & preparations viz. tablets, capsules, inhalation, beverages, alcohol, macerated in water, fried, cooked in oil, raw, roasted etc.
364 A REVIEW STUDY OF THE ROLE OF KAMDUDHA RAS IN MAHASTROTASA VYADHI , *Dr. Vasavi Totawar (Madurwar) and Dr. Mukund Dive and Dr. Sneha Kubde
Rasashastra is one of the pharmaco-therapeutic branches of Ayurveda which deals with metals and minerals. It incorporates many of the inorganic,herbo- mineral and metallic pharmaceutical preparations namely Kharaliya Rasayana, Parpati Rasayana, Pottali Rasayana and Kupipakwa Rasayana. Kamdudha ras comes under the category of Kharaliya Rasayana. Kharaliya Rasayana prolongs the shelf life of herbal formulations. It enhances the therapeutic efficacy. Kharaliya rasayana also provides bilateral safety and efficacy to both mercury and herbs. Bhavana( levigation) given in Kharaliya Rasayana is helpful for the purpose of bringing about the desired alteration in mentioned drugs. There are many texts in Samhitas, articles and web pages which highlights the uses of Kamdudha Ras. It is used in various vyadhis of Mahastrotasa like Amlapitta, Pittajatisara, Rakta Atisara, Raktapitta etc. In this review article I am trying to explain the mechanism of action of Kamdudha Ras in Mahastrotasa Vyadhi. Kamdudha ras is Shitviryatmak, Raktastambhak and Pittashamak. The effect of Kamdudha Ras appears on the digestive system, Cardiovascular system, Nervous system and Urinary system. It reduces heat in the body, balances acid production in the stomach, reduces inflammation of the organs of the digestive system and lowers the tendency of bleeding.
365 PANDEMIC INFECTIOUS DISEASES W.S.R. TO SANKRAMAK ROGA: A REVIEW BASED ON AYURVEDA SAMHITAS , Dr. Ashwini Kumar Vidyarthi* and Dr. Suraj Khodre
The advancement of science and research increases life span of human being but on the other threat of Sankramak Roga also increasing day by day due to the vitiated state of Vayu, Jala, Doshas & Dhatu. Development of medical system in India started with the early development of civilization and Ayurveda is practiced in India since Vedic period. Various literatures of Ayurveda like Charak Samhita described concept of Janpadodhwansa (mass destruction) and epidemics. Charaka Samhita depicts the role of amalgamation of causative factor like Doshas and Dushyas in relation with occurrence of disease. If these factors multiply by huge exposure of Krimi in very short period of time then it leads spread of diseases on large scale. Sankramak Roga spread from one person to another or from an animal to a person. Vihara, Anindra, stress, pollution and health status is degrading day by day therefore risk of Sankramak roga is also increases. Ayurveda described Sankramak roga, their cause, mode of transmission and their prevention along with treatment modalities.
366 COMPARISON OF METFORMIN WITH INSULIN IN THE MANAGEMENT OF GESTATIONAL DIABETES AT A TERTIARY CARE HOSPITAL , Dr. Smavia Aslam*, Dr. Intikhab Shamshad, Dr. Aabid Raza Ullah
Objective: Purpose of this study is to determine the efficacy of metformin as opposed to insulin in management of gestational diabetes mellitus. Methodology: The study took place in department of Gynecology and Obstetrics, Sheikh Zayed Hospital, Rahim Yar Khan from June 2018 to April 2019. Study design is experimental prospective comparative study. Ethical approval was obtained from Hospital Ethics Committee. Sample was calculated using non probability consecutive sampling technique. Total 770 Patients were randomly divided into two equal groups, group M (metformin) and Group I (insulin). Glycemic control, mode of delivery and associated medical complication were recognized as possible maternal outcomes while congenital anomalies (if any), macrosomia, hypoglycemia, hyperbilirubinemia were the neonatal outcomes assessed by clinical and laboratory investigations. These outcomes were subjected to statistical analysis by using computer software SPSS version 23. Percentages were calculated for dichotomous variables and range, mean and standard deviation was calculated for continuous data. Chi square and t-test were applied to compare the two groups. P value less than 0.05 was considered as significant. Results: Overall 100% (n=770) female patients were included, in this study; divided into two equal groups 50% (n=385) in each i.e. metformin (Group M) and insulin (Group I). Significant difference was found between age (p=0.000), gravidity (p=0.012), gestational age (p=0.000), BMI in early pregnancy (p=0.000), FBS at entry (p=0.000), FBS after treatment (p=0.000), HBA1c at entry (p=0.000), HBA1c after treatment (p=0.000), in groups. Association was found between Preeclampsia (p=0.000), Pre-term birth (p=0.000), Neonatal birth weight>4 (p=0.002), neonatal hypoglycemia (p=0.000), in groups. Conclusion: This study concludes that metformin is as much effective as insulin in management of gestational diabetes mellitus. Metformin when used securely can prove effective as it does not cause any congenital anomalies or maternal or neonatal complications. But insulin still remains the gold standard for treatment of gestational diabetes mellitus.
367 COVID-19 PANDEMIC CAUSING MENTAL STRESS: A CROSS SECTIONAL STUDY TO EVALUATE THE LEVEL OF ANXIETY AND ITS SOURCES AMONG MEDICAL UNDERGRADUATES OF GUJRANWALA MEDICAL COLLEGE , Asad Ali Shan*, Rumaiha Sadia, Iqra Mehmood Malik, Dr Rabia Javed, Safwat Shabbir, Muhammad Hashim Fakhri, Muzaffar Abdullah, Ammar Noor, Muhammad Haris khan, Noor Ul Husnain, Mohammad Talha Murtaza, Ali Imran Chadhar and Malik Azaz Haider
Background: Covid-19 has emerged as an unexpected pandemic at the end of 2019. Being new to the world it brings about uncertainties and psychological stress, anxiety being a part of it. Medical students are a high-risk group prone to developing anxiety and the purpose of our study is to determine the severity of this anxiety and its sources. Methodology: An observational cross-sectional study was conducted among 300 students from 1st year to final year of Gujranwala medical college. A self-reporting questionnaire consisting of GAD-7 scale was sent online to the participants and the data was analyzed using SPSS version 22. Quantitative variables were expressed using frequencies and percentages. Graphs and tables were utilized where needed. Results: A total of 88 (32%) out of 272 students exhibited minimal anxiety, 105 (38%) showed mild anxiety, 54 (19%) moderate anxiety and 25 (9%) severe anxiety. The overall anxiety level of the participants was „mild‟ with a GAD-7 mean score of 7.188 +/-3.49. Causative factors of anxiety included fear of being infected (53.80%) and bringing infection home (68.4%), stress regarding disconnection with friends and family (56.80%) and delay of the academic year (72.06%), worries related to effect on academic performance (69.12%) and acquisition of clinical skills (80.88%) Conclusion: Medical students are indeed facing anxiety and in these unforeseeable circumstances there is a dire need of counseling and provision of moral support to the students in order to maximize their performance in near future.
368 CLINICAL AUDIT OF PATIENTS WITH CHOLELITHIASIS , Dr. Intikhab Shamshad*, Dr. Alina Altaf, Dr. Kashif Fareed
Background: Gallstone is a major health problem worldwide. Cholelithiasis prevalence in Pakistan is about 15 to 20 %. Common risk factors for gallstones formation are old age, female, obesity and diabetes mellitus etc. Aim of study: To evaluate the clinical profile of patients with Cholelithiasis. Methodology: It is a cross-sectional study done at Jinnah Hospital Lahore from August 2017 to January 2018. We enrolled 75 patients in the study of age more than 30 years of age diagnosed as Cholelithiasis to study their clinical profile. All diagnosed patients of gallstones through ultrasound were admitted in ward. Clinical presentation like signs, symptoms and preoperative ultrasound findings of all patients were noted on a performa. Results: Total 75 were admitted studied with the history of Cholelithiasis. The mean age of patient was 45.5±6.48 years and duration of disease was 6.2±2.53. We found that 75% patients in our study were female. Almost 65% patients were from rural background. The clinical features observed were fever 32%, nausea 45%, vomiting 38% jaundice 18%, abdominal pain 92% and dyspepsia 26%. The ultrasound findings among patients were single stone 15%, multiple stone 32%, bile duct stones 15%, thickening of gallbladder 40%, and bile duct dilation 14%. 70% of patients managed by laparoscopic cholecystectomy and 30% by open cholecystectomy. Biochemistry of gallstone was, cholesterol stone 28%, mixed 54% and pigmented 18%. Conclusion: We concluded that incidence of gallstones is high forty year of age with female preponderance. The most common presenting complain was pain and tenderness at right hypochondrium. Ultrasound proved to be best screening test for Cholelithiasis.
369 CLINICAL PROFILE AND OUTCOME OF ACUTE MYOCARDIAL INFARCTION IN ELDERLY , Dr. Muhammad Ahsan Shafiq, Dr. Muhammad Waqas, Dr. Abdullah Mushtaq, Dr. Alina Ajmal, Dr. Khurram Irshad, Dr. Muhammad Irfan Jamil*
The aim of our study was to evaluate clinical profile and in-hospital outcome of patients presented with Acute Myocardial Infarction. Methodology: It was a descriptive cross sectional study conducted at Department of Cardiology, Holy Family Hospital Rawalpindi. Duration of study was 6 months from February 2018 to July 2018. We enrolled 90 patients who fulfilled inclusion criteria. Patients with stable or unstable angina, congestive heart failure (CHF), congenital heart diseases, cardiomyopathies and valvular heart diseases were excluded from the study. Informed consent was taken from all the patients. Patients presenting to our emergency department with symptoms of acute myocardial infarction –chest pain, giddiness, shortness of breath, epigastric pain- were evaluated with 12 lead resting ECG and cardiac enzymes (CK MB and Trop I). Results: There were total 90 patients included in our study. Out of 90 patients, 46 (51.1%) were in 55-64 years of age group. Mean age in our study was 63.5±5.49 yrs. There were 59 (65.5%) male and 31 (34.5%) female with male to female ratio of 1.9:1. Chest pain 67 (74.4%) was the most common clinical symptom. Approximately 36.5% patients presented within 12 hours of onset of symptoms. And only 30 (33.33%) were thrombolysed. Smoking 54 (60%) was the most common risk factor involved in our study. Sixty three (70%) patients were diagnosed STEMI on ECG, while 18 (20%) NSTEMI at the time of presentation. We found that anterior wall MI 25 (30%) was the most common type of infarction. The most common post MI complication was Arrhythmia in 18 (20%) patients. The overall mortality rate in our study was 17 (18.8%). Conclusion: There was male preponderance in our study. Almost half of the patients belonged to the age group 55-64 yrs. Though the chest pain is the commonest symptom of myocardial infarction, but large amount of the elderly patients present with atypical symptoms such as Dyspnea, drowsiness, nausea perspiration confusion and epigastric pain. The high mortality rate (18.8%) in our study was mainly due to late presentation of patient to the hospital. Only thirty percent of patient were thrombolysed. It is important to avoid delay in the transit time from home to hospital, since thrombolysis in elderly confers more of a survival advantage. Higher frequencies of smoking, diabetes, hypertension and dyslipidemia was observed.
370 ANTIHYPERTENSIVE DRUGS PRESCRIPTIONS PATTERN AT A TEACHING HOSPITAL , Dr. Ammara Muzaffar*, Dr. Khuzaima Shakir and Dr. Labika Zulfiqar
Background: Hypertension has been managed according to several guidelines, which serve as reference standards. Conversely, countless physicians apply their own knowledge and do not follow the usual guidelines. Objective: To assess the pattern of antihypertensive drugs prescribed at Surayya Azeem Teaching Hospital, Lahore. Methodology: This cross study was conducted from January to August 2018 on 200 outdoor hypertensive patients with and without, diabetes mellitus and asthma. Information obtained from patients included age, sex, economical status, history of diabetes mellitus, asthma and number and classes of antihypertensive medications used. The data collected was analyzed statistically, by using SPSS version 20. Results: It was observed that 38% of hypertensive patients on mono-therapy were controlled by CCB while 28% by ARB, 20% by ACEI and 14% by beta blockers and 78% of Hypertensive patients on polytherapy were prescribed combination of CCB+ARB while 18% ARB+D and 4% CCB+ARB+D. In diabetes group, 32% of hypertensive patients with diabetes mellitus were prescribed CCB while 30% CCB+ARB, and 6% beta blockers. In asthma Group 56% of hypertensive with asthma was treated with CCB, 22% with ARB, 9% with CCB+ARB, 9% with ARB+D and 4% with ACE inhibitors. The most commonly prescribed drugs were amlodipine, lisinopril, losartan, valsartan, and hydrochlorthiazide. Conclusion: The prescribing pattern for treatment of hypertension alone and with diabetes mellitus or asthma, in Surayya Azeem Teaching Hospital, Lahore, was found as per JNC8 and NICE guide lines. Primary care physicians can control their hypertensive patients with drugs mentioned above alone or in combinations with confidence.
371 CLINICAL PROFILE AND MANAGEMENT OF DIABETIC FOOT AT A TEACHING HOSPITAL , Dr. Labika Zulfiqar*, Dr. Khuzaima Shakir and DR. Ammara Muzaffar
Background: In diabetes mellitus involvement of foot with infection, neuropathy and vascular involvement is a diabetic foot. It is a common problem. Objective: To find the pattern of diabetic foot infection in a tertiary care unit and its surgical solution. Methodology: This was a descriptive study conducted at a surgical unit in Surayya Azeem Teaching Hospital, Lahore. It included 32 cases suffering “diabetic foot” admitted from July 2018 to January 2019. All adult patients regardless of sex and age were involved in the study. Results: There were 32 patients presented with diabetic foot and 29 (90.6%) were male. Only eighteen were known diabetic. Smokers were 11 (34.4%). The right foot was involved in 19 (59.4%). The disease was advance as Wagner Grade 1, in 3 (9.4%), Grade 2, 5 (15.4%) Grade 3, 16 (50%) and beyond the grade were eight patients. Ulcer size was less than 4 cm in 2 (6.25%). The infection was superficial in 2 (6.25%), subcutaneous in 13 (40.6%) and deep in 23 (71.9%) patients. In 5 patients Rays amputation was done, forefoot amputations in 2, below knee amputations in 11, above knee amputation in five patients. Two patients were managed conservatively, and eight were subjected to significant debridement of leg and/ thigh and submitted to the Plastic Surgery department for plastic procedures. Conclusion: We concluded that infection is the major cause of infected foot in our study. The below knee amputations, above knee amputations and Rays' amputations, were the common type of surgeries performed in our study.
372 AUDIT OF LAPAROSCOPIC CHOLECYSTECTOMY AT A TERTIARY CARE HOSPITAL , Dr. Muhammad Tahir*, Dr. Muzna Ali Khan and Dr. Muhammad Rassan
Objective: To evaluate the clinical practices and outcome of laparoscopic cholecystectomy at our institute. Methodology: This was a cross sectional study, conducted at Surgical Unit II, Sheikh Zayed Hospital, Lahore, from May 2019 to October 2019. Sample size: 100 patients undergoing standard laparoscopic cholecystectomy selected by non probability sampling. All the patients of laparoscopic cholecystectomy during the study period having a clinical diagnosis of acute and chronic cholecystitis were included, whereas patients who had previously undergone midline abdominal operations, ventral hernias, with evidence of common bile duct pathology, having bleeding disorders and hepatitis were excluded. Study variables were operating time, duration of hospital stay, frequency of operative, and postoperative complications. Results: There were 85 females and 15 males. Mean age was 40 ± 1.2 years. In this study, 68% patients were having chronic cholecystitis due to Cholelithiasis whereas 32% were having acute cholecystitis. Abdominal ultrasound showed multiple stones in 82% and single stone in 18% patients. Adhesions in 30%, Mucocele in 1% and empyema in 2% patients was reported. Gall bladder was perforated in 12% patients and 8% patients converted to open procedure. The mean operative time for laparoscopic cholecystectomy was 71.2+ 2.6 minute. The postoperative complications were; wound infection in 4%, shoulder pain 1% and surgical emphysema 1%. The mean hospital stay was 1.38 days. Conclusion: Laparoscopic Cholecystectomy proved a safe procedure in term of operative and postoperative complications in our setup.
373 FREQUENCY OF RETINOPATHY IN PATIENTS WITH TYPE ІІ DIABETES MELLITUS , Dr. Muhammad Rassan*, Dr. Muzna Ali Khan and Dr. Anum Asif Malik
Background: Diabetes mellitus is the most common endocrine disorder in the world and the incidence of diabetes mellitus is increasing day a day. Among its several vascular complication, retinopathy is devastating micro vascular complication and leading cause of preventable acquired blindness. Objective: Aim of this study was to determine the frequency of diabetic retinopathy among newly diagnosed type II diabetic patients presents at Nishtar Hospital Multan. Material and Method: Total 200 patient with recently diagnosed type II diabetes mellitus with age range from 35-65 years were enrolled in the study. Study was conducted at Diabetic OPD, Nishtar Hospital Multan in 6 months duration from August 2017 January 2018. Participants were also interviewed and examined in order to determine demographic characteristics and medical history. Patients with type I diabetes, hypertension and h/o previous eye surgery were excluded from the study. Fundoscopic examination was performed by consultant ophthalmologist after taking informed consent on all the patients and presence or absence of retinopathy. Results: There were total 200 patients in this study with age ranges age ranges from 35-65 years. The mean age was 46.41 ± 8.20 years. In our study we found that majority of the patients i.e. 88 (44%) were between 46 to 55 years of age. Out of 200 cases, 125 (62.5%) were male and 75 (37.5%) were females with male to female ratio of 1.6:1. After investigating we found that 138 (69%) patients were having diabetes for more than 4 months duration. 101 (50.5%) diagnosed diabetic patients were having monthly income more than twenty thousand. All the selected patients were then undergone fundoscopic examination performed by consultant ophthalmologist for diagnosis of diabetic retinopathy and we concluded that diabetic retinopathy was present in 41 (21.5%). Conclusion: This study concluded that the frequency of diabetic retinopathy in recently diagnosed type II diabetes mellitus was 21.5% which is relatively high and emphasizes the detailed ophthalmic examination of each patient at the time of diagnosis of diabetes.
374 STUDY REGARDING RESISTANT HYPERTENSION IN PATIENTS PRESENTING AT TEACHING HOSPITAL , Dr. Muhammad Siddique Akbar*, Dr. Muhammad Husnain and Dr. Muhammad Tahir
Objective: To evaluate the resistant hypertension in hypertensive patients presenting at Tertiary care center. Material and methods: This cross sectional consisted on 150 hypertensive patients and conducted at Department of Medicine, Sheikh Zayed Hospital Rahim Yar Khan from January 2019 to June 2019. Hypertension was considered as resistant hypertension when hypertensive patients managed with a combination of minimum 3 optimally dosed antihypertensive drugs of different classes, one of which ideally is a diuretic but having blood pressure 140/90mmHg (assessed on clinical examination, history and medical record) with patient’s good compliance with medication. Results: Total 150 hypertensive patients were selected for this study. Mean age of the patients was 56.45 ± 9.63 years, mean Systolic blood pressure was 131.66 ± 26.62 and mean diastolic blood pressure 83.90 ± 14.6. Resistant hypertension rate was 39 (26%) in 150 hypertensive patients. Conclusion: Findings of this study revealed that female hypertensive patients were victim of resistant hypertension as compared to male hypertensive patient. Age group of 56 to 70 years were most affected age group.
375 TREND OF MEDICINE PRESCRIPTION IN STABLE ANGINA AT TERTIARY CARE UNIT , Dr. Anum Asif Malik*, Dr. Muhammad Husnain and Dr. Muhammad Siddique Akbar
Background: Stable angina is widespread diseases in Pakistan so; this study was designed to evaluate the prescribing trends and to find out the most prescribed drug in Stable angina in public sector hospital Multan, Pakistan and assessing its prevalence in both genders. The purpose of the study was to identify the therapeutic agents being prescribed majorly in Pakistan and to analyze that whether the current prescription patterns are in accordance with evidence based guidelines. Materials and Methods: A cross-sectional study was conducted from January-2019 to April-2019, through collection of data from prescriptions of patients suffering from stable angina in public sector hospitals of Multan Pakistan. Data observations from the total 200 prescriptions collected from the hospitals of Multan graphically demonstrated the trends of drug classes per prescription. Results: The study identified that in the treatment of stable angina Antiplatelet are the most frequently prescribed drug class in Multan and adjacent areas. Followed by CCBs on 2nd rank and nitrates on 3rd rank, ACE inhibitors and ARBs on 4th number, after which statins occupy the 5thposition, lastly comes the position of beta blocker i.e. 6th and diuretics are the least prescribed class. Results: The study identified that in the treatment of stable angina Antiplatelet are the most frequently prescribed drug class in Multan and adjacent areas. Followed by CCBs on 2nd rank and nitrates on 3rd rank, ACE inhibitors and ARBs on 4th number, after which statins occupy the 5thposition, lastly comes the position of beta blocker i.e. 6th and diuretics are the least prescribed class. Conclusion: The anti-platelet blocker drugs were the most prescribed drug class followed by calcium channel and vasodilators occupying the second and third rank respectively. The study also revealed that men are 1.5 times more vulnerable to the development of angina than the females. The study is also showing sound evidence that there is need to follow guidelines for proper treatment.
376 OBSERVATIONAL STUDY REGARDING HEPATITIS B & C POSITIVE BLOOD DONOR’S PROFILE , Dr. Shiena*, Dr. Kinza Javaid, Dr. Adeen Shafey
Background: Viral Hepatitis B and C is a public health problem and is spreading at intense speed in all the population strata. Objective: The purpose of this study was to observe features of hepatitis B and hepatitis C +ive blood donors. Methodology: This cross sectional descriptive study was conducted from June to November 2019 at blood bank, Nishtar Hospital Multan. Blood screening was done by ICT-kit and PCR test methods. Both voluntary and replacement donors who were declared as +ive from the blood bank were selected for interview through preformed questionnaire after taking informed consent. The sample size of 220 blood donors was taken including both genders. The characteristics concerned with their personal profile, educational status, vaccination status, medical treatment received in the past, living habits, family history of hepatitis B and C were included. The data was collected and analyzed. Results: The survey found that 106 (48.18%) were illiterate and (52.72%) were workers. A majority of 184 (83.63%) responded that they could not be vaccinated against Hepatitis B again and about half, 112 respondents (50.90%) had a history of Hepatitis C case in their family. There were large number of respondents 172 (78.18%) who do not bring their own new disposable syringes for injection therapy at quacks clinics. Conclusion: The blood donors who were detected to be positive for hepatitis B or C were having following characteristics: Majority belonging to rural areas, <50years unmarried males, poor social class, no hepatitis B vaccination, not using new syringes for treatment by quacks very frequently.
377 ASSESSMENT OF THE SOCIAL FACTORS ASSOCIATED WITH GERIATRIC DEPRESSION IN ELDERLY PEOPLE , Dr. Adeen Shafey*, Dr. Kinza Javaid and Dr. Shiena
The aim of our study to evaluate social factors responsible for depression in elderly. Methods: It is a descriptive case series study performed at Nishtar Hospital Multan. We included 385 patients in our study. Data was gathered through questionnaires filled out during the interview. We analyzed data using SPSS version 18. Results: Urbanization is the highest factor of depression in elderly people between the age of 60-65 yrs. Joint family system is the next social factor (73%). Some other factors, like their past(70%), traumatic events in their life(58%), living a retirement life(61%), unemployment(55%), smoking habit(61%), sleep disorders(54%)are also responsible for depression in elderly patients. Conclusion: Depressing symptoms were predominant among hospitalized old age patients and independently associated with intellectual decline, poor family function and weakness. Some other factors that are responsible for geriatric depression include living alone, marital status, sleep disorders, income status, no physical activity etc.
378 CASES OF ACUTE POISONING PRESENTING IN EMERGENCY DEPARTMENT , Dr. Tuba Khalid*, Dr. Komal Tariq, Dr. Madiha Chisti
Objective: Acute poisoning is one of the most common reason of hospitalization. Chemicals, medicines and environmental agents are the main causes of poisoning worldwide. Acute poisoning cases are responsible for significant morbidity and mortality, which has drawn the world attention. The type of poison used depends on various factors like the geographical area, social, financial and educational status etc. Thereby purpose of current study was to access risk factors, survival and mortality of acute poisoning cases presented at Sheikh Zayed Hospital Rahim Yar Khan. Methodology: This is hospital based descriptive cross-sectional study of 155 patients admitted in medical emergency due to acute poisoning. Study duration was 6 months from May 2019-October 2019. Patient of either gender with age above 14 were included by Non-probability convenient sampling method. Demographics, nature of poison and clinical profile (mode of poisoning, clinical presentation and mortality rate) were studied. The collected data was presented as frequency and percentages. Results: Among 155 enrolled patients, there were 65 (41.9%) males and 90 (58.1%) females. The minimum age of patient was 15 years with mean age of 28.52±9.23 years. Majority 44.5% (69) of the patients were in age group of 15-25 years. We found that majority of the patients 21.2% (n=33) presented with Paraphenylene diamine (kala pathar) followed by 18% (28) patients with organophosphates and 10.3% (16) patients with Aluminum phosphide, 10.3% (16) with benzodiazepine, 10.3% (16) with Methanol (alcohol) and in 10.9% (17) patients the cause of poisoning was unknown. Survival and mortality rates in our study were 76.1% and 23.9% respectively. Conclusion: Acute poisoning is one of the most frequent medical emergency. These patients needs multidisciplinary approach, ICU care, and good knowledge of toxicology of attending doctor. Most of our patients were young. The commonest poison ingested was with Paraphenylene diamine (kala pathar) followed by organophosphates, Aluminum phosphide, benzodiazepine and Methanol (alcohol). Suicidal intention was the main reason for acute poisoning.
379 HEALTH RELATED BEHAVIOUR AND LIFE STYLE SURVEY OF MEDICAL STUDENTS , Dr. M. Wisam Mubashir*, Dr. Komal Tariq, Dr. Tuba Khalid
Background: A regular habit is essential for the preservation of health because healthy body has healthy mind. Objective: To determine the health related behaviour and lifestyle of the 1st Year MBBS students of Sheikh Zayed Hospital, Rahim Yar Khan. Material and Methodology: Cross-sectional observational study of 170 students was done in Sheikh Zayed Hospital, Rahim Yar Khan with their informed consent. A questionnaire was designed and data was collected in 30 days. Data was analyzed by Microsoft Excel version 2017. Results: A total of 170 students surveyed, 90 (52.9%) males and 80 (47.1%) females; students that took good care of their personal hygiene (95%) had regular sleep pattern of approximately 6-7 hours (45.3%) and those who performed physical activity for approximately two and half hours/ week (71.2%), had good eating habits (whom took fruits, milk, regular meal time) (90%). Conclusion: Most of the students had good personal hygiene and eating habits. Physical activity performed was adequate but there was room for improvement. Sleeping patterns were distribution.
380 ISOTRETINOIN: A POTENTIAL TREATMENT FOR COVID-19 , Ahmed M. Abbas*, Islam M. Ebrahim, Abdelrahman G. Ramadan and Alaa Rashad Ali
The emergence of coronavirus disease-2019 (COVID-19) pandemic and its catastrophic consequences resulted in extreme demand for treatment. Nevertheless, it requires a relatively long time to approve new drugs to be used on humans. Therefore, researchers are reconsidering widely available and already approved drugs to be used in the treatment of COVID-19. This review illustrates the promising effect of isotretinoin in the treatment of SARS-CoV-2 owing to its ability to reduce Angiotensin Converting Enzyme (ACE2) receptor expression and its impact on immunity, androgen receptors, and respiratory diseases.
381 NIGELLA SATIVA, NATURAL HONEY, PROBIOTICS AND PARAPROBIOTICS: COULD THEY HELP IN THE TREATMENT OF COVID-19 INFECTION? , Ahmed M. Abbas*, Ghada R. Fathalla, Walaa R. Fathalla, Asmaa S. Shaltout, Fatma M. Helbawi, Heba Allah Nashaat, Menna Allah Nashaat, Mostafa H. Abdelsalam and Emad Zarief Kamel
Coronavirus disease-2019 (COVID-19) pandemic emerged in December 2019 resulted in extreme demand for treatment. This review summarizes the potential effect of nigella sativa, natural honey, probiotics and paraprobiotics in the treatment of COVID-19.
382 OUTCOMES OF LABOUR OF NUCHAL CORD , Dr. Ansam Layth Abdulhameed* and Dr. Rozhan Yassin Khalil
Background: The nuchal cord is described as the umbilical cord around the fetal neck. It is classified as simple or multiple, loose or tight with the compression of the fetal neck. The term nuchal cord represents an umbilical cord that passes 360 degrees around the fetal neck. Objective: To find out perinatal outcomes in cases of labour of babies with nuchal cord and compared with other cases without nuchal cord. Patient and Methods: The prospective case-control study was conducted in maternity teaching hospital centre in Sulaimani / Kurdistan Region of Iraq, from June 2018 to April 2019. Cases of study divided into two groups. First group comprised of women in whom nuchal cord was present at the time of delivery they were labelled as cases. Second group was a control group composed of women in whom nuchal cord was absent at the time of delivery. Results: This study included (200) patients, (100) women with nuchal cord in labour. (59%) of the cases of nuchal cord in age group (20-29) years, (40%) of them were primigravida, delivery modes for women with nuchal cord were mainly normal vaginal delivery (76%) and cesarean section (24%). Causes of caesarean section were meconium stain liquor (33.3%), fetal distress (29.2%). (50%) of nuchal cord more than (60) centimetre in length, (74%) of neonate with low apgar score at first minute but (3%) of neonate have low apgar score after five minutes, (19%) of neonate were admitted to neonatal intensive care unit and fetal stillbirth was observed for only one neonate with nuchal cord, but no observed any early neonatal death. The results were compared with a normal umbilical cord cases during labour. Conclusion: Nuchal cord occurs mainly in primigravida between (20-29) years age group. A length of cord is highly significant relation with nuchal cord. Nuchal cord lead to increase meconium stain liquor and associated with increase probability of operative delivery and associated with low apgar score of neonate at first minute and increased admition to neonatal intensive care unit. This suggests increase neonatal morbidity but not associated with neonatal mortality.
383 CLINICAL PROFILE AND OUTCOME OF ACUTE MYOCARDIAL INFARCTION IN ELDERLY , Dr. Muhammad Ahsan Shafiq*, Dr. Waqas, Dr. Abdullah Mushtaq, Dr. Alina Ajmal, Dr. Khurram Irshad, Dr. Muhammad Irfan Jamil
The aim of our study was to evaluate clinical profile and in-hospital outcome of patients presented with Acute Myocardial Infarction. Methodology: It was a descriptive cross sectional study conducted at Department of Cardiology, Holy Family Hospital Rawalpindi. Duration of study was 6 months from February 2018 to July 2018. We enrolled 90 patients who fulfilled inclusion criteria. Patients with stable or unstable angina, congestive heart failure (CHF), congenital heart diseases, cardiomyopathies and valvular heart diseases were excluded from the study. Informed consent was taken from all the patients. Patients presenting to our emergency department with symptoms of acute myocardial infarction –chest pain, giddiness, shortness of breath, epigastric pain- were evaluated with 12 lead resting ECG and cardiac enzymes (CK MB and Trop I). Results: There were total 90 patients included in our study. Out of 90 patients, 46 (51.1%) were in 55-64 years of age group. Mean age in our study was 63.5±5.49 yrs. There were 59 (65.5%) male and 31 (34.5%) female with male to female ratio of 1.9:1. Chest pain 67 (74.4%) was the most common clinical symptom. Approximately 36.5% patients presented within 12 hours of onset of symptoms. And only 30 (33.33%) were thrombolysed. Smoking 54 (60%) was the most common risk factor involved in our study. Sixty three (70%) patients were diagnosed STEMI on ECG, while 18 (20%) NSTEMI at the time of presentation. We found that anterior wall MI 25 (30%) was the most common type of infarction. The most common post MI complication was Arrhythmia in 18 (20%) patients. The overall mortality rate in our study was 17 (18.8%). Conclusion: There was male preponderance in our study. Almost half of the patients belonged to the age group 55-64 yrs. Though the chest pain is the commonest symptom of myocardial infarction, but large amount of the elderly patients present with atypical symptoms such as Dyspnea, drowsiness, nausea perspiration confusion and epigastric pain. The high mortality rate (18.8%) in our study was mainly due to late presentation of patient to the hospital. Only thirty percent of patient were thrombolysed. It is important to avoid delay in the transit time from home to hospital, since thrombolysis in elderly confers more of a survival advantage. Higher frequencies of smoking, diabetes, hypertension and dyslipidemia was observed.
384 TALUS ENUCLEATION: A CASE REPORT , Amine EL Maqrout*, Mouad Beqqali Hassani, Moncef Boufettal, Reda Lah Bassir, Kharmaz, M. O. Lamrani, M. Mahfoud, A. EL. Bardouni and M. S. Berrada
Enucleations of the talus are rare and serious traumatic injuries. They have a poor functional prognosis since they are complicated, in the majority of cases, by osteonecrosis of the talus. We report a case of anteromedial enucleation of the open right talus type II of Cauchoix in a young adult, 27 years old, following a work accident, by indirect mechanism. The patient benefited urgently from a reduction in dislocation by external maneuvers with repair of the capsuloligament elements. The slope was stabilized with a transplant foot nail. After 1 year of follow-up, the ankle was painless, stable and of satisfactory mobility. Without radiological signs of necrosis.
385 BEHAVIORAL EVIDENCE OF ANTIDEPRESSANT-LIKE ACTIVITY OF CASSIA SIEBERIANA EXTRACT IN MICE , Bakou Niangoran François*, B. A. Abdoulaye, Diabate D. and Atayi E.
Objective: The present study was designed to evaluate the acute and chronic behavioral and antidepressant effects of hydro alcohol extract of stem bark of Cassia sieberiana in standardized mice models of depression. Materials and Methods: hydro ethanolic extract of stem bark from Cassia sieberiana were prepared, and phytoconstituents were determined using appropriate chemical analytical methods. Animals were divided into five groups (n=5/group): The control group received vehicle (saline water 0,1ml/mouse). Amitriptyline (20mg/kg b.w., IP) was used as the positive control or standard group while the treated mice received CS (100, 200, and 400mg/kg body weight i.p). In the acute treatment study, a single dose was administered 30 min prior to testing. For the chronic treatment study, a single dose was administered daily for 14 days. In the chronic dose study, the behaviors of all groups were assessed for antidepressant activity 30 min after the last treatment dose on the 14th day. Different standardized depression models were used for behavioral tests to evaluate the antidepressant activity, such as forced swim test (FST), and tail suspension test (TST) test. Results: the preliminary pharmacological screening with acute dosing exhibited the antidepressant activity of CS, but its antidepressant activity was more enhanced after repeated dosing. In comparison with the acute studies, chronic dose studies displayed a significant antidepressant manifestation in the behavioral patterns when compared to the vehicle controls. Conclusion: The results obtained in this work suggest that the hydro ethanolic extract of stem bark from Cassia sieberiana may possess an antidepressant activity.
386 NANO-MATERIALS: A SCIENTIFIC APPROACH TO VALIDATE AN ANCIENT DOSAGE FORM THE “CALX (KUSHTA) IN UNANI MEDICINE” , Talha Mushtaq* and Abdul Hannan
Nanotechnology is an innovative scientific technique in the 21st century. By analyzing the connection between nanotechnology and natural medicine, the utilization of Nano innovative strategies can be improving bioavailability of Unani medications. It is demonstrated that nanotechnology is one of the fastest, the most potential and the extensively high and new innovative procedure in the present period, and it greatly promotes the improvement and bioavailability of Unani/herbal drugs. It is noted that 80% of the total population has faith in herbal medications, mainly plant-based medications for their necessary healthcare. Unani medications generally introduce in the market in conventional dosage structure but, now different rational methodologies of Nanotechnology are being built up now a day to deliver natural medicine because of their poor rate of absorption and target explicit approach. In Unani Medicine. Kushta (Calx), the most ancient form of Nano-medicine is utilized since 1000 BC. The majority of the Plant actives are ineffectively absorbable in view of their hydrophobic behavior. This nature of constituents leads to reduced bioavailability and required repeated administration or increased dose, and thus limits the clinical use of Unani medications. Unani Medicine has the technique to change over them either into carbonates or oxides. The oxide structure is actually known as Kushta (Calx) and the procedure of transformation is known as Taklees (calcination). The breakthrough in this respect will be accomplished from the exploration of the nanomization of Unani medications against malignancies and various other disorders.
387 ANTITUMOR POTENIAL OF MANGANESE NANOPARTICLES , Dr. Eman Abuheiba*, Sawsan M. El-Sonbaty, Nahed Abdel-Samed and Eman Kandil
This study aimed to evaluate the antitumor activity of manganese nanoparticles in vitro and in vivo in the management of hepatocellular carcinoma induced in rats. MnNPs were characterized by means of transmission electron microscopy TEM and MnNPs nanoparticles are of size range between 32.67-190.1 nm. In vitro study of Manganese nanoparticles on HepG2 revealed IC50 of 21.5mM .The in vivo efficacy of manganese nanoparticles was evaluated by measuring the antioxidant activities such as superoxide dismutase activity SOD and malondialdehyde level MDA against oxidative stress caused by diethylnitrosamine (DEN) in rates liver tissues. This treatment significantly improved the alanine aminotransferase (ALT) activity and total protein compared to DEN group. Results showed that manganese nanoparticles MnNPs were effective in treatment of HCC induced by diethylnitrosamine (DEN) in rats. So manganese nanoparticles MnNPs can serve as a good therapeutic agent for the treatment of hepatocellular carcinoma, and deserve further studies in the future.
388 AVULSION FRACTURES OF THE TIBIAL SPINES IN ADULTS: A REPORT ON A CASE , Mouad Beqqali Hassani*, Amine EL Maqrout*, Ayoub Mjidila, Moncef Boufettal, Reda Allah Bassir, Mohamed Kharmaz, Moulay Omar Lamrani, Mustapha Mahfoud, Ahmed EL. Bardouni and Mohamed Saleh Berrada
The avulsion fracture of the tibial spines is a common lesion among adolescents but rare among adults, resulting in discontinuity of the anterior cruciate ligament. The classification of Meyers and Mac Keever modified by Zaricznyj is the most used. The treatment will depend on whether or not the insertion of the anterior cruciate ligament is moved to the tibial plateau. Orthopedic treatment gives excellent results for stage I. Surgical treatment is imperative for stages III and IV. As for Stage II, it will be a case-by-case decision. This fracture can give complications that must be prevented. We present the clinical observation of a young adult who has a tibial spines’ fracture, their diagnostic and therapeutic management with review of the literature.
389 UTILIZATION PATTERN OF ANTI-MALARIA DRUGS BY CAREGIVERS FOR TREATMENT OF MALARIA IN CHILDREN UNDER FIVE YEARS IN IMO STATE, NIGERIA , Udujih O.G., Ukaga C.N., Udujih H.I*., Iwuala C. C., Udujih O. S.
The utilization pattern of anti malaria drugs in the treatment of childhood malaria was studied with the aim of investigating the influence of education and occupation on choice of malaria drugs. The study was carried out between September 2005 and January 2008 in two Local Government Areas (LGAs) of Imo State by administration of structured questionnaire through household surveys of caregivers. The result showed that out of the 4093 respondents, the most commonly used drugs during the period of survey were Chloroquine(13.6%), Malareich (11.4%), Fansidar(10.1%), Artesunate(8.3%), Amodiaquine(7.8%), Amalar(7.7%), Alaxin (7.6%)And Maloxine (7.6%). Overall, the highest number of respondents using monotherapy was among those with primary level education. The utilization of anti-malarials in relation to occupation of caregivers showed that Malareich was most used among Civil Servants (17.7%), Traders (14.9%) and Nurses (11.6%) while Fansider (15.7%) was used among Teachers. The Artemisinin combination therapy (ACT) was most used by Teachers while momotherapy was most preferred by Nurses (46.4%). There was variation in choice of drugs among respondents in the two LGAs however, choice of anti-malaria drug in relation to educational levels of respondents was not statistically significant (P=0.38) while it differed significantly (P< .05) in relation to occupational groups. In light of these findings, it is imperative to monitor and inform caregivers on the proper anti-malaria therapies through more targeted and strategic programs.
390 SLOW ACCOUTUMANCE PROTOCOL FOR ANTITUBERCULOSIS DRUGS DELAYED HYPERSENSITIVITY REACTION IN CHILDREN: ABOUT ONE CASE , N. Aarbaoui, F. Benbrahim, S. Benchekroun, Chafik Mahraoui and Dr. Naima EL Hafidi*
Introduction: Antituberculosis drugs hypersensitivity reactions remains an unpredictable side effect, this occurrence may deprive patients of drug therapy, which subsequently need to be reinitiated as no better alternatives exist. Case report: We report a case of a seven years old boy, who was diagnosed with two tuberculosis localizations: caseous pneumonia and mediastinal lymphadenopathy. An associated HIV infection was ruled out and was started on a drug combination regimen of isoniazid, rifampicin, ethambutol, and pyrazinamide. After 20 days of therapy he developed a pruritus and generalized maculopapular exanthema, with fever, the blood test was normal. We considred this presentation as a drug toxidermia. The antituberculosis therapy was stoped, and we prescribed antihistaminic treatement. Three days later, the rash has completely disappeared and we achieved apyrexia. An accoutumance protocol of antituberculosis drugs was started, we followed a slow protocol on 21 days. The time intervals between dose escalations of each drug were 24 hours. Subsequent drugs were sequentially added three days later when the preceding drug was tolerated. The tuberculosis treatment has been completed for six months by drug combination regimen, without any side effects, with improvement of clinical and radiologycal condition. Conclusion: Slow accoutumance in our patient is considered as an approach to the management of antituberculosis delayed hypersentivity reactions. The literature lacks reported cases on antituberculosis drug accoutumance in children. The availability of validated protocols is crucial for the success of this procedure.
391 SKIN CARE IN AYURVEDA , Dr. Ravi Joshi*
Skin is the best organ of the body interacting with the environmental agents like physical, chemical and biological agent. interaction with these factors result in specific reaction pattern producing characteristic skin lesions in different parts of the body. The prevalence of skin disease becoming more due to the following factors- faulty diet and life style, excessive and improper use of chemicals-cosmetics, soap, shampoo, diodorants and exessive use of antibiotics and steroids. Ayurveda has discussed of all skin disease under the name of Kushtha, and in other words it can be known as “Ayurveda Dermatology”. Kushtha are mainly divided into seven types of Maha Kushtha and eleven types of Kshudra Kushtha. Generally differential diagnosis and identification of a Perticualr Kushtha is very difficult as there are no clear tools presented in original Ayurveda texts. Disease of skin account for a great deal of Misery, suffering, incapacity and economic loss, including the genetic causes the diet, climate, sunlight mental factors and allergy etc., have been proved as aetiological factors beyond doubts. Natural hurbs seem to be more promising in the field of dermatology as already discribed in ancient Ayurvedic texts.
392 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF SEGESTERONE & ETINYL ESTRADIOL BY RP-HPLC METHOD , Butt Khadheeja*, Dr. Devanaboyina Narendra and Gadi Vijaya Lakshmi
A simple, Accurate, precise method was developed for the simultaneous estimation of the Segesterone and Ethinyl Estradiol in syrup dosage form. Chromatogram was run through AgilentC18 150 x 4.6 mm, 5. Mobile phase containing Buffer 0.01N KH2PO4 (5ph): Acetonitrile taken in the ratio 65:35 was pumped through column at a flow rate of 1.0ml/min. Buffer used in this method was 0.01N KH2PO4. Temperature was maintained at 30°C. Optimized wavelength selected was 260nm. A simple, Accurate, precise method was developed for the simultaneous estimation of the Segesterone and Ethinyl Estradiol in syrup dosage form. Retention time of Segesterone and Ethinyl Estradiol were found to be 2.302 min and 3.324min. %RSD of the Segesterone and Ethinyl Estradiolwere and found to be 0.6 and 1.0 respectively. %Recovery was obtained as 100.33% and 99.45% for Segesterone and Ethinyl Estradiol respectively. LOD, LOQ values obtained from regression equations of Segesterone and Ethinyl Estradiolwere 0.91, 2.75and 0.04, 0.11 respectively. Regression equation of Ethinyl Estradiol is y = 14306x + 2432.1. And y = 7317.8x + 2228.5. of Segesterone. Retention times were decreased and run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.
393 A CONCEPT OF RAKTA DHATU W.S.R TO KRIYASHARIR – REVIEW ARTICAL , Dr. Mohit Kumar* and Prof. Dr. Balkrishan Panwar**
Raktadhatu (Blood) is an object considered one of the Dhatu (Tissue) among the seven, which all Ayurvedic scholars agree unanimously. The word 'Rakta' derives from the Sanskrit word 'Raj Ranjane' which means red. Rudhiram, Asriga, Shonitam, Astram, Lohitam are synonyms of Raktadhatu (Blood). Raktavaha Strotas (channels) plays an important role in the Raktadhatu (Blood) metabolism of which liver & spleen is the principal organ. It is also with Raktadhara Kala with the Raktadhatu Formation & Storage (Blood). Despite the existence of Panchamahabhuta Rakta (Blood) is Dhatu (tissue) prevalent in Tej & JalaMahabhut. Raktadhatu (Blood) has a quantity of 8 Anjali. In Raktadhatu (Blood) Metabolism, Sira (Blood vessels) Kandara (tendenum) in the form of Updhatu (secondary tissue) while Pitta (secondary tissue) as Mala is made (Excreted part) Supporting the body and preserving life in the Body is main Raktadhatu (Blood) feature. When producing Raktadhatu (Blood), Individuals known as RaktasaraPurusha in excellence condition. All manner of deviations. The pathogenesis occurs in Raktadhatu (waning or increment). Raktadhatu vitiation (Blood) suggests a skin disease within the body. So it's an important life sustaining entity. Hence, it is important to protect this Dhatu (tissue) with all possible. A test which is one of the body's most critical points.
394 A LITRARY REVIEW ON ANGUTAJA SHALYA IN SHALAKYA , Dr. Shanno Shaikh*
While a foreign body is impacted, the prime aim should be to locate and to expel it out from the body. When there was no X ray, MRI, CT, or USG – a time when no radiology was not at all known to the world, about 2000 years ago, sushruta, the legend surgeon of ancient India had wonderfully traced out those foreign substances lost in body. Even now some of these methods have scientific relevance and can be adopted in our OPDs. A parent coming with complaint of their child crying of swallowing a button or a pin or a bead got stuck into their nose is a common event in all our clinical practice. Sometimes we confront with simple cases ranging an impacted small fish bone in the tonsils, a busted balloon or bubblegum in the mouth which has gone inside the respiratory tract, a swallowed blade or pin, or even most complicated cases of air embolism or fat embolism or a cardio- respiratory embarrassment.
395 A CRITICAL REVIEW OF INDICATIONS OF DIFFERENT AYURVEDIC BHAISHAJYA KALPANA , *Vd. Mayuri Narayanrao Manwatkar, Vd. P. V. Kulkarni and Vd. S. V. Suryavanshi
Ayurveda is a science of life where the intelligent Vaidya should examine the 10 tatvas – Dosha, aushadha, desha, kala, satmya, agni, satva, oka,vaya and bala & then should proceed to the treatment accordingly and should not rely on the knowledge of kalpas only. So the examination of 10 tatvas from all point of view is necessary. Out of these aushadha is the main tool of chikitsa. The aushadha should be examined by considering all parameters like – rasa, veerya, vipaka, prabhava, janma desha, kala, avastha, kalpana &sanyoga. The aushadha varies in its action accordingly with the kalpana. The precise selection of the desired drug increases its potency, shelf life, reduce the dosage & helps to cure the disease easily and accurately. So to study the indications of different Ayurvedic bhaishajya kalpana this article is written by reviewing the Bryhat trayee of Ayurveda with its commentaries so that we can decide the kalpana precisely in any disease condition.
396 LITERATURE REVIEW ON SIDDHA MEDICINE FOR THE MANAGEMENT OF “VALIPPU NOI” WITH JATHIKAAI MATHIRAI- A DRUG REVIEW , Dr. K. Rajeswari*, Dr. M. Supritha Muthu, Dr. K. Vennila, Dr. M. Meenakshi Sundaram and Dr. R. Meenakumari
Seizure disorder are called as Valippu in siddha traditional system of medicine is one of the most common serious neurological disorder affecting the children. Epilepsy is a chronic non communicable disease of the brain that affects around 50 million people worldwide. It is characterised by recurrent seizures, which are brief episodes of involuntary movement that may involve a part of the body (partial) or the entire body(generalized) and are sometimes accompanied by loss of consciousness and control of bowel or bladder function. Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Seizure can also vary in frequency, from less than 1 per year to several per day. In siddha system Seizure disorder is correlated with valippu noi and it can be effectively managed with Jathikaai Mathirai. All the ingredients of Jathikaai Mathirai possess anti-convulsant activity. Hence this article gives an insight on the efficacy of the drug for Valippu noi (seizure disorder) based on review of various literatures and scientific studies.
397 A STUDY TO ASSESS THE KNOWLEDGE REGARDING COVID-19 (TRANSMISSION, MANAGEMENT & PREVENTION) AMONG B.SC NURSING STUDENTS,THIRUVALLUR DISTRICT, TAMIL NADU. , *Dr. D. Sudhakar, M.sc(N), Ph. D
In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The nationwide (India) corona virus cases has crossed 1.9 lakh. The total cases in the country stood at 1,90,535 including 5,394 deaths, according to data from the Union Health Ministry(NDTV NEWS- June 1 2020)(4). In such pandemic situation the knowledge regarding the disease to manage and prevent the further spread plays a vital role in most populated country. This study helps to know the knowledge level of Nursing students regarding transmission, management and prevention of Covid-19. Research approach: Non experimental qualitative Research design, Research design Descriptive survey design, Setting of this study: The study was conducted at Indira College of Nursing, Thiruvallur, Tamil Nadu, Sample size: The total sample size was 30, Sample technique: Convenient sampling technique was used for this study. Results: Among 30 samples 7(23.4%) showed good knowledge, 18(60%) had average knowledge and 5 (16.6%) fair knowledge regarding Covid-19.
398 A REVIEW ARTICLE - CLINICAL EVALUATION OF THE EFFECT OF HRIDYAMRITA VATI WITH ARJUNA KSHEER PAKA AS ANUPANA IN VATAJA HRIDYA ROGA W.S.R. TO STABLE ANGINA , Dr. Anupama Rai*, Dr. Dhruv Kumar Mishra and Dr. Abhishek Bhushan Sharma
Background: Angina pectoris is a symptom complex caused by transient myocardial ischaemia, which occurs whenever there is an imbalance between myocardial oxygen supply and demand. Or we can say Stable Angina is a condition where in myocardial ischaemia occurs due to fixed atheromatous stenosis of one or more coronary arteries .Coronary artery disease is the most common cause of angina and the most common cause of death worldwide .The World Health Organization has estimated that 3.8 million men and 3.4 million women die from CVD each year. It has been estimated that CAD is responsible for 10 % of disability – adjusted life years in low– income countries and 18 % in high – income ones. In Eastern Europe and much of Asia, however, the rates of CAD are rapidly rising. This condition is on upward trend day by day due to faulty life style and dietry habits (fast food, junk food, Smoking, Excessive consumption of alcohol, stress etc .In ayurveda, Stable angina can be co- related with Vataja Hridaya Roga Aim of study- The present study was carried out to assess combined effect of Hridayamrita vati with Arjunaksheera paka as anupana in Vataja hridaya roga. Materials and Methods- To fulfill the objectives total 40 patients were registered of pre- diagnosed case of stable angina and these patients were administered Hridayamrita vati 2 tab BD with 40 ml Arjunaksheer paka as anupana for 90 days and a diet chart. Result- This study shows that overall effect of therapy, 21.21% had complete relief, 39.4% of patients were markedly improved, 33.33% were moderately improved,6.06% were mild improved and 00.00% of patients were unchanged .Conclusion- It was found that given therapy have significant results in subjective parameters. Medicines have properties i.e. Hridya, deepaniya, pachaniya, vata-kapha shamaka and tridoshashamaka.
399 MANAGEMENT OF VICHARCHIKA THROUGH VAMAN WITH NIMBA SWARAS , Akansha Verma*, Dr. Piyush Gupta and Dr. Ruchi Gupta
In Ayurveda all the Skin disorders are mentioned under the term ”Kushta”. Kushta is divided into 2 categories – Maha kushta & Kshudra Kushta. “Vicharchika” is mentioned under the title Kshudra Kushta. Clinical features of Vicharchika opined by Acharya Charak- Kandu, Shyavapidaka, Bahusrava with involvement of Kapha dosha. while Acharya Sushrata mentioned it‟s clinical feature -Rajyo, Atikandu, Rukshata, Ruja with involvement of Pitta dosha. Vicharchika is compared to Eczema. Eczema is a specific response of the skin, non-inflammatory. The word Eczema means “to boil out”. Acute Eczema is characterized-oozing, weeping, Erythema & Chronic Eczema is characterized – dry & scaly skin with lichenification & pigmentation. The symptoms of Vicharchika is similar to Eczema as pidaka(papules), kandu(pruritis), srava(oozing), ruja(pain), shyavata(pigmentation). Vaman is the prime modality treatment for Kapha dosha. The Drugs used in the treatment for Deepana & Paachana with Panchakola churna 3gms & Chitrakadi vati 2 tab (BD) before food with luke warm, Arohana Snehpana with Tiktak ghrita, Sarvanga Abhyanga with Somraji oil followed by ushna jala snana will be advised. After the completion of course of treatment samsarjan karma.
400 DESCRIPTION OF UNANI DRUGS USED FOR LIVER DISORDERS , *Dr. Najmus Sehar, Dr. Mohd Nafees Khan and Dr. Maqbool Ahmad Khan
Liver is the largest solid organ of the body, situated in the upper part of the abdomen on the right side. The liver has a multitude of important and complex functions, including to manufacture proteins, including albumin (to help maintain the volume of blood) and blood clotting factors to synthesize, store, and process fats, including fatty acids (used for energy) and cholesterol; to metabolism. According to the Unani system of medicine liver is Adhwa Raisa (the principal or vital organ) from which the primary faculties i-e the faculties necessary for the maintenance of life). The equilibrium of body and nourishment of organ are depending on liver, because of because food is actually other configuration (form) of blood and kailoos (digestive fluid) is converted into blood into the liver. Quwwat Hadima (digestive faculty), Quwwat jadhiba (absorptive faculty), Quwwat masika (retentive faculties) and quwwat dafia (expulsive faculty) are present in every organ of body but in the stomach and liver it present with more power. The objective of the present study is to popularize the Unani drugs and their knowledge to serve the humanity. Unani system of medicine has wide range of hepatoprotective drugs in the Pharmacopoeia. The study contains some single as well as compound hepatoprotective drugs and their uses. Unani system of medicine can be the best alternative to treat the liver disorder.
401 UNDERSTANDING THE ETIOPATHOGY AND SYMPTOMOLOGY OF NON ALCOHOLIC FATTY LIVER DISEASE WSR YAKRITUDARA , Vishala Kala*, Dr. Abhishek Bhushan Sharma and Dr. Kimmi Seth
Nonalcoholic fatty liver disease (NAFLD) is a global epidemic that ranges from isolated hepatic steatosis (nonalcoholic fatty liver [NAFL]) to steatosis plus inflammation (nonalcoholic steatohepatitis [NASH)] with or without fibrosis. In majority of patients, it is associated with metabolic risk factors as obesity, diabetes mellitus and dyslipidaemia. If remain untreated it may progress to advanced stages of hepatic fibrosis and cirrhosis, HCC, liver failure and then become the most common cause of death. In modern science there is no such effective treatment to cure NAFLD. Here we have tried to explain NAFLD as Yakritudara. Understanding the nidana, samprapti and sampraptighataka and lakshana of Yakritudara is the main aim of our study.
402 A CRITICAL REVIEW ON BASTI KARMA , Vaidya Nisha Rajendra Khairnar*
Basti Karma is one of the modalities among the five biocleansing/detoxifying procedures (Panchakarma procedures/ Samshodhana Chikitsa) advocated in Ayurveda as i.e. Vamana (Therapeutic Emesis), Virechana (Therapeutic Purgation), Basti (Medicated Enema), Nasya (Infiltration of drugs through nostrils) and Raktamokshana (Bloodletting by different methods). Basti Karma the medicated oil or herbal decoction is administered through the anal route. In modern medicine enemas are most commonly given to clean the lower bowel as a last resort for constipation treatment when, all other method fail. But rather than this, Basti Karma mentioned in Ayurvedic classics is having broader therapeutic action on almost all the tissues of the body and have rejuventive, curative, preventive and health promotive actions.
403 APPLICATION OF NASYA KARMA IN URDHWAJATRUGATA ROGAS , Vaidya Nisha Rajendra Khairnar*
Nasya is an Ayurvedic treatment method, characterized by nasal administration of medicines. Nasya treatment is mainly considered for Urdhwajatrugata Rogas (diseases above the neck). Nasya treatment refers to an Ayurvedic procedure that includes instillation of herbal oils, juices or powders through the nasal route. As stated by Ashtanga Sangrah, Nose is closest route to head (Brain) so the medicine that used in Nasya administered through the nostrils pervade into the nervous (Brain) and venous system (Blood circulation) present in and around the nostrils. Then they evacuate the morbidity present or distributed in nearby area such as eye, ear, throat. Thus it relieves the blockage of the channels & influences head region by removing all accumulated Doshas from nose, throat and head region and cure Urdhwajatrugata Rogas effectively as well as nourish the sensory organs such as nose, ear & eyes. Nasya is one among the five Panchakarma therapies.
404 FIVE MEMBER NITROGENATED HETROCYCLIC COMPOUNDS [A REVIEW] , *Ritesh Kumar, Ravi Verma, Dr. Gaurav Kumar Sharma and Dr. Kaushal Kishore Chandrul
This review article aims to represent the chemistry and applications of five membered nitrogenous heterocyclic compound containing one or more than one nitrogen atom in ring. All of the five membered nitrogenous heterocyclic compounds have different types of applications in pharmaceuticals and other fields like agriculture. This review paper generally highlight the chemistry and application of several five membered nitrogenous heterocyclic compounds and their derivatives which were synthesized recently as well as in past years. Heterocyclic organic compounds applied as pharmaceuticals, agrochemicals and veterinary fields, applied as optical brightening agents, like antioxidants, like corrosion inhibitors and like additives with a variety of else functions. Also, numerous dyestuffs and pigments were heterocyclic structures. They show biological activities, including antibacterial, antifungal, and anticancer. characterization, and aiming to further biochemical studies. The nitrogenated containing heterocyclic compounds to increase the physical working capacity in conditions of hyperthermia, hypothermia,and acute normobaric hypoxia and hypercapnia has been investigated. The main aim of this paper is to represent the information regarding the five membered hetrocyclic compounds that constitude the largest family or organic compounds.These are extremely important with wide array of synthetic pharmacological activity and industrial applications.
405 CONCEPT OF GASTRO-INTESTINAL SYSTEM IN AYURVEDA: A CONCISE REVIEW , *Kumar Manoj and Kureel Manoj
Concept of gastrointestinal tract is very much elaborated by the Ayurvedic Saamhitas. A consistent, clear and precise anatomical description for the most part of the gastro-intestinal tract has been furnished by Atreya Samhita which has been quoted by Vaidyaka-Sabda Sindhu. The gastrointestinal tract is described by various terms like Mahsrotas, Annavaha srotas and Kostha etc. Srotasa are channel system for transportation and transformation of sharirbhava and dhatu. The term Annavaha Srotas points out the functions performed by this channel means the transportation of the food. Annavahasrotas is associated with digestion and flow of food material which later forms rasadhatu. Sushruta explained that Amasaya is the most important part of the alimentary tract whereas Charaka has included both stomach and small intestine in it. Annavaha Srotas is related to structural and functional units associated with mechanical and chemical digestion in mouth, stomach and small intestine as well as absorption from stomach and small intestine. Here absorption of food material forms the first dhatu Rasa dhatu.
406 HERBLE DRUDG IN USED IN CANCER A COMPLETE REVIEW , Kaushal Kumar Gupta, *Shashi Daksh, Dr. Gaurav Sharma (HOD) and Dr. Kaushal K. Chandrul (Dean)
Malignant growth has nearly made ruin among the human culture as the quantity of mortalities is expanding step by step and a seemingly endless amount of time after year. Various investigations have been never really out the remedy for malignancy however without much of any result. Herbals have been considered as effective anticancer specialists and their significance in the treatment and the board of malignant growth can't be neglected. Present survey is a genuine endeavor to assemble the most encouraging anticancer specialists from plant starting point and rundown their significant malignant growth corrective possibilities Malignant growth has nearly made ruin among the human culture as the quantity of mortalities is expanding step by step and a seemingly endless amount of time after year. Various investigations have been never really out the remedy for malignancy however without much of any result. Herbals have been considered as effective anticancer specialists and their significance in the treatment and the board of malignant growth can't kbe neglected. Present survey is a genuine endeavor to assemble the most encouraging anticancer specialists from plant starting point and rundown their significant malignant growth corrective possibilities
407 DESCRIPTION OF UNANI DRUGS USED FOR LIVER DISORDERS , *Dr. Najmus Sehar, Dr. Mohd. Nafees Khan and Dr. Maqbool Ahmad Khan
Liver is the largest solid organ of the body, situated in the upper part of the abdomen on the right side. The liver has a multitude of important and complex functions, including to manufacture proteins, including albumin (to help maintain the volume of blood) and blood clotting factors to synthesize, store, and process fats, including fatty acids (used for energy) and cholesterol; to metabolism. According to the Unani system of medicine liver is Adhwa Raisa (the principal or vital organ) from which the primary faculties i-e the faculties necessary for the maintenance of life). The equilibrium of body and nourishment of organ are depending on liver, because of because food is actually other configuration (form) of blood and kailoos (digestive fluid) is converted into blood into the liver. Quwwat Hadima (digestive faculty), Quwwat jadhiba (absorptive faculty), Quwwat masika (retentive faculties) and quwwat dafia (expulsive faculty) are present in every organ of body but in the stomach and liver it present with more power. The objective of the present study is to popularize the Unani drugs and their knowledge to serve the humanity. Unani system of medicine has wide range of hepatoprotective drugs in the Pharmacopoeia. The study contains some single as well as compound hepatoprotective drugs and their uses.
408 ROLE OF SWASTHAVRITTA IN SCHOOL AGE CHILDREN , Dr. Shivani Rana*, Dr. Deepak Pathania, Dr. Ankush Jagota, Dr. Umesh Shukla, Dr. Rajika Gupta and Prof. T. C. Thakur
Health is a state of complete physical, mental & social well-being and not merely the absence of disease or infirmity among the pupils. Ayurveda indicate prevention and health promotion, and provides treatment for disease. Its main objective is to achieve desirable health and well-being through a comprehensive approach that addresses mind, body, behavior, and environment. It is the science of preventing diseases, prolonging life, and promoting health under the Swasthavritta. Children between the ages of 5-17 years are school age children. About 30 percent of the population is comprised of this age group. It is a period of rapid growth and development of the children. Children in school age are prone to get specific health problems. To prevent the disease and promote the health of school age children, Swasthavritta plays an important role. Various regimens i.e. Daily regimen (Dincharya), seasonal regimen (Ritucharya), Sandhyacharya (Evening regimen), Ratricharya (Night regimen), and Aahara (Dietary habits) and Vihara (lifestyle), Sadvritta (Ideal routines) and Achara Rasayana etc. is given which are very helpful to an individual for healthy life and prevention of diseases. So an attempt has been taken to prevent the diseases among the school going children and promote their health by intervening the Swasthavritta in their life through this paper.
409 ROLE OF NASHYA KARMA IN ARDHAVBHEDAKA , *Vd. Ravi S. Gaikwad and Vd. Anil Pansambal
The life style of the people of modern era has changed due to rapid urbanization. Due to changed work expectations for better life style, stress is causing increased incidence of acute and chronic disorders. Ardhavbhedaka is one of the chronic illness, which is wide spread in the population with varying severity. Ayurveda prostulated the unique principle of Tridosha, Dhatu and Mala for the homeostasis of the body. In Ayurvedic text, almost all the Achrayas have mentioned Ardhavbhedak in Shiro-Roga. Ardhavbhedaka is paroxysmal unilateral headache associated with vertigo and pain of varing intensity is seen. According to Acharya Sushruta, it is tridoshaja disease and Acharya Charaka it is vata –Kaphaja, Acharya Vaghbhat it is Vataj. Ardhavabhedaka defines Ardha Mastak Vedana. Ayurveda has a variety of natural medication in the treatment of Ardhavabhedaka. Nasa is nearest root to alleviate the disease of head. Ayurvedic therapeutics especially Nasya karma (Errhine therapy) has attracted considerable glamour for providing safe and effective remedies in the treatment of Ardhavbhedaka. According to Acharya Sushruta Ardhavabhedaka is best treated with Ghrita and it is effective in subsiding Pittaja and Vataja disorders; it improves Dhatus and is overall booster for improving Ojas. So use Go Ghrita Nasaya in the treatment of Ardhavbhedaka.
410 CONSENSUS ON INSULIN THERAPY: REHABILITATION OF DIABETES , Ananya Raj*, Arpita Biswas, Dr. Dhrubo Jyoti Sen and Dr. Beduin Mahanti
Insulin is involved in regulation of glucose utilization in the body. Inability of the body to synthesize insulin or human cells resistance to insulin leads to a condition called Diabetes mellitus which is characterized by chronic hyperglycemia. There are two types of diabetes; type 1 and type 2. Exogenous supply of insulin is needed consistently for type 1 diabetes treatment and type 2 diabetes also needs to be cured by the exogenous supply of insulin in advance stages of the disease. Insulin Site of administration of insulin injection is equally important for better and safe action of insulin and can be given by intramuscular or intravenous route. Insulin replacement therapy is essential for anyone with type 1 diabetes. Most patients with gestational or type 2 diabetes may also require insulin. The goals of insulin therapy are: to achieve optimal glycemic control without causing hypoglycemia or excessive weight gain and to minimize the impact on lifestyle. The therapeutic goals should be individualized according to patient’s age, disease duration, complications, comorbidities, lifestyle, and expected survival. Early insulins were extracted from the pancreas of pigs and cows but good glycemic control was difficult to achieve because of residual impurities after the purification process. The newer and purer animal insulins are better tolerated and can potentially achieve a level of glycemic control similar to synthetic human insulins. Clinically significant hypoglycemia rates between the human and animal insulins also appear to be similar. This review explores insulin in terms of its historical perspectives, regimens, adverse effect along with the future perspective.
411 AN APPRAISAL OF THE CONCEPT OF KALA IN AYURVEDA , Dr. Ashutosh Kumar Yadav* and Dr. Suman Yadav
Ayurveda holds opinion that in all bio transformation, Kala plays major role but the Vedic literature differ in opinion as they consider Kala as fraction, measure of time, collation etc. Ayurveda describes about 7 types of Kala specifying each in detail with its function. Then all the 7 Kala’s are broadly divided into 3 categories as Snayu praticchanna Kala, Jarayu santata and Shlesma veshthith Kala.
412 AYURVEDA PERSPECTIVE ON GARBHINI PARICHARYA: AN LITERATURE BASED REVIEW , Dr. Shubhangi Nayabrao Lakade* and Dr. Pramod Belhekar
Women are an important part of our society as she carries a new future in her womb and pregnancy is an important factor in women's life. During this period she should take care of food and daily habits. Ayurveda has explained Garbhini Paricharya which includes rules regarding Ahara & Vihara which should be followed during pregnancy. Ayurveda has explained Garbhini Paricharya through various classical texts. This article explained various aspects of Garbhini Paricharya as per Ayurveda texts.
413 GARBHA SHARIR; AN AYURVEDA REVIEW W.S.R. TO ANATOMICAL PERSPECTIVES , Dr. Amardeep Singh* and Dr. Rakesh Kapoor
The term Garbha includes zygote, embryo or foetus. Garbha is the result of fusion of Shukra and Shonita inside the Garbhashaya. Garbhashaya acts as Kshetra for the implantation and growth of Garbha. Aahar Rasa of mother provides nourishment and helps in the growth of Garbha during the gestational period. Other elements like Garbha Samagri, Shadbhavas, Garbhiniparicharya and Panchamahabhuta etc. also play important role in formation and development of Garbha. Garbhavakranti is the process of development of the Garbha from cells to mature fetus. It reveal process of fertilization and development of the Garbha starting from the parental units, their fusion, implantation, its growth and finally the delivery. Relation of eight Prakriti and sixteen Vikaras also shows great impact on the growth of the Garbha.
414 A REVIEW ON APPLIED ASPECT OF GUNAS AN AYURVEDA CONCEPT , Dr. Dinesh Kumar Malviya* and Prof. A. K. Sonkar
Ayurveda described many concepts related to the health and disease management, concept of Tridosha is one of that which derived from Panchmahabhutas. Our body is said to be healthy when all the three Doshas (Vata, Pitta, Kapha) are in state of equilibrium. The patho-physiology as well as the management of diseases mainly depends upon Tridosha theory. Vata, Pitta and Kapha can be observed in our body by means of their action (Karma) and properties (Gunas). The Ahara and medicine possess specific Gunas (properties) through which they impart health benefits. Considering importance of Guna present article exploring various aspects of Gunas.
415 GOUT: AN OLD DISEASE IN NEW PERSPECTIVE , *Dr. Dhrubo Jyoti Sen and Pritha Halder
Gout is a picturesque presentation of uric acid disturbance. It is the most well understood and described type of arthritis. Its epidemiology is studied. New insights into the pathophysiology of hyperuricemia and gouty arthritis; acute and chronic allow for an even better understanding of the disease. The role of genetic predisposition is becoming more evident. The clinical picture of gout is divided into asymptomatic hyperuricemia, acute gouty arthritis, intercritical period, and chronic tophaceous gout. Diagnosis is based on laboratory and radiological features. The gold standard of diagnosis is identification of characteristic MSU (Monosodium Ureate) crystals in the synovial fluid using polarized light microscopy. Imaging modalities include conventional radiography, ultrasonography, conventional CT, Dual-Energy CT, Magnetic Resonance Imaging, nuclear scintigraphy, and positron emission tomography. There is remarkable progress in the application of ultrasonography and Dual-Energy CT which is bound to influence the diagnosis, staging, follow-up, and clinical research in the field. Management of gout includes management of flares, chronic gout and prevention of flares, as well as management of comorbidities. Newer drugs in the pharmacological armamentarium are proving successful and supplement older ones. Other important points in its management include patient education, diet and life style changes, as well as cessation of hyperuricemic drugs.
416 VARISARA DHAUTI/ SHANKHAPRAKSHALANA , *Dr. Priya Pathak, Dr. Ankush Jagota, Dr. Umesh Shukla, Rajika Gupta and Prof. T. C. Thakur
Varisara Dhauti is one of the major Hatha yoga practices, it is also known as Shankhaprakshalana. “Dhauti” refers to 'internal washing' and “Vari” means 'water'. Generally the term Shankhaprakshalana is applied, Shankha means 'conch', because of its resemblance to the stomach and intestines; Prakshalana means 'cleaning’. Shankhaprakshalana is modified to suit the fast paced life and persons with weak constitutions. It is a technique by which all the toxic materials accumulated in the gastrointestinal canal are washed out. In Shankhaprakshalana, intake of plain salty water and some yogic Aasanas are the only requirements for the process. No drugs are required. All the deleterious effects of purgatives are totally absent. Hatha Yoga has six basic steps of Moksha, i.e., Aasana, Pranayama, Mudra, Pratyahara, Dhyana and Mukti. For proper Aasana and Pranayama body should be devoid of any obstruction like diseases, Meda, Shlesma etc. Provisions for removal of these are explained in the six Shodhana Kriya/ Shatkarma. Shatkarma is not mentioned in the Patanjali Yoga Sutra. Description of Shatkarma is available in the text of Hatha Yoga.
417 SROTAS AND SROTOMULA- AREA OF THIRST IN AYURVEDA , *Dr. Kaumik Verma, Prof. H. K. Rai and Dr. Arvind Kumar
Ayurveda is one of the world’s oldest holistic healing therapies. It was developed thousands of years ago in India. Ayurvedic medicine is an ancient system of health care. Dosha, Dhatu and Mala are considered as the basis of our human body. Other than these structures, Srotas is another important entity that is the basis of the body. Purusha is called as the Srotomaya, because Srotas are present all over the body, and they are essential in maintaining the Dosha, Dhatu and Mala. Manifestation of a disease occurs in the body as a result of the defective Srotas of the body. Hence, any defect of Srotas must be corrected quickly, for the restoration of normal health. Present study emphasises on the proper understanding of the concept of Srotas in systematic and well organised manner, so as to understand the functions carried out by it.
418 AYURVEDA REVIEW ON PREPARATIVE METHODS OF RASA DRAVYA; AN IMPORTANT ASPECT OF RASA SHASHTRA , *Dr. Amitkumar Sukhdeo Mane
Ayurveda the traditional science of health promotion not only restore health of an individual but also provides basis of healthy society. The various principles of ayurveda help in the prevention and management of diseases. Ayurveda encompasses several concept related to the well being of society and Rasashastra is one of them. This science involves utilization of mineral, metal and herbs for the management of optimum health status. Mainly the history of Rasashastra begins with the uses of mercury which considered as Rasa Dravya. The qualities of Rasa Aushadhi depend upon their preparative methods such as; Mardana, Murchana, Rodhana, Niyamana and Jarana, etc. Considering importance of preparative methods of Rasa Dravyas this article explore Ayurveda aspects on preparative methods of Rasa Dravyas.
419 METHOD OF UJJAYI PRANAYAMA IN THE MANAGEMENT OF HYPOTHYROIDISM , Dr. Dinesh Ram*, Dr. Sandeep S. Kamble, Dr. Rachana Jain and Dr. Rajeev Kumar Sharma
Thyroid disorders are one of the most common endocrine disorders in the world. The thyroid gland is responsible for the body‟s metabolism, protein production, and calcium level balance in the body. Disease in thyroid gland arises due to irregular levels of thyroid hormones. Hypothyroidism is due to under activity of thyroid gland and decreased levels of thyroid hormones. It is a quite common disease and can occur at any age. For hypothyroidism, most of the patients are ultimately rendered with the lifelong supplementation of synthetic thyroid hormones. Ayurvedic treatment can be an ideal way to get rid of daily hormone supplementation. The Ayurvedic approach towards hypothyroidism has become an effective and popular way as it does not depend on synthetic drugs and so has no side effects. Yoga breathing exercises, called Pranayama in Sanskrit, are an important part of developing a Yoga practice. According to the Yoga Sutras, Pranayama is one of the classical eight limbs of Yoga. Ujjayi Pranayama is one technique that helps calm the mind and warm the body. The current study was conducted to determine the effect of practicing Ujjayi Pranayama on Hypothyroidism in Adults.
420 THERAPEUTICS ASPECTS OF AGNI KARMA IN AYURVEDA , *Dr. Hanumant Mansing Nagawade and Vaidya Nisha Rajendra Khairnar
Shalya Tantra is one of the important branches of Ayurveda in which Surgical and Parasurgical techniques has described for management of various diseases. Sushruta known as the father of surgery. „Agni Karma‟ is one amongst these parasurgical procedures. Agnikarma is an important therapeutic measure in Ayurvedic system of medicine, which has got worldwide popularity because of its simple administration and efficacy in variety of disorders. In Agni Karma therapeutic burning with special tools are done on specific sites. It is unique form of therapy performed with the help of Agni which has been described to be the superior then Ksharkarma, as the disease treated by it do not relapse and moreover those incurable by medicines (Bheshaja), operations (Shastra) and caustics (Kshara) yield to it. Agni Karma has been given special place in surgery by Sushruta and it is believed that disease treated by Agni Karma never reoccurs.
421 BHAGANDARA (FISTULA- IN- ANO) - A REVIEW ARTICLE , *Dr. Hanumant Mansing Nagawade and Vaidya Nisha Rajendra Khairnar
Bhagandara has been described by Acharya Sushruta as one among Ashtamaharoga (eight major diseases) which is difficult to cure. This disease has been described in Ayurvedic texts in great detail. The etiopathogenesis, symptoms, types, preventive measures and curative aspects have been mentioned in detail. The word Bhagandara is composed of two words bhag and darana. Bhagandara is a common disease occurring in the Ano- rectal region around the anus which extends up to the genitalia. The formation of a Pidika leads development of Bhagandara characterised by opening around gud Pradesh along with painful discharge. In this article we will study about Bhagandara, its causes, classification, sign & symptoms, management and many more descriptions according to Ayurveda and modern medicine.
422 METHOD DEVELOPMENT AND VALIDATION FOR SIMULTANEOUS ESTIMATION OF TERBINAFINE & ITRACONAZOLE BY RP-HPLC METHOD , Yalla Chandana*, Dr. Devanaboyina Narendra, P. Venkata Kishore and Gadi Vijaya Lakshmi
A simple, Accurate, precise method was developed for the simultaneous estimation of the Terbinafine and Itraconazole in tablet dosage form. Chromatogram was run through Agilent C18 150 x 4.6mm, 5.0. Mobile phase containing Buffer 0.01N KH2PO4 (4.8pH) : Acetonitrile taken in the ratio 60:40v/v was pumped through column at a flow rate of 0,8 ml/min. Temperature was maintained at 30°C. Optimized wavelength selected was 270nm. Retention time of Terbinafine and Itraconazolewere found to be 2.340 min and 2.940min. %RSD of the Terbinafine and Itraconazole were and found to be 1.2 and 1.2 respectively. %Recovery was obtained as 99.56% and 100.16% for Terbinafine and Itraconazole respectively. LOD, LOQ values obtained from regression equations of Terbinafine and Itraconazole were 0.77, 2.34 and 1.33, 3.42 respectively. Regression equation of Terbinafine is y = 1316.x + 560.8 and y = 2912x + 3286 of Itraconazole. Retention times were decreased and that run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.
423 FORMULATION, CHARACTERIZATION AND INVITRO EVALUATION OF LAMIVUDINE MICROSPHERES FOR SUSTAINE RELEASE , Y. Phalguna*, Swetha Pothula, Ravinder Kumar Sarepalli and G. Mounika
In the present work, Microspheres of Lamivudine using Sodium alginate, Chitosan, Eudragit as polymers were formulated to deliver Lamivudine. The results of this investigation indicate that solvent evaporation method can be successfully employed to fabricate Lamivudine microspheres. FT-IR spectra of the Drug and optimised revealed that the drug is compatible. Micrometric studies revealed that the mean particle size of the prepared microspheres and are suitable for microspheres for oral administration. Increase in the polymer concentration led to increase in % Yield, % Drug entrapment efficiency, Particle size, % swelling. The invitro drug release decreased with increase in the polymer concentration. Analysis of drug release mechanism showed that the drug release from the formulations followed zero order release kinetics. Based on the results of evaluation tests formulation coded F4 was concluded as best. formulation.
424 ACUTE ORAL TOXICITY AND EFFICACY OF URINEJ CAPSULE (POLY-HERBAL FORMULATION) AGAINST BPH (BENIGN PROSTATIC HYPERPLASIA) , Nilesh Patel, Dr. Janmejay Patel, Achal Patel and Prof. Dr. Upendra U. Zala*
Introduction: Natural therapies have a long history of use in our country to support optimal prostate health. The toxicity profile of newly developed drug is requiring providing scientific base and wide acceptance. Aim: To evaluate acute oral toxicity of Urinej capsule (poly herbal formulation) on Swiss albino mice and its efficacy against Benign Prostatic Hyperplasia (BPH). Method: The protocol of present study was certified by IAEC (SKPCPER/IAEC/2016-02/03) as per the CPCSEA. The acute oral toxicity was assessed according to OECD guideline AOT-425 to know single dose (2000 mg/kg) toxicity of test drug. The effect of test drug was assessed on Testoviron Depot (TD) injection (2.5mg /kg /day) induced BPH in male wistar rats. The body weight, urine volume, kidney markers and physical parameters of prostate were analyzed by following provided methods at the end of study. Results: There were no physical - behavioral changes and mortality observed in any animal during 14 days. Body weight of all animals did not reveal any significant change as compared to vehicle control group. Urinej capsule showed significant effect on body weight, urine volume and different prostatic and biochemical parameters. All the parameters were normalized in test drug treated group. Conclusion: The No-Observed-Adverse-Effect-Level (NOAEL) Urinej capsule is 2000 mg/kg as it did not have any toxic effect at that dose. Urinej capsule might inhibit the 5É‘-reductase enzyme. The achieved normal value of kidney markers and physical prostate parameter suggests its effectiveness against BPH.
425 STRUCTURE, PATHWAY PREDICTION FOR FUNCTIONAL ELEMENTS OF E2 GLYCOPROTEIN PRECURSOR IN SARS-COV-2 TO ANALYZE IT'S ROLE IN COVID-19 DISEASE , Subodh Choukidar*, Talib Yusuf, Talib S. H. and Sanjay N. Harke
The COVID-19 is caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus -2). It has became a major global health issue of 2019-20.[2] It’s single stranded RNA virus of approximately 30 kb genomic length. Due to positive sense it has ability of rapidly translate it's genome in the host cell.[9] Reason for spread of disease from human to human is via droplets or direct contact with infected person. The World Health Organization (WHO) declared COVID-19 outbreak as sixth public health emergency of international concern (PHEIC) on 30 January 2020.[5] More research is needed to identify the structural as well as functional characteristics of SARS-CoV-2’s proteins that are essential for pathogenic mechanism.[2] In this study our aim is to analyze the structural features of E2 glycoprotein precursor which is trans membrane protein of SARS-CoV-2 by performing structure validation. Further it has been observed het group NAG (N-Acetyl-D-Glucosamine) in the protein's structure by predicting secondary structure features, which has the ability to induce the cell apoptosis mechanism by it’s catalytic activity.[14] The said study is to implement the correlation between activity of NAG group of the protein inside the cellular environment and their possible adverse effects on human body. This will help us in identification of the possible functional activity of E2 glycoprotein precursor in pathogenesis with the help of advance computational biology named Bioinformatics. Swiss model (Automated protein structure homology modeling server), PDBsum, KEGG Database above said server and program are used to analyze the activity.[1,10,11,12,13]
426 DRUG USE AT ORTHOPAEDIC OUT-PATIENT DEPARTMENT , Aarohi Vyas*, Aanal Patel, Aarya Nair, Abigail Abraham, Sandipkumar Bhatt and Bimal Modi
Objective: The objective of this study is to assess and evaluate the drug use and prescription pattern in Orthopaedic OPD in relationship with patient demographics variables and drug used. Material and Methods: This study was conducted in the Orthopaedic OPD of tertiary care hospital from Nov18 to Mar19. Out of 18,000 patients who visited OPD, only data of 1003 prescriptions were randomly collected based on the selection criteria. The details like subjects’ demographics and prescribed drugs were recorded in the pre-designed data collection form. The prescribed drugs were assessed based on WHO core prescribing indicators with respect to the formulary and non-formulary medication. Result: Total of 1003 prescriptions was collected and analyzed. Pain in hands, legs, hip and back was most commonly encountered and was generally treated using various NSAIDs with or without specific therapies like antibiotics and gastro-protectants. In comparison with WHO core prescribing indicators, average of 4-5 drugs was encountered per each prescription, drugs prescribed by generic name were 99.48%, and prescriptions encountered with antibiotics and injectable were 5.68% and 1.09 %. Drugs prescribed from the hospital formulary were 92.57%, of which Tab. Diclofenac was the commonly prescribed and from non-formulary were 7.4%. Prescriptions containing drugs prescribed with fixed dose combination were 235 in number. Conclusion: NSAIDs are the most commonly prescribed drug followed by gastro-protectants. The drugs prescribed from formulary by generic name were high and rational.
427 GENETIC ENGINEERING – THE FOUNDATION OF CUTTING-EDGE EXTRAMURAL RESEARCH , *Kushal Nandi, Subarna Mahanti, Dr. Dhrubo Jyoti Sen, Dipra Dastider and Dr. Sudip Kumar Mandal
A molecular genetic technique use for the direct manipulation, alteration or modification of genes or genome of organisms in order to manipulate the phenotypes is called genetic engineering. Genetic engineering, also called Genetic modification or Genetic manipulation, is the direct manipulation of an organism's genes using biotechnology. It is a set of technologies used to change the genetic makeup of cells, including the transfer of genes within and across species boundaries to produce improved or novel organisms. New DNA is obtained by either isolating and copying the genetic material of interest using recombinant DNA methods or by artificially synthesizing the DNA. A construct is usually created and used to insert this DNA into the host organism. The first recombinant DNA molecule was made by Paul Berg in 1972 by combining DNA from the monkey virus SV40 with the lambda virus. As well as inserting genes, the process can be used to remove, or "knock out", genes. The new DNA can be inserted randomly, or targeted to a specific part of the genome. Humans have altered the genomes of species for thousands of years through selective breeding, or artificial selection as contrasted with natural selection. More recently, mutation breeding has used exposure to chemicals or radiation to produce a high frequency of random mutations, for selective breeding purposes. Genetic engineering as the direct manipulation of DNA by humans outside breeding and mutations has only existed since the 1970s. The term "genetic engineering" was first coined by Jack Williamson in his science fiction novel Dragon's Island, published in 1951 – one year before DNA's role in heredity was confirmed by Alfred Hershey and Martha Chase, and two years before James Watson and Francis Crick showed that the DNA molecule has a double-helix structure – though the general concept of direct genetic manipulation was explored in rudimentary form in Stanley G. Weinbaum's 1936 science fiction story Proteus Island. In 1972, Paul Berg created the first recombinant DNA molecules by combining DNA from the monkey virus SV40 with that of the lambda virus. In 1973 Herbert Boyer and Stanley Cohen created the first transgenic organism by inserting antibiotic resistance genes into the plasmid of an Escherichia coli bacterium. A year later Rudolf Jaenisch created a transgenic mouse by introducing foreign DNA into its embryo, making it the world's first transgenic animal These achievements led to concerns in the scientific community about potential risks from genetic engineering, which were first discussed in depth at the Asilomar Conference in 1975. One of the main recommendations from this meeting was that government oversight of recombinant DNA research should be established until the technology was deemed safe.
428 CLINICAL PROFILE OF CHILDREN WITH THALASSEMIA MAJOR AGED 5 TO 14 YEARS , Ipsita Jena, Sristi Ganguly* and Narendra Nath Soren
Background: Thalassemia is one of the commonest genetic disorders in India, causing children to be transfusion dependent. Despite high burden, there is delay in recognition, screening, diagnosis and adequate management, making study on their clinical profile a priority in Odisha. Methodology: This was a hospital based cross-sectional study done in SCBMCH and SVPPGIP, Cuttack during September 2019 to January 2020. Diagnosed cases of Thalassemia major patients aged 5 to 14 years, on blood transfusion were included in the study and those with other hemoglobinopathies or chronic illness not attributed to thalassemia were excluded. The demographic and clinical characteristics of the patients noted and data analysed using SPSS and expressed in percentages. Results: Among the 200 patients studied, male to female ratio was 2.03, with mean age 7.9 years. 71.5% of the study population had malnutrition, with 39% having stunting and 21% having both stunting and wasting. The average pre-transfusion haemoglobin was 6.3g/dl, age at diagnosis of 53% was between 6 to 9 months. Most (66%) of the cases received blood transfusion at frequency of once a month. Majority (40%) had their ferritin values >2000 (average-2096.45 ng/ml).Fatigue (56%) and splenomegaly (97.5%) were the most common symptom and clinical finding seen. 79% and 63% had good compliance and good knowledge about the disease respectively. No mortality was seen in our population, though 3.5% had complications. Conclusion: Owing to the high prevalence, measures for early detection, prompt diagnosis and optimum management of thalassemia patients, with easy access to services and education of masses is the need of the hour.
429 OBSERVATIONAL STUDY REGARDING HEPATITIS B & C POSITIVE BLOOD DONOR’S PROFILE , Dr. Shiena*, Dr. Kinza Javaid, Dr. Adeen Shafey
Background: Viral Hepatitis B and C is a public health problem and is spreading at intense speed in all the population strata. Objective: The purpose of this study was to observe features of hepatitis B and hepatitis C +ive blood donors. Methodology: This cross sectional descriptive study was conducted from June to November 2019 at blood bank, Nishtar Hospital Multan. Blood screening was done by ICT-kit and PCR test methods. Both voluntary and replacement donors who were declared as +ive from the blood bank were selected for interview through preformed questionnaire after taking informed consent. The sample size of 220 blood donors was taken including both genders. The characteristics concerned with their personal profile, educational status, vaccination status, medical treatment received in the past, living habits, family history of hepatitis B and C were included. The data was collected and analyzed. Results: The survey found that 106 (48.18%) were illiterate and (52.72%) were workers. A majority of 184 (83.63%) responded that they could not be vaccinated against Hepatitis B again and about half, 112 respondents (50.90%) had a history of Hepatitis C case in their family. There were large number of respondents 172 (78.18%) who do not bring their own new disposable syringes for injection therapy at quacks clinics. Conclusion: The blood donors who were detected to be positive for hepatitis B or C were having following characteristics: Majority belonging to rural areas, <50years unmarried males, poor social class, no hepatitis B vaccination, not using new syringes for treatment by quacks very frequently.
430 ASSESSMENT OF THE SOCIAL FACTORS ASSOCIATED WITH GERIATRIC DEPRESSION IN ELDERLY PEOPLE , Dr. Adeen Shafey*, Dr. Kinza Javaid and Dr. Shiena
The aim of our study to evaluate social factors responsible for depression in elderly. Methods: It is a descriptive case series study performed at Nishtar Hospital Multan. We included 385 patients in our study. Data was gathered through questionnaires filled out during the interview. We analyzed data using SPSS version 18. Results: Urbanization is the highest factor of depression in elderly people between the age of 60-65 yrs. Joint family system is the next social factor (73%). Some other factors, like their past(70%), traumatic events in their life(58%), living a retirement life(61%), unemployment(55%), smoking habit(61%), sleep disorders(54%)are also responsible for depression in elderly patients. Conclusion: Depressing symptoms were predominant among hospitalized old age patients and independently associated with intellectual decline, poor family function and weakness. Some other factors that are responsible for geriatric depression include living alone, marital status, sleep disorders, income status, no physical activity etc.
431 AUDIT OF LAPAROSCOPIC CHOLECYSTECTOMY AT A TERTIARY CARE HOSPITAL , Dr. Muhammad Tariq*, Dr. Muzna Ali Khan and Dr. Muhammad Rassan
Objective: To evaluate the clinical practices and outcome of laparoscopic cholecystectomy at our institute. Methodology: This was a cross sectional study, conducted at Surgical Unit II, Sheikh Zayed Hospital, Lahore, from May 2019 to October 2019. Sample size: 100 patients undergoing standard laparoscopic cholecystectomy selected by non probability sampling. All the patients of laparoscopic cholecystectomy during the study period having a clinical diagnosis of acute and chronic cholecystitis were included, whereas patients who had previously undergone midline abdominal operations, ventral hernias, with evidence of common bile duct pathology, having bleeding disorders and hepatitis were excluded. Study variables were operating time, duration of hospital stay, frequency of operative, and postoperative complications. Results: There were 85 females and 15 males. Mean age was 40 ± 1.2 years. In this study, 68% patients were having chronic cholecystitis due to Cholelithiasis whereas 32% were having acute cholecystitis. Abdominal ultrasound showed multiple stones in 82% and single stone in 18% patients. Adhesions in 30%, Mucocele in 1% and empyema in 2% patients was reported. Gall bladder was perforated in 12% patients and 8% patients converted to open procedure. The mean operative time for laparoscopic cholecystectomy was 71.2+ 2.6 minute. The postoperative complications were; wound infection in 4%, shoulder pain 1% and surgical emphysema 1%. The mean hospital stay was 1.38 days. Conclusion: Laparoscopic Cholecystectomy proved a safe procedure in term of operative and postoperative complications in our setup.
432 A CASE STUDY: PATIENT RESPONSE TO 12-WEEK INDIVIDUALIZED EXERCISE PROGRAM DURING RADIATION AND CHEMOTHERAPY TREATMENT , Wonders K. Y. Ph.D., FACSM*, Stemly M. and Hale R. MD
Introduction: This case study observes the outcomes of a 12-week individualized exercise program on a 44-year old anal/rectal cancer patient’s quality-of-life including: body composition, balance, muscular strength, cardiovascular health, muscular endurance, lower-body flexibility and chronic pain. Case presentation: The patient experienced treatment with high-beam radiation and 5-flourouracil chemotherapy. The patient was primarily concerned with her ability to manage her hip, lower leg and ball of foot pain all while becoming stronger. Management and Outcome: The patient experienced improvements in muscular strength, cardiovascular fitness, muscular endurance, flexibility, pain and self-perceived wellness. Discussion: As the patient progressed her hip began to tolerate greater ranges of motion and movements which used to cause her pain/discomfort stopped causing her pain/discomfort.
433 A CASE STUDY ON VARISARA DHAUTI/ SHANKHAPRAKSHALANA IN VATARAKTA , *Dr. Priya Pathak, Dr. Umesh Shukla, Dr. Rajika Gupta and Prof. T. C. Thakur
Ayurveda is an age old science of health which lays emphasis on the health than to cure disease. The aim of Ayurveda is to provide a quality of life to the human being. Nowadays human beings are vulnerable to many disorders due to their altered lifestyle and food habits. Occurrence of Vatarakta is one of the outcomes of these modifications. Vatarakta is the disease which is caused by vitiation of Vata as well as Rakta. Aggravated Vata is blocked by vitiated Rakta, in turn leading to further aggravation of Vata. Thus aggravated Vata vitiates whole Rakta producing complex effects leading to the condition Vatarakta (Ruja spreads as Aakhu Visha. Due to its remittent and relapsing nature and complications there is no permanent cure of this disease, which is a challenge for 21st century and for future. In present era, people are coming closer to the nature and want alternate remedy. Hence Ayurveda, an ancient system of Indian Medicine will be the future medicinal science of the world. In Ayurvedic system Vatarakta can be safely managed using various Shodhana and Shamana procedures. Samshodhana Chikitsa of Vatarakta has been described in most of classics hence, Samshodhana Chikitsa (Varisara Dhauti/Shankhaprakshalana) is considered. Samshodhana Chikitsa is one of the prime purificatory procedures employed in treating a constellation of symptoms and stubborn disorders. By this mode of therapy vitiated Doshas are evacuated from the body and thus nidus necessary for disease formation is removed radically. Thus Shodhana in Ayurveda is considered important before prescribing Shamana drugs. The reason being, it cleanses the body for better absorption and action of Shamana drugs. In the present case male patient presented with typical symptoms of Vatarakta. He was treated with Varisara Dhauti/ Shankhaprakshalana at the interval of 7 days for 3 weeks and he recovered fully with no symptoms left.
434 A CASE STUDY ON APPROACH TO UDARA CHIKITSA , *Vd. Mayuri Narayanrao Manwatkar, Vd. M. W. Nalkande and Vd. S. V. Suryavanshi
Udara is mentioned in Ashta mahagada i.e. 8 major illnesses in Ayurveda classics. Agni dushti(vitiation of Agni) by malina ahara (faulty food materials & eating habits), doshasanchay (accumulation of doshas) due to apaka (improper conversion of food) and resultant Udara. So it is considered as kruchrasadhya (difficult to treat). But once the samprapti is visualised considering these 3 factors in mind then it can be treated accordingly. So this paper focusses on approach to Udara chikitsa which is based on visualisation of its samprapti and application of various siddhantas using shamana and shodhana aushadhis.
435 A CASE REPORT OF AGNIKARMA PROCEDURE IN THE MANAGEMENT OF KADAR (CORN) , Dr. Suman Yadav* and Dr. Preeti
Kadara has been described in the texts under the heading of Kshudra roga (minor diseases). Kadara is generally known as corn. It is a very painful lesion which commonly affect the plantar surface of the foot. Acharyas have explained the use of several measures to treat the Kshudra rogas. Agnikarma(thermal cauterization) is suitable for the treatment of Kadara is mentioned in our Ayurvedic treatise. This study was done to evaluate the efficacy of Agnikarma using lauha shalaka (iron probe). So, a single case study of Kadar is reported here which was treated by two sittings of Agnikarma procedure. Assessment of the lesion was done before, during and after treatment along with follow up after 1 week of treatment. During the full course of Agnikarma procedure it was observed that Agnikarma is better in curing Kadar (corn).
436 THE OUTCOME OF PREGNANCY IN FIBROIDS UTERUS , Dr. Nadia Aziz*, Dr. Bushra Nasir and Dr. Nadia Akram
Objectives: To study the outcome of pregnancy in Fibroids of the Uterus. Design of Study: Prospective / Experimental Study. Place and Duration of Study: This study was conducted at Sheikh Zayed Hospital Rahim Yar Khan, from January 2019 to January 2020. Materials and Methods: This study was carried to hunt out the results of maternity associated with female internal reproductive organ fibroids and to search out the actual indisputable fact that every pregnant female ought to be screened for female internal reproductive organ fibroids (UF). If the fibroids diagnosed together with pregnancy, these patients wish alert prenatal care and thus the maternity got to be treated as high risk maternity. Fifty pregnant females with fibroids of the womb were listed throughout this Prospective Experimental Study. Performa was designed to record age, socio economic standing, area, complications in early, late maternity and delivery. Written consent was taken from each patient. Permission was in addition taken from ethical committee of the institutes. The information was analyzed on SPSS version 10 for results. Results: In this study it was observed that incidence of pregnancy with fibroids uterus was higher (54%) n=27 at the age of 31-35 years as compared to other age groups. The women of middle socio economic group had higher incidence of pregnancy with Fibroids of the Uterus (46%) n=23 as compared to other socio economic group of women. The women from rural areas had double incidence of pregnancy with Fibroids of the Uterus (68%) n=34 as compared to women having pregnancy with Fibroids of the Uterus from urban areas (32%) n=16. The incidence of miscarriage of pregnancy with Fibroids of the Uterus was maximum (28%) n=14 and patients of fetal growth restriction was minimum (04%)n=02 in complications of pregnancy. The incidence of Postpartum hemorrhage was maximum (46%) n=23 and minimum (08%) n=04 in case of retained placenta during delivery.
437 AUDIT OF UTI CAUSING MICROORGANISMS IN DIABETIC PATIENTS , Dr. Nadia Akram*, Dr. Bushra Nasir and Dr. Nadia Aziz
Aim of study: The prevalence of asymptomatic and symptomatic UTI is very high among diabetic patients. This study was conducted to assess the frequency of microorganism involved in urinary tract infection among diabetic patients. Methodology: It is cross-sectional study done at Pathology department and Diabetic OPD of Jinnah Hospital, Lahore for a period of 6 months from December 2018 to April 2019. Total 250 samples of Urine was collected from patients visiting diabetic OPD. Patients having symptoms of UTI or having more than 5 WBC/HPF on urine analysis were selected for the study and urine culture was performed on their samples. Using a standard quantitative loop, urine samples (1 μL and 10 μL) were used to inoculate Cysteine lactose electrolyte deficient (CLED) agar (Oxoid, Basingstoke, UK), MacConkey, 5% Sheep Blood agar, and chromogenic UTI (Oxoid) agar plates. Plates were incubated for 24 h at 37°C and the outcome was judged as significant/nonsignificant growth, or contaminated (discarded). Significant bacteriuria was defined as urine culture plates showing ≥105 colony-forming units (CFU)/mL of single bacterial species. Results: Total 250 urine samples of diabetic patients were selected for study. Among these patients 162 (64.8%) were female and 88 (35.2%) were males. 171 (68.4%) patients were having symptoms of urinary tract infection and remaining 79 (31.6%) were asymptomatic. Asymptomatic patients were having more than 5 WBC/HPF on complete urine analysis. 31 patients were having HbA1c with in target range (i.e. 6-7), 100 patients were having HbA1c 7-8 and remaining 119 patients were having HbA1c above 8. After 24 hours of intubation in the required media we found 20 sample were having mixed growth/contaminated, 195 (78%) sample were having E.coli growth, in 64 (25.6%) patients were Klebsiella spp, Staphylococcus in 31 (12.4%), Pseudomonas in 15 (6%), Proteus in 9 (3.6%), Streptococcus in 2 (0.8%), Enterococcus spp. in 3 (1.2%) and Candida spp. in 1 (0.4%). Conclusion: UTIs are frequent in patients with diabetes. The most frequent microorganism is E. coli and fungal infections are least common in diabetic patients in our study. Symptomatic UTI are more common in patients due to late presentation to hospital. Among asymptomatic UTI cases, female were more common as compared to male.
438 FREQUENCY OF MICRO-ORGANISMS IN ACUTE EXACERBATION OF COPD , Dr. Madiha Chisti*, Dr. Ramza Naeem Butt and Dr. Maryam Tariq
Objectives: To identify the frequency of bacterial pathogens in acute exacerbation of COPD. Materials & Methods: This cross sectional was conducted at Department of Pulmonology, Lahore General Hospital from August 2018 to February 2019 over the period of 6 months. A total of 162 patients of acute exacerbation of COPD of age 40-70 years and both genders were included. Patients with h/o concomitant bronchial carcinoma, pneumonia, chronic renal failure and chronic congestive failure were excluded. After taking informed written consent, a fresh sample of sputum was collected into a sterile container and was sent for culture and sensitivity. Each sample was examined and interpreted by consultant pathologist and identification of bacterial pathogens was noted. Results: Mean age was 57.10 ± 7.63 years. Out of the 162 patients, 112 (69.14%) were male and 50 (30.86%) were females with male to female ratio of 2.24:1. In this study, I have found the Streptococcus pneumoniae was the predominant organism isolated in 52 (32.10%) patients followed by Klebsiella pneumoniae in 38 (23.46%), Pseudomonas aeruginosa in 29 (17.90%), Moraxella catarrhalis in 23 (14.30%), Methicillin - Resistant Staphylococcus aureus in 19 (11.73%) and H. influenza in 01 (0.62%) patients of acute exacerbation COPD. Conclusion: This study concluded that streptococcus pneumoniae was the predominant organism isolated in patients of acute exacerbation of COPD followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Moraxella catarrhalis, Methicillin - Resistant Staphylococcus aureus and H. influenza.
439 TYPES AND MODES OF BURN INJURIES AND MORTALITY RATE AT A TERTIARY CARE HOSPITAL , Dr. Maryam Tariq*, Dr. Ramza Naeem Butt and Dr. Sikandar Riaz Cheema
Objective: To assess the various types and modes of burn injuries and mortality rate at tertiary care hospital. Material and methods: This retrospective study was conducted at Department of Plastic Surgery, Jinnah Hospital Lahore from January 2018 to June 2018 over the period of 6 months. Total 100 with burn injuries were selected from hospital record and analyzed. Etiology of burns, nature of burn injury and severity of burn injury was assessed. Results: Total 100 with burn injury were selected. Mean age of the patients was 32 years. 30-40years age group was the most commonly affected. Etiologies of injuries are flame burns (60%), scalds (25%), electrical burns (10%) and chemical burns (5%). Most of the burn injuries are accidental (65%), followed by suicidal (15%), industrial (12%) and homicidal (8%). Conclusion: Results of present study showed the male patients were more victim as compared female patients. Age group 30-40 was the most commonly affected age group. Most of the patients were found with flam burn. Most of the patients were found with 31-40% TBSA and higher number of mortality was noted in 71-80% TBSA.
440 USES OF ULTRASOUND IN PELVIC FLOOR BIOMETRY: A REVIEW ARTICLE , Dr. Ansam Layth Abdulhameed* and Dr. Mohammed Tareq Alkhaffaf
Ultrasound imaging of pelvic floor biometry, in particular translabial or transperineal ultrasound is in the process of becoming a new diagnostic standard in urogynecology. Ultrasound has several practical advantages compared with MRI, such as shorter examination time, fewer exclusion criteria, relatively low cost, high patient compliance and easy accessibility, furthermore it is easier to perform real-time assessment during dynamic maneuvers such as Valsalva or pelvic floor muscle contraction on ultrasound. Pelvic floor ultrasound provides a useful screening tool for women with defaecatory dysfunction.
441 AN AYURVEDIC PERSPECTIVE OF VATARAKTA , *Dr. Priya Pathak, Dr. Nitu Tegta, Dr. Ankush Jagota, Dr. Umesh Shukla, Dr. Rajika Gupta and Prof. T. C. Thakur
WHO defines Health as “A state of complete physical, mental & social well-being and merely the absence of disease or infirmity”. Health of an individual solely depends on his diet and lifestyle. Ayurveda more than a medical science it is a culture or lifestyle, one should adopt its applied aspects for one‟s well-being. But with the march of time, in the rapid modernization most of dietary habits, social structure, lifestyle & environment have been changing. The consumption of baked food, half fried vegetables etc. cause incomplete digestion. This modern living in India makes fast food culture, which is spreading its wings in remote villages too. Nowadays human beings are vulnerable to many disorders due to their altered lifestyle and food habits. Occurrence of Vatarakta is one of the outcomes of these modifications. In Ayurvedic texts Vata is the most significant among Tridoshas. Due to its six fold distinguishing features like Ruksha, Laghu, Sheeta, Khara, Chala and Sukshama Gunas. At the same time, it is a well-known fact that the life of living beings absolutely depends on Rakta. Vatarakta is an illness where both Vata and Rakta are afflicted by distinct etiological factors. In ancient Ayurvedic literature, detailed description of its etiology, epidemiology and symptoms are given. In its management, internal as well as externally used medications have been prescribed by different Acharyas. Acharya Sushruta described Vatarakta under Vatavyadhi named as Vatashonita. Vatarakta is the disease which is caused by vitiation of Vata as well as Rakta. Aggravated Vata is blocked by vitiated Rakta, in turn leading to further aggravation of Vata. Thus aggravated Vata vitiates whole Rakta producing complex effects leading to the condition Vatarakta (Ruja spreads as Aakhu Visha).
442 A REVIEW ON KARMA OF ANUSHASTRA , Dr. Hanumant Mansing Nagawade*
Ancient surgical science was known as Shalya – Tantra. Shalya Tantra is branches of Ayurveda that deals with surgical and parasurgical techniques for the management of various diseases. Shalya Tantra involves uses of various techniques or Karma to facilitate surgical or parasurgical interventions and Anushastra Karma is one of them. The Anushastra Karma play vital role in surgical interventions, therefore in this article the various aspects related to the Anushastra Karma presented. Anushastra Karma means uses of non-surgical instruments to perform surgical procedure. Anushastra include Kshara Karma, Agni Karma, Jalaukavcharana etc.
443 LITERARY REVIEW OF PARIKARTIKA WITH SPECIAL REFERENCE TO FISSURE IN ANO , *1Dr. Suman Yadav, Dr. Ashutosh Kumar Yadav and Dr. Vikramaditya Dubey
Parikartika is a common anorectal disease In general we compare Parikartika with the fissure in ano. It is a very painful condition. In Ayurvedic text, Parikartika is mentioned not as a separate disease entity but as a complication of different Ayurvedic procedures such as vaman, virechana and basti and complication of some diseases like Arsh Atisar, Grahani. Health of an individual depends upon his diet, environmental condition and lifestyle. In present era lifestyle disorders like hypertension, diabetes mellitus, hypothyroidism, obesity etc. are affecting large number of population in the world .Anorectal diseases like fissure in ano, hemorrhoid etc. could be considered as a problem originated from bad food habits and improper lifestyle.
444 ETIOLOGY OF PLEURAL EFFUSION AT A TERTIARY CARE HOSPITAL , Dr. Aisha Anwar*, Dr. Muhammad Zulqarnain, Dr. Rana Ihtasham-ul-Haq
Objective: To study the various diseases in cases of pleural effusion presenting at Holy Family Hospital, Rawalpindi. Material and methods: This cross sectional study was conducted at Department of Medicine, Holy Family Hospital Rawalpindi, from September 2018 to March 2019. Total 100 patients with pleural effusion were selected and different diseases were studded in selected cases. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed by parapneumonic effusion/empyema (25%) and malignant effusion (9%) while congestive cardiac failure (13%) was the most common cause of transudate effusion followed by liver cirrhosis in 8% of cases of all cases of the pleural effusion. Conclusion: Tuberculosis is the most common cause of pleural effusion while infections, malignancies and CCF comprise a significant number of cases.
445 SUSCEPTIBILITY PATTERN OF MYCOBACTERIUM TUBERCULOSIS TO FIRST LINE ANTI TUBERCULOSIS DRUG , Dr. Rana Ihtasham-ul-Haq, Dr. Muhammad Zulqarnain, Dr. Aisha Anwar*
Objective: To determine the susceptibility pattern of Mycobacterium Tuberculosis (MTB) to 1st line Anti tuberculosis therapy. Study design: Cross sectional study. Study Setting: Department of Biochemistry, Holy Family Hospital, Rawalpindi. Study Duration: July 2018 to March 2019. Methodology: This was a cross sectional study carried out at Department of Biochemistry, Holy Family Hospital Rawalpindi, during July 2018 to March 2019. In this study the cases of both gender with age more than 15 years were included. The cases that have already taken ATT were excluded. Sputum samples were obtained and then processed at solid Lowenstein Jensen (LJ) media for at least 6 weeks, MTB isolated from these sample were then tested for their susceptibility to the 1st line ATT drugs. The MIC of the studied drugs per ml of LJ medium for susceptibility testing were 0.2 mcg for isoniazid, 02 mcg for streptomycin, 05 mcg for Ethambutol, 100 mcg for pyrazinamide and 01 mcg for rifampicin. Results: In this study there were total 115 cases; out of which 72 (62.60%) were males and the mean age of the participants was 35.19±10.67 years. Drug resistance was seen in 36 (32.17%) of cases and few of the cases had more than 1 drug involvement. The most common drug to which was resistance was seen was streptomycin affecting 19 (16.52%) of the cases. it was followed by Isoniazid where it was seen in 17 (14.78%) of the cases. Single drug resistance was seen in 30 (26.08%) of the cases. three and four drug resistance were seen in 2 (1.73%) of cases each. Conclusion: Drug resistance is seen in almost every 3rd case and the most common drug to show resistance is streptomycin.
446 A STUDY ON INFLAMMATORY MARKERS AND THE METABOLIC SYNDROME , Dr. Khushbakht Jabbar*, Dr. Muhammad Zaryab Haider and Dr. Zaryab Zaki
Background and objective: The metabolic syndrome has been conceptualized as a clustering of metabolic risk factors. Therefore, the main objective of the study is to analyse the relationship between inflammatory markers and the metabolic syndrome. Material and methods: This descriptive study was conducted in Post Graduate Medical Institute (PGMI), Lahore during October 2018 to March 2019. This study was done with the permission of ethical committee of hospital. The data was collected from 250 patients of both genders. The study groups were divided into three main parts. Results: The data was collected from 250 patients from which 150 females and 100 males. In the second group C-reactive protein is higher than in the first group with statistical significance (p = 0.02). Leukocytes have a less important value in establishing proinflammatory and cardiovascular risk contribution in patients with metabolic syndrome compared with C-reactive protein. Conclusion: It is concluded that obesity is the main factor of metabolic syndrome. Patients diagnosed with metabolic syndrome present an activated inflammatory status. Inflammatory syndrome is expressed according to the number of metabolic syndrome components.
447 ANALYSIS OF GALLSTONES FOUND IN GALLBLADDER AFTER CHOLECYSTECTOMY , Dr. Khushbakht Jabbar*, Dr. Muhammad Zaryab Haider and Dr. Kashif Fareed
Background: Gallstones are formed within the gallbladder or in biliary tract. They can be termed as cholesterol stones whose major constituent is cholesterol or pigment stones, which mainly are composed of bilirubin or there can be calcium and oxalate stones too. Objective: To establish the composition of stones found within the gallbladder after cholecystectomy for symptomatic gallstones. Methodology: This cross sectional study was conducted in Services Institute of Medical Sciences, Lahore, from 1st August, 2017 to 30th June, 2018, with a sample size of 200 consecutive patients of cholecystectomy for symptomatic gallstone. After examining the physical characteristics of the stones (color, number, shape and surface) were analyzed by semi- quantitative colorimetric analysis. Demographic data of patients, morphology of stones and the percentage different chemical components were noted on pre-established performa and analyzed by SPSS software version 22. Results: The mean age of the 200 patients was 37.82 ± 11.67 years and 90% patients were female. Overall 10% cases had solitary stone while 90% cases had multiple stones and 25% patients had light brown stones, 30% had dark brown stones, 35% had gray stones and 10% had black stones. In this study, 85% cases had mixed stones whereas 15% had cholesterol stones. The mean percentages by weight of calcium, cholesterol, iron, phosphorus and bilirubin were 50± 10.59%, 27.45± 11.57%, 14.3± 6.28%, 13.25± 8.36% and 5.1± 2.46% respectively. Conclusion: It is concluded that gallstone disease is common in third decade of life and mixed stones is the most frequent variety of gallstones and calcium is the most abundant substrate of the gallstones.
448 FREQUENCY OF ABDOMINAL TUBERCULOSIS IN PATIENTS PRESENTING WITH ACUTE ABDOMEN AT A TERTIARY CARE HOSPITAL , Dr. Eeman Riaz*, Dr. Nayab Amin and Dr. Faiza Iram
Objective: This study was performed for determination of frequency of abdominal tuberculosis among 200 patients presented with acute abdomen at Department of surgery, Jinnah Hospital Lahore. It is a cross-sectional study performed within 6 months duration from November 2018 to April 2019. Patients with age above 15 years of either gender were included in the study. Informed consent was taken from all the enrolled patients. Detailed history and examination was performed on every patient. Baseline laboratory investigation i.e. CBC, ESR, LFTs, RPM, PT, aPTT, Electrolytes and ECG was done for all patients. The diagnosis of acute abdomen was made on history of absolute constipation, abdominal pain etc., and examination and through abdominal ultrasonography. All the patients underwent open surgical laparotomy. Biopsy sample was collected and sent to pathology laboratory. Abdominal tuberculosis was confirmed on biopsy report. Patients having other systemic illnesses, IHD, end stage renal disease, liver cirrhosis, malignancy and those who not fit for surgery were excluded from the study. In this current study there were 200 cases that presented with acute abdomen. The mean age was 35.46±11.24 years. Biopsy report of 44 (22%) patients was positive for Abdominal Tuberculosis. There was no significant difference of gender, although it was observed that Abdominal Tuberculosis was more common in patients with age less than 40 years. Conclusion: We concluded that prevalence of Abdominal TB was very high in patients presented with acute abdomen, there is no difference with respect to gender distribution. 30-40 years age was most commonly involved.
449 FREQUENCY OF ISOLATED MICROORGANISM AND THEIR ANTIBIOTIC RESISTANCE PATTERN IN PEDIATRIC INTENSIVE CARE UNIT , Dr. Faiza Iram*, Dr. Eeman Riaz and Dr. Nayab Amin
Objective: This study was conducted to assess the frequency of different microbial isolates and their antibiotic resistance pattern in patients admitted to Pediatric Intensive Care Units of Jinnah Hospital Lahore. Methods: In this descriptive cross-sectional study, samples drawn from 253 pediatric patients of Intensive Care Units were included. Data was taken from records of the Pathology Department of the concerned hospitals, from September 2018 to July 2019. Data was collected about the types of specimens, culture positive microbes, and the antibiotic sensitivity of the bacterial isolates. Results: Amongst the cultures included, 64.8% showed no growth while 32% showed bacterial growth and 3.2% showed fungal growth. Most frequently isolated organism was Escherichia Coli (22.7%) followed by Klebsiella pneumonie (18.8%), Acinetobacter baumannii (16.8%), Staphylococcus Aureus (10.9%), Pseudomonas (9.9%), Candida (7.9%). The most common pathogen isolated from the respiratory tract was Klebsiella (38.7%); from urinary tract, E.coli (63.2%); from blood, Staphylococcus Aureus (30%). Antibiotic sensitivity showed that the isolated pathogens were most susceptible to Meropenem. It was however less effective against Acinetobacter. Vancomycin was also effective against majority of microbes isolated except for Klebsiella. Fosfomycin showed mixed results. Conclusion: In Paediatric ICU most commonly isolated pathogens are E.coli, Klebsiella, Acinetobacter and S.aureus. Meropenam and Vancomycin combination is the best guess empiric antibiotic keeping in mind antibiotic sensitivity pattern of these microorganisms.
450 MIGRATION OF INTRA UTERINE DEVICE IN THE ABDOMINAL CAVITY, EXPLORATION STRATEGY AND LAPAROSCOPIC MANAGEMENT ABOUT A CASE , F. Z. Belkouchi*, J. Meddah, Nadim, Y. Kerroum, A.Ahallat, K. Fathi and S.Bargach
The intra uterine dispositive (IUD) is a famous mechanical reversible contraception device. Moreover, some rare complications may occur like uterine perforation and also it migration into gynecologic, urinary or gastro-intestinal organs. In our department we report a case of a 30-year-old woman Gravida 3 Para 3, with three vaginal births. Who came to our gynecologic unit to remove the IDU she kept for 5 years, the IUD’s string wasn’t found. An ultrasonography showed an empty uterine cavity with the IDU in the abdominal cavity, other radiologic examinations were made to localize the device. Laparoscopy was used to remove the IUD successfully.
451 DIAGNOSTICS OF THE PELVIC BONE SARCOMAS , Polatova D. and Dr. Savkin A.*
Due to the low prevalence, the multitude of histological forms of bone and soft tissue sarcomas (0.2-0.6% of all oncological diseases), their diagnosis and treatment are very difficult, poorly studied and still remain the subject of research. Tumor formations of the pelvic bones are characterized by a variety of histological forms, clinical flow and prognosis. In most cases, it has been proven that from qualitative studies of neoplasms in the pelvic bones, primary bone sarcomas are most common, followed by soft tissue sarcomas and metastatic lesions. Using available sources, we found inconsistency in the data on the prevalence of various histological types of pelvic sarcomas.
452 CARDIOPATHY AND PREGNANCY: ABOUT 12 CASES , *Dr. M. C. Fourati, M. Sebti, F. Zidane, Pr. M. Yousfi and Pr. S. Bargach
Pregnancy in women with heart disease is relatively rare and stable (about 1% of pregnancies since 1930), but is a major cause of maternal morbidity and even mortality.[1] Indeed, during pregnancy and the postpartum period, important cardio-circulatory changes occur that can aggravate heart disease. In developed countries, the distribution of heart disease has changed over the last 30 years due to improved health conditions, a reduction in the incidence of rheumatic fever and increased life expectancy, with congenital heart disease predominating.
453 FIBROPLASIA OSSIFICANS PROGRESSIVA OR MUNCHMEYER’S DISEASE: PEDIATRIC CASE REPORT , Dr. L. Berrada*, H. Rhouda, M. Sahli, A. Sefiani and Y. Kriouile
Myositis or Fibroplasia Ossificans Progressiva (MOP or FOP) or Munchmeyer’s disease is a rare genetic disease. Its diagnosis is easy at an advanced stage where standard radiography shows a true ectopic skeleton associated with bilateral malformations of the feet and hands. Its evolution is fatal with the risk of rootedness, petrification and death by restrictive respiratory failure. We report a case of FOP diagnosed in a 9-year-old child. The genetic study confirmed the diagnosis. The aim of this article is to recall the circumstances of discovery, the radiological diagnosis with the importance of the association of characteristic congenital malformations and finally to highlight the difficulties of management and treatment.
454 RADIO INDUCED OSTEOSARCOMA: A PEDIATRIC CASE REPORT , L. Berrada*, M. El khorassani, A. Kili, M. El Kababri, M. Khattab and L. Hessissen
Radiotherapy is one of the major components of curative management of cancer. This is not without side effects, especially the development of radiation-induced tumors. Due to improved treatments and an overall increase in the lifespan after cancer, osteosarcoma is considered to be one of the most commonly found tumours in this context. We report the case of a patient treated with radiotherapy for orbital rhabdomyosarcoma, who subsequently developed radio-induced osteosarcoma, which had a localisation hard to manage by surgery.
455 MANAGEMENT OF CLOSED SUBTROCHANTERIC FRACTURE OF LEFT FEMUR IN A PATIENT WITH PYCNODYSOSTOSIS: A CASE REPORT , Tan Chen Liang* and Surinder Singh
Pycnodysostosis is a rare autosomal recessive disorder caused by a mutation in cathepsin K (CTCK) found in osteoclasts. Individuals with pycnodysostosis have characteristic clinical features such as short stature, stubby fingers and narrow palate. Radiologically, the bones appear to have a sclerotic cortex with relative sparing of the medullary canal, making surgical option for internal fixation of fracture rather difficult. This article reports a closed transverse left subtrochanteric fracture in a patient with pycnodysostosis that was managed conservatively.
456 UNILATERAL CONGENITAL THENAR HYPOPLASIA: A CASE REPORT , Tan Chen Liang* and Surinder Singh
We present a case of a 15 years old girl with features of Cavanagh syndrome with hearing loss, visual defects, congenital cardiac problem and developmental defect of her right hand. It is a rare presentation worldwide with a higher incidence among females. This case was misdiagnosed twice and this presentation is to increase awareness of the condition.
457 IG A NEPHROPATHY AND DIGESTIVE HYDATIDOSIS: ABOUT A CASE , Hajar Benzouina*, Dalal Elhamssili, Tarik Bouattar, Loubna Benamar, Rabia Bayahia and Naima Ouzeddoun
Introduction: Ig A nephropathy is a glomerulonephritis characterized by a nephrotic syndrome and hematuria with histological evidence of Ig A mesangial deposits. It can be primary or secondary to infections including parasites. We illustrate through this clinical case the renal impairment probably secondary to hydatid disease. Clinical observation: Mr C. A 29 year old is followed for hepatic, splenic and peritoneal hydatidosis. He is admitted to the nephrology department for lower limb oedema, ascites with weight gain of 30 kg. Blood pressure is 130/90mmHg. The rest of the somatic examination is normal. Biologically, there is a nephrotic syndrome with acute renal failure with preserved diuresis (serum creatinine 400 umol/l), microscopic hematuria and leukocyturia. Renal biopsy revealed IgA nephropathy. Treatment is symptomatic based on water depletion by loop diuretics and ultrafiltration in hemodialysis and etiologic based on treatment of hydatidosis with Albendazole. The evolution is marked by the regression of the nephrotic syndrome but persistence of moderate chronic renal insufficiency with a serum creatinine around 180 mmol/l. Conclusion: IgA nephropathy secondary to hydatid disease is a serious form that can progress to end-stage renal disease, hence the importance of rapid management of the infection.
458 STIR VERSUS T1/T2 WEIGHTED IMAGES TO EVALUATE ABNORMAL ENDPLATE SIGNAL IN THE LUMBAR SPINE , *Beth Vettiyil M.D., Michael Aguilar M.D. and Oganes Ashikyan M.D.
Purpose: To compare STIR with T2-/T1-weighted (T2W/T1W) images in detecting abnormal endplate signal in the lumbar spine (L. spine) in patients presenting with back pain. Subjects and methods: After obtaining IRB exemption, we retrospectively reviewed 50 routine clinical lumbar MR studies of patients with back pain. All patients underwent MRI on 1.5T or 3T scanners. All scans consisted of sagittal T1W, T2W, and STIR sequences as well as axial T2W sequences. Patients with a history of lumbar spine surgery, infection, or neoplasm were excluded from this study. We evaluated a total of twelve endplates in each patient from T12-S1 levels. We recorded whether abnormal signal was present on T2W/T1W sequences, STIR sequences or both sequences. Modic type change was recorded for each endplate based on the appearance on T2W and T1W images. Results: There were 24 male and 26 female patients with ages ranging from 25 to 85 years. Abnormal STIR signal in the endplates was seen in 22% of all endplates in the lumbar spine. Abnormal T2W/T1W signal in the endplates was seen in 20.8% of all endplates. 4.7% of all endplates demonstrated abnormal signal only on STIR images. 5.2% of all endplates demonstrated abnormal signal only on T1W/T2W images. Overall, 8% of patients had abnormal findings only on STIR images, and 8% of patients had abnormal findings only on T1W/T2W images. Abnormal STIR signal was present in 83.3%, 72.3% and 91.7% of L. spine endplates that demonstrated Modic type I, II and III changes, respectively. Conclusion: STIR and T1W/T2W images provide complimentary, but sometimes different information about endplate integrity in the L.spine. Spine MRI protocols may benefit from the addition of STIR or other fat saturated fluid sensitive sequences to conventional T1W/T2W images to maximize MR sensitivity for detection of endplate pathology.
459 EFFICACY OF YAWADI LEPA IN THE MANAGEMENT OF MUKHDUSHIKA , Dr. Swapnil S. Bhavar*
In ayurved acne is called as Mukhdushika. Generally it appears in the adolescence. In the age of 16-19 in males and in 16-17 in females. It occurs when pores of the skin becomes clogged with oil, dead skin cells, and bacteria. According to ayurveda acne or mukhdushika is a message from your body telling you that, something is wrong inside your body in dosha system like, stomach are upset, or having acidity, changing diet habits or you are moving from healthy diet to unhealthy diet or life style. Exposure to polluted environment and sweetening can also make the condition worse. Strong soaps, hard scrubbing, and pricking at pimples can make acne worse. Ayurveda is an ancient healthcare system of India which is based on eternal principle of health life. The whole clinical approach of Ayurveda is based on preventive, promotive & curative aspect.
460 A LITRARY REVIEW ON: ARSHA WSR TO HAEMMORRHOIDS , Dr. Rajesh Kumar Soni*, Dr. Rajesh Gupta, Dr. Sudesh Rani Gupta, Dr. Mahendra Lodha
Arsha is mentioned in all classical text book of Ayurveda. According to Ayurveda Acharya sushrut and Acharya Vaghbhata described Arsha in the “Ashtha Mahagada”. Acharya has explained Arsha is like an enemy which gives trouble to the persons. In Ayurvedic literature give some various synonyms eg.Durnamakam, Gudakila, Gudankur etc. Main characteristic feature of Arsha is sprouts like growth in the ano-rectum and torture to the patients. All Ayurvedic literature described that the Arsha is difficult to cure and trouble to the patients like as enemy. Symptoms of Arsha is clinically resemble as feature of piles. Maximum concepts are similar to each other. It is the most common and troublesome disease among all the diseases of GIT. Its frequency is increasing with advancing age. Over the age of 50 year most of the persons suffer from complaints of piles during their life time. The main complaints of piles are bleeding, pain and prolapsed pile mass. The familiar treatments for the Arsha are medical management, injection therapy, rubber band ligation, cryosurgery, Haemorrhoidectomy etc. Acharyas Sushrut has given four types of measures for the treatment of Arsha which is Bheshaj, Kshar-karma, Agni-karma and Shastra-karma.
461 KADAR WSR TO CORN: A LITERARY REVIEW , Dr. Rajesh Kumar Soni*, Dr. Rajesh Kumar Gupta and Dr. Sudesh Rani Gupta
Kadar is a dolorous, firm enlargement which is elevated at the middle and shrunk from sides. Kadar is described as kshudra rog in sushurut samhita nidan sthan addhyaya no.- 13 and management in sushurut samhita Chikitsa sthan addhyaya no.- 20. astang hridaya has described kshudra rog in uttar tantra addhyaya no.- 31 and 32. acharya bhoj described kadar as manskeel. Kadar is related to corn in modern science. Corn (Kadar) is the hard, conical and horny thickening. It is localized as hyperkeratosis of affected skin occurs on the sole, tip of toes and inter-phalangeal joints due to defective wear, thron prick, continuous friction and individual susceptibility etc. Disorder of Kapha and Vata dosha and vitiation of meda and rakta dhatu are mainly responsible in the pathogenesis of Kadar. This article describes kadar in the detail.
462 AYURVED & MODERN PERSPECTIVE OF DENGUE FEVER (DANDAKA JWARA) , Rahul Panditrao Surnar*, Avinash Deshmukh and Deepali Amle
Dengue fever is a Viral disease,which spreads to the people through the bite of an infected Aedes Species (Aedes Aegypti or Aedes albopictus) mosquito. Dengue virus belongs to the family of Flaviviridae,having four serotypes that spread by the bite of infected Aedes mosquitoes. Dengue is common in more than 100 countries around the globe. Modern medicine does not have any specific treatment for this disease.Whatever treatment is available that is based on the signs & symptoms in this disease. In Ayurveda,Dengue fever can be correlated with Dandaka Jwara,which means joint pain.Because of this,it is also known as Breakbone fever. As there is no treatment of Dengue fever in modern science ,Ayurveda can be very useful in managing the disease. But for this thorough understanding of Dengue fever from both the perspective i.e Modern as well as Ayurved is necessary.
463 SHOOLHARAN YOGA IN MANAGEMENT OF PAIN A REVIEW , *Priya Darshani Koul, Dr. Yadavendra Yadav, Dr. Usha Sharma, Dr. Shuchi Mitra and Dr. Khem Chand Sharma
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Shoolaharan yoga, an ayurvedic polyherbal formulation, consists of strychnos nux-vomica and other seven ingreditents in vati (tablet) form.[1] It is mentioned in AFI taken from Rasendra Saar Samgrah, for several therapeutic uses. It is one of the most widely used ayurvedic product indicated for pain/colic, malabsorption syndrome, diarrhea, abdominal lump and digestive impairment. All the ingredients present in this yoga have proven to be efficacious in different types of pain. In this article pharmacological actions related to pain have been discussed.
464 BRACHYTHERAPY AND RADIOISOTOPES , D. K. Awasthi*, Gyanendra Awasthi and Meet Kamal
Brachytherapy (brak-e-THER-uh-pee) is a procedure that involves placing radioactive material inside your body. Brachytherapy is a type of radiation therapy that's used to treat cancer. Brachytherapy is sometimes also called internal radiation therapy. In this type of radiation therapy, the radioactive source delivered through seeds, ribbons, catheters or wires is placed within or just next to a tumor and may be left in place permanently or temporarily, depending on the cancer type and location. That allows eliminations of cancer cells from inside the tumor mass as opposed to a radiation beam going through healthy tissue to reach tumor cells (in case of external beam radiotherapy).
465 BEAUTY PARLOR SYNDROME: RARE, BUT REAL EMERGING THREAT TO FEMININE NATURE , Dr. Mahendra Kumar R.*, Dr, Krishna Deshpande, Ankitha Kotian, Manasa R. and Shwetha S.
Beauty parlor syndrome is the term used to characterize a stroke triggered by hair washing in a hairdressing parlor. It is a clinicopathological disease associated with an infarction within the vertebrobasilar arterial system with complex symptomatology. Post-circulation strokes account for about 20-25 percent of all ischemic strokes and remain a major cause of disability and mortality in patients. Diagnosis can be challenging, partly due to substantial overlap in anterior circulation symptoms and signs with ischemia. For this reason, early detection of symptoms and causes of ischemia in the posterior circulation is essential to choose the most appropriate therapy. To help preserve patients' quality of life and reduce healthcare costs related to this condition, clinicians need to accurately diagnose the condition and appropriately manage patients through the long course of their illness. The aim of this narrative review is to focus on the etiology, pathogenesis, and natural history of PBS for adequate patient management and therapeutic interventions. This review seeks to raise awareness of this rare form of syndrome so that individuals with beauty parlor syndrome are identified and provided with appropriate care.
466 GENE SILENCING IS ONE OF THE MOST EFFICIENT AND PROMISING FUNCTIONAL GENOMICS TOOLS , *Soumitra Ghosh, Arghya Biswas, Soumik Nanda, Sneha Das, Susmita Basak, Supradip Mandal, Arpita Biswas, Dr. Dhrubo Jyoti Sen, Dr. Beduin Mahanti and Dr. Dhananjoy Saha
Gene silencing is defined as epigenetic of gene expression leading to inactivation of previously active individual genes or larger chromosome regions. Silencing of a target gene can be achieved at two levels-transcriptional and post-transcriptional stages. The transcriptional gene silencing occurs through the repression of the process of transcription & the post transcriptional gene silencing occurs by the degradation of mRNA. There is also another type called Meiotic. Mechanisms responsible for repression of genes involve changes in level of DNA methylation & alterations in covalent modifications of histone proteins which leads to chromatin compaction. These are the effects of small RNA regulators such as small interfering RNAs (siRNAs), microRNAs (miRNA), Piwi-associated RNAs (piRNAs) etc. Virus can also conduct gene silencing which is known as Virus Induced Gene Silencing by cloning and inserting plant endogenous gene sequence in recombinant viral vectors. Even Gene Silencing helps in buildup resistance against biotic & abiotic stress & helps in knock down any kind of undesirable genes.
467 A CLINICAL STUDY ON THE MANAGEMENT OF DANTAVESHTA (PYORRHOEA ALVEOLARIS) WITH VIDANGADI GUGGULU , Dr. Priya Sharma*, Dr.Satish Sharma, Dr. Vijayant Bhardwaj and Dr. Priyanka Thakur
Dantaveshta is mentioned under Dantamulagata Rogas by Acharya Susruta . It occurs due vitiated Kapha and Rakta Dushti that result in Puyastrava and Chaladanta. Periodontitis or pyorrhea alveolaris is the inflammation of the periodontium of the tooth that leads to loosening of teeth. The present study is done in single group of 10 patients of Dantaveshta. Patients were treated with Vidangadi Guggulu .The signs and symptoms were studied before and after treatment. Results of the study indicates significance of this drug as it gives 49.36% relief in the signs and symptoms of the patients and 80% of the patients were moderately improved and 20% of the patients were mildly improved.
468 ARRHYTHMIA OF RARE ETIOLOGY , Dr. Tridip Kumar Sengupta*, Dr. Tanmay Mukhopadhyay and Dr. Kanak Kumar Mitra
Palpitation / Arrhythmia is one of the most important and common cardiological problem in any cardiology and / or Medical Out-patient Department (OPD) or Emergency Room(ER) of any hospital or clinic. Arrhythmia can cause palpitation, dizziness, syncope, chest pain or breathlessness and trigger heart failure or even sudden death.[1] The causes of arrhythmia are: (a) Cardiac – Ischaemic heart disease, structural changes (left atrial dilatation secondary to mitral regurgitation, cardiomyopathy, pericarditis, myocarditis, aberrant conduction pathways); (b) Non-cardiac: caffeine, smoking, alcohol, pneumonia, drugs (beta-blockers, digoxin, L-dopa, tricyclics, doxorubicine) and pheochromocytoma.[2] Fexofenadine is an anti-histamine used to relieve allergy symptoms such as watery eyes / runny nose, itching eyes / nose, sneezing etc. It works by blocking a certain natural substance (histamine) that our body makes during allergic reactions. This patient, having symptoms of allergic reactions took Fexofenadine, advised by allergy clinic. His allergic reaction subsided; but eventually he developed arrhythmia. The arrhythmia subsided after stoppage of Fexofenadine.
469 AN APPROACH OF ACHARYA SUSHRUT ON ASHMARI , Dr. Mohit Maru* and Dr. Rajesh Gupta
Urolithiasis is a very common disease in today’s era. Due to changed standard of living and sedentary life style of people and it is strongly associated with race, ethnicity and region of residence. In Ayurveda this is known as Ashmari which is similar to calculi or stone. Apthya is an important factor in formation of ashmari. context about ashmari is available in most of the literature of ayurveda, both shaman and shodhan chikitsa is described for the treatment of ashmari. Acharya sushrut has mentioned shaman chikitsa like use of ghrita (medicated ghee), taila (medicated oil), paneeya kshara etc and he has also described about shalya karma for ashmari.
470 CARE IN CRISIS: MANAGEMENT OF HEMATOLOGY PATIENTS DURING COVID 19 PANDEMIC , *Prakas K. Mandal, Prakash S. Shekhawat and Tuphan K. Dolai
COVID-19 pandemic is probably the biggest crisis mankind has ever seen. It changed everything; how we live and how we die. Our healthcare is over- burdened and frontline warriors are getting down more than any other illness has ever caused. We need fresh guard and make our priorities regarding individual patient. Our ‘hit hard and hit fast’ has changed to ‘go soft and go slow’. In the disease entities other than potentially curable acute leukemias and aggressive lymphomas, we should consider low intensity and preferably oral therapy. Allogenic stem cell transplantation (SCT) for aplastic anemia should not be deferred unlike autologous SCT for myeloma. We should promote more collaboration, reporting to various registries and make use of digital medicine to minimize in-person visits and categorizing cancer patients into tiers and thus reducing risk of covid 19 infection. Hopefully, with real time data and new information, we will win the war and can answer the big unknowns.
471 CHEMISTRY OF PANCREATIC POLYPEPTIDE HORMONE WITH OFFICIAL PREPARATION , Arpan Chanda*, Arunava Chandra Chandra, Dr. Dhrubo Jyoti Sen and Dr. Dhananjoy Saha
Insulin which is a peptide hormone is produced by β‒cells of the pancreatic islets and it is considered to be the main anabolic hormone of the body. It further regulates the metabolism of carbohydrates, fats and protein by promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cells. In these tissues the absorbed glucose from the blood is thus converted into either glycogen via glycogenesis or fats (triglycerides) via lipogenesis, or, in the case of the liver both glycogenesis and lipogenesis. Glucose production and secretion by the liver is strongly supported by high concentrations of insulin in the blood. Circulating insulin on the other hand also affects the synthesis of proteins in a wide variety of tissues. It is thus an anabolic hormone which promotes the conversion of small molecules in the circulating blood into large molecules inside the cells. Conversely low insulin levels in the blood have the opposite effect that promotes widespread catabolism, especially of reserve body fat. β‒cells of the pancreatic islets are specifically sensitive to blood sugar levels thus they secrete insulin into the circulating blood in response to high level of glucose; and conversely inhibits the secretion of insulin when blood glucose levels are low. Insulin is responsible for glucose uptake and metabolism in the cells, therefore reducing the blood sugar level. The α‒ cells which are present near the β‒cells of the pancreatic islets, takes their cues from the β‒cells and secretes glucagon into the blood in just the opposite manner i.e. increased glucagon secretion when blood glucose is low, and decreased glucagon secretion when glucose concentrations are high. Glucagon thus increases blood glucose level by stimulating glycogenolysis and gluconeogenesis in the liver. The secretion of insulin and glucagon into the circulating blood in respective response to the glucose concentrations in the blood is termed as glucose homeostasis. Insulin was the first peptide hormone discovered. Frederick Banting and Charles Herbert Best, working in the laboratory of J.J.R. Macleod at the University of Toronto, were the first to isolate insulin from dog pancreas in 1921. Frederick Sanger sequenced the amino acid structure in 1951, which made insulin the first protein to be fully sequenced. The crystal structure of insulin in the solid state was determined by Dorothy Hodgkin in 1969. Insulin is also the first protein to be chemically synthesized and produced by DNA recombinant technology. It is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system.
472 AYURVEDA VIEW ON PRAMEHA W.S.R. TO ROLE OF GENETICS FACTORS , Rohit Naresh Shukla* and Dr. Satyendra Singh
The ancient practice of Indian medicine merely works around theories and principles of Ayurveda science. The Ayurvedic scholars explained various theories related to the disease and health management, Genetics is one of them which involve characteristics transmission from generation to generation. Ayurveda describe genetics with the help of concept of basic units like Beeja, Beejabhag and Beejabhagavayav. Prakriti is also considered important for genetics. Hereditary and congenital types of diseases are classified by some ancient scholars. Ayurveda mentioned different types of hereditary diseases like Prameha which may also occur due to the improper lifestyle, lack of exercise and faulty dietary habits. According to some Ayurvedic literature, Prameha is a Kulaj Vikara and occurs as a result of Beej Dosha.
473 RISK FACTORS, COMPLICATIONS, MANAGEMENT AND CLINICAL OUTCOME OF NOSOCOMIAL DIARRHEA IN MEDICAL ICU , *Binsa Jose, Christeena Mariyam Baby, K. S. Irfan, Olivia Sunny Mukalelparambil, Antriya Annie Tom and Dr. Rakesh K. R.
WHO defines diarrhea as the passage of 3 loose stools per day. A Bristol score of 6 or 7 is also classified as diarrhea‖. The incidence of diarrhea in intensive care unit ranges from 2- 95%. Diarrheal episodes of duration less than 14 days is acute diarrhea if it is greater than 14 days then it is persistent diarrhea and a chronic diarrhea is of duration greater than 30 days. Both infectious and noninfectious etiology accounts for diarrhea. The infectious causes can be bacterial, viral and protozoal, Non-infectious diarrhea can be disease, medication and diet related. The major complications associated with diarrhea in critically ill patients are Skin breakdown, electrolyte abnormalities, nutritional deficiencies, metabolic acidosis, hemodynamic instability, severe dehydration. Discontinuation of provoking medications, antidiarrheals, probiotics, metronidazole and vancomycin specifically in clostridium difficile induced diarrhea are the treatment option employed for the management of diarrhea Diarrheal patients in the intensive care unit are also seen to have a rise in morbidity rates. High rates of nosocomial co-infections are associated with certain bacteria that leads to diarrhea which when untreated escalates the morbidity and mortality rates. Diarrhea affects adversely multiple clinical outcome such as hospital mortality rates and length of stay.
474 A REVIEW ON KHALITYA PALITYA TREATMENT APPROACH , Dr. Pratiksha Sadanapurkar* and Shreeranga Chhapekar
Sapta dhatu are present throughout the body but its proportion is different in different organs, hence they also have some specific sthanas in the body as Tri-doshas like meda dhatu on Udar (abdomen) and sphik (buttocks), Sukhra on face, maja dhatu on areas related eyes, rasa is related to skin throughout the body. This can be of great help while treating the Khalitya (hair loss) and Pailtya (Greying) in that area because here we are not only considering the Doshas but also the specific dhatus to be treated. It helps us to reach the sukshma samprapti of the disease. Palitya and Khalitya in certain areas can also be beneficial to understand the penetration of ushma in the deeper dhatus. If all these factors are taken into consideration it increases the chances of treating Khalitya and Palitya as is it said to be Asadhya in Madhav Nidan.
475 CHANGING TRENDS IN DENTAL CLINIC WITH PEDIATRIC CONSIDERATIONS DURING COVID-19 , Dr. Kritika Choubey*, Dr. Ankur Jain, Dr. Rinky Sisodia, Dr. Satish Maran, Dr. Anaya Kulkarni and Dr. Sapna Mishra
We are facing a global health crisis unlike any which the world has seen in many decades. The coronavirus disease (COVID-19), which has been characterized as a pandemic by the World Health Organization, is attacking societies at their core. In the human body, this coronavirus is abundantly present in nasopharyngeal and salivary secretions of affected patients, and its spread is predominantly thought to be respiratory droplet/ contact in nature therefore dentists, auxiliaries as well as patients undergoing dental procedures are at high risk of cross-infection. Most dental procedures require close contact with the patient’s oral cavity, saliva, blood, and respiratory tract secretions. Also while treating paediatric patients dental professionals indulge in close, face-to-face, communication with patients and parents, which could possibly introduce them to droplets generated from an unprotected cough or sneeze. Saliva is rich in COVID 19 viral load. Dental professionals, may encounter patients with suspected or confirmed SARS-CoV-2 infection and should act diligently not only to provide care but at the same time prevent nosocomial spread of infection. Thus, the aim of this article is to provide specific modifications in dental home for practice regarding patient screening, infection control strategies, and patient management protocol and also providing guidance to all paediatric dentist while attending patients <16 years of age.
476 AYURVEDA PERSPECTIVE TOWARDS PANDEMIC DISEASES W.S.R. TO CURRENT SCENARIO: A REVIEW , Dr. Pradeep Kumar Chouhan* and Prof. Sapna Malviya
Ayurveda is a science which can be applied for both preventive and curative aspects of various diseases. Since ancient time outbreaks, pandemics of Sankramak Roga (communicable diseases) were known to the Ayurvedic scholars. They coined the term Aupasargika Roga for epidemics, which indicates sudden, outbreaks of a particular disease in a local area. When this outbreak rapidly spreads to the other parts of the country it is termed as Janapadodhvansa Roga (Pandemics). Increasing population, change in environment, increased prevalence of drug resistant in microbes and poverty has increased cases of Sankramak Roga in 19th and 20th century. HIV, Swine-flu, Ebola virus outbreak and recently world is facing Covid-19 threat. According to Ayurveda Janapadodhvansa can be managed through preventive and curative approaches of Ayurveda like; Shodhana and Rasayana.
477 TREATMENT ADHERENCE IN END STAGE RENAL DISEASE USING ESRD- AQ IN A MAJOR HOSPITAL IN INDIA , *Alpha Shereef, Jayakrishnan S.S. and Sajeevkumar K.S.
Introduction: Chronic kidney disease (CKD) is a progressive irreversible structural damage or kidney function. It is a major metabolic disorder responsible for the increased global morbidity due to non communicable disease. End stage renal disease (ESRD) is the most serious stage. In patients with ESRD, renal replacement therapy such as long term dialysis or kidney transplantation is needed for survival. Objective: To assess the treatment adherence in end stage renal disease patients using ESRD-AQ. Study design and setting: Cross sectional study carried out in the Department of Nephrology, Govt. Medical College, Thiruvananthapuram, Kerala, India. Study period & Population: Six months with 88 participants and Patients those who were reported to the dialysis center during the study period. Procedure: Patient included in the study was asked to give an informed consent based on the IRB approval of the study. Then patients/ care giver were interviewed by using valid questionnaire. It consists of 46 questions divided into five sections. Results & Discussion: The number of married patients exceeded in this study. The economic status of majority of patients was in the below poverty level and most of them were from rural area. Majority of patients had 4 hours of duration of haemodialysis. Most of the patients had haemodialysis twice weekly. Most of the patients had high adherence in medication. Fluid restriction had medium adherence. Dietary recommendation had high adherence. Majority of patients (84.1%) had diabetes and hypertension as co-morbidity. Conclusion: Adherence to diet recommendations, fluid restrictions, prescribed medications and attendance at haemodialysis sessions were essential for optimal and effective treatment of patients with end stage renal disease. Counselling and education of patients on HD are important to improve therapeutic outcome. Treatment adherence is a dynamic behaviour therefore needs constant monitoring. Family supports are important to improve patient’s adherence towards the treatment.
478 DRUG USE PATTERN AND ASSESSMENT OF ADVERSE DRUG REACTIONS IN THE MANAGEMENT OF NEPHROTIC SYNDROME IN PAEDIATRICS , Priya Nair S.*, Jayakrishnan S. S. and Susan Uthup
Nephrotic syndrome is a common chronic disorder, characterized by alterations of permselectivity at the glomerular capillary wall, resulting in its inability to restrict the urinary loss of protein. The objective of the study was to find out the drug use pattern and assessment of adverse drug reaction during the management of Nephrotic syndrome in paediatrics. It was a six months prospective observational study conducted in the tertiary care setting, with 81 patients along with their caretakers attending the Paediatric Nephrology Clinic, Department of Paediatrics, SAT hospital, Govt. Medical College, Thiruvananthapuram, Kerala, India. Patients who meet the inclusion criteria are included in the study. The prescription of the patients were collected and data regarding the physician’s clinical assessment of patients, laboratory results , drug prescribed, details of patients with adverse effects, treatment taken and recovery status were entered in the prepared proforma. The study data revels that, majority of the patient population were in the age group between 5 to 10 years and showed male predominance. Mean age of onset of Nephrotic syndrome in the study population was found to be 4.1 ± 3.2 years. In the study group most of the patients were steroid responsive, steroid dependent, followed by steroid resistant. The compliance rate was found to be very high. The non-compliance reported was due to ignorance and adverse effects. The most common ADR with prednisolone was found to be increased appetite followed by behavioural and mood change. Stunting, cushing’s syndrome, osteoporosis and cataract were the other adverse effects. The most commonly occurring ADR with levimasole was extreme fatigue, followed by muscle weakness, memory loss and vasculitic rashes. Cyclophosphamide is effective among late responders and frequent relapsers. The study concluded that Childhood Nephrotic syndrome has a relatively favourable long-term prognosis. ADRs contribute significantly to patient’s morbidity and mortality and are a significant public health concern.
479 AN OBSERVATIONAL STUDY OF ETIOPATHOLOGICAL FACTOR OF MEDO ROGA W.S.R TO OBESITY , *Dr. Pandey Akanksha, Dr. Avadhesh Kumar and Dr. Jaiswal Ramnihor Tapsi
Medoroga and Sthaulya (obesity) is considered as synonyms in Ayurvedic samhita on various places. It is characterized by excessive deposition of meda dhatu (~ adipose tissue ) and mansa dhatu specialy in particular part of body hips abdomen and breast create superfluous mobility of sphiga, udara, stana, and abdominal extension, the metabolism (anabolism) of that kind of stout patient bothered, patient suffering from lack of interest i.e. deprived mental status. Obesity is often expressed in terms of body mass index (BMI). Overweight is usually due to obesity but can arise from other causes such as abnormal muscle development or fluid retention. There are several causes like sedentary life style, lack of exercise, faulty dietary intake, excessive intake of sweet, stress, psychological and genetic etc. To prevent this troublesome problem, it is necessary to avoid most of the Etiological factors which are the main preventive measures. Obesity like Metabolic syndrome has received increased attention more and more in the past few years.
480 HEALTH STATUS OF THE INMATES IN WOMEN SHELTER HOME, RANCHI: FINDINGS OF A HEALTH CAMP , Shalini Sunderam, Anju Prabha Kumari*, Dewesh Kumar, Neelanjali Kumari and Vivek Kashyap
Introduction: There is scanty data revealing the health profile of the inmates of shelter home, so there was a felt need to assess the actual situation of these shelter homes. Aim and objectives- (i) To obtain the socio-demographic information of the inmates of the women shelter home. (ii) To assess the health status of the study population. Methodology: This cross sectional study was carried out among the inmates, at Nari Niketan, Kanke, Ranchi on 17th October 2019, during a health checkup camp, conducted by Department of Community Medicine, RIMS, Ranchi. Out of total 37 females residing there, only 26 females participated in the study and were interviewed using pretested semi structured questionnaire. Result- The mean age(SD) of the participants was 23.65(6.026) years. Maximum participants (85%) were from Jharkhand, 61.5 % were unmarried and 35% of the participants had no formal education. On general examination, 100% participants were found anemic and underweight. More than half (58%) of the study population were manifesting symptoms of anxiety and depression. Conclusion: The population residing in the women shelter home was found vulnerable to malnutrition, anemia, and mental disorder. The population needs proper attention in terms of balanced diet, regular health checkup and good counseling by the psychologists.
481 ISOLATION AND ANTIBIOTIC SENSITIVITY PATTERN OF MICROORGANISMS FROM URINE SAMPLE CAUSING UTI IN A TERTIARY CARE HOSPITAL, SOUTH KARNATAKA – A RETROSPECTIVE STUDY , Bernaitis L., Vipin Unni P., Sumona Kundu, Revathi P. Shenoy* and H. Manjunatha Hande
Aim and objective: A retrospective study was undertaken to identify the various pathogens isolated from the urine samples and to determine the antibiotic resistance pattern of the major uropathogens causing UTI among patients attending Kasturba Hospital, Manipal. Materials and Methods: A total of 96 patients (40-60 years ) with UTI, from the period of April to may 2014 , urine samples were collected and examined for microscopic, Gram stain and culture techniques. Isolated microorganisms were identified using microscopically, morphological and biochemical tests. Antibiotic susceptibility tests were done on Mueller-Hinton agar by the Kirby-Bauer disk diffusion method as per Clinical and Laboratory Standard Institute Guidelines. Results: The most common organism isolated was Escherichia coli 71 (74%)followed by Klebsiella pneumoniae 16(17%). The other organisms isolated were Pseudomonas 1 (2%), Beta-hemolytic streptococci 1 (2%), Methicillin resistant Staphylococcus aureus 2(2%),Enterococcus 1 (1%),Enterobacter 1(1%) and Proteus 1 (1%). Escherichia coli was sensitive to Amikacin and most resistant to Ampicillin/Amoxicilli 81(84%cases were resistant).Klebsiella pneumonia has developed complete resistance to Ampicillin/Amoxicillin96(100%) group of drugs and sensitive to Amikacin.Among the first line drugs, Amikacin and Netilmicin are the most effective whereas the Penicillin group of drugs is the least effective.Imipenem is the most effective reserve drug and high level of resistance is seen against the third degree cephalosporins. Conclusion: The study presents a very dismal picture against all the drugs used in empirical therapy for UTI. Both the Penicillin group and the Cephalosporin group of drugs have developed significant resistance against them.The only oral antibiotic effective among the first line drugs is Cotrimoxazole.
482 PHARMACOGNOSTICAL AND PHARMACEUTICAL EVALUATION OF HARITAKI KWATH , Dr. Priyanka Balasaheb Varpe*, Dr. Jayprakash Ashok Khairnar and Dr. Ravindra Baban Aatram
Mutrakrichchra nearer to urinary tract infection, in which dysuria is the most common feature, is one of the prime diseases affecting mutravaha srotas (urinary system) involving the basti marma (bladder). Haritaki have been described in the treatment of mutrakriccha and its krimighna properties mentioned by Bhavaprakash. Haritaki was selected in the present study for the sensitivity of organisms found in urine culture to Haritaki kwath disc. The present study was aimed at setting up a standard profile of Haritaki kwath which was prepared using pharmacognostically authenticated raw drugs followed by subjecting it to detailed pharmacognostical and physicochemical analysis as per standard protocol. The observations were systematically recorded. Pharmacognostical findings of raw drugs confirm the authentication of Haritaki fruit bharad churna. The Total Ash% was 4.33%, Acid insoluble Ash Value was 0.870%, Loss on drying was 19.96. Spectroscopy shows absorption value at 1.43 on U.V absorption spectra 302nm. This facilitates proper soaking and boiling of the raw material.
483 AWARENESS AND ATTITUDE OF HEALTHCARE PROFESSIONALS REGARDING COVID-19 IN CENTRAL INDIA , Sonali S. Patil*, Sarita K. Sharma, Ujwala U. Ukey, Pragati G. Rathod and Uday W. Narlawar
Background: Relentless spread of the ongoing COVID-19 pandemic has become a major cause of concern for healthcare professionals who have a crucial role to play in identification, assessment, reporting and management of potential cases of COVID-19.A poor understanding of the disease among healthcare workers may result in rapid spread of infection. Also they have the highest risk of being infected by this highly contagious disease. The present study was conducted, to assess the level of awareness and attitude of healthcare professionals about COVID-19 in Central India. Materials and methods: The present cross sectional study was conducted at a tertiary-care hospital and teaching institute using an online semi-structured questionnaire.919 respondents(311 post graduate students,156 interns and 452 nurses) completed the survey giving a response rate of 83.54 %.Statistical analysis was done using Microsoft office excel. Results: Social media, television and newspaper were the main sources of information. The overall awareness for all subgroups regarding etiology, symptoms and preventive measures was fairly good. However certain gaps were identifed in their knowledge about sequence of donning and doffing PPE, drugs used for treatment and chemoprophylaxis, containment and surveillance. A higher percentage of correct responses were obtained from postgraduate medical students and interns as compared to the nurses. The attitude of healthcare professionals towards COVID-19 appeared to be fairly positive. Conclusion: Healthcare professionals have adequate awareness of COVID-19 and a positive attitude. However there is a need to implement periodic educational interventions and training programs.
484 TREATMENT ON BHAGANDARA W.S.R. TO FISTULA IN ANO WITH IFTAK TECHNIQUE – A SINGLE CASE STUDY , *Dr. Jitendra Kumar Yadav and **Dr. Arun Kumar Singh
Fistula in ano is an abnormal communication between the anal canal or rectum and the perianal skin, which causes a chronic inflammatory response. The most common cause is nearly always by a previous anorectal abscess. The chief complaint of anorectal fistula is constant drainage or discharge. There occurs infection of anal gland which is responsible for Fistula in ano. There are many type of treatments available like Ksharsutra chikitsa, IFTAK (Interception of fistulous track and application of ksharsutra), LIFT(Ligation of intersphincteric fistula tract), VAAFT (Video-assisted anal fistula treatment), laser treatment.
485 STUDY ON HEART FAILURE PROFILE OF PATIENTS PRESENTING AT BAHAWALPUR VICTORIA HOSPITAL , Dr. Rubina Zain*, Dr. Anum Yaseen and Dr. Anfal Ijaz
Objective: To assess the heart failure profile of patients presenting at Bahawalpur Victoria Hospital. Material and methods: This cross sectional study was conducted at Outpatients Department of Bahawalpur Victoria Hospital, from January 2019 to June 2019 over the period of 6 months. Total 1000 patients presented with symptoms and signs of heart failure according to Framingham criteria either male or female and having age >20 years were included. Results: In present study mean age of the patients was 50.70±14.8 years. Male patients were 644 (64%) and female patients were 356 (36%). Most of the patients belonged to age group 51-60 years. Total 544 (54.4%) patients were hypertensive, obese were 105 (10.5%) smokers were 417 (41.7%). Ischemic heart disease was the most common (586/58.6%) etiology. Conclusion: Findings of this study showed that male were more victim of heart failure as compared to female. Age group 51-60 years was the most commonly affected age group. It is also revealed that most of the patients were hypertensive and smokers. Ischemic heart disease was the most common etiology.
486 AUDIT OF METABOLIC SYNDROME IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) , Dr. Anum Yaseen*, Dr. Anfal Ijaz and Dr. Mehak Khadim
Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive resulting from exposure to noxious stimuli or gases. Additionally, exacerbations and comorbidities contribute to the overall severity in the individual patient. Objective: The objective of this study was to assess the frequency of metabolic syndrome in patients with chronic obstructive pulmonary disease. Material and Methods: This study was conducted in Department of Medicine Bahawalpur Victoria Hospital during August 2018 to August 2019. This is a cross sectional study which include 148 patients, who were presented with COPD in the hospital. After approval from ethical committee all the parents were informed for the purpose of the study and a written informed consent was taken from the patients. Their Waist Circumference, Glucose Level (mg/dL), Triglyceride level (mg/dL), High Density Lipoprotein level (mg/dL), Systolic & diastolic blood pressure was measured for the diagnosis of metabolic syndrome. Effect modifiers like age, gender and BMI were addressed through stratification of data. All the data was collected through a well-defined Performa. Results: From 148 patients, it was observed that the minimum age was 36 years and maximum age was 65 years with mean and standard deviation of the age was 52.44 ± 7.83 years. The minimum waist circumference was 70 cm and maximum was 114 cm with mean and standard deviation was 90.24 ± 13.80cm. The minimum glucose level was 80 mg/dL and maximum was 115 mg/dL with mean and standard deviation was 94.05 ± 11.15 mg/dL. Conclusion: The frequency of metabolic syndrome was found in 43.9% patients with chronic obstructive pulmonary disease. All effect modifiers have significant influence.
487 A CLINICAL TRIAL OF THE DRUG SHATPUSHPA (ANETHUM SOWA) ON ARTAVA SHAYA(OLIGOMENORRHEOA): A REVIEW , Dr. Himani Purohit*, Dr. Omprakash Sharma and Dr. Pratibha
A clinical trial was carried out on 25 oligomenorrhoea [Artava Kshaya] patients aged between 18 and 30 years having complaints of irregular, scanty and painful menstruations. They were administrated Satapuspa churna for three months in a dose of 5 g twice daily with cow grita. The specific investigations were done in order to exclude TB endometritis, endocrine disorders, diabetes etc. The clinical assessment was carried out in thirty days intervals. It is inferred that the study discloses the effect of satapuspa churna on irregularity of interval of menstruation , duration of menstruation, amount of blood flow and pain during menstruation, which were highly significant in clinical study. Not any serious side effects were noticed during clinical trial.
488 CUTANEOUS TUBERCULOSIS HIDING PULMONARY TUBERCULOSIS: A PEDIATRIC CASE REPORT , Laila Berrada, Chafik Mahraoui and Naima El Hafidi
Morocco is an endemic area of tuberculosis, where lung disease occupies the first place. Skin tuberculosis represents only 1 to 2% of extra pulmonary tuberculosis.[1] Its diagnosis is difficult to establish because of the polymorphism of the anatomo-clinical presentation and the multiplicity of differential diagnoses. We report the case of a child who had developed bifocal tuberculosis after tuberculous contagium, and the skin tuberculosis led to discovering pulmonary tuberculosis. Cutaneous tuberculosis occurs in several clinical forms that can coexist or complicate each other. It remains a current disease, the diagnosis of which is difficult because it is often unknown.In the case of a secondarily ulcerated and irregular nodular skin lesion, failure to respond to conventional treatment should lead to histological and bacteriological examination. Peri-orificial cutaneous tuberculosis, although rare, must also be mentioned in the face of a symptomatology that is dragging and resistant to symptomatic treatment. The improvement of living conditions and the implementation of an anti-tuberculosis control approach are essential for the eradication of the disease.
489 SALMONELLA MENINGITIS IN AN INFANT: A CASE REPORT , I. Amassas*, S. Benchekroun, F. Benbrahim, C. Mahraoui and N. Hafidi
Introduction: Salmonella infections are a public health problem, generally the bacterial agents "salmonella" are responsible for digestive infections, meningeal localization remains very rare. This localization is associated with a high mortality rate of more than 50%, relapses and abscesses of the brain are not uncommon. Reporting to us a case of salmonella meningitis, focusing on his diagnostic and therapeutic management. Materials and Methods: This is a 03-month-old infant, with no pathological history, admitted for management of a suspected recurrent meningitis, clinical examination objected a high fever, hypotonic infant with a bulging anterior fontanel. Thecerebrospinal fluid analysis was compatible with bacterial meningitis with direct examination of BGN, the culture identified salmonella, and the patient was initially put on ceftraixone at a meningeal dose. The evolution was marked by the persistence of fever with the onset of a convulsive state complicated by left ptosis, ciprofloxacin was added at a rate of 20 mg / kg / day for 06 weeks with a very good result. Discussion: Salmonella meningitis is rare, this localization particularly concerns newborns and infants whose contamination is often inter-familial. Early and adequate therapeutic management determines the patient's vital and functional prognosis. Conclusion: Salmonella meningitis is an infrequent but serious pathology, regardless of their location, especially gastroenteritis, must be treated early and properly to avoid complications such as meningitis.
490 PRIMARY LYMPHOMAS OF BONE , *Beth Vettiyil, MD and Brandon Walter Evans, MD
Primary lymphomas of the bone are rare cancers that only affect the osseous structures without any lymph node involvement. These patients usually present with localized pain and swelling. Radiological studies may show an aggressive local osseous lesion. Treatment options also need to be aggressive, usually involving a combination of surgical and non-surgical options. We present a case of a 56 year old male who presented with progressive painful swelling in his right lower extremity.
491 A STUDY TO ASSESS THE KNOWLEDGE ABOUT OCCUPATIONAL HEALTH ILLNESS AND MEDICATION USE AMONG SUGAR FACTORY WORKERS IN BHARATHINAGAR , Manu P. R., Chethan Kumar T. and Vikneshwari A.*
Occupational health hazards or occupational disease as a source or situation with potential for harm in terms of injury or ill health, damage to property, damage to the workplace environment, or a combination of these. The workers are working in sugar industries are prone to face a number of stress. Repeated attacks can cause fine scarring of the lungs and impaired breathing. This study is conducted with the aim to assess the knowledge about health illness and medication use among sugar factory workers in Bharathinagar. This is a cross sectional study, conducted in a sugar factory at Bharathinagar, Mandya district, over a period of 6 months. The workers were selected by convenient sampling technique. Out of 140 workers, majority of the workers are in the age group of 51-60 years (48.57%), All are male workers. Majority (68.57%) of the workers having monthly income between 20000- 25000, majority (44.29%) of the workers are having the working experience between 21-30 years, majority (42.86%) of the workers have the habits of both alcohol and smoking. From the study we revealed that (57.14%) of the workers are suffering from the musculoskeletal problem and majority (89.28%) of the workers are having the knowledge of risk of exposure to noise, (61.42%) of the workers are having the knowledge of risk of exposure to heat, (85.71%) of the workers are having the knowledge of risk of exposure to dust. Most of the workers had poor knowledge about self-reported practice regarding personal protective equipment. The finding of this study shows that most of the workers had knowledge about occupational health hazards, and unsatisfactory self-reported practice.
492 CLINICAL STUDY ON VANDHYATWA (FEMALE INFERTILITY) W. S. R. TO ANOVULATORY FACTOR AND ITS MANAGEMENT BY 3 STEP TREATMENT- A CASE STUDY , Dr. Madhuri S. Bhalgat* and Dr. Swapnali B. Bari
A female patient of 29 years old of primary infertility with pitta pradhan vata prakruti was diagnosed as anovulation (anartava) on the basis of follicular study. Along with this she was diagnosed as pittaj yonidushti according to her complaints. Three step treatment was given to her with pathyakar aahara and vihara. She was treated with Lashunadi taila matra basti in premenstrual phase (15/11/2019 to 21/11/2019) followed by oral administration of Chandraprabhavati and Shatpushpa choorna. In post menstrual phase (28/11/2019 to 2/12/2019) pichu dharana i.e. medicated vaginal tampon treatment was given. After this treatment she missed her period, we performed her UPT (30/12/2019), it detected presence of HCG in urine sample and on 20/01/2020, SLIUP of 8.5 weeks seen in USG report. Successful conception is achieved in that patient within one month. This treatment was found effective in one patient of vandhyatwa. Anovulatory factor is an important subset in infertility in present case. Ovulation is under the control of vata especially apana vayu which can be regulated by basti with vatahar dravya. So considering “Lashunah Prabhanjanam”, Lashunadi tail matra basti is given in premenstrual phase. So in this case ovulation induction is rescuer. Considering pittaj yonidushti, the acidic pH of vagina can hamper sperm entry which is remedied by doing pichu dharana. Present single case study will explain how to understand and manage infertility based on Ayurveda perspective.
493 ASSOCIATION OF POSITIVE FAMILY HISTORY WITH BREAST CANCER IN YOUNG FEMALES WITH BREAST LUMP , Dr. Amna Afzal*, Dr. Anum Akbar and Dr. Ammara Mehmood
Background; Breast cancer is most frequently diagnosed cancer in females. It has a major impact on health of women. According to a World Health Organization [WHO] estimate, more than 1.2 million people are diagnosed with breast cancer worldwide every year. This study was conducted to determine the frequency of breast cancer in patients presenting with breast lumps in our population. Objective; To determine frequency of breast cancer among young females presenting with breast lumps at a tertiary care hospital. Material and Methods; Consecutive 160 young ladies presenting with breast lumps were taken. Young females with breast lumps were taken and diagnosed for breast cancer. All the data was entered and analyzed using SPSS-20. Results; Of these 160 study cases, 98 (61.2 %) were un-married female patients while 62 (38.8 %) were married female patients. Mean age of our study cases was 23.23 ± 3.85 years (with minimum age of our study cases was 18 years while maximum age was 32 years). Our study results have indicated that majority of our study cases i.e. 123 (76.9 %) were aged up to 25 years. Mean body mass index of our study cases was 26.23 ± 1.92 kg/m2 and obesity was present in 48 (30.0 %). Mean disease duration was 2.98 ± 2.54 months and 111 (69.4%) had duration of illness up to 3 months. Breast cancer was noted in 40 (25.0%) of our study cases. Conclusion; High frequency of breast cancer was noted in our study among young females presenting with breast lumps. Breast cancer was significantly associated with marital status, increasing age, residential status, socioeconomic status and family history of breast cancer. These findings suggest that females at every age group with breast lumps need specialized care for diagnosis and management.
494 BILATERAL MÜLLER-WEISS DISEASE: A RARE CAUSE OF FEET PAIN , Dr. Safaa Fellous*, Hanan Rkain, Saloua Afilal, Jihad Moulay Berkchi, Latifa Tahiri and Fadoua Allali
Müller–Weiss disease, or spontaneous osteonecrosis of the tarsal navicular in adults, is a rare cause of chronic mid-foot pain, characterized generally by a collapse of the lateral portion of the tarsal navicular. In this article, we describe a case of bilateral spontaneous osteonecrosis of the lateral portion of the tarsal navicular in a 56-year-old woman. This case illustrates the diagnostic imaging findings for Müller-Weiss disease.
495 COVID 19 –X-RAYS, CT, ULTRASOUND AND PET/CT – A REVIEW , *Dr. Beth Vettiyil MD, Adam Thomas MD FRCP, Anish Mitra MD MPH, James Vincent Cortez MD and Angel Serah BASc EIT PEO
COVID-19 or Coronavirus disease 2019 is a pandemic that has now spread across the world. It has infected millions of people with 25 million cases tested positive and 855, 000 deaths worldwide as of September 1, 2020.[1] This virus was first brought to attention when a cluster of pneumonias of unknown etiology started popping up in Wuhan, Hubei Province, China towards the end of 2019.[2] A new coronavirus was identified and named severe acute respiratory coronavirus 2 (SARS – COV- 2) by the International Committee on Taxonomy of Viruses (ICTV) in February 2020. (2) The World Health Organization declared COVID-19 a Public Health Emergency of International Concern on January 31, 2020 and a Pandemic on March 11, 2020.[3] As of September 1, 2020, COVID-19 has spread to 212 countries and territories spanning 6 continents.[4]
496 MACRODYSTROPHIA LIPOMATOSA: CASE REPORT , Dr. Samuel Villeda Bojorque*, Elvis Iván López, José Carlos Echeverría Solís and Mary Cotí De Xicara
Lipomatosa macrodystrophia is a not well know pathology worldwide, which is characterized by a rare form of localized gigantism that can be seen from birth. This has a slow and progressive growth pattern in which the increase in size of the mesenchymal tissues and fibroadipose tissue is evidenced. These alterations cause a great clinical, functional and psychological repercussion in affected patients. This is the case of a 14-year-old male patient with lipomatosa macrodystrophia in the left hand who presents clinical and radiological characteristics of this pathology.
497 BUDD-CHIARI SYNDROME IN FEMALE PATIENT TRIGGERED BY ORAL CONTRACEPTIVES WITH PREVIOUSLY UNDIAGNOSED JAK2 MUTATION , Goran Bokan,* Nikola Malešević and Vlado Đajić
Budd-Chiari Syndrome (BCS) is usually characterized by a triad of symptoms: epigastric pain, hepatomegaly and ascites. The actual incidence of Budd-Chiari syndrome is not fully known, but it is thought that usually is based on a latent hematological hypercoagulable process that is responsible for almost 75% of cases. The paper presents a case report of a patient who took oral contraceptives and had a previously undiagnosed JAK2 mutation that led to BCS.
498 AWARENESS, ACCESSIBILITY AND UTILIZATION OF CONTRACEPTIVES AMONG WOMEN OF CHILDBEARING AGE IN 3 SELECTED HOSPITALS IN ENUGU NORTH , Obiefuna Adaobi Genevieve, Nwagbo D.F.E, Chukwu Sunday Kyrian, Chukwu Stella Nchekwubedi and Obeagu Emmanuel Ifeanyi*
The study was done to determine the level of awareness, accessibility and utilization of contraceptive among women of child bearing age (15-49years) at Enugu. A sample of 350 women of child bearing age (15-49years) will be used. The most common source of information about contraceptive methods was from health personnel 147 (43.1%), followed by family/friends 103 (30.3%), school 64 (18.8%), television/radio 14 (4%) while the least common source was from magazines 13 (3.8%). As regards awareness of forms of contraceptive methods, 327 (93.4%) were aware of emergency contraception, 320 (91.4%) were aware of use of male condom as contraceptives, 315 (90%) pills, 304 (86.9%) safe period, 300 (85.7%) withdrawal method, 269 (76.9%) injections, 268 (76.6%) IUCD, 158 (45.1%) vasectomy, 156 (44.6%) tubal ligation, diaphragm 97 (27.7%), female condom as the least method of contraceptive respondents were aware of, with 45 out of 350 respondents (12.8%). The study found that majority of the respondents were within the age group of 15-29, this represents n=174 (49.7%) of total number of 350 respondents, followed by 30-39 age group with n=141 (40.3%) of respondents. This study has shown that while there is good contraceptive awareness 97.4% in Enugu, Nigeria, this has not been matched by commensurate contraceptive prevalence but prospects for improvement exist. Majority of the respondents knew where to access their choice of contraception, with 69.4% citing the teaching hospital. Among the respondents 78.3% had used a form of contraceptive and 36.6% were currently using one form of contraceptive at the time the study was conducted. Male condom however was the most frequently used form of contraception, followed by pills which might be due to easy accessibility of these methods. The notable barrier to contraceptive use was fear of side effects with weight gain being the most frequent.
499 EFFECTS OF CO-ADMINISTRATION OF MYRISTICA FRAGRANS HOUTT (NUT MEG) AND VITAMIN E ON OSMOLITY FRAGILITY OF POTASSIUM BROMATE INTOXICATED WISTAR RATS , Anonde Andrew Chekwube, Okoroiwu I.L., Okolie N. J. C., Udokwu Euphemia Ifeoma and Obeagu Emmanuel Ifeanyi*
Department of Medical Laboratory Science, Imo State University, Owerri, Imo State, Nigeria.
500 EFFECTS OF CO-ADMINISTRATION OF MYRISTICA FRAGRANS HOUTT (NUT MEG) AND VITAMIN E ON PLATELETS, PT AND APTT OF POTASSIUM BROMATE INTOXICATED WISTAR RATS , Anonde Andrew Chekwube, Okoroiwu I. L., Okolie N. J. C., Udokwu Euphemia Ifeoma and Obeagu Emmanuel Ifeanyi*
The present study was designed to evaluate the effects of co-administration of Myristica Fragrans Houtt (nut meg) and vitamin E on platelets, PT and APTT of potassium bromate intoxicated wistar rats. Dried nuts of nut meg were purchased from Ubani market in Umuahia North Local Government Area, Abia State, Nigeria and were identified by a botanist in the Department of Forestry and Environmental Management, Michael Okpara University of Agriculture, Umudike. In week two and three, there was significant decrease in platelet in all the treatment groups compared with control. There was no significant change in platelet after one week. In week one there was no significant difference in platelet of rats exposed to 10, 30 and 50 mg bromate and those treated with corresponding doses of nutmeg and vitamin E alone. However the combination of doses of nutmeg and vitamin E increased platelet count. In week 2 and 3, there was significant difference in platelet of rats exposed to 10, 30, and 50 mg bromate group, and those treated with corresponding doses of nutmeg and vitamin E alone and in combination compared with rats exposed to bromate alone. In week one, two and three, there was significant increase in average PT in all the treatment groups compared with control. Average PT varied significantly from week one to three in all the treatment groups. In week one two and three, there was significant difference in Average PT of rats exposed to 50 mg bromate and those treated with 500 mg nutmeg and 100 mg vitamin E alone and in combination compared with rats exposed to 50g bromated alone. The trend was similar in groups exposed to 10 and 30mg bromate compared with the respective treatment groups. In week one, two and three, there was significant increase in average APTT in all the treatment groups compared with control. Average APTT varied significantly from week one to three in all the treatment groups. In week one two and three, there was significant difference in Average APTT of rats exposed to 50 mg bromate and those treated with 500 mg nutmeg and 100 mg vitamin E alone and in combination compared with rats exposed to 50mg bromate alone. The trend was similar in groups exposed to 10 and 30mg of bromate compared with the respective treatment groups.
501 A REVIEW LITERATURE: MURDHNI TAILA , *Dr. Kalpana S. Wakode and Dr. Pooja Yashwant Keware
Ayurveda, the science of life, is treating mankind since ancient time and it aims to treat the diseases from its base and not only the symptoms. Now a day, in a world of competition, peoples are suffering from various stress related disorders like depression, insomnia and anxiety etc. A person might appear to be healthy but he may be suffering from one or other psychosomatic complication which may require relaxation therapies to lead a healthy life. One such therapy is Murdhni Taila.
502 CANCER HITS, BODY PAYS & THERAPY SAYS: SILVER BULLET , Dr. Kishor Dholwani, Kushal Nandi, Tanistha Mumtaz Chatterjee, Arpita Biswas and Dr. Dhrubo Jyoti Sen*
Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy (including immunotherapy such as monoclonal antibody therapy) and synthetic lethality. The choice of therapy depends upon the location and grade of the tumour and the stage of the disease, as well as the general state of the patient (performance status). Cancer genome sequencing helps in determining which cancer the patient exactly has for determining the best therapy for the cancer. A number of experimental cancer treatments are also under development. Under current estimates, two in five people will have cancer at some point in their lifetime. Complete removal of the cancer without damage to the rest of the body (that is, achieving cure with near-zero adverse effects) is the ideal, if rarely achieved, goal of treatment and is often the goal in practice. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness; and chemotherapy and radiotherapy can have a negative effect on normal cells. Therefore, cure with nonnegligible adverse effects may be accepted as a practical goal in some cases; and besides curative intent, practical goals of therapy can also include (1) suppressing the cancer to a subclinical state and maintaining that state for years of good quality of life (that is, treating the cancer as a chronic disease), and (2) palliative care without curative intent (for advanced-stage metastatic cancers). Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases. Angiogenesis inhibitors were once thought to have potential as a “silver bullet” treatment applicable to many types of cancer, but this has not been the case in practice.
503 CELLULITIS VARANSHOPHA W.S.R TO: A LITRERY REVIEW , *Dr. Anjali Meena and Dr. Vishnu Dutt Sharma M.S. Ph.D. (Ayu.)
Acharya susuruta father of Indian surgery (shalay tanta) in which surgical & parasurgical technique are described for management of various disease . vranashopha explained by acharya sushurta resemble in inflammatry swelling like cellulitis. cellulitis appear as a swellon , red area of skin . it is spreading inflammation of swelling like cellulitis explained a infection of deeper layer of skin and underlying tissue .Cellulitis is characterized by acute , diffuse spreading , edematous , inflammation of dermis and superficial subcutenous tissue. Jalloukavacharna best therapy because of its safty and high efficacy in the management of vranashpha.
504 TEST FOR DETECTION OR IDENTIFICATION OF POISON , Kumari Anupama*, Tiwari R. C., Dikshit Manisha, Singh Anoop Kumar and Sharma Vedbhushan
Cases of acute as well as chronic toxicity are increasing in number. Day by day a lot of new poisons in various forms are emerged with the development of human beings. So the new techniques and methods for diagnosis of poisoning is a need. Diagnosis by sign & symptoms is the main key till now. With the help of chemical screenings & thin layer chromatography like techniques, a qualitative diagnosis of majority of poisons can be done. Other highly developed methods like gas liquid chromatography, high performance liquid chromatography, ultraviolet – visible spectroscopy, atomic absorption spectroscopy, etc., possesses high specificity & accuracy for qualitative as well as quantitative estimation of poisons in any sample. Other than this chemical test or color test are also be done in various forensic laboratories and at site of crime. With help of these test type of poison detection becomes more easy.
505 SODHANA- A PROCESS OF PURIFICATION OR DETOXIFICATIONS OF VISHA AND UPVISHA IN AYURVEDA , Kumari Anupama*
Agadtantra, one of the parts of Ashtang ayurveda has specific importance regarding study of poisons, which helps to prevent persons from effect of poison. Several Acharyas have statement that not all medicinal plants are safe to use since they can bear many toxic and harmful phyto-constituents in them. There are some poisonous plants also, called Visha and Upvisha. To reduce their toxic effect some purification procedure should be done to prevent the fatal effect of visha dravya. So it is important to understand the process of Shodhana of Visha and Upvisha mentioned in Ayurvedic text. The science is proficiency of Visha Drvayas (poisonous drugs) for their theuraptic use is known as Shodhana. Various procedures of Shodhan is used for purification of drugs like Swedan, Mardan, Prakshalan (washing), Dhalana, Nirvapan, Bharjana, Bhavana (Levigation), Nimajjana (Dipping).This article helps to describe methods of purification of Visha and Upvisha mentioned in Ayurvedic text, which will help to understand purification of Visha dravya to avoid fatal effect and it will also help to increase the faith of patient over Ayurveda.
506 REVIEW AND EMPIRICAL PAPER ON SANDHIGATA VATA , *Dr. Singh Shailendra Kumar, Dr. Pravesh Kumar and Ashok Kumar
Ayurveda has described about the pathogenesis and the treatment of various disorders, the incidence of some of which have increased in the present scenario. Janu Sandhigata Vata correlated with osteoarthritis (OA) of the knee joint is one such chronic, degenerative, inflammatory disease which has a great impact on the quality of the life of an individual. Different modalities of treatment have been explained in the classics to tackle the condition effectively. Here we have randomly taken, records of 30 patients suffering from osteoarthritis (sandhigatavata) from the State Ayurvedic PG College and hospital Chaukaghat Varanasi, The patients were all age groups and both male and female. The recorded data shows about the prevalence of sandhigata vata in different human being.
507 AYURVEDIC ASPECTS OF DRAKSHA- VITIS VINIFERA L , *R. G. Raghi and Jollykutty Eapen
Ayurveda, the life science describes each and every plants on earth as medicine. Draksha (Vitis vinifera L.) is one of such extensively used Ayurvedic medicine. In this article an extensive literary review of the drug was done regarding its historical background, synonyms with its interpretation along with vernacular synonyms, properties, varieties, therapeutical uses, dosage forms and formulations in which draksha is an ingredient.
508 UNDERSTANDING TO TWACHA SHARIR: A REVIEW ARTICLE , Dr. Vikash*, Dr. Sakshi and Dr. Subhash Upadhyay
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. In Ayurveda classical text Twacha is included under “Pancha gyanendriya Adhisthana.” Twacha has various opinions regarding its uttapati, Twacha Stara and associated disorders. Several concepts about Twacha are also quite useful in diagnosis and treatment of many disorders. In Ayurveda several views and counterviews regarding concepts of Twacha is existing. So today it is necessary to clarify the visionary of Acharyas. Therefore this study is undertaken to verify and reveals various mysterious concepts about Twacha which will be useful in diagnostic, prognosis and therapeutic purpose of various disorders and craft a pathway for future research work.
509 RASASHASTRA AN AYURVEDA CONCEPT, GENERAL CONSIDERATION AND ROLE IN HEALTH MANAGEMENT: A REVIEW , Dr. Amit Kumar Meena*, Dr. Mukesh Kumar Bhamu, Dr. Sanju Kumar and Dr. Manraj Meena
The ancient literature of Indian system of medicine belongs from Ayurveda science which mentioned various principles and theories for the maintenance of general health. Amongst the many concepts of ayurveda the concept of Rasashastra is one of the prime importance which helps in the management of different diseases. The Rasa Dravyas mainly prepared with the classical approaches of ayurveda like Sodhana, Putta and Marana, etc. Rasashastra merely deals around mineral, metal and herbomineral formulations. The formulations of Rasashastra possess anti-stress, rejuvenating, anti-oxidant, aphrodisiac, anti-ulcers and hepato-protective effects, etc. These properties of Rasa Dravya impart great therapeutic utility in the management of different pathological conditions. Present article emphasizes general considerations and therapeutic utility of Rasashastra.
510 NARAYANA TAILA: A CLASSICAL OVERVIEW , Dr. Shalini Patel*, Prof. (Dr.) Sunil Kumar Joshi and Dr. Prashant Srivastav
Aushadha is an integral component of the Trisutriya Ayurveda and Ayurveda is our prestigious science of life. Similarly, as a part of Chikitsa Chatushpada in Ayurvedic classics importance is given to Aushadha. Moreover, the world‟s oldest available written literature i.e. Veda glorify the drug by giving it the status of „Bramha‟. A lot of Ayurvedic drug preparations are mentioned in classical texts, Narayana Taila is one of them and it is described by different Acharyas. It contains 33 ingredients according to different authors such as Yogaratnakara, Sharangadhara, etc. Bhaishajya Ratnavali elaborates 33 ingredients of Narayana Taila along with its indications in various diseases and different rout of administration in „Vatavyadhi Chikitsa Adhyaya‟. The name of this oil preparation reflects its important. It is named after the name of “Lord Vishnu” as Lord Vishnu destroyed the evil demons in the same way it cures the various disease. It is used to correct vitiated Vata dosha in different diseases. In this article, an attempt is being made by the author to discuss and compile all the critical overview about Narayana Taila.
511 A REVIEW STUDY OF MALAHARA KALPANA , Dr. Purva Pareek*, Dr. Avadhesh Kumar Bhatt, Dr. Babulal Saini and Dr. Deepa
Malahara kalpana comes under bahya kalpana (external application). Malahara Kalpana is the ointment preparation which has Siktha Taila (bees wax and oil mixture) or Ghrita, as the basic constituent. The other ingredient may include herbal, metal and mineral contents depending upon the usage. Rasa Tarangani a Rasa Shastra treatise of 20th century by Acharya Sadananda Sharma has enumerated various types of Malahara Kalpana taking mainly Siktha Taila as a base. Though this Kalpana holds firm roots in treating diseases the mention and explanation of this particular topic is scattered in this treatise. Hence the present article is an attempt to elucidate and unfold the Malahara Kalpana of Rasatarangani. In nut shell, a short review over historical background reveals that from Vaidika period to modern period various evolutionary changes in the preparation of Malahara Kalpana have taken place. During Vaidika period, simply a paste of drug was applied but later on other materials like Navaneeta, Ghrita etc. were started to add, with an intention to make them more potential.
512 AN EXPOSITORY OF TEXT- RASA JALA NIDHI , Dr. Malavi Shayan* and Dr. Praveen Kumar H.
Rasa Jala Nidhi a Sanskrit text with English translation is a compilatory work in Rasashastra, where it includes the matter from various books that are extinct now. The book is an ocean of Indian Chemistry, Medicine, and Alchemy of the 20th century. The present work is an expository of the text Rasa Jala Nidhi and to highlight its contributions and specialities in the field of Rasashatra.
513 UNDERSTANDING THE ASHMARI IN MODERN POINT OF VIEW – A REVIEW ARTICLE , *Dr. Hemant Bhardwaj, Dr. Pratibha and Dr. Omprakash Sharma
The signs and symptoms as well as the morphology of stone found in Ashmari are similar to that of urolithiasis. Ashmari is the third most common and distressing affliction of the urinary tract. Acharya Sushruta included it in the Astamahagada and explained it in detail. Ashmari is included under Astamahagada may be due its potentiality to cause complications of urinary system and also it is difficult to treat.Despite modern techniques, the recurrance rate of Urolithiasis is approximately 50% within 5 years. Thus there must be some drug that corrects the metabolic errors and prevents the formation of stone. In Ayurveda a detailed description of Ashmari is mentioned under the heading of Ashmaribhedana (lithotripsy action), Ashmari patana (lithogogue action), basti shoolaghna (spasmodic action) and mootrala (diuretic action). Renal calculi affect 1 in 20 people at some time or other in their lives, to a negligible or a noticeable extent. Hence, it is very important to know all the aspects of this urinary problem so that it can be nipped in the bud.
514 ROLE OF VEERTARVADI GANA IN ASHMARI: A REVIEW ARTICLE , *Dr. Hemant Bhardwaj, Dr. Pratibha and Dr. Omprakash Sharma
Group of drug described as Gana in Samhita. Veertarvadi Gana is one out of 37 Ganas mentioned in Sushruta Samhita Sutrasthan 38/4, with 18 herbs in it. They are indicated in Vaatvikar, Ashmari, Sarkara, Mutrakrichha, Mutraghat. Ashmari is very common problem due to todays lifestyle, Dietary habits, it contributes more in formation of Mutrashmari (Urinary Calculus). Aacharya Sushruta included it in Ashthaumahagada. The main aim of this article is to review the importance & utility of Veertarvadi Gana in Mutrashmari.
515 ELECTROSPUN NANOFIBERS PRINCIPLE, PROCESS AND ORAL APPLICATIONS , Dr. C. Pradeep*, Dr. Suman Kumar, Dr. Saravpreet Singh and Dr. Bountey Singh
The world of nanomaterials comprises a wide range of intriguing materials with outstanding physical and chemical properties and characteristics. These materials include zero-dimensional nanopar-ticles or quantum dots, one-dimensional nanowires, nanorods,nanofibers, and nanotubes, and two-dimensional nanosheets .Widely regarded as nanomaterials with great potential applica-tions, nanofibers stand out among the rest of the nanomaterials.One of the most striking features of nanofibers is their exception-ally high surface area-to-volume ratio and high porosity, making them a robust and attractive candidate for many advanced appli-cations In particular, electrospun nanofibers have gained great attention in the field of tissue engineering due to the ease of fabrication and tailorability in pore size, scaffold shape, and fiber alignment. The delivery of biological active ingredients, factors, or drugs can achieve fast and supported regeneration. Nanofibers combined with inorganic ceramics, or polymers with nanoparticles can create functional materials for the speed up wound healing, or osseointegration processes The objective of this article is to review electrospun nanofibers in dentistry in the range from the process to the applications.
516 ROLE OF YOGA IN PRIMARY AND SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES: A NARRATIVE REVIEW , Dr. MD Abu Bashar*
Yoga and Modern medicine are not mutually exclusive to each other. While modern medicine has a definitive role in terms of its treatment and management of acute illnesses and emergency conditions, Yoga offers services in terms of preventive, promotive and rehabilitative methods in addition to many management methods to tackle modern illnesses. Several studies have shown that yoga and/or meditation can control risk factors for cardiovascular disease like hypertension, type II diabetes and insulin resistance, obesity, lipid profile, psychosocial stress and smoking. Some randomized studies suggest that yoga/meditation could retard or even regress early and advanced coronary atherosclerosis. However, there are many limitations with reported studies and large trials with improved and uniform methodologies and long term outcomes are required to confirm these findings. In view of the existing evidence, it appears appropriate to incorporate yoga/meditation for primary and secondary prevention of cardiovascular diseases.
517 COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF DRAKSHADI GRANULES AND PATOLADI SYRUP IN AMALPITTA W.S.R TO NON ULCER DYSPEPSIA , Dr. Gauri Sharma*, Dr. Sunil Thakur, Prof. Y.K. Sharma
Ayurveda considers disturbance of Agni system as the root cause of all the diseases, particularly related to Gastro- intestinal tract diseases. Amalpitta is one of such diseases which occur due to the Agni Vaikritya leading to production of Amma. Hurry, Worry and Curry are the main attributes of Amalpitta. The present study was conducted to explore the potential of an Ayurvedic formulations Drakshadi Grnaules and Patoladi Syrup in the management of Amlapitta w.s.r. to Non-Ulcer Dyspepsia. The study was conducted on 30 patients. Investigations were done to rule out any pathology. The subjective criteria included the symptoms: Hrita Kantha Daha (Retro-sternal burning), Amlodgara (Sour eructations), Utklesha (Nausea), Avipaka (Indigestion) Chhardi (Vomiting), Aruchi (Loss of appetite), Kukshi Daha (Epigastric burning), Udaradhamana (Flatulence) and Klama (Mental fatigue). Assessment of the patients revealed that therapies given in Group 1 and Group 2 were equally effective. No untoward effect was reported.
518 PERSPECTIVES ON CAFFEINE INDUCED ANXIETY WITH SPECIAL REFERENCE TO PEOPLE WORKING FROM HOME IN PANDEMIC COVID-19. , *Pooja Verma and Dr. Rahul Singh
The damage coronavirus pandemic have made on mental health from people working from home have not addressed by any authorities. The aim of the study was to analyse the coronavirus anxiety scale associated with caffeine consumption in people working from home. The 50 people study conducted provided reliability and evidence behind hopelessness and anxiety among people at home. The elevated scores of corona anxiety scale was found in people who were consuming more caffeine. Conclusion: Fear and caffeine consumption seems to be the reason of elevated CAS score.
519 AYURVEDA MANAGEMENT OF MANYASTAMBHA (CERVICAL SPONDYLOSIS) W.S.R. TO THERAPEUTIC ROLE OF NASYA KARMA , Dr. Samir Suneri*, Dr. Arunesh Kumar Dwivedi, Dr. Diwakar Patel, Dr. Archana Tiwari and Dr. Shri Pati Jha
Ayurveda the natural system of Indian civilization practicing from ancient time and offers many holistic approaches for health management. Ayurveda suggested prevention and management of many diseases including treatment of Manyastambha. The sign and symptoms of Manyastambha can be correlated with Cervical Spondylosis. The disease not only affects health of an individual but also put burden on quality of life and hampers day to day activities significantly. The disease considered as Vata vyadhi which may occur due to the Diwaswapa, improper downwards & upwards movements of neck, overstretching of neck, improper sleeping positions and uses of inappropriate pillow, etc. Ayurveda described many approaches for the management of Manyastambha including Nasya Karma. Present article describing role of specific ayurveda modalities in the management of Manyastambha W.S.R. to cervical spondylosis.
520 A REVIEW ARTICLE ON DASHANG LEPA FOR JWARA IN CHILDREN , Dr. Sanket Prakash Khedekar* and Dr. Madhavi Deodas
Dashanga Lepa is traditional formulation belongs from Ayurveda classics used to treat many diseases including rheumatoid arthritis, fever, inflammatory conditions, skin ailments and insect bite, etc. The formulation consisted of Shirisha, Yashtimadhu, Tagara, Rakta chandana, Ela, Jatamanshi, Haridra, Daruharidra, Kushta and Sugandha bala. These ingredients offer antioxidant, anti-inflammatory, anti-allergic, calming and soothing properties. The formulation mainly used for topical conditions like Visarpa, Dushta vrana and Visha visphota. The ingredients of formulation like Yashtimadhu and Haridra, etc. possess anti-pyretic properties and can relieve symptoms of fever like inflammation and body ache. Therefore present article summarizes role of Dashanga Lepa in Jwara especially in children.
521 THE ROLE OF VASANTA KALPAS IN TODAY’S ERA , Dr. Sangeeta Rao* and Dr. Ravindra Angadi
Vasantakalpa are the group of formulations having the term ‘Vasanta’ in their nomenclature viz Vasantakusumakarara rasa, Laghumalinivasanta, Svarnamalinivasanta etc. These formulations have similarity in either main ingredients or indications like Rasayana, Vajikara, Sarvarogahara etc. The action of Vasantakalpas is similar to the action of Vasantarutu on nature that is in this season the old and degenerated leaves are replaced by the new ones, in the same way Vasantakalpas rejuvenate the degenerative body and give pleasantness to the mind. Vasantakalpas supplement proteins to replace tissues lost by normal wear and tear and also for the synthesis of enzymes and some hormones.
522 REVIEW ARTICLE ON PREVENTION AND MANAGEMENT OF CARDIAC DISEASES IN AYURVEDA , Dr. Priyanka*, Dr. Yogesh Jakhar and Dr. Anupam Pathak
Now a days cardiac diseases are major health problem, and becoming the chief cause of the death in all over the world. Previously cardiac diseases were mainly found in elderly peoples but due to change in the diet pattern, life style, and environmental conditions cardiac diseases are extremely increasing in younger population also. However, various advance treatment in the modern medicine for the patients of cardiac diseases, but these techniques are not affordable by everyone. In Ayurveda, there are a number of drugs, medicinal preparation, Rasyana, Pathya Apathya and diverse techniques of Yoga described which have wonderful preventive and curative effect on cardiac diseases. Furthermore, the good health is necessary for everyone, so all the section of Ayurveda can work together in the prevention of cardiac and other diseases also.
523 A REVIEW ARTICLE ON KASAYA KALPANA , Dr. Priyanka*, Anupam Pathak and Yogesh
Kasaya kalpanaa are the oldest dosage forms which are explained in Ayurveda. Ayurveda is an earliest scienc. Ayurvedic pharmacology gives fundamental status to the various pharmacological actions of various drugs. There are several dosage forms of drugs in Ayurveda. A better dosage form will decrease the dose and provide more better and ideal results. Kasaya kalpana is one of those forms. Various Kasaya Kalpanas are explained by Acharyas in the text of Ayurveda. Various Kasaya Kalpana are said to produce various pharmacological actions. For understanding probable mode of action of various dosage knowledge of Kasaya Kalapana is necessary.
524 A DHAMANI FOR TRANSPORTATION OF AMA IN AMAVATA: A REVIEW ARTICLE , Dr. Sachin Sharma*, Dr. Sakshi and Dr. Subhash Upadhyay
Charaka and Sushruta believed that diseases were caused by a disturbance in the equilibrium of the three Ayurvedic humors, and that this disturbance was often a direct cause of the disease. They also recognized several remote causes, both external and internal, for example, entry of toxic materials from outside to inside through vessels, errors of living, natural decay from old age, and climate or weather that could play a role in the manifestation of disease. Ama is also an entity which causes vitiation in dosha, dhatu and mala. Ama is a pathological entity and causes abnormality in srotas, dhatu etc resulting into development of various diseases. Ama generates acute diseases and chronic conditions as well. Amavata is one of such chronic state of ama. Derangement of kapha dosha especially shleshaka kapha in amavata produces joint pain and swelling with tenderness which can be correlated with rheumatoid arthritis. Ama is the toxin that builds up in the body usually as a result of improper digestion. These toxins circulate through dhamanis in the body and typically deposit in weaker areas such as the joints. This leads to the arthritic symptoms of pain and inflammation.
525 SANDHI SHARIR IN AYURVEDA AND APPLIED ANATOMY IN KNEE JOINT: A REVIEW ARTICLE , Dr. Sachin Sharma*, Dr. Sakshi and Dr. Subhash Upadhyay
In Ayurvedic Classics Atreya, Dhanvantari Sushruta and all other communities have made it important the knowledge of body to have undoubtedly for the sake of knowledge. The definition of Sandhi in various Ayurvedic literature are given as “asthi samyoga sthaaana” or “to unite” or “the meeting point of two or more stuctures. counted so only Asthi Sandhi or bony joints should be considered under the term Sandhis. In our Ayurvedic literature different Aacharyas have mentioned different numbers of Sandhi. According to Aacharya Sushruta Sandhis are two hundred and ten in number, which are responsible for various movements, and are distributed throughout the body. In Ayurvedic Samhitas the description of anatomy of Sandhi in detail is not found. It is observed that the incidences of joints disorders are increasing in today’s world. It is the burning problem for people and society. A thorough knowledge of the structure and function of the joint is required to diagnose and treat the diseases of joints.
526 ROLE OF SHIRODHARA BY BRAHMI TAILA IN ESSENTIAL HYPERTENSION: A CONCEPTUAL STUDY , Dr. Vandana Rawat*, Dr. Vipin Kumar and Dr. Sheetal Verma
Hypertension is a most common life style disorder and an important public health challenge in both economically developing and developed countries. Also it is one of the psycho-somatic disease and important risk factors for cardiovascular mortality. It has been estimated that hypertension accounts for 6% of deaths all over world. With the increasing age, the burden of hypertension increases and more among the individuals aged ≥60 years and its prevalence is 65.4%. There is no any direct reference of Hypertension in Ayurveda. So according to its dosha, dusya, lakshana etc. we can correlate with raktagata vata, vata vyadhi or rakta vriddhi etc. In India, Shirodhara is a common and ancient ayurvedic procedure, and its clinical benefits are being observed in thousands of patients. It involves the rhythmic and consistent flow of lukewarm oils or any medicated liquid on the forehead for atleast 30 mintues. Brahmi is a medhya drug along with anti hypertensive effects. Taila itself has vatahara, suksma and sinigdhtva properties. So Shirodhara by medhya drug i.e. Brahmi taila may be probably beneficial and useful for breaking the pathogenesis of Essential Hypertension.
527 EFFECT OF ERANDA TAILA IN JARA (AGEING) AWASTHA , Dr. Madhu Parihar*, Dr. Ritu Kapoor, Dr. Manoj Adlakha and Dr. Savitha P. K.
Ayurveda has considered “Jara ʺ or “Vardhakyaʺ as a natural and inexorable process or “Swabhavaja Vyadhiʺ (Natural diseases). Acharya Sushruta in Adhidaivika Vyadhi mentioned Svabhava Balapravritta Vyadhis, which include Kshudha (Hunger), Pipasa (Thrist), Nidra (Sleep), Jara (Ageing) and Mrityu (Death). Jara is of two types viz. “Kalaja-Jaraʺ (Natural ageing) and “Akalaja-Jaraʺ (Premature ageing). Kalaja is a natural phenomenon. Akalaja is a condition where you look older than your actual age. Presently it is most common problem and many factors are responsible for it. Akalaja Jara is affected by Aharatmak Hetus (Junk food, Consumption of pesticides etc.), Viharatmaka Hetu (Divaswapna, Ativyavaya etc.), Manasika Hetu (Bhaya, Krodha, Shoka etc). All these factors causes Akalaja Jara as they causes Mandagni responsible for Srothoavarodh (Obstruction of channel) and Vata Prakopa, affecting the Dhatu Poshana process. To reverse the symptoms of Akalaja Jara, Eranda Taila is indicated. In Sutrasthana 45/114 Acharya Sushruta has mentioned Eranda Taila useful in Vyah Sthapanam’ and is known for its anti-ageing and rejuvenation action. Full description regarding the action of Eranda Taila on ageing will be discussed in the full paper.
528 MYCOBACTERIUM TUBERCULOSIS: A REVIEW , *Anuru Sen, Dr. Dhrubo Jyoti Sen, Dr. Sudip Kumar Mandal, Ravichandra G. Patel and Dr. Beduin Mahanti
This review on tuberculosis includes an introduction that describes how the lung is the portal of entry for the tuberculosis bacilli to enter the body and then spread to the rest of the body. The symptoms and signs of both primary and reactivation tuberculosis are described. Routine laboratory tests are rarely helpful for making the diagnosis of tuberculosis. The differences between the chest X ray in primary and reactivation tuberculosis is also described. The chest computed tomography appearance in primary and reactivation tuberculosis is also described. The criteria for the diagnosis of pulmonary tuberculosis are described, and the differential is discussed. The pulmonary findings of tuberculosis in HIV infection are described and differentiated from those in patients without HIV infection. The occurrence of tuberculosis in the elderly and in those patients on anti-tumor necrosis factor alpha inhibitors is described. Pleural tuberculosis and its diagnosis are described. Efforts to define the activity of tuberculosis and the need for respiratory isolation are discussed. The complications of pulmonary tuberculosis are also described.
529 INTRODUCTION OF SROTAS IN AYURVEDA - REVIEW ARTICLE , Dr. Deepika Sharma*, Dr. Sakshi and Dr. Subhash Upadhyay
In Ayurveda Srotas plays a major role. Acharyas explained purusha as assumed to be made of innumerable Srotas. The equilibrium of dosha, dhathu and mala maintains health. To maintain continuity in the life cycle, these bodily elements have to be continuously regulated, nourished and replenished. Srotas are the channels or inner transport system of the body which is the site for the activities of other bodily elements like dosha, dhathu, mala, agni, etc. Among these some Srotas are micro and some are macro in structure and they adopt the same colour of particular dhathus of the body to which they belong. In Ayurvedic classics, it has been described that the entire range of life process in health and disease depends on the integrity of Srotas. Therefore the present article is an attempt to study the fundamental facts of Srotas.
530 DESCRIPTION OF SNAYU SHARIR: A REVIEW ARTICLE , Dr. Deepika Sharma*, Dr. Sakshi and Dr. Subhash Upadhyay
Ayurveda is a science which requires a lot of research to establish its authenticity along with modern medical science. The first step in this is to define the terms mentioned in Ayurvedic classics, especially the basic terms. The science cannot be implemented methodically as long as the terms are not properly understood. Sharira Rachana is the subject which deals with a lot of anatomical terms and defining these terms are important for application of the science. Snayu is a term which is explained elaborately in classical texts but yet it is unable to point out exact structure related with it in human body. During this study, the references related to the Snayu are collected and tried to explain as a structure form. Literally the term Snayu means to bind. It is explained as a structure which helps in binding the joints and helps the body in weight bearing. Structurally it has been described something similar to a fibrous in nature.
531 AYURVEDIC AND MODERN METHOD OF PRESERVATION OF DEAD BODY-REVIEW ARTICLE , Dr. Kaushal Kumar*, Dr. Subhash Upadhyay and Dr. Arti Rajhansa
Mahrishi Sushruta was first surgeon of india. Acharya sushruta is the father of surgery according to ayurveda. According to Sushruta to become a best physician & surgeon the dissection of the dead body is very necessary. Dissection and preservation described by Sushruta in Sushruta Samhita in brief. Knowledge of good method of preservation is necessary fo preservation. If wrong method of preservation is applied to preserve the dead body then there are more chances that the body got damaged. According to Acharya Charaka knowledge of Shuksam and Sathul Sharir is very necessary for the Sharir Rachana. The theoretical knowledge learnt from the teacher & observed in the practical classes should be supplementary to each other. An effort is made by collecting all available literatures in the Ayurvedic science, how the body is collected, where it will be preservation, method of preservation etc. Modern preservation method is different from the Ayurvedic method of preservation.
532 AYURVEDA VIEW TOWARDS IMMUNITY IN CHILDREN; AN ESSENTIAL NEED OF CURRENT SCENARIO , Dr. Ajay Chavan* and Dr. Dipti Ajay Chavan
Children are hope not only for parents but for nation also as they are the future citizens. Modern world witnessed change in lifestyle & diversified environmental condition which hamper health of the parents as well as their children. They are more prone to the various types of infectious and developmental disorders due to the underdeveloped immune system. Vyadhikshamatva (immunity) is the power of the body to fight against various foreign matters and to protect the body from diseases. It has been reported that more than one million children (under five years) die annually due to the various infectious diseases around the world. Ayurveda has given a lot of importance to Vyadhikshamatva .This concept of Ayurveda has similarity to the modern medical science in various ways. Good immunity provides strength, improves intelligence and helps child to live a healthy and happy life.
533 THE NATURAL RELAXATION THERAPY “SHIRODHARA W.S.R. TO JALDHARA” , Stuti Sahani, Mrigank Shekhar and Sudarshan Bind*
Panchakarma is a traditional form of detoxification of the body and mind that facilitates rejuvenation .Different therapies are included under it. Shirodhara is one among deeply relaxing therapies of panchakarma where medicated liquids are dipped slowly and steadily onto the forehead and Agyachakra of the patient ,laying down upan a massage table.Various liquids such as coconut water, buttermilk ,kwath , milk , water, etc. Are used according to individual need of patient.The procedure where plain water is used as liquid medium is called jaladhara.this procedure induces a relaxed state of awareness, which results in a dynamic psycho-somatic balance.Head is place of prana, udana and vyana vayu, sadhaka pitta and tarpaka kapha. Jaladhara re-establishes the functional integrity between these three subtypes of Dosha. The forehead and head are arias of many vital spots(Marma). Jaladhara makes the patient to concentrate on these vital areas by which the stability arrives in the functions of mind. It induces Agyachakra that resides between eyebrows and produce utmost state of relaxation. Jaladhara is equally effective to shirodhara and have an advantage over previous therapy that water is a natural resorce and whole society can afford it easily.
534 YONIDHAWAN KARMA IN KAPHAJ YONIVYAPDA: LITERATURE REVIEW , Karishma Bilade* and Madhuri Bhalgat
Ayurveda is an ancient science which deals with natural good health, disease free life of person. Ayurveda is one of the special human sciences on the earth for benefits of all persons. Now a days, most of women go through physical and psychological stress she don’t have enough time for her personal hygiene so women prone to the disease like Yoniroga. Number of patients having symptoms like Yonigatstrava, Yonikandu and Yonivedana are seen in day to day practise. For the treatment of Kaphaja Yonivyapda Stanikchikitasa like Yonidhavan, Yonidhupan, Vartidharan, Yonipuran, Yoniprakshalan describe in Sanhita. Out of this Yonidhavan found effective in Kaphaj Yonivyapada. Yonidhavan means cleaning or purification of yoni. Dravya used for dhavana does there work through Rasa, Virya, Vipaka Guna and reduces Sthandushti by dosh prakopa. Here effort has been put forth to make conceptual study of Yonidhavan Karma in Kaphaj Yonivyapda. Samanya, Vishesh Hetu, Sanprapti, Lakshan, Chikitsa of Kaphaj Yonivyapda with Yonidhavan karma are describe below.
535 “PREVENTION IS BETTER THAN CURE” -A 2020 IDRS (INDIAN DIABETIC RISK SCORE) BASED STUDY, AMONG THE BUDDING FUTURE PHYSICIANS AT TIMES OF UNEXPECTED PANDEMICS LIKE THE COVID 19. , Dr. Gayathri Dilliraj and Dr. A. Jamuna Rani*
Introduction: The IDA (International diabetes federation) has stated that Diabetes is one of the chief non communicable diseases globally. Adolescents have comparatively higher risk of developing type II diabetes mellitus mainly owing to their sedentary lifestyle habits. So early awareness and proper knowledge about diabetes among budding physicians needs to be emphasized at the earliest. Materials & methods: Cross sectional study conducted among the 250 first year medical college students, belonging to the 2019-2020 batch of Sree balaji medical college & hospital. The Indian diabetic risk score-IDRS questionnaire was the index used to estimate their associated risk. Students with high risk (score>/=60) & moderate risk (score of 30 – 50) were identified. Results: The results of our questionnaire based IDRS study showed that 58% of the students had moderate risk of developing diabetes & 2.8% of the students were in the high risk category.73.2% of the students had no/very less exercise regimen in their daily schedule, especially the girl students. Thus the study emphasises the need of incorporating some form of exercise/physical activity in adolescents daily lifestyle to ensure they are healthy. Especially in times of pandemics like the trending COVID 19, where continuous social isolation and staying confined indoors for months, has made adolescents more lazy and mentally deprived.
536 A COMPARATIVE STUDY OF VYAGHRI HARITAKI, VYAGHRI TAILA NASYA AND JALA NETI IN THE MANAGEMENT OF VATAJA PRATISHYAYA W.S.R. TO ALLERGIC RHINITIS , Dr. Priyanka Thakur*, Dr. Vijayant Bhardwaj, Dr. Satish Sharma, Dr. Rajika Gupta and Dr. Priya Sharma
Pratishyaya is a severe and general body debilitating condition, which manifest due to the migration of the Kapha, Rakta&Pitta from the root of the Nasa Pradesh, they get lodged into Shira Pradesha, which is already titrated by the Vata Dosha.[34] Vataja Pratishyaya is explained in Ayurvedic system of medicine as Sneezing, Watery discharge from nose, Stuffy nose, Itching in nose etc.[8] which have relevance with Allergic Rhinitis which was selected for present study. The present study was done on 30 patients of Vataja Pratishyaya, who were grouped into three groups with 10 patients in each group. Group A was treated with Vyaghri Haritaki Avleha as oral drug, Group B with Vyaghri taila nasya and Group C with Jala Neti for local application. The signs and symptoms were studied before and after treatment, study showed better results in group B (50% markedly improved, 50% moderately improved) and almost equal results in Group A and Group C (80% moderately improved, 20% mildly improved).
537 RISK STRATIFICATION OF COVID -19 PATIENTS USING THE ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II SCORE , Deepan Karthick, M. Divahar, Sathik, Rajmohan and J. A. Jayalal*
SARS-COV-2 disease 2019 has emerged as a major global health threat with a great number of deaths in the world amounting to nearly 8 lakhs. In this study we looked for the association between Acute Physiology and Chronic Health Evaluation II score and hospital mortality in patients with coronavirus disease 2019, and to assess the predictive ability of Acute Physiology and Chronic Health Evaluation II score. It is a Retrospective observational cohort study carried out in a teaching hospital Tirunelveli medical college COVID care ward. 100 Confirmed patients with coronavirus disease 2019 as decided by the RTPCR testing and hospitalized in the COVID care unit with moderate to severe infection were included in the study. Of these 100 potentially eligible patients with symptoms of coronavirus disease 2019, 14 patients died and with intensive care all others were cured .The Mean Acute Physiology and Chronic Health Evaluation II score (22.21 ± 6.05) calculated was relatively higher in patients who were succumbed to death with the mean Acute Physiology and Chronic Health Evaluation II score of 9.87 ± 4.40 in patients who have survived the infections (p < 0.001). Acute Physiology and Chronic Health Evaluation II score has shown independent association with the resultant hospital mortality (adjusted hazard ratio, 1.07; 95% CI, 1.01-1.13) and have demonstrated better discriminative ability (area under the curve, 0.966; 95% CI, 0.942-0.990). The cut-off value of above 17, Acute Physiology and Chronic Health Evaluation score could predict the death of the patients with COVID -19 with a sensitivity of 96.15% and specificity of 86.27%. The survivor probability of patients with coronavirus disease 2019 with Acute Physiology and Chronic Health Evaluation II score less than 17 was notably higher and in patients with Acute Physiology and Chronic Health Evaluation II score lesser than 17, they were survived (p < 0.001). Conclusions: For effective clinical prediction of hospital mortality in patients with coronavirus disease 2019, Acute Physiology and Chronic Health Evaluation II score can be used and when the score is greater than or equal to 17, it is an early warning indicator of death and will prompt the physicians to upgrade the treatment protocol.
538 ANTIMICROBIAL ACTIVITY OF LEAVES OF VITEX NEGUNDO AGAINST PATHOGENIC ORGANISMS COMPARED WITH CONTROL DRUG , Aishwarya N. Kapse* and C. J. Chandekar
The crude extract from the leaves of Vitex negundo traditionally used in Indian system of medicines were screened against Escerichia coli NCIM 2931, Salmonella typhi MTCC 734, Salmonella typhimurium MTCC 98, Klebsiella pneumoniae MTCC432, Proteus vulgaris NCIM2857, Proteus mirabilis MTCC425, Pseudomonas aeruginosa NCIM5029, Staphylococcus aureus MTCC 96, Staphylococcus epidermis MTCC 435, Bacillus cereus NCIM2155, Bacillus subtilis NCIM 2063 and Bacillus megaterium NCIM 2087 by using agar well diffusion method. Vitex negundo crude extract showed significant activity against organisms. Zone of inhibition of the extract compared with the standard antibiotics.
539 ROLE OF VIRECHANA KARMA (THERAPEUTIC PURGATION) IN PSORIASIS – A CASE STUDY , *Dr. Bikash Raj Ghimire and Dr. Samichha Neupane
Out of 11 types of kshudrakustha explained in our classic, Ekakustha is one among them which comes under vatakaphaja disorder that resembles psoriasis in conventional medical science. Psoriasis is a chronic autoimmune disease characterized by patchy skin lesion which are typically erythematous, itchy, and scaly and vary from small localized to large extensive and spread throughout the body. Psoriasis typically presents with red patches and white silver scales on the top. Psoriasis is generally thought to be genetic disease which is triggered by environmental factors other factors like trauma, general illness and stress are also involved. In allopathic medicine the cure of this disease is out of questions as the cause is unknown. Ayurveda emphasize the holistic approaches in treating psoriasis. The line of treatment of skin diseases are shodhana and shamana therapy. Virechana karma (purgation therapy) followed by internal medications is considered as best line of management for skin disorders.
540 JALAUKAVCHARAN IN UTSANGINI (CHALAZION) – A SINGLE CASE STUDY , Sejal Gamit, Dr. Shital Baraiya, Dr. Divyesh Gamit3, Bhakti chhaya
Chalazion is caused by inflammation of the mebomian gland, usually on the upper eye lid. And commonly present in multiplicity. Chalazion also called as tarsal or Meibomian cyst. It can be co-related with Utsangini. Utsangini is one of the Vartmagata and Tridhosha pradhan Vyadhi. Where the symptoms include the Abyantaramukhi (Opening in the inner side), Bahya utsanga (Nodular swelling in the external surface of the eye lid), Tadrup pidika (Similar blisters around the main Utsanga), Tamra (A copper coloured Pidika), Sarvaja (Produced due to vitiation of all Doshas) associated with Kandu (Itching) called as Utsang pidika or Utsangini. Acharya Vagabhatta mentioned that Utsangini is a Rakta (Red colored), Rakten (Produced by only Rakta) and called as Utsanga. In treatment Acharya Vagbhatta suggest Bhedana, Nishpdan, Lekhana, Pratisaran, Parisheka. In Utsangini chikitsa, Acharya Shushrut mentioned 3 types of the treatment Chedana, Bhedana and Sodhana which is depending upon the size and the chronicity of the Pidika. Shodhan karma is necessary for a permanent cure to the diseases. Raktamokshana is the best procedure of Shodhana karma which is indicated for Dushita rakta. The present case has been treated with leech therapy, where leech was applied upon the palpebral part by everting the eye lid. Remarkable results were observed in the form of improvement in all the signs and symptoms of the disease. It proposes a good and cost-effective approach to treat Utsangini with Raktamokashan.
541 MANAGEMENT OF FROZEN SHOULDER (AVABAHUKA) THROUGH KRISHNA MRITTIKA AND YOGIC PRACTICES: A CASE STUDY , *Dr. Nitu Tegta, Dr. Priya Pathak and Prof. D. K. Mishra
Frozen shoulder, also known as Peri-arthritis or Adhesive capsulitis causes a significant loss in range of motion typically occurs in cycle of 3 stages. It predominantly occurs in females in their fifties. In textual references of Ayurveda Frozen Shoulder is closely related to Avabahuka. In this condition, Vata is localized in the shoulder region, getting aggravated, dries up the bindings (ligaments) of the shoulders, constricts the Siras present there and causes Avabahuka. In Ayurveda various para-surgical procedures were mentioned for diseases of Vata and Kapha. The most common treatment for frozen shoulder is mobility, exercises and anti-inflammatory drugs. Panchkarma procedures have also found effective and safe in the management of the disease but these treatment modalities are costly, require a professional skilled person and are not easy to carry out at any place at any time. The main purpose of this case study is to find a cost effective, safe and easy procedure for the management of the disease. A forty five year old female patient diagnosed as Avabahuka; presented with pain (Shoola), stiffness (Stabdhata) and restricted movement (Bahupraspanditahara) in left shoulder was reported in Swasthvritta O.P.D. In this disease treatment can be done with Krishna Mrittika along with Yogic practices. Krishna Mrittika has anti-inflammatory property as mentioned in classical text by Acharya Sharangdhara while Yogic practices are also helpful in removing the stiffness of the joint.
542 THERAPEUTIC EFFECTS OF REHABILITATION OF MUSCLE STABILITY ON STROKE PATIENTS WITH HEMIPLEGIA , *Dr. Hanan Omer, Dr. Wajid Hameed and Dr. Sara Saleem
Objective: To evaluate the effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia. Methods: A total of 200 stroke patients who were hospitalized from April 2018 to April 2019 were enrolled. They were randomly divided into an observation group and a control group (n=90) that both received conventional hemiplegia rehabilitation therapy. On this basis, the observation group was subjected to training for core muscle stability, five times a week for a total of ten weeks. The balance functions before and after training were assessed using the Berg Balance Scale (BBS). The function of hemiplegic lower limb was evaluated by Brunnstrom staging and the Fugl-Meyer motor assessment (FMA) scale. The walking speed was estimated using the 10 m walking test. Musculoskeletal ultrasonography was performed to measure the thicknesses of three abdominal muscles of the paralytic side, i.e. transverse abdominis, internal oblique and external oblique muscles. Results: After treatment, the BBS scores of the two groups were significantly higher than those before treatment, with significant differences (P<0.05). The BBS score of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the Brunnstrom stage and FMA scale score, and standing and stepping scores were significantly higher than those before treatment (P<0.05). The Brunnstrom stage, FMA scale score, stepping score and walking speed of the observation group significantly exceeded those of the control group (P<0.05). After treatment, the thicknesses all increased compared with those before treatment, but the thicknesses of internal oblique and external oblique muscles were not significantly different (P>0.05). The thickness of transverse abdominis muscle of the observation group significantly surpassed that before treatment (P<0.05), whereas the thicknesses of the control group were similar (P>0.05). The thickness of transverse abdominis muscle of the observation group was significantly higher than that of the control group (P<0.05). Conclusion: Rehabilitation training of core muscle stability can effectively improve the balance function and walking speed of stroke patients, probably by increasing the thickness of transverse abdominis muscle.
543 PREVALENCE AND PROGNOSIS OF CEREBROVASCULAR ACCIDENTS; A CROSS-SECTIONAL STUDY CONDUCTED AT SERVICES HOSPITAL, LAHORE , *Dr. Hanan Omer, Dr. Wajid Hameed and Dr. Sara Saleem
Cerebrovascular accidents or stroke is an important healthcare concern. Ischemic stroke is an acute neurologic deficit that results from focal cerebral ischemia leading to permanent tissue damage (infarction). The cause is commonly associated with atherothrombotic occlusion of large arteries, cerebral embolism (embolic infarction), non-thrombotic occlusion of small, deep cerebral arteries (lacunar infarction), and proximal arterial stenosis with hypotension that decreases cerebral blood flow in arterial watershed zones (hemodynamic stroke). Stroke is being observed as a rapidly growing problem and an important cause of illness and death in Pakistan. The aims of this cross-sectional study were to establish the prevalence and prognosis of cerebrovascular accidents and its subtypes in Lahore, Pakistan. Data were collected on all patients who experienced CVAs between December 2018–March 2019, used the diagnosis coding program in Services universirty, Lahore, Pakistan. Out of 215 patients 63.7% were male and 36.3% were female. The overall incidence of ischemic stroke after acute myocardial infarction was 85.26%. Hypertension, diabetes mellitus were shows as more risk factors for ischemic stroke type compared with hemorrhagic stroke, and embolic stroke. The overall status of stroke patients were shown 92.1% live and 7.9% were dead. Incidence of complicating hospitalizations with cerebrovascular accident continues to grow and is associated with increased mortality and adverse discharge. This highlights the need for early diagnosis, better risk stratification, and preparedness for need for complex long-term care in this vulnerable population.
544 A REVIEW OF PHARMACUTICAL STUDY AND USES OF MUKTA SHUKTI , Dr. Amita Shrma, Dr. Umesh Shukla and *Dr. Rajendra Kumar Dixit
Amlapitta is very common disease. In recent times, due to modern lifestyle and changes in dietary habits, mental stress and strains, incidences of hyperacidity become more. It can be correlated with Amlapitta, or Urdhawaga Amlapitta. which is a burning problem of the society. Though the drugs of modern system pacify the symptoms to some extent, they will manifest a set of complications.
545 MANAGEMENT OF FISTULA IN ANO (BHAGANDARA) THROUGH THE KSHARA SUTRA , Dr. Rajendra Kumar Dixit*, Dr. Shruti Dixit and Dr. Rishi mishra
The fistula is a tortuous track lined by unhealthy granulation tissue and fibrous and has one end communicating with the perianal skin and the other end with the rectum.
546 ROLE OF APATARPANA CHIKITSA IN SANTARPANAJANYA SANDHIGATA VATA: A CASE STUDY , *Vd. Ganesh O. Pawar and Dr. Dilip K. Puri
Sandhigata vata is one of the most common vatavyadhi. The word itself describes about the disease i.e. it affects the sandhis, which hamper daily activities. So, while treating patients of sandhigata vata with santarpana hetus root cause should be eliminated and the choice of treatment is aptarpana therapy. A 40 year old female patient reported to the hospital with pain, stiffness of all joints, angagauravata (heaviness in body) since last 2-3 years diagnosis of santarpajanya sandhigatavata was made based on history taking and finding out hetus along with clinical symptoms. Ayurvedic treatment was adviced with sequential administration of langhana, deepan-pachana, virechana along with shaman aushadhi. The follow up was done. There was significant improvement in symptoms of patient after treatment. Assessment of symptoms done subjectively. This case study reveals the use of uniform drug therapy for every patient should not be approached.
547 ROLE OF DIET AND LIFE STYLE MODIFICATION IN LONGEVITY , *Dr. Riyanka Kumari, Dr. Ankush Jagota, Dr. Umesh Shukla, Dr. Rajika Gupta and Prof. T. C. Thakur
Ayurveda aims first at maintaing a healthy body and preventing ailments by adopting a proper, healthy lifestyle. The term longevity is defined as the long life, endurance and prolonged existence. According to the latest WHO data published in 2018, life expectancy in India is: Male 67.4, female: 70.3 and total life expectancy is 68.8 which gives india a world life expectancy ranking of 125. Life style modification involve altering long- time habits, typically of eating or physical activity, and maintain the new behaviour for month or years. If a patient intakes wholesome food then there is no need of medicine and if a patient continuously consumes unwholesome food then also there is no need of medicine as medicine will not be effective. All available classics and commentaries. various publication, text books, research papers , data available on different website. Pathya is defined as the ahara (diet) which is congenial to a person according to his constitution, appetite and digestive capacity of the body. Public policies should put more emphasis on creating healthy food,built,and social environment to support and promote healthy diet and lifestyle.
548 STUDY OF BREAST CANCER TREATMENT WAITING TIMES: EXPERIENCE OF NATIONAL INSTITUTE OF ONCOLOGY OF RABAT, MOROCCO , Sara Daoudi*, Imane Adrif, Mustapha El Kabous, Narjiss Berrada, Hind Mrabti and Hassan Errihani
Background: Breast cancer is a public health problem in terms of its frequency and severity. Along with the increase in the incidence of this cancer, there has been growing awareness of the length of delays in accessing care. Measuring waiting times is a good indicator of quality and performance of cancer care. The aim of this study was to determine the waiting times of medical care of patients with breast cancer in the National Institute of Oncology in Rabat (INO). Materiel and methods: This is a descriptive retrospective study of 505 cases of patients followed for breast cancer at INO. The five most observed following waiting times in the department of medical oncology were evaluated. Results: The mean age was 48 years old. The average deadline from diagnosis to chemotherapy was 82.6 days. The average deadline between chemotherapy and radiotherapy was 53.7 days. Overall, the average deadline between surgery and chemotherapy was 59.3 days. The average deadline between surgery and adjuvant chemotherapy was 61.4 days. The average deadline from neoadjuvant chemotherapy to surgery was 68.8 days. Conclusion: Controlling access times to treatment is a real strategic issue for improving breast cancer care through the development of an active and continuous policy to improve these times. It is essential to reduce the waiting time during the care pathway to ensure successful treatment and to meet patients’ needs.
549 FREQUENCY AND PATTERN OF INTRA-ABDOMINAL INJURIES IN PATIENTS HAVING BLUNT ABDOMINAL TRAUMA , Dr. Mirza Shahryar Baig*, Dr. Yar Jahan and Dr. Rehan Ahmad Khan
Between 1 and 45 years of age, the most common cause of mortality is trauma resulting in the loss of daily activities more than other well-known diseases, such as malignant tumors and cardiovascular diseases. Objective: The purpose of this analysis was to determine the pattern and incidence of intra-abdominal injuries in subjects having blunt abdominal trauma. Study Design: An Observational Study. Place and Duration: In the Surgical Unit of Sheikh Zayed Hospital, Rahim Yar Khan for six months duration from July 2018 to December 2018. Method: A total of 50 blunt abdominal trauma cases were included in the study. These cases were over 12 years of age and were of both sexes admitted to the Accidents and Emergency Department of Sheikh Zayed Hospital, Rahim Yar Khan. Results: From a total of 50 patients, the males were 41 (82%), and female patients were9 (18%) included in the study. There were 15 (30%) patients with liver damage, and splenic lesions were noted in 13 (26%) patients. In eleven (22%) patients, there was damage to the intestine varies from the gastric region to the anal canal).In the small intestine, five patients attained injury, and in the duodenum and stomach, two patients were noted with injuries and four patients in the large intestine. In two (4%) cases, there was an injury to the pancreas. The three patients (6%) had Mesenteric tear, and the diaphragm was ruptured in 2 (4%) patients. The retroperitoneal hematoma was noted in five (10%) patients. Three patients (6%) had renal damage, and injury to the bladder was observed in 2 patients. Conclusion: It is concluded that intra-abdominal organs are most commonly susceptible to injuries. In the blunt abdominal trauma, the solid organs were injured more. In our analysis of blunt abdominal trauma, the most usual injured organ was the Liver, followed by other organs, including the intestine, spleen, and retroperitoneal hematoma.
550 DIFFERENT TYPES OF MANIFESTATIONS OF ANEMIA IN RHEUMATOID ARTHRITIS PATIENTS , Dr. Rehan Ahmad Khan*, Dr. Yar Jahan and Dr. Mirza Shahryar Baig
Objectives: This study's basic aim was the assessment of anemia in rheumatoid arthritis patients, differentiated between the types of anemia and correlation between anemia and duration of rheumatoid arthritis. Material and method: This cross-sectional study was conducted in Sheikh Zayed Hospital Rahim Yar Khan, from January 2019 to November 2019. A total of 100 samples were obtained, among them 50 patients diagnosed with rheumatoid arthritis, 50 samples were collected from healthy subjects as control. Fifty informed male and female consented patients diagnosed with Rheumatoid arthritis were recruited for the study. Rheumatoid arthritis patients with chronic disease (renal failure, heart disease, liver disease, malignant diseases) were also excluded. Result: (60%) of rheumatoid arthritis are anemic and (40%) non-anemic. The result demonstrated that the Hb level, RBCs, and PCV are significantly reduced in anemic rheumatoid arthritis patients than non-anemic rheumatoid arthritis patients with P value (0.000) Hb, RBCs, and PCV. The result also demonstrated that MCH significantly reduced in anemic rheumatoid arthritis patients of compared to non -anemic rheumatoid arthritis patients with P value (0.003) while MCV & MCHC are within a normal range. In anemic rheumatoid arthritis patients, serum ferritin was significantly reduced in 7, while 23 patients have a normal serum ferritin level. Based on a 15μg/L cutoff for ferritin, 23% of anemic rheumatoid arthritis patients have IDA, and 77% have ACD. Conclusion: There are two types of anemia in rheumatoid arthritis patients, IDA and ACD. Anemia of chronic disease is more common as compared to IDA in rheumatoid arthritis patients.
551 RISK FACTORS FOR ACUTE IDIOPATHIC PANCREATITIS , Dr. Taha Akhtar Khan*, Dr. Muhammad Salman Asif and Dr. Mohammad Huzefa Abid
Objective: To determine the risk factors for Acute Idiopathic Pancreatitis (AIP) in Lahore's tertiary care hospital. It is cross-sectional study performed at Department of Surgery Sheikh Zayed Hospital Lahore, from January 2019 to December 2019. Material and Methods: All abdominal pain cases diagnosed as acute pancreatitis based on history, clinical examination, and serum amylase levels (>3 times average) were included in the study. Imaging studies (ultrasound, Computed Tomography (CT) scan abdomen and Endoscopic retrograde cholangiopancreatography (ERCP) were conducted in each case to confirm the diagnosis. A thorough assessment was done to determine the cause of acute pancreatitis, including the radiological findings, previous history of abdominal trauma or surgery along with past medical history, drug history and socioeconomic activities (alcohol/smoking/ Gutka/Pan/pan/charas). Results: 70 cases of acute pancreatitis, including 23 idiopathic cases, found Gutka/Pan/pan Chewing as the leading risk factor for acute idiopathic pancreatitis, especially in young male patients with atypical presentation. Conclusion: Further studies are needed to determine the pathophysiological role of this increasingly important risk factor of acute pancreatitis.
552 FREQUENCY OF POST-SURGICAL COMPLICATIONS OF THYROIDECTOMY AT A TERTIARY CARE HOSPITAL , Dr. Muhammad Salman Asif*, Dr. Taha Akhtar and Dr. Muhammad Huzefa Abid
Objective: This study's objective was to determine the frequency of postoperative complications after thyroid surgery due to malignancy in the histopathology report. Study design: Descriptive cross-sectional study. Place & Duration of study: This study performed at Sheikh Zayed Hospital, Lahore, from January 2019 to December 2019. Methodology: 114 patients who underwent completion thyroidectomy to treat well-differentiated thyroid cancer were included in this study. Patients with medullary, anaplastic, and thyroid lymphoma were excluded. Serum calcium levels were monitored one day before the surgery and on the first postoperative day. Written and informed consent was taken, and data collected on a predesigned form. Results: Recurrent laryngeal nerve (RLN) was identified and preserved in all cases. Two (1.7%) patients developed transient hoarseness of voice, 8 (7.01%) had transient hypocalcemia, and 4 (3.5%) patients developed seroma. Two (1.7%) patient was re-explored on the same postoperative day for neck hematoma, which caused dyspnea and tachypnea. No patient developed a wound infection. No patient developed permanent hypoparathyroidism/hypocalcemia at three months follow-up. Conclusion: Complete thyroidectomy can be securely used as a foundation of treatment for well-differentiated thyroid malignancies.
553 AUDIT OF LIPID PROFILE IN CASES OF HYPERTENSION PRESENTING AT TERTIARY CARE HOSPITAL , Dr. Muhammad Zaid Bin Zia*, Dr. Muhammad Wajid Rasool and Dr. Shahrukh Maqsud
Objective: To study lipid profile in cases of hypertension presenting at Nishtar Hospital Multan. Material and Methods: This descriptive study was conducted at the Department of Medicine Nishtar Hospital Multan. From April 2018 to October 2018. A total of 100 patients admitted with hypertension were the participants of the study. The patients are in the range of 40-80 years. Both known hypertensive patients on treatment for a varying period and newly diagnosed hypertensive patients were included in the study. Results: Serum T.C., TGL, VLDL, LDL, TC/ HDL, LDL/ HDL were significantly elevated in the hypertensive group compared to healthy controls. Serum HDL was low in patients with hypertension as was compared with controls, which was statistically significant. The LDL was raised in obese compared to nonobese patients, which is statistically very significant. TC/ HDL and LDL /HDL were also raised in obese patients, which is statistically significant. T.C. is raised in the CVA group, which is statistically highly significant. LDL is raised in the CVA group, which is statistically very significant. TC/ HDL and LDL/ HDL are raised in the CVA group compared to the non-CVA group, which is statistically significant. T.C. is raised in the IHD group, which is statistically significant. LDL is raised in the IHD group, which is statistically very significant. LDL/HDL is raised in men, which is statically significant. Conclusion: There is a significant alteration of lipid profile in hypertensive patients as compared to controls. Total cholesterol, LDL cholesterol, triglycerides, VLDL, TC/HDL, and LDL/HDL ratios are significantly elevated in patients with hypertension. HDL is significantly reduced in hypertensive patients. Hyperlipidemia is seen in most hypertension cases, with the Type IIa pattern being the most frequent. Mean T.C., LDL, TC /HDL, LDL/ HDL were higher in obese. Mean T.C., LDL, TC/ HDL, and LDL/ HDL ratios are raised in the CVA group. Mean T.C. and LDL are raised in the IHD group.
554 BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN CENTRAL VENOUS TIP CATHETER , Nitasha Faiz*, Uzma Jabeen and Samina Sadiq
Objective: The purpose of this study is to find out the frequency of colonization of by different bacterial pathogens and their antibiotic sensitivity pattern in our setting. Material & Methods: conducted a cross-sectional study at the Multan Institute of Cardiology. The study was conducted over six months from April 2020 to September 2020. Forty-three patients were selected through simple consecutive sampling having indwelling central venous catheters (CVCs). The isolated organisms were identified by standard microbiological procedure and subjected to antimicrobial sensitivity. SPSS-16 was used for statistical analysis. Results: In this study, a total of forty-three Catheter tips were evaluated through microbiological examination. Out of 43 samples, sixteen were found positive, six from peripheral blood and seven from the Tip of the catheter. Three patients had positive cultures both from blood and from the Tip of the catheter showing the same bacteria in both cultures. Remaining samples either had no organism grown or had nominal growth. Out of 43 samples, 16 (37.2%) showed significant growth of an organism. The most common organisms found in the culture were Acinetobacter (SPP) baumannii 5 (31.2%), Staphylococcus aureus 4 (25%), Coagulase Negative Staphylococcus 2 (12.2%), Pseudomonas aeruginosa 3 (18.7%) followed by and Klebsiella pneumonia 1 (6.25%) All five gram positive bacteria were sensitive to Vancomycin (100%) while Imipenim 4 (57%) and Amikacin (8 (50%) were sensitive for gram-negative bacteria Conclusion: The incidence of Catheter-related infection in our hospital was 37.2%. Acinetobacter baumannii was the most common pathogen isolated from culture. Vancomycin and linezolid were sensitive for Gram-positive bacteria, while Imipenim and Amikacin were sensitive for gram-negative bacteria. Piperacillin-tazobactum proved to be a right broad-spectrum antibiotic. Empirical therapy for such infections in health care settings should be used to get a good outcome.
555 STANDARD OPERATIVE PROCEDURE & PROBABLE MODE OF ACTION SHIROPICHU , Dr. Arun Kumar Gupta* and Dr. Trupti Gupta
Headache is one of the commonest symptoms, and primary headache disorders are among the most pervasive disorders, heartrending people in all countries.[1] India appears to be no exception. The Global Burden of Disease Study 2010 (GBD2010) found tension-type headache (TTH) and migraine to be the 2nd and 3rd most prevalent disorders worldwide. The human head is homespun to all the body's major sensory organs, and the most imperative of these is the brain. Although the nose, ears, tongue, nerves, and others parts are important, without a healthy brain, they'd all be inoperable. Shiropichucures the diseases of Head & also maintain the health of head. Mode of action of Shiropichucan be pronounced locally as well as systemically. Shiropichuincreases the circulation there by amending the brain circulation which is very important in stress. Symptom like migraine headache, which is caused by extra cranial Vasodilatation and the neurological symptoms which are produced by intra cranial vasoconstriction.Shiropichumay be helpful in regularizing the blood supply of brain and can relieve the pain of migraine. Shiropichuis one of the most active treatments for dropping stress and nervous tension. It works through action on TarpakKapha, Sadhak Pitta and PranVayu.
556 COMPREHENSIVE REVIEW OF SHROSHULA IN AYURVEDA RESERVE , Dr. Trupti Gupta* and Dr. Arun Kumar Gupta
Manahsantapa is the leading factor in creating the disease Shirahshula according to Charaka (Cha. Su. 17/10). It is clearly mentioned by Charak and Harita that Shoka and Bhaya is specifically responsible for VatikaShirashula It is estimated that 82% of headache occurs due to tension. Its increasing global incidence is a cause of concern for all which has forced to initiate the research work to discover an effective medicine for the better management of this challenging ailment.Majority of the drugs employed in modern medicine for this disease are almost limited to suppress the symptoms. A repeated and long term use of such drugs is found to cause serious side effects like memory loss, gastro - intestinal disorders, weight gain etc. and tend to be habit forming. Therefore, search for a safer management is of great importance. Medhya Rasayanas described in Samhitas are primarily meant for the enhancement of the Dhee (Intelligence power), Dhriti (Grasping Power). Smriti (memory power) like intellectual function. If we can successfully enhance these functions, it may help to combat against various causes of headache like stress, tension, anxiety, fear, grief, anger etc. by which it can help a lot in the management of VatikaShirah-shula also. In present era, Shirahshula is the most common disease, it is mainly due to aggravation of vatadosha as well as tridosh. Panchakarma like- BrahanaNasya, Murdhnisneha (Shirodhara, Shiropichu, ShiroAbhyang & Shirobasti) Dhumapana, Kawal, Gandush, Taladharan, NetraTarpana are advised to treatment of shiroshula. Some Oral Medications like Shirahshuladivajraras, BrahatvatachintamaniRas, VatakulantakRas, VatgajankushRas, Kamdhudharasa, Tribhuvankeertiras, Laxmivilasras, MahalaxmivilasRas, Godantibhasma, Tankadbhasm, Pravalbhasma, Sankhabhasma, Muktabhasm, MuktasuktiBhasm and GairikBhasm should give in shirahshula. We are advice Pranayama, Yoga & proper diet to cure shirahshula.
557 FREQUENCY OF POST RENAL BIOPSY MACROSCOPIC HEMATURIA , Dr. Shahrukh Maqsud*, Dr. Rida Rana and Dr. Urva Shahid
Background; Macroscopic hematuria is a commonly seen condition in the emergency department (ED), which has a variety of causes. This study was performed to ascertain frequency of macroscopic hematuria among patients undergoing native renal biopsy using free hands ultrasound assisted renal biopsy technique within first 24 hours, as there is no such study done in Pakistan on this topic. Objective: To determine frequency of macroscopic hematuria after native renal biopsy using free hands ultrasound assisted renal biopsy technique within first 24 hours. Material and Methods: It is a cross-sectional study performed at Nishtar hospital Multan over a period of one year, from January 2019 to January 2020. Sample was collected through random convenient sampling technique. Sample size was 138. Data was analyzed by SPSS. Results: Of these 138 study cases, 91 (65.9 %) were male patients while 47 (34.1%) were female patients. Mean age of our study cases was 47.57 ± 7.26 years (with minimum age of our study cases was 35 years while maximum age was 60 years). Of these 138 study cases, 56 (40.6%) belonged to rural areas and 82 (59.4%) belonged to urban areas. Monthly family income up to Rs. 350000 was noted in 67 (48.6%) while more than 35000 rupees 71 (51.4%) of our study cases. Obesity was present in 41 (29.7 %) of our study cases. Chronic kidney disease (un-explained renal failure) was noted in 77 (55.8%), proteinuria in 46(33.3%) and unresolved AKI in 15 (10.9%) of our study cases. Mean needle size was noted 17.15 ± 0.59 and 86 (62.3%) had needle size with gauge 18. Macroscopic hematuria was noted in 30 (21.7%) of our study case. Conclusion; High frequency of macroscopic hematuria after native renal biopsy using free hands ultrasound assisted renal biopsy technique was noted in our study. Macroscopic hematuria was significantly associated with male gender, increasing age, residential status, monthly family income and indications for renal biopsy. The early diagnosis followed by corrective/preventive measures can help decrease disease morbidity among targeted population. This will help decrease disease burden and improve quality of life of these patients.
558 FREQUENCY OF MICROORGANISMS INVOLVED IN UTI AMONG DIABETIC PATIENTS AT A TERTIARY CARE CENTER , Dr. Muhammad Wajid Rasool*, Dr. Urva Shahid and Dr. Rida Rana
Aim of study: The prevalence of asymptomatic and symptomatic UTI is very high among diabetic patients. This study was conducted to assess the frequency of microorganism involved in urinary tract infection among diabetic patients. Methodology: It is cross-sectional study done at Pathology department and Diabetic OPD of Nishtar Hospital Multan for a period of 6 months from December 2018 to April 2019. Total 250 samples of Urine was collected from patients visiting diabetic OPD. Patients having symptoms of UTI or having more than 5 WBC/HPF on urine analysis were selected for the study and urine culture was performed on their samples. Using a standard quantitative loop, urine samples (1 μL and 10 μL) were used to inoculate Cysteine lactose electrolyte deficient (CLED) agar (Oxoid, Basingstoke, UK), MacConkey, 5% Sheep Blood agar, and chromogenic UTI (Oxoid) agar plates. Plates were incubated for 24 h at 37°C and the outcome was judged as significant/nonsignificant growth, or contaminated (discarded). Significant bacteriuria was defined as urine culture plates showing ≥105 colony-forming units (CFU)/mL of single bacterial species. Results: Total 250 urine samples of diabetic patients were selected for study. Among these patients 162 (64.8%) were female and 88 (35.2%) were males. 171 (68.4%) patients were having symptoms of urinary tract infection and remaining 79 (31.6%) were asymptomatic. Asymptomatic patients were having more than 5 WBC/HPF on complete urine analysis. 31 patients were having HbA1c with in target range (i.e. 6-7), 100 patients were having HbA1c 7-8 and remaining 119 patients were having HbA1c above 8. After 24 hours of intubation in the required media we found 20 sample were having mixed growth/contaminated, 195 (78%) sample were having E.coli growth, in 64 (25.6%) patients were Klebsiella spp, Staphylococcus in 31 (12.4%), Pseudomonas in 15 (6%), Proteus in 9 (3.6%), Streptococcus in 2 (0.8%), Enterococcus spp. in 3 (1.2%) and Candida spp. in 1 (0.4%). Conclusion: UTIs are frequent in patients with diabetes. The most frequent microorganism is E. coli and fungal infections are least common in diabetic patients in our study. Symptomatic UTI are more common in patients due to late presentation to hospital. Among asymptomatic UTI cases, female were more common as compared to male.
559 THE RELATIONSHIP WITH BRAIN AND FATTY ACIDS , Aysel Sari*
Fatty acids, which are the content of fats, have functions in many syntheses in organs in the body, as well as in synthesis in the brain. These functions are not only high energy sources. It has very important roles in the process of health formation, protection and treatment of discomforts depending on the properties of fatty acids. Briefly, adjuvant and neoadjuvant effects are clearly known. The aim is to emphasize its importance in the light of recent studies on the effects of fatty acids on brain and health.
560 PRIMITIVE NEUROECTODERMAL TUMOR (PNET) OF THE PROSTATE: CASE REPORT , EL. Mouhtadi S.,* Filali N., Abahssain H., Harrak S., Mrabti H., Boutayeb S. and Errihani H.
Primitive neuroectodermal tumor (PNET) is a malignant tumour of the neural crest which is now included in the PNET/EWING family. Showing to share the same characteristic cytogenetic overlaps and a t-translocation.[11,22] (q24 ; q12).[1]
561 IMMUNE CHECKPOINT INHIBITORS IN THE TREATMENT OF PATIENTS WITH CANCER AND PREEXISTING AUTOIMMUNE DISEASE: CASE REPORT , EL. Mouhtadi S.,* Filali N., Abahssain H., Harrak S., Mrabti H., Boutayeb S. and Errihani H.
The anti-tumour immune response involves a cycle of complex immunological events, in which T lymphocytes play a major role. Cytotoxic T cells lysis tumour cells in collaboration with T lymphocytes with auxiliary functions.
562 SEVERE TOXICITY OF FLUOROPYRIMIDINES LINKED TO DIHYDROPYRIMIDINE DEHYDROGENASE (DPD) DEFICIENCY: EXPERIENCE OF NATIONAL INSTITUTE OF ONCOLOGY OF RABAT, MOROCCO , EL. Mouhtadi S.,* Filali N., Abahssain H., Harrak S., Mrabti H., Boutayeb S. and Errihani H.
We report the experience of the National Institute of Oncology of Rabat of severe toxicities due to Fluoropyrimidines, linked to a deficiency in dihydropyrimidine dehydrogenase (DPD) in cancer patients.
563 AYURVEDIC REVIEW OF SADHYO-VRANA AND THEIR MANEGMENT , Dr. Subhendra Yadav*, Dr. Rajesh Gupta and Dr. Anita lalwani
Ancient surgical science-shalya tantra embraces all processes is aiming at the removal of the factor responsible for producing pain or misery to the body or mind. Varans are a frequently encounter problem in the present era produced mainly due to trauma or pathologic insult and may cause long term agony to the patients. In this review article we have tried to describes sadhyo-varna, their lakshan, and their manegment according to Ayurveda.
564 CONCEPTUAL STUDY OF TWAK SHARIR W.S.R. TO PADADARI , Ganesh J. Dolas* and Dr. Vinod M. Choudhari
Twak (skin) is one of the most important organs (Dyanendriya) which receives sense/stimuli through Adhisthanas. Twak generates anticipated response against the stimuli like; Sparsh (touch). Twacha (skin) not only helps to understand touch sensation but it also covers whole body, protect from shock and performs functioning thermostat through sweat channels (Swedvahi Strotas). The pore present in skin helps in the hair nourishment and detoxification process. It is believed that each and every components of skin having anatomical and physiological importance. Padadari is one of the commonest and most negligible disease. It is observed that people are least bothered about their feet though feet bear the whole body weight. In India 80% of population live in rural area. Most of them work in farms in wet soil and water also. So incidence of cracking the skin of the foot is very common. For management of Padadari knowledge of skin is very important. All of Aacharyas explain briefly about Twak sharir, in this research article we try to focus on Twak Sharir.
565 RASAVAHA STROTAS: AN AYURVEDIC REVIEW , Dr. Sanjana Aswar* and Dr. P. C. Yawatkar
Strotas are innumerable channels or pathways which supply nourishment to dhatu and whole body. Strotas carry all like poshya rasa to poshaka rasa, specific materials, hormones, enzymes, thought process, stimulus. It is such a minute supply that is not seen but visible by their actions or by functioning that occurs. Any disturbance in physiology of strotas may lead to pathological manifestation, therefore it is very important to understand physiological and clinical concept of strotas along with its management. Ayurvedic samhitas described anatomical and physiological concepts of strotas brodly along with the diseases related to strotodushti. In this article I try to opt on Rasavaha strotas in detail view.
566 ETHNOBOTANY, PHYTOCHEMICAL AND PHARMACOLOGICAL PROFILE OF CASSIA TORA: A REVIEW ARTICLE , Dr. Sandeep Malik*, Dr. Jagdish Mohan Onkar and Dr. Pratibha
Cassia tora Linn is a small annual herbs or undershrub growing as common weed in Asian countries. It is found as a weed throught India. The plant which is used in several traditional medicines to cure various diseases. This weed has been known to possess antiproliferative, hypolipidemic, immunostimulatory, anticancerous, antimutagenic and hepatoprotective activity. A wide range of chemical compounds including anthraquinones, chrysophanol, emodin, rhein, euphol, basseol, palmatic, isostearic, behenic acid etc. have been isolated from this plant. The presented review summarizes the information concerning the botany, ethnopharmacology, phytochemistry, biological activity and toxicity of the Cassia tora plant.
567 MEDICINAL USES OF SUNN HEMP (CROTALARIA JUNCEA LINN): A REVIEW ARTICLE , Dr. Sandeep Malik*, Dr. Pratibha and Dr. Jagdish Mohan Onkar
Vetiveria zizanioides is popularly known as Khas Khas, Khas or Khus grass in India. It is a densely tufted grass, found throughout the plains and lower hills of India, particularly on the riverbanks and in rich marshy soil. Vetiver has been known to India since ancient times. It has been considered as a highclass perfume and copper plate inscriptions list the perfume as one of the articles used by royalty. Two species of Vetiveria are found in India, of which V. zizanioides is the common source of the well known oil of vetiver, which is used in medicine and in perfumery. Khas grass grows wild in many states, namely Haryana, Uttar Pradesh, Rajasthan, Gujarat, Bihar, Orissa and Madhya Pradesh and throughout South India. It is systematically cultivated in the North Indian states of Rajasthan, Uttar Pradesh and Punjab and in the South Indian states of Kerala, Tamil Nadu, Karnataka and Andhra Pradesh. The yield from the cultivated crops, however, meets only a very small percentage of the requirements of the country. The bulk of the roots used for cooling purposes and for the extraction of the oil are obtained from the wild. Vetiver oil is regarded as stimulant, diaphoretic and refrigerant. This oil is used in perfumery, cosmetics and soaps and for flavouring sherbets (Indian cool drinks). Local application of leaf paste for rheumatism, lumbago and sprain gives good relief. The dried roots are also used to perfume the linen clothes. The rachis is used in the manufacture of moodas, sirkies, etc. The young leaves are browsed by cattle and sheep. Dried culms are used for making brooms and thatching of huts. Pulp is suitable for manufacturing paper and straw board.
568 REPRODUCTIVE PHENOLOGY OF SIDA CORDIFOLIA L.: A REVIEW ARTICLE , Dr. Sandeep Malik*, Dr. Pratibha and Dr. Jagdish Mohan Onkar
Sida cordifolia commonly known as Indian ephedra belongs to family Malvaceae. The present paper highlights the important phenological events, associated with the reproductive success of S. cordifolia. The leaf fall and renewal occurs throughout the year with maximum leaf fall in the month of December, January and April-June and minimum in the month of February to March and August to September. Maximum leaf renewal was observed during the month of February to March and July to August and Minimum in the month of May to June and September to January. Flowering was observed throughout the year with maximum flowering in the month of February to April (11.8-38.3 0C) and August to September (24.4-33.9 0C) and minimum in the month of October to November and May to June. Anthesis occurs at noon during summers and in the afternoon during winters and fully open 7-10 days after the bud initiation. Number of ovules/ovary was 13 and pollen ovule: ratio 190:1 in the month of March. The unicellular and tetra radiate trichomes were found on the leaves and ovary surface. The maximum fruiting was observed in the month of November to December and March to May and fruit-set percentage was 64% recorded in the month of March. The fruits were 0.75cm in diameter. The number of seeds/fruit was 13. Fruit formation and maturation occur simultaneously and dispersal of seeds occurs accordingly. Seed matures 7-12 days after closure of flower. The seed set percentage was 70.5%. The present study may provide the necessary information for the better cultivation and conservation of S. cordifolia.
569 MEDICINAL USES OF CHIRBILWA (HOLOPTELEA INTEGRIFOLIA).: A REVIEW ARTICLE , Dr. Sandeep Malik*, Dr. Pratibha and Dr. Jagdish Mohan Onkar
Holoptelea integrifolia Planch of Ulmaceae family is an important tree having medicinal properties, commonly known as Chirabilva in India. It is a large, spreading, glabrous, deciduous tree having foul smell in leaves and bark. Heartwood is light yellow, lustrous, interlockedgrained, even-textured, moderately heavy and strong which contains biomolecules like tannins, flavonoids, pigments and phenolic compounds. Chirabilva is described in Lekhaniya and Bhedaniya Mahakashaya of Charaka Samhita indicating its laxative and purgative action. It has anti-inflammatory, anti-bacterial, anti-oxidant, wound healing and hypolipidemic activities. It is useful in inflammations, colic, intestinal worms, vomiting, wounds, skin diseases, filariasis, obesity and diabetes mellitus.
570 MEDICINAL USES OF CHIRBILWA (HOLOPTELEA INTEGRIFOLIA).: A REVIEW ARTICLE , Dr. Sandeep Malik*1, Dr. Pratibha2 and Dr. Jagdish Mohan Onkar3
Holoptelea integrifolia Planch of Ulmaceae family is an important tree having medicinal properties, commonly known as Chirabilva in India. It is a large, spreading, glabrous, deciduous tree having foul smell in leaves and bark. Heartwood is light yellow, lustrous, interlockedgrained, even-textured, moderately heavy and strong which contains biomolecules like tannins, flavonoids, pigments and phenolic compounds. Chirabilva is described in Lekhaniya and Bhedaniya Mahakashaya of Charaka Samhita indicating its laxative and purgative action. It has anti-inflammatory, anti-bacterial, anti-oxidant, wound healing and hypolipidemic activities. It is useful in inflammations, colic, intestinal worms, vomiting, wounds, skin diseases, filariasis, obesity and diabetes mellitus.
571 CONCEPT OF NEWBORN CARE IN AYURVEDA , Dr. Nagendra Thakre* and Dr. Praveen Raghuwanshi**
Newborn babies or neonates truly constitute the foundation of human life. They have unique health issues and problems due to structural and functional immaturity of various body organs depending upon their gestational age and birth weight. Care of the newborn is described by both Ayurvedic and Modern texts in detail. In ancient texts, Acharyas gave their opinions on every aspect of the Care of newborn (Navjat Shishu Parichariya) which starts from birth to full stability of newborn. Various procedures were advised the management of newborn child by Acharyas with a few differences in opinion regarding the sequences of those procedures. The procedures involved in the Care of newborn (Navjat Shishu Parichariya) are Pranapratyagamana, Snana, Mukha vishodhan, Pichudharan, Garbhodaka vamana, Nala chedana, Jatakarma, Raksha karma, Suwarna prasana. In modern science newborn care is mentioned in detailed with the use of different instruments and protocol based management.
572 A LITERARY REVIEW OF RUKSHAN KARMA AND IT’S APPLICATION , *Dr. Rishabh Kumar, Dr. Ramnihor Tapsi Jaiswal and Dr. Manohar Ram
Acharya Charak explain six basic principles or method of treatment which are called as “Sadvidhoparma”. Whatever the disease the line of treatment lie within Sadvidhopakrma. The term upkrma refer to planning or application of medicine. Because of six branch for application of medicine it is called as Sadvidhoparma. It includes Langhan,Brimhana, Rukhsana,snehana,Sthambhana and Swedana.Acharya Vagbhatt divided these 6 principles into method of treatment, (1)-Santarpana and (2)-Aptarpana. Santarpana includes Brimhana,snehana and Sthambhana,where as Aptarpana includes Langana,Rukshan and swedana.. Ayurveda gives same importance to patient as well as a healthy person. Dhatusamyam is basic factor for a healthy life. These six Upakrama are path to achieve Dhatusamya. The detail review of Rukshan karma will be given in this article.
573 BRAIN TARGETED DRUG DELIVERY SYSTEM , Varsha Z. Gite*, Vaishali K. Ghume and Dr. Ramanlal N. Kachave
Targeted drug delivery is a method of delivering medication to a patient in a manner that increases the concentration of the medication in some parts of the body relative to others. Targeted drug delivery is a method of delivering medication to a patient in a manner that increases the concentration of the medication in some parts of the body relative to others. Targeted drug delivery seeks to concentrate the medication in the tissues of interest while reducing the relative concentration of the medication in the remaining tissues. The inherent advantage of this technique has been the reduction in dose & side effect of the drug. The brain is a delicate organ, and evolution built very efficient ways to protect it. The brain is shielded against potentially toxic substances by the presence of three barrier systems: the blood brain barrier (BBB), the blood cerebrospinal fluid barrier (BCSFB) and the blood tumor barrier (BTB). General methods that can enhance drug delivery to the brain are of great interest in treatment of various CNS diseases. By localizing drugs at their desired site of action one can reduce toxicity and increase treatment efficiency. In response to the insufficiency in conventional delivery mechanisms, aggressive research efforts have recently focused on the development of new strategies to more effectively deliver drug molecules to the CNS. This review intends to detail the barriers in brain targeted drug delivery system, mechanism of transfer of drug via BBB, problems faced in brain targeted drug delivery, various approaches of brain targeted drug delivery system and its applications in treatment of various CNS diseases.
574 IMPORTANCE OF DINCHARYA IN AYURVEDA: A REVIEW ARTICLE , Dr. Navedita Kumari* and Dr. Anupam Pathak
Health includes one‟s reserve of physical strength and stamina as well as mental steadiness to meet the requirements of the daily life. Only healthy individual of sound body and mind can endure social and cultural pressures. Health not only means freedom from the disease, but the ability to work with the satisfaction and self control. Health is the best root factor in achieving Dharma (attain pious acts), Artha (wealth), Kama (desire) and Moksha (salvation). Lifestyle change, more than any other factor, is considered to be the best way of preventing the disease and early death in our society. When people in western society die before the age of 65, it is considered to be early or premature death. Many factors contribute to early death. The major causes of early death have changed from infectious diseases to chronic lifestyle-related conditions. The most important is unhealthy lifestyles that contribute to more than half of all early deaths. One who wants to keep fit himself for whole of his life time should also be fit for every day. Health depends on how one spends day. The ideal life style for a day is called as daily regimen (Dinacharya). Daily regimen explains the various duties from one day to the next day.
575 A CRITICAL REVIEW ON KUPIPAKWA RASAYANA , Dr. Deepak Kumar Tiwari*
Rasa Shastra and Bhaishajya kalpana are the main part of Ayurvedic pharmaceutics science. Rasa shastra deals with the herbo mineral and metallic preparations with their types, occurrence, physical properties and organoleptic characteristics. Basically there are four types of Rasoushadhis are mentioned in Rasa granthas such as Kupipakwa Rasayana, Parpati Rasayana, Pottali Rasayana and Kharaliya Rasayana. Kupipakwa Rasayana is very difficult to prepare and require long period for preparation. However, it bears a unique place in Rasa Shastra because of its mercurial preparations with faster action and synergistic effects in the body at very low dose. The kupi indicates that the preparation is made in kupi (glass bottle) on mild to severe heat by using an instrument known as Baluka yantra. In this article detail knowledge regarding the definitions, etymology, types, manufacturing procedures, instruments useful in Kupipakva Rasayana are discussed. This study definitely will give an idea about usefulness of Kupi pakwa rasayana.
576 ROLE OF MONTELEUKAST IN DYSMENNORHOEA , Mahjabeen Naaz, Juzer Sabuwala, Ayesha Naaz, Heena Farheen and Dr. S. P. Srinivas Nayak*
Dysmenorrhea is termed as painful menstrual periods which are caused by uterine contractions which often reduce the quality of women’s life. Prostaglandins play a major role in the pathomechanism of dysmenorrhea. Leukotrienes have also been postulated to increase the sensitivity of pain fibers in the uterus. Considerable amounts of leukotrienes have been demonstrated in the endometria of women with primary dysmenorrhea. Potent prostaglandins, cyclooxygenase metabolites of arachidonic acid, and leukotrienes, lipoxygenase metabolites of arachidonic acid, are thought to play a key role in the inflammatory process during menstruation. These abnormal uterine contractions cause poor reperfusion and oxygenation, leading to the pain, and also cause prostaglandins and leukotrienes to be released into the systemic circulation, resulting in symptoms such as nausea, vomiting, diarrhea, and headache. The intensity of menstrual cramps and dysmenorrhea-associated symptoms are linked to the amount of prostaglandins and leukotrienes released. Hence, there is a significant role of prostaglandins and leukotrienes in the pathogenesis of dysmenorrhea leading to pain. Therefore, the present work contains a review about the use of leukotriene antagonists in controlling the pain stimulus in women suffering with dysmennorhea.
577 THERAPEUTIC REVIEW OF HERBO-MINERAL PREPARATION: MRUTPRANDAYI RASA , Dr. Jaya Singh*, Dr. Praveen Raghuwanshi and Dr. Prashant Tiwari
Rasa Shastra is a branch which deals with Rasa, Metals, Minerals, Gems, Herbal drugs and various Principles of Alchemy and Metallergy etc. Mrutprandayi rasa is one such Kharaliya herbo-mineral formulation mentioned in various ayurvedic text.Mrutprandayi rasa is commonly indicated in Sarva Jwara (Fever)chikitsa,Jwara run a chronic and complex course and is difficult to treat.It is also indicated in various other diseases like Grahini, unmad etc. Aims and Objective: The main objective of this article is to discuss the therapeutic uses of Mrutprandayi rasa and to discuss the different pharmacological properties and therapeutic uses of isolated constituent drugs of Mrutprandayi rasa. Materials and Method: Data is collected from related ayurved and modern medical literature, articles which have been published in various journals on website. Discussion: Most of the drug in Mrutprandayi rasa is katu, tikta rasatmak with ushna veerya, laghu, ruksha, and tikshna gunatmak having jwarghna property. Conclusion: Mrutprandayi rasa is a very effective drug, it has multidimensional broad spectrum activity so this can be used in all type of jwara.
578 ROLE OF HRCT IN ASSESSMENT OF LUNG DISEASES , Dr. Abhishek Jaiswal*, Dr. Syed Zubair Ayoub
HRCT is currently the best modality for evaluation of large and small airways disease and diffuse interstitial lung diseases thus improving the diagnostic accuracy and specificity.[1] HRCT is more sensitive in differentiating normal from abnormal lung parenchyma. It can also characterize diseases into interstitial, airway, and airspace processes. It is more sensitive in detecting abnormalities, providing better information and a more accurate differentiation between different pathologies than the chest radiograph and conventional CT. All these reasons explain the increasing use of this technique in the investigation and evaluation of many lung disorders.
579 INTRODUCTION OF GARBH VRUDDHIKAR BHAVA: A REVIEW ARTICLE , Dr. Kaushal Kumar*, Dr. Sakshi, Dr. Aarti Alankar Rajhans and Dr. Subhash Upadhyay
Since the advancement of science, world has progressed in every field. The field of anatomy also is not untouched by this progress. Still the basic principles, established by Ayurvedic Scholars in the field of Rachana Sharir stand true in the light of modern science also. Foundation of Ayurveda Science is based on the ancient philosophies which are fundamental sciences of the ancient Indian think tank. Ancient scholars have enumerated a number of factors, which together lay the physiological and physical make-up of an individual. The combination of these factors and the state of doshas in Shukra (sperm) and Artava (ovum) at the time of conception determines the constitution of a person. Ayurvedic thinking supplies strong foundation to make an understanding of human constitution. There are the various factors responsible together which have an effect on constitutional, temperamental, psychological and spiritual make up of each individual. Shad garbhkarabhavas (factors) i.e. Matrija, pitrija, Atmaja, Sattvaja, Satmyaja and Rasaja have the influence on the constitution of the body. In this research paper how these Shad garbhakarabhavas (procreative factors) plays an important role during the formation development of the foetus is described. The present Literary / conceptual study, thus, focus mainly on interpreting these observations on the basis of modern scientific knowledge. The consortium of all these six procreative factors is necessary for healthy offspring.
580 CLINICAL IMPORTANCE OF SHATA KRIYAKAAL- A SYSTEMATIC REVIEW , Dr. Rita Singh* and Dr. Anurag Singh Rajput
Shatkriyakala is an important tool to assess the entire process of disease manifestation described by Sushruta in Sutrasthana in the 21st Chapter of Vranaprashniya Adhyaya. Shatkriyakala include six stages viz Sanchaya, Prakopa, Prasara, Sthansamshraya, Vyaktavastha and Bhedavastha. Kriya means prevention and Kala means measure,so Kriyakala is the opportunity to treat vitiated doshas or Roga in their different stages.In a way we can say its an apportunity to recognize and treat the disease before it gets fully manifestated. Acharya Vagbhata described this whole process of intake of various Nidan, vitiation of Vatadi Doshas resulting into appearance of various sign and symptom of disease as Samprapti which is similar to all the stages of Kriyakala.
581 A REVIEW ON DEXAMETHASONE AND ITS SIGNIFICANCE , Pavithran G., Anusha V. H. and Vyshnavi V. Rao*
Dexamethasone is a globally used corticosteroid in treatment rheumatic problems, skin diseases and cancers. It was first discovered by Philip Showalter Hench in 1957 and was approved for medicinal use in 1961. It is one among the list of essential medicines released by World Health Organization (WHO). National Institutes of Health (NIH), US and National Health Service, UK have recommended use of Dexamethasone in patients with severe COVID-19 symptoms and are on external oxygen supply. This article aims to discuss the structure of Dexamethasone, its pharmacokinetics, applications in the various fields of medicine, side effects and brief the role of Dexamethasone in the treatment of COVID-19. This article highlights the latest research developments in the use of Dexamethasone for the treatment of COVID-19. Lack of sufficient data on SARS-CoV-2 relating it to the symptoms and treatment makes it extremely significant for new age researchers to build upon the already established antiviral drugs such as Dexamethasone.
582 REVIEW OF MEDA DHATU SARTA IN RELEVANCE WITH PRAKRITI , Dr. Bhag Singh Kushwah* and Dr. Nagendra Thakre
Ayurveda is one of the greatest gifts given by the sages of ancient India to mankind. Ayurveda is designed for healthy and long life. Agni (digestive ire), Prakruti (constitution), Dhatusarata (tissue excellence), Doshas (bio energies) are the pillars of Ayurveda, which help in diagnosis, treatment and research. Ayurveda defines health as a state of physical, psychological, social and spiritual well being and is based on the theory of Panchamahabhoota (the five basic elements – Space, Air, Fire, Water and Earth) and Tridoshas (three biological humors – Vata, Pitta and Kapha) which are present in each and every cell of the body along with mind and spirit. The equilibrium of doshas is called health and imbalance (Vikriti) is called disease (Ashtanga Hridaya, Sutra Sthana). Together these three doshas determine the physiological balance and constitution of the individual which is called as Prakriti in Ayurveda. Medo Dhatu is an important Dhatu among Saptadhatu. This has received equal importance as other Dhatu. Literally, the word Medo is derived from root “Jhimida Snehana”. This stands for Sneha, Fat, and Oil etc. It means the substance which has snigdhatva property is called Medos. There are so many oily substances in the body like Vasa, Majja etc. When Medodhatu is produced in excellence condition individuals known as Medosara Purusha.
583 NANOSUSPENSION: AN EMERGING METHOD OF DRUG DELIVERY , Dr. Meenakshi Savant*
Background: Nanosuspension is an innovative drug delivery method emerging as a new approach to overcome the various limitation of conventional drug delivery. Solubility and bioavailability are two major factor which limit the efficacy of pharmaceutical product. Method: this review describes the methods of pharmaceutical nanosuspension production including advantages and disadvantages, potential benefits, characterization tests, and pharmaceutical applications in drug delivery. Result: Various techniques are used in formation of nanosuspension like homogenization, milling, precipitation etc. Nanosuspension is found to have a great potential to solve the issue of delivery of active pharmaceutical gradient having poor bioavailability, solubility. It also help in enhancing the site specific delivery. Conclusion: Nanosuspensions can be delivered by oral, parenteral, pulmonary and ocular routes. Nanosuspension technology is able enough to bring enormous immediate benefits and will revolutionize the research and practice of medicine in the field of pharmacy.
584 AN IDEAL ESTIMATION TO VALIDATE LIPID PEROXIDATION INDUCING OXIDATIVE DNA DAMAGE , A. Manoj*, B. Vishnu Bhat, C. Venkatesh and Z. Bobby
Lipid peroxidation is the oxidative degradation of lipids. It is the process in which free radicals steal electrons from the lipids in cell membranes leading to cell damage. The end products of lipid peroxidation are reactive aldehydes, such as Malondialdehyde (MDA). Malondialdehyde (MDA) is the organic compound colourless liquid which is a highly reactive compound that occurs as the enol. The production of this aldehyde is used as a biomarker to measure the level of oxidative stress. Malondialdehyde reacts with bases adenosine and guanosine in DNA, forming DNA adducts hence it well correlates with DNA damage and chromosomal aberrations. Malondialdehyde and other thiobarbituric reactive substances (TBARS) condense with two equivalents of thiobarbituric acid to give a fluorescent red derivative that can be assayed spectrophotometrically. The methodology for estimation of MDA was standardised for determining the oxidative stress induced DNA Damage in Perinatal Asphyxia. Peripheral veins samples were collected in heparinised tubes. Plasma were separated and stored in deep freezer and estimated the amount of MDA in oxidative stress DNA damages of cases and controls. MDA estimation is recommended for evaluation of oxidative stress induced DNA damage. There was significant elevation of serum MDA level in Perinatal asphyxia.
585 AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE AND NEW TREATMENT APPROACHES , Korapati Ramarao, Abdul Mushtaq Mohammed, Safi Ur-Rahman Mohammed, C. Sai Jayanth Guptha and Dr. S. P. Srinivas Nayak*
Autosomal dominant polycystic kidney disease is the most common inherited kidney disease, results in progressive loss of renal function due to the development and growth of cysts. Advances in understanding the nature of the disease have led to increased awareness of ADPKD, improvements in imaging modalities for diagnosis and assessment and the availability of effective therapies because patients with ADPKD often experience a range of renal and extrarenal complications. Approximately 78% of cases of ADPKD arise from PKD1 mutations. PKD2 mutations account for another 15%. These mutation-driven changes produce the hallmark disease process of ADPKD: development of large, fluid-filled cysts in the kidney, which over time increase kidney size and volume and compromise kidney function, leading to decreased life expectancy, need for dialysis and/or transplantation, cardiovascular/cerebro-vascular disease, and intracranial aneurysms. The involvement of the vasopressin system makes it a target for therapy designed to slow progression of ADPKD. Steps are to taken to slow down the progression of disease by early diagnosis and symptomatic treatment approaches are needed to be followed to prevent the complications. As RAAS mechanisms are prime factors for progression and worsening of the condition, steps should be taken to prevent the over activity of RAAS by using many of the newer therapeutic agents show promise in preventing or stabilizing cyst growth, providing much needed hope in this currently relentless condition. Hypertension should be kept in check to prevent any chances of strokes. Making lifestyle changes such as dash diet and maintaining adequate hydration to maintain the normal renal sufficiency are some of the key approaches to control or to prevent the progression of this condition and help the patient to lead normal life and life expectancy.
586 AN OVERVIEW OF SHARAD RITUCHARYA , *Dr. Leena Gehani, Dr. Rachna Jain and Dr. Kavita Shivhare
The newly emerging diseases and diminishing immunity have made humans to seriously think about their health. Lifestyle modulation and adaptation according to climate is the need of hour. The glorious Ayurveda has its principal focus of conserving health and prevention of disease before their occurrence.[1] To serve this purpose, Aacharya have described Dincharya (daily regimen) and Ritucharya (seasonal regimen). One can cherish good health by following proper Ritucharya, described in classical texts of Ayurveda. The living beings especially humans are hugely affected by the change in climate. The features of all the Ritus, dietary and habitual modulation according to changing Ritu has been widely explained in the foremost texts of Ayurveda. Here, the Sharad Ritu which is one of the Ritu’s of Dakshinayan is overviewed so as to present the dietary and behavioral regimen in this season. The Sharad Ritu marks the transition from summers to winters. The hot sun rays in Sharad Ritu exaggerates the Pitta Dosha which is already accumulated in body in the Varsha Ritu. So dietary and habitual modifications which are Pitta Shamak in nature should be followed in Sharad Ritu along with the Shodhan procedures like Virechan and Raktamokshan.
587 IMPORTANCE OF PRAKRUTI PARIKSHANA IN PRESENT TIME , Dr. Madan Mohan Sharma, Dr. Bhanu Pratap Singh and Dr. Chhaju Ram Yadav
Prakruti represents an interesting component of basic principles of Ayurveda. It is the innate constitution of an individual based on predominance of Dosha determined at the time of conception which cannot be changed till death. It is the basic constitution of body and mind formed by the unique combination of three Dosha. Based on the predominance of individual Dosha, there are three major types of Prakruti named after predominant Dosha, viz., Vata, Pitta and Kapha. Each Prakruti has different characteristic features. A balanced Tridosha Prakruti is considered as ideal. Knowledge of the basic Prakruti of a person is useful to stay in a state of positive health.
588 IMPORTANCE OF SWATHA LIFESTYLE IN STRESS MANAGEMENT - A REVIEW , Dr. Siddharth Rajaram Gupta* and Dr. Kalapana K. Jadhav
In developing countries (including India) has led to people engaging themselves in converting time into money by this they are addicted to faultily lifestyle which playing important role in determining our Health all this is due to because people are very much far away from the meaning of health and importance of health form all dimensions i.e. physical, mental, social and spiritual. The judgment capacity of a stressed person is generally compromised and the faulty decision (known as pragyaparadha) is another important aetiological factor for several diseases (ibid).Thus, a vicious cycle is formed caused lot of stress to an already stressed person. They live in worry, tension, anxiety, fear & anger due to above factors & may suffer from the lifestyle related disorders such as hypertension, dyspepsia, indigestion, hyperacidity, diabetes, coronary heart disease etc. Such disorders can cause many other diseases or death. These diseases are often termed as ‗Diseases of longevity‗. Hence this work is intended to discuss the detail about Swasthya i.e. Health in Stress through Ayurveda.
589 “VAJRAK GHRUT” AN EFFECTIVE REMEDY IN MANAGEMENT OF CHARMA KUSHTHA (LICHEN PLANUS) , Dr. Rashmi Payasi* and Dr. Rahul Sharma
Ayurveda, the science of life, evolved from the quest of man to have happy life. The main Aim of Ayurveda is maintaining health of healthy person and curing the diseased ones. These principles even prove true in today’s modernized culture. Ayurvedic medicines are often considered effective for chronic and lifestyle disorders. Hypertrophic Lichen Planus (HLP) is a rare inflammatory skin condition and develops into squamous cell carcinoma in few cases. It has resemblance with Charma Kushtha mentioned in Ayurvedic classics. All skin diseases in Ayurveda are termed as Kushtha. Charma is one of the type of Kshudra-Kushtha. It is considered as Chirkari Vyadhi of Raktavahastrotodushti. Vajrak Ghrut is an Ayurvedic medicine, in herbal ghee form. This medicine has ghee as it is base. It is used for preparatory procedure for Panchakarma and also as medicine, used in the treatment of Lichen Planus, Herpes, fever, liver diseases etc.
590 AYURVEDA PERSPECTIVE OF PARINAMASHOOLA AND ROLE OF TILADI GULIKA IN THE DISEASE MANAGEMENT , Dr. Arunesh Kumar Dwivedi*, Dr. Archana Tiwari, Dr. Diwakar Patel, Dr. Rajesh Uikey, Dr. Shri Pati Jha, Dr. Ashutosh Chaturvedi
Ayurveda is considered as holistic and basic science of Indian medical system which not only suggests ways of healthy living but also provides therapeutic approaches for managing diseases of different organs. Ayurveda emphasized diseases of digestive tract and Parinamashoola is one of them, it is considered as common pathological conditions related to the digestive tract and resembling characteristics similarity with duodenal ulcer as per modern science. It occurs in the Parinamakaal of food, related with the Annavaha Srotas and affects quality of life significantly. Ayurveda described various approaches such as; detoxification measures, utilization of herbs & classical ayurveda formulations and Yoga practices for the management of such types of conditions. Tiladi Gulika is one such ayurveda drugs possess properties which can relives severity of Parinamashoola. Present article reviewed ayurveda perspective of Parinamashoola and role of Tiladi Gulika in its management.
591 A REVIEW ON STRATEGICALLY DESIGNED DRUG DELIVERY SYSTEM W.S.R. TO RASA FORMULATIONS , Dr. Rahul Sharma*, Dr. Anil Nagle and Dr. Raj Kishore Pati
Ayurveda is glory of Indian medical system believe in disease management through scientific and spiritual approaches. In this was ayurveda suggested uses of many formulations which were prepared on the basis of logical approaches. The rationality to design different ayurveda formulations based on the specific needs of patients. Churna, Vati, Kwatha, Arishta, Kalka, Asava and Avaleha, etc. are different formulations used for specific pharmacokinetic and pharmacodynamic purposes. Ayurveda formulations designed for oral, nasal and topical applications, etc. Ayurveda also described role of different formulations for the particular age groups means liquids or semisolid drugs for pediatric and geriatric patients. Similarly the therapeutic science of mercury Rasashaastra which also deals with other mineral/mental based formulations elaborated uses of different formulations such as; Bhasmas, Parpati and Pottalis, etc. These formulations prepared for particular benefits and prepared from scientific approaches so that therapeutic potency get enhanced and toxicity reduces. Taking importance of ayurveda formulations and their rationality of utilization this article emphasizes strategic aspects of Ayurveda formulations W.S.R. to Rasashaastra.
592 HOMEOPATHIC CONCEPT OF DISEASE PATHOGENESIS AND THEIR MANAGEMENT USING INTERNAL MEDICINES: A REVIEW , Dr. Viplav Narendra Kavishwar* and Dr. Chandramohan Ramchandra Indapure
Most of the medical field based on the conventional therapeutics work on the “Principle of contraria contraris curantur”. Homeopathy is the science which is developed by the Hahneman and is based on the principle of “Similia similibus curantur” i.e. Law of similar. It works on the concept of let likes be cured by likes. It requires administration of drugs which causes symptoms in healthy person similar to those in sick person. These drugs induce healing mechanism in the body so that it can work against its own disorders. We can also employ rebounding effect of conventional medicines in a curative way. This will help Homeopathic medicines to increase their spectrum of treatment and therapeutic utilities.
593 AYURVEDA ASPECTS OF VICHARCHIKA W.S.R. TO ROLE OF AYURVEDA LEPA AND VIRECHAN KARMA IN DISEASE MANAGEMENT , Dr. Arunesh Kumar Dwivedi*, Dr. Archana Tiwari, Dr. Hari Prasad Sharma and Dr. Hanuman Pancholi
Vicharchika is pathological condition mainly related to the skin tissue which is considered as Rakta Pradoshaja Vikara and can be correlated with eczema as per modern term on the basis of sign and symptoms. It is believed that disease mainly involves vitiation of Kapha Dosha and possesses symptoms like; redness, edema, itching, dryness, cracking, blistering and crusting. The disease affects person physically as well as psychologically therefore Ayurveda takes prime focuses on such conditions and mentioned line of treatment in the form of herbal remedies, Ayurveda formulations, Panchkarma and avoidance of causative factors. The topical applications of Ayurveda formulations in the form of Lepa mainly recommended curing skin manifestation and Virechan Karma as modality of Panchkarma also provides health benefits in such types of pathological condition. Therefore this article summarizes Ayurveda aspects on Vicharchika and its management W.S.R. to role of Lepa and Virechan Karma for topical and detoxification purpose respectively.
594 INDIAN ACADEMICIANS SEED, HARVEST, GERMINATE & CULTIVATE THE BUDDING PHARMACISTS TO SERVE FOR MANKIND BECAUSE SERVICE TO HUMAN IS THE SERVICE TO GOD , Prof. Dr. Dhrubo Jyoti Sen*
Outlook: Before you pray for life: Believe on Pharmacist Before you speak to doctor: Listen to Pharmacist Before you spend money for medication: Earn the trust on Pharmacist Before you write your consent: Think over Pharmacist’s devotion Before you quit from life: Try to feel Pharmacist’s noble profession Before you die: Live with Pharmacist’s oath.
595 A COMPARATIVE STUDY ON EFFICACY AND SAFETY OF ONDANSETRON V/S GRANISETRON IN PATIENTS RECEIVING CANCER CHEMOTHERAPY , Basavanna P. L.*, Vikas Laxman, Dicty Varghese, Elisha Tom and Mohammad Rowgani
Background and Objectives: Chemotherapy has brought wonders to human race but also has got many adverse reactions. Out of which nausea and vomiting rank among top three adverse drug reactions. The desire to control chemotherapy induced nausea and vomiting (CINV) is strong that patients postpone or even refuse the treatment. Ondansetron and Granisetron are the most common drugs used for treatment of CINV. Hence this study is carried out to compare the efficacy and safety of these two drugs. Methods: This is a prospective observational study conducted in oncology department, KR Hospital, Mysuru. 100 participants who satisfied the inclusion criteria were enrolled for the study. Among them, 50 were given Ondansetron and rest of them were given Granisetron for prevention of CINV. A well-designed data collection form was prepared to collect the data. Efficacy of antiemetics was assessed using NCI-CTC grading score. Result: The study showed that 14% experienced CINV while giving Granisetron plus Dexamethasone and 32% experienced CINV while giving Ondansetron plus Dexamethasone which indicates that Granisetron along with Dexamethasone is slightly better than the other. Conclusion: Though Granisetron regimen is found to be more effective, the choice of drug depends on the cost.
596 ROLE OF ULTRASOUND IN EVALUATION OF THYROID DISEASES. , Dr. Syed Zubair Ayoub*
Ultrasonography is the most common and most useful way to image the thyroid gland and its pathology, as recognized in guidelines for managing thyroid disorders published by the American thyroid Association.[1] Thyroid nodule is a common clinical problem. Epidemiologic studies have shown that the prevalence of palpable thyroid nodules is found in approximately 5% of women and in 1% of men living in iodine - sufficient parts of the world.[2]
597 EMPATHY AMONG DOCTORS - MEDICAL STUDENT’S PERSPECTIVE , Dr. A. Jamuna Rani*, D. Shanmuga Priyaa and Dr. Gayathri Dilliraj
Introduction: “Empathy is seeing with the eyes of another, listening with the ears of another and feeling with the heart of another”- Alfred Adler. As the quote implies, empathy is the experience of understanding another person’s thoughts, feelings and conditions from his or her point of view, rather than one’s own. Empathy benefits social relationships. It is beneficial for patients and physicians.[1] Empathy is a crucial component of the patient-physician relationship and has been associated with improved patient outcomes in multiple studies.[2] It facilitates treatment and improves physical and psychosocial outcomes.[1] It is better to be more empathetic than being sympathetic in a situation. Empathy is an active connection. This study is about the perception of empathy of doctors among medical students. It is inevitable for a physician to be empathetic towards their patients. Nowadays patients seek more empathy from their doctors. It is associated with increased patient satisfaction, improved adherence to therapy decreased medical errors, fewer malpractice claims and better outcome. Reflective thinking among 71 medical students regarding their experiences with doctor as a patient was given as an activity. Only 2 of them opposed the fact that doctors should be empathetic, remaining 69 had a common idea about the need for being empathetic towards their patients. This activity underlines the need for empathy. Objective: The objective of our study is to reinforce the need for empathy among the budding physicians. Method: This study is a qualitative study among 1st MBBS students based on reflective thinking about their experience as patients. Results: Interpretation of the feedback reflected that the students as patients seeked more empathy from the physicians. They have also suggested some characters that should be imbibed by a physician while treating a patient and some characters which a doctor should not possess. Conclusion: “Empathy is about finding echoes of another person in yourself”-Mohsin Hamid. Empathy is perceived as one of the individual abilities that defines efficiency in medicine and as an essential condition for patient- centred care. Therefore, this study is an eye-opener for all medical professionals regarding empathy and patient care.
598 SYNTHESIS AND ANTI-CANCER ACTIVITY OF NOVEL QUINAZOLINE DERIVATIVES , K. Dhunmati*, Sandhiya V. and Kousalya M.
Objective: The objective of the present study was to synthesize and screen the in-vitro anticancer activity of quinazoline derivative on MCF 7 Cell line. Method: Quinazoline derivatives belonging to the N-containing heterocyclic compounds have caused universal concerns due to their wide and distinct biopharmaceutical activities. The synthesized quinazoline derivatives was screened for anticancer activity against MCF 7 cell line study (via) MTT assay at different concentration level. Result: From the investigation of the study nearly 11 compounds were synthesized out of which two compounds such as 4-(2-fluorophenyl)-1,4,5,6 tetrahydro-2-(methyl thio) benzo quinazoline (C1) and 4-(3,4 dimethoxyphenyl)-1,4,5,6-tetrahydro-2-(methylthio) benzo quinazoline (C2) showed anti cancer activity. Conclusion: From the studies the results reveals that the compound quinazoline derivatives has significant anticancer activity against breast cancer cell line.
599 KHAGESWARA RASA- A KUPIPAKA RASAYAN W.S.R. TO PHARMACEUTICO-ANALYTICAL STUDY , Dr. Praveen Raghuwanshi* and Dr. Nagendra Thakre
Ayurveda places great emphasis on prevention and encourages the maintenance of health through close attention to balance in one‟s life, right thinking, diet, lifestyle and the use of herbs. Knowledge of Ayurveda enables one to understand how to create this balance of body, mind and consciousness according to one‟s own individual constitution and how to make lifestyle changes to bring about and maintain this balance. Rasa shastra is the branch deal with the knowledge which teaches us to purification, process, conversion of the drugs, irrespective of their nature into Rasa like form means in an absorbable, bioavalabile form. Khageswara Rasa is Sagandha, Saagni Kupipaka Rasayana described in R.R.S. containing purified Mercury, Sulphur and Green Vitriol in equal proportions processed with Bhavana of Arjuna Kwatha than preparation of small Balls like pellets from the Bhavita mixture. Finally these pellets are subjected to Kupipaka for 36 hrs. with specific heating patterns, Analytical study of Khageswara Rasa shows weight loss on drying is 1.69 % which indicates the preparation has less moisture value, suggesting its long shelf life. Total Ash value is 22.41%, pH Value is 4.9, XRD report shows that all peaks are of Hg, S and Fe. In the SEM analysis particle size was Maximum 540nm and 440nm was Minimum at 5KX and 335nm, 281.nm at 7KX. This proves that the drug can be easily absorbed. EDX report shows Hg-72.34% and S-27.64% of product optioned from neck of the bottle and product optioned from bottom reports shows Fe-88.25% and S-11.75% of Khageswara Rasa.
600 DIAGNOSTIC SIGNIFICANCE OF APGAR SCORE IN PERINATAL ASPHYXIA , A. Manoj*, B. Vishnu Bhat, C. Venkatesh and Z. Bobby
This case control study was conducted to evaluate the clinical status of infant for recruitment of babies with Perinatal asphyxia and without Asphyxia. 80 cases and 60 healthy controls were participated. Apgar score of cases at 1minutes, 5 minutes and 10 minutes of cases were <3 in 60, 11, and 6 babies, 4-6 in 20, 55 and 30 babies and 6-7 in 0,14 and 11 babies respectively. Whereas, in controls Apgar score >7 at 1 and 5 minutes were seen in 56 and 60 babies respectively which indicated that they are healthy new born. The mean and SD of Apgar score in cases was significantly lower (4.9±1.624) against (8.633 ±0.6040) among controls. Male babies 52(65%) were more affected than female 28 (34.9%). Foetal distress in asphyxiated newborn (86.25%) was due to obstetric complications and Maternal illness. There was significant negative correlation between Apgar score and Obstetric complications (p value< 0.05).
601 AN INSIGHT INTO THE ORGANOGENESIS OF HUMAN LIVER , *A. Manoj and Annamma Paul
The objective of the current study was to learn the development of liver inorder to strengthen the Gross Anatomy and Microsopic Anatomy studies of liver and also ascertain the congenital anomalies of liver due to disturbance in its organogenesis. Hepatogenesis commence at Fourth week of Intrauterine life by proliferation of endodermal diverticulam at the ventral aspect of the junction between Foregut and mid gut into the septum transversum where it divides into Pars Hepatica and Pars Cystica forms liver and gall bladder respectively. On seventh week of fetal development Pars hepatica differentiates into clusters of liver parenchyma in which billiary capillaries emerges for delivery of its secretions. The trunk of hepatic buds persists as common bile duct and its two branches were right and left hepatic ducts. Haemopoeitic cells, Kuffer cells, Capsule and fibroareolar tissue derived from mesoderm of septum transversum. Fibroblast Growth Factor 2 (FGF2) secreted by cardiac mesoderm induces the development of hepatic bud which generates hepatoblasts, intending the formation of hepatocytes. Pars cystica and its duct give rise to gall bladder and its ducts. The stalk of endodermal diverticulam connected to foregut forms the common bile duct. Umbilical and Vitelline veins of sinus venosus grows into septum transversum which breaks into capillary network eventually forms hepatic sinusoids between the plates of liver cells. The abnormal development of liver leads to absence of left lobe of liver, Reidel’s lobe, Supradiaphagmatic liver, ectopic lobes of liver etc.
602 CONCEPTUAL STUDY OF MEDO DHATU IN KAPHA BAHULYA PRAKRITI W.S.R. TO LIPID PROFILE , Dr. Bhag Singh Kushwah*, Prof. (Dr.) Anju Sharma, Dr. P. C. Sharma and Dr. Rajeev Mishra
Ayurveda is one of the most ancient medical science of the world which conceives and describe the basic and applied aspects of life processes. Among the seven Dhatus, Meda is an important Dhatu, which stands on 4th number. Medo Dhatu formed from Mamsa Dhatu through action of Medo Agni on Posakansh of Medo Dhatu, having properties of Snehatva and Sthiratva because of the Jala and Prathvi Mahabhuta. Lipids are groups of organic substances of fatty nature, insoluble in water but soluble in fat solvents, which are utilized during metabolism by living organisms. Lipid disorders or Dyslipidemia are the most common metabolic disorder has been in clinical practice and identified as a potential risk factor for cardiovascular diseases and involves abnormally elevated levels of any or all lipids in the blood. Prakriti is one of the most important concepts of Ayurveda and it is decided at the time of conception. Prakriti can be defined as body constitution. Prakriti is first fold examination among ten folds of examination as mentioned in Charaka Viman Sthan by Acharya Charaka. Dhatusarata is qualitative, quantitative and functional assessment of Dhatus is called as Dhatu Sarata or tissue excellence. Physical as well as mental strength can be assessed by examining Sarata of every Dhatu. Purest form (Vishuddhatara) of Dhatu is called as Sara Dhatu. Dhatu Sarata represents tissue excellence; Meda Dhatu Sarata contributes the excellence of adipose tissue and lipids.
603 LATE PRESENTATIONS OF HERNIA WITH COMPLICATIONS IN COVID-19 PANDEMIC , Dr. J. A. Jayalal*, Dr. Rajesh S., Dr. Sathik, Dr. Deepan Karthick, Dr. Poornachandran and Dr. Rajmohan
Background: COVID-19 pandemic has created a remarkable changes in the approach of patients for elective surgery for their presenting surgical diseases. Due to various physical, economic and social reasons they are not able to report early even when the red flag signs are raised, resulting in undue Complications, leading on to increased morbidity and mortality. This study is to identify the presentations of different types of hernia with complications in the emergency department and analyse the classification, presenting feature, delay in presentation and surgical outcome for hernia with complications. Methodology: It is a retrospective study involving 100 cases of acute emergency surgeries carried out for hernia with complications in a teaching hospitals. Results: In this group of 100 surgical emergencies 77 % were males and 23 % were females with male to female ratio of 3.3 The mean age group 52.8 years. The most common presentations were Inguinal hernia with complications 59%,followed by Umbilical hernia 17%,incisional hernia 9% ,paraumbilical hernia 10% and femoral hernia 5%.Intestinal obstruction was the commonest presentation in Inguinal ,Umbilical and ventral hernia ,but strangulation was common in femoral hernia. After development of complications ,there were undue delay of 24-48 hours in 45% of patients and more than 48 hours in 17 patients for reporting in the hospital. 83 % of patients had viable intestine or omentum as the contents of the sac ,but in 17 patients it was non-viable ,hence undergone bowel resection and anastomosis. The reasons cited for late reporting were ignorance, lack of public health hospitals with surgical facilities in the local area, non-availability of public transport system and fear of contracting with COVID-19 infections in this pandemic .Swelling, pain, vomiting ,constipation, obstipation and abdominal distension were the commonest presenting symptoms. All patients underwent surgery and apart from the minor complications like pain and seroma persisted in 56% and 30% patients in the post-operative period . Wound gapping was present in 7 % of patients. Mortality was 2% among this patients. Conclusion: As we are passing through a uncertainty of the pandemic ,adequate steps to be taken to make the essential surgical care made available, accessible and affordable to common public, lest to prevent undue complications arising out of late presentation resulting in increased mortality.
604 IMPORTANCE OF DIET (AAHAR) AND LIFE STYLE (VIHAR) IN ANORECTAL DISORDERS , Dr. J P Chaudhary*, Dr. Kavita and Dr. Anupam Pathak
“Sarveroga Malayatanani” Etiology of all diseases is collection of toxic (Excretory) product in the body. Which happen due to faulty diet and change in life style. For healthy body we have to need balanced healthy diet, balanced physical activity and balanced sleep. These are explained in Ayurveda as three sub pillars of healthy body, which helps to maintain three pillars (Three Dosh) of living body. Here, we are discussing about most common and immerging dis eases of Anorectal region. The commonest etiopathogenesis of these diseases is constipation, which is risk factor for metabolic diseases. If, we go on depth of Ayurveda, it’s Main aim is to prevent constipation, Anorectal diseases and metabolic diseases by maintain proper digestive activity. Ayurveda deals with both prevention and management of Anorectal diseases. Preventive aspect explained under headings of Dincharya, Ritucharya, Dasaharavidha visheshayatana, Aaharo- pyogivarg, Sadavrita and Neendra. Primary principal treatment of disease in Ayurveda is, to correct and ignite our Agni (Digestive Fire) along with detoxification of body. This will maintain our normal metabolic activity and makes us healthy.
605 CLINICAL SINGLE CASE STUDY OF VENOUS ULCER MANAGEMENT BY LEECH THERAPY , *Dr. Anjali Meena, Dr. Vishnu Dutt Sharma M. S. Ph.D. (Ayu.) and Dr. Pankaj potalia
A wound on the leg or ankle caused by abnormal or damaged veins .A venous ulcer is a sore on your leg that very slow to heal, because of weak blood circulation in the limb. venous ulcer develop mostly along the medial distal leg ,and painful with negative hypertension may be gravitation which is due to hydrostatic pressure by weight of blood column from the right atrium which is maximum at foot and ankle dynamic which is due to muscular contraction across the incompeletent perforator with a high pressure up to 200mm Hg.Venous ulcer commonly develop is around and above the medial malleoli because of presence of large number of perforators in ayurveda compare siragat vat janya vran, suhruta has treat jaloka one of most effective method of bloodletting useful even in infected and chronic non healing ulcer and some orally medicine.
606 SHAMAN CHIKITSA IN THE MANAGEMEN OF VICHARCHIKA -A CASE STUDY W. S. R OF ECZEMA , Dr. Ashwini Jadhav*
In Ayurveda, Eczema is a form of dermatitis is termed as “vicharchika”.The most common twak vikara affecting all the age group of population.vicharchika is one among Kushata roga.so, samanya nidan, samprapti, poorvarupa mentioned for kushta Can be considered here.vicharchika is identified as Raga,kandu, daha , rookshata with predominance of kapha dosha. In the present study 28 year male patient vicharchika (eczema) was treated with Arogyavardhini Vati, Gandhak Rasayan, Karanj tail for external application Patient reported significant improvement in sign and symptoms.
607 ROLE OF MATRUSTANYA ASCHYOTANA IN NEONATAL CONJUNCTIVITIS (NETRA ABHISHYANDA) –A CASE STUDY , Dr. Shubhangi Kapil Thakur*
Acharya Vagbhat describes that Aschyotana is the first and best line of treatment for all type of eye disease.[1] It relieves congestion/redness of eye pain, itching, watering and burning sensation. In modern practice various medicine and wide range of antibiotics are used for treatment of conjunctivitis having some toxic effect on eye. In Ayurveda ancient Acharya described Matrustanya (mother milk) Aschyotana as a remedy for the treatment of Abhishyanda2 i.e Conjunctivitis, mother milk is easily available uncontaminated, sterile, fresh, pure, economic and having lots of factor like immunoglobins, anti-infective factors which are helpful in the treatment of neonatal conjunctivitis with no side effects. A full term 5 days male baby having complaints of right eye discharge watery and intermittent mild sticky discharge, lid edema, conjunctival congestion ,unable to open eye properly treated with matrustanya aschyotana. Changes were noted in redness, congestion and mucopruluent discharge of eye. The details of the findings are presented in this case study report.
608 EFFECTS OF NURSING EDUCATION AS AN INTERVENTION TO DECREASE PHYSICAL AND PSYCHOLOGICAL OUTCOMES AMONG HOSPITALIZED WOMEN WITH CERVICAL CANCER RECEIVING CHEMOTHERAPY AT TIKURANBESA SPECIALIZED HOSPITAL (BLACK LION SPECIALIZED HOSPITAL), ETHIOPIA, 2019/20. , Benalfew Lake* and Alemkanch Ayele
Background: women with cervical cancer receiving chemotherapy experiences a variety of side effects which has influence on prognosis of illness, activity of daily living and the quality of life. There is a need of nursing care education for management and prevention of problem among women with cervical cancer. Objectives: The study aimed to evaluate the effectiveness of nursing education as interventions on physical and psychological outcomes women with cervical cancer receiving chemotherapy. Methods: A Randomized Controlled Trials design was used and participants were selected using simple random sampling technique based on criteria of selection. After the collection of baseline data, out of 426 eligible participants, 142 patients were randomized to experimental group (n=71) and to control group (n=71) respectively. Women with cervical cancer in the experimental group received planned nursing education as interventions delivered by a nurse interventionist, whereas the control group received routine care from the ward nurses. Results: Women with cervical Cancer who received nursing education had improved from both physical & psychological outcomes. In the physical outcomes, the mean scores of chemotherapy related to other symptoms (Z=5.84), and fatigue (Z=4.48) in the experimental group had much lower than in the control group of other symptoms (7.26 ± 2.20), and fatigue (8.54 ± 3.47) respectively. In the psychological outcomes, the mean scores of emotional wellbeing (Z=38.9) had much higher in the experimental group than control group (28.73 ±3.83); but anxiety (Z=8.47) and depression (Z=7.53) in the experimental group had lower than in the control group, anxiety (10.11 ±2.35) and depression (9.01 ±2.25) respectively. Conclusion: This study demonstrated that the nursing education as intervention was well accepted by women with cervical cancer and has significant effect towards the improvement of physical and psychological outcomes of cervical cancer women receiving chemotherapy.
609 A REVIEW STUDY ON “EFFECT OF RASAYANA CHIKITSA IN MICRO VASCULAR COMPLICATIONS OF MADHUMEHA” , Dr. Kalpana Verma* and Dr. Ashish Pareek
Background & objective: Diabetes Mellitus is one of the major metabolic disorders, characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Diabetes associated with long term potential effect on almost all systems of body. It leads to various complications. These complications can be managed by Rasayana Chikitsa (Rejuvenation therapy) according to Ayurveda which nourishes, develops & corrects the vitiated Saptadhatu. Objective: To study the Micro vascular complications in Madhumeha. To study Rasayana dravya from samhitas. To evaluate the Karmukatva (Activity) of Rasayana dravya on Micro vascular complications. Material and Methodology: Literary study of Rakta-Medodushti in complications of Madhumeha thoroughly was done. Literary study of micro vascular complication of Diabetes was done, Karmukatva of Rasayana dravya on micro vascular complications was studied. Result: Diabetic Neuropathy, Nephropathy & Retinopathy are the micro vascular complications of Madhumeha. These complications are mainly due to Rakta- Medo dushti. The Suvarna & Raupya bhasma are sheet veerya & rasayana which acts specifically as balya & give strength to nerves in Diabetic neuropathy. Medovaha & Mootravaha srotosdushti in Diabetic nephropathy cause structural changes in glomeruli. This structural change is corrected by Haridra &Triphala by their rasayana effect. Triphala act as Mehaghna (antidiabetic), Haridra act as Medoghna (lipolytic). There is Rakta dushti in Retinopathy which is marked by retino vascular micro aneurysm & blot hemorrhages. Manjishtha acts as rakataprasadana (blood purifier), vranaropana (wound healing). Suvarnamakshika bhasma is raktaprasadaka, acts on hemorrhagic disorders such as Retinal hemorrhages. Conclusion: On the basis of above study, Rasayana dravyas improve quality of life by alleviating micro vascular complications.
610 CONCEPT OF ASTHAVIDHA PARIKSHA W.S.R TO MALA PARIKSHA , *Dr. Anuja Ravikant Bodhare and Dr. Pallavi A. Gune
Stool examination is an important laboratory investigative tool in medicine, which is used to understand the health and disease condition of a person. Asthavidha Pariksha(eight fold examination) in Ayurveda is one of the important examinations to find the various causes behind the diseases. In Ashtavidha Pariksha there are eight factors which are taken into consideration during the examination and tests carried out with the patients. Also, Mala Pariskha is one the most important examination part for diagnosis the diseases of patients. Ashtavidha pariksha: Nadi (Pulse), Mootra(Urine), Malam(Fecal matter), Jihwa (Tongue), Sabdam(Voice of patients), Sparsham (Touch), Druk(Eyes & Vision), Akriti(General body build). In this article an attempt has been made to focus on Ashtavidha Pariksha with special reference to Mala Pariksha. Hence Ahstavidha Pariskhawith Mala Pariksha plays an unique role in Ayurvedic Chikitsa.
611 A CONCEPT OF PURISH (MALA) AND DEFECATION PATTERNS- REVIEW ARTICLE , Dr. Siddharth Rajaram Gupta* and Prof. Dr. Kalpana K. Jadhav
Ayurveda gives special emphasis to Mala that is why it’s included in trya aupstambha. Sharir is the basic thing through which the three purusharths mentioned in Ayurveda can be achieved, so it becomes essential to know the body composition. In Ayurveda the concept of formation of body is mentioned as ‘’Dosha Dhatu Mala Mulam hi Shariram”. That’s why Ayurveda science has given vast detail of Purish (mala) like what should person eat (Ahara) according to his temperature, excretion of mala, time of defecation and consistency of purish according to diseases. The above objectives have been discussed with the help of various references found in Ayurveda texts and modern anatomical, physiological are concluded that purish vaha strotas can be correlated to the large intestine and its defecation positions of the modern concept.
612 CONCEPT OF IMPORTANCE OF SHATAKRIYA KALA IN STAGE-WISE DISEASES MANAGEMENT IN AYURVEDA , *Dr. Anuja R. Bodhare and Dr. Pallavi A. Gune
In Ayurveda mention of Dinacharya and Ritucharya help in preventing a wide array of diseases, at the same time helping us to keep fit and healthy. This is one part of prevention of disease, the other dimension is ‘an early diagnosis of the illness in its budding stages’. The art of understanding a disease and its stages of pathogenesis was probably explained for the first time in Ayurveda in a very comprehensive way. Not only understanding a disease and making an accurate diagnosis, but also to have a minute track of each and every stage of pathogenesis of disease is a must for any medical science, if it’s aiming at both diagnosing and curative aspects of a disease management. This article will be focusing on discussion related to diagnosing the disease at various stages of its manifestation.
613 YOGA IN THE MANAGEMENT OF DIABETES MELLITUS , *Dr. J P Chaudhary, Dr. Kavita and Dr. Anupam Pathak
Diabetes mellitus is a chronic metabolic disorder in which the body is unable to make proper utilisation of glucose, resulting in the condition of hyperglycaemia. Excess glucose in the blood ultimately results in high levels of glucose being present in the urine (glycosuria). This increase the urine output, which leads to dehydration and increase thirst. India has the largest diabetic population in the world. Changes in eating habits, increasing weight and decreased physical activity are major factors leading to increased incidence of Diabetes. Lifestyle plays an important role in the development of Diabetes. Yoga offers natural and effective remedies without toxic side-effects, and with benefits that extend far beyond the physical. This system of Yoga is a simple, natural programme involving five main principles: proper exercise, proper breathing, proper relaxation, proper diet and positive thinking and meditation. It is a cost effective lifestyle intervention technique.
614 HEALTH BENEFITS OF SURYA NAMASKAR , *Dr. J P Chaudhary, Dr. Kavita, Dr. Anupam Pathak
“Surya Namaskar” is a sanskrit word which means obeisance or prostrations (Namaskar) to the sun (Surya). It implies that one should rise before sun rise (in Brahama muhurat- 1:45 Hours before sunrise) in order to do this exercise or pay obeisance to the rising sun. Of course this exercise is good no matter what time you may do it, but it is best done while the stomach is empty. It is a yogic exercise which consists of twelve postures, one following another, in a fixed, cyclic order to ensure improvement and good health in one’s digestion, agility, rejuvenation, beauty and longevity. It will also help one to lose weight and trim the waist. There is no equipment to buy. You just need a little space in your apartments or home.
615 SIGNIFICANCE OF DUSHIVISHA AS A DIAGNOSTIC TOOL & ITS TREATMENT WITH VARIOUS AGAD KALPA , *Dr. Rajashri V. Joshi and Dr. Jayant Phadke
Agadtantra is branch of branch of ayurveda amongst 8 that are from astang ayurveda. Today life is fast life consist instant food, which has a used much quantity of preservative. Ayurveda has a described a more detailed concept of viruddha ahar. The types of viruddha ahar also described in detail. The consumption of viruddha ahar can lead into amavisha in body. The dushivisha is sthavar, jangam & krutrim visha described by acharya sushruta. In ayurvedic samhita agad kalpa are mentioned which are used for the visha chikitsa.
616 FREQUENCY OF FACTORS LEADING TO MULTI-DRUG RESISTANT TUBERCULOSIS , Dr. Imran Saeed*, Dr. Anum Mushtaq Khan, Dr. Sadia Naz
Objective: The objective of this study is “to determine the frequency of factors leading to Multidrug resistance tuberculosis, in patients presenting at Nishtar Medical University and Hospital Multan”. Material and methods: This cross sectional was conducting at Department of Pulmonology, Nishtar Medical University and Hospital Multan from March 2019 to September 2019. Total 126 patients with MDR-TB were selected for this study. Association of reasons for interruption of ATT course, inadequate chemotherapy, under whose prescription ATT used previously and Previous H/O of taking ATT with gender, age and area of residence was assessed. Results: Total 126 patients with MDR-TB were included in this study. Minimum age of the patients was 20 years and maximum age of the patients was 60 years. Mean age of the patients was 39.44 ± 9.043. Most 65 (51.6%) of the patients with MDR-TB belonged to age group 31-40 years and 74 (58.7%) were male and 52 (41.3%) were female. Conclusion: Results of this study revealed that the most common age group affected with MDR-TB was 31-40 years. Male were more victim as compare to female. Mostly patients reported with MDR-TB have previous history of taking ATT under.
617 STUDY REGARDING POST-OPERATIVE COMPLICATIONS OBSERVED AT SURGICAL DEPARTMENT OF SHEIKH ZAYED HOSPITAL RAHIM YAR KHAN , Dr. Sadia Naz, Dr. Anum Mushtaq Khan and Dr. Tehmina Sadiq*
Aim of study: To evaluate post-operative complications during hospital stay of patients in a general surgical ward at a tertiary care teaching hospital of Punjab. Methodology: It is a cross-sectional observational study conducted at a tertiary care center. Duration of the study was 3 months from April 2019 to June 2019. All the patients who underwent surgery due to any reason were included in the study after taking informed consent. Detailed history, examination, treatment and post-operative observed complications were noted on preformed proforma. All the data was analyzed using SPSS version 18.0. Results: Total 342 patients underwent surgical procedures which included 150(43.8%) elective and 192(56.2%) emergency procedures. Most common surgical procedure done was exploratory laparotomies 65(19%). Appendectomy was performed in 56 (16%), hernia repair in 34(9.9%), cholecystectomy including open and laparoscopic in 38 (11.1%), thyroidectomy in 25 (7.3%) and ano-rectal surgery including peri-anal fistula, hemorrhoids and sinuses in 40 (11.6%) of the patients. Complications were found in 198 (57.8%) of the patients. Most of the complications occurred after emergency surgeries in 130 (65.6%) patients as compared to 68 (34.3%) patients in elective procedures. Most common was postoperative pyrexia in 130 (38%) patients followed by postoperative nausea and vomiting in 98 (28.6%), prolonged paralytic ileus 42 (12.2%), intra-abdominal bleeding 33(9.6%) wound infection in 50 (14.6%), respiratory tract infection in 18 (5.2%) and thromboembolism phenomenon was observed in 3 patients. Two patients developed fecal fistula while 3 patients developed wound dehiscence. 8 patients died postoperatively in the hospital during the study period. Conclusion: We found that the most common postoperative complication was fever followed by post-operative nausea/vomiting, spinal headache, wound infection and respiratory tract infection. Post-operative complications are more common in emergency surgery than elective. It is important that the resident staff should be aware of these complications and how to manage them.
618 THE EFFECTS OF LOW DOSE HYDROXYCHLOROQUINE AND AZITHROMYCIN COMBINATION THERAPY ON COVID-19 PROGNOSIS , Naderali E. K.*, Naderali M. M. and Wong C. F.
Background and Objective: The global pandemic of COVID-19 has challenged medical and scientific communities to produce effective therapy options for this new highly contagious virus. At present there are no effective treatment thus utilizing existing medication to counter COVID-19 is vital. This report outlines the safety, tolerability and effectiveness of combination of hydroxychloroquine and azithromycin in COVID-19 prognosis. Methods: From 18th March to 30th September 2020, fifteen COVID-19 patients from different parts of Iran were treated at their home following the diagnosis of COVID-19 infection. Diagnosis was confirmed by chest CT scan examination between 18th March 2020 till 10th July 2020 and by PCR testing from 11th July 2020 till 30th September 2020. Results: All 15 patients fully recovered from their symptoms following administration a of low dose hydroxychloroquine (200 mg mane for 10 days) and azithromycin (500 mg nocte for 7 days). There were no adverse events due to therapy and the combination therapy was well tolerated. Conclusion: At the time that there are no bespoke therapy options available for COVID-19, high mortality rate could be reduced by low dose hydroxychloroquine and azithromycin combination therapy.
619 COMPOSITION OF ORGANIC ACIDS AND ANTI-NUTRITIONAL FACTORS OF PAPAYA (CARICA PAPAYA L. VAR SOLO 8) AT DIFFERENT STAGES OF MATURITY , Larissa Edwige Koffi, Gbocho Serge Elvis Ekissi*, Hubert Kouassi Konan, Jaurès Oscar Gbotognon and Jean Parfait N’Guessan Kouadio
Papaya (Carica papaya L. var solo 8) is a fruit produced and widely consumed in Côte d’Ivoire is exported. To make better use of it, this study was conducted to determine its composition in organic acids, oxalates and phytates during four stages of maturity. Thus, these parameters were determined in three parts (skin, pulp and seeds) of the papaya. The contents of organic acids, oxalates and phytates in each studied part decrease from the immature state to the advanced state and present significant differences (p <0.05). The most dominant organic acids in papaya are salicylic, tartaric and adipic acids. Salycilic acid is very present in the pulp with contents varying from 54.71±0.02 (A) to 14.07±0.09 g/Kg (D). Tartaric acid is predominant in the skin of papaya with contents varying from 39.70±0.03 (A) to 12.63±0.13 g/Kg (D). Adipic acid has high contents in the pulp ranging from 20.44±0.01 (A) to 0.54±0.07 g/Kg (D). Fumaric acid is non-existent in the three parts of the papaya during the four stages of maturity and oxalic acid in the skin and pulp. The oxalate and phytate contents are higher in the seeds and vary respectively from 15.46±0.47(A) to 5.84±0.06g/Kg (D) and from 10.54±0.05 (A) to 5.35±0.01g/Kg (D).
620 EVALUATION OF KIDNEY INJURY MOLECULE-1, CYSTATIN C, AND SERUM ELECTROLYTES IN STREPTOZOCIN INDUCED DIABETIC RATS TREATED WITH MORINGA OLEIFERA LEAF POWDER , Arvin Nwakuilite*, H. U. Nwanjo, D. C. Nwosu and Emmanuel Ifeanyi Obeagu
 This work was done to determine the kidney injury markers in strreptozocin-induced diabetic rats treated with moringa oleifera leaf. This was conducted using 5 groups of 10 rats each were used. Group1 negative control, group2 positive control (diabetics), groups 3 and 4 treated with 150mg/kg and 300mg/kg of moringa oleifera leaf respectively.The parameters analysed includescystatinc C, kidney injury molecule-1 and electrolytes. P values p<0.05 were considered statistically significant. The study showed that there was no significant difference in the CYS-C levels of all the rats across the group. Also there was a significant decrease in the KIM-1 values of the rats in group 4 (1.72 ± 0.39) when compared with those in group 1, 2 and 3 (2.30 ±0.38, 2.35 ± 0.30 and 2.76±0.39) respectively, Also, there was no significant difference in the serum electrolyte values of all the rats across the groups, indicting absence of severe kidney injury. From this study, it could be inferred that moringa oleifera leaf powder used in treatment of streptozocin-induced diabetes in rats metabolic acidosis and reduced the toxic damage to the kidney and liver.  
621 EVALUATION OF SOME TRACE ELEMENTS IN STREPTOZOCIN INDUCED DIABETIC RATS TREATED WITH MORINGA OLEIFERA LEAF POWDER , Arvin Nwakuilite*, H.U. Nwanjo, D.C. Nwosu and Emmanuel Ifeanyi Obeagu
 This work was done to determine the trace elements in strreptozocin-induced diabetic rats treated with moringa oleifera leaf. This was conducted using 5 groups of 10 rats each were used. Group1 negative control, group2 positive control (diabetics), groups 3 and 4 treated with 150mg/kg and 300mg/kg of moringa oleifera leaf respectively.The parameters analysed includes; zinc, copper, selenium manganese. P. values p<0.05 were considered statistically significant. The study showed that there was a significant increase in the magnesium levels of rats in groups 4(0.047±0.19) when compared with groups 1 and 2 (0.19±0.14 and 0.13±0.37), there was a significant increase (P <0.05) in the zinc levels of rats in groups 4(0.58± 0.08) when compared with that of groups 1 and 2(0.30±0.15 and 0.39±0.05), there was a significant increase in the selenium levels of rats in group 2 (7.51±1.79) when compared with those in groups 1, 3 and 4(6.43±1.21, 6.30±1.51 and 6.30±1.11). Also there was no significant difference in the Cu levels of rats in all the groups. From this study, it could be inferred that moringa oleifera leaf powder used in treatment of streptozocin-induced diabetes in rats reduced the toxic damage to the kidney and liver.  
622 DISTAL END LEFT ANTERIOR DESCENDING CORONARY ARTERY DILATATION: CASE REPORT , A. Bakkali MD, PhD, H. Bouhdadi MD* and M. Laaroussi MD
Coronary artery anomalies include anomalies of origin, termination, structure, or course. Coronary artery fistulas result from abnormalities of termination.
623 COLONIC DUPLICATION CYSTS AS A CAUSE OF BLEEDING PER RECTUM IN INFANTS: A CASE REPORT AND REVIEW OF LITERATURE , *Kirsty Wallace and James Lucocq
Enteric Duplication Cysts may be located anywhere along the gastrointestinal tract, with 75% located in the intra-abdominal cavity. Of these the most common site is the small bowel, with colonic duplication cysts being less common. They can present in multiple different ways, but are often asymptomatic. In this study, we report a case of a colonic duplication cyst in an infant which presented with bleeding per rectum, and review the literature surrounding enteric duplication cysts.
624 COVID-19 PANDEMIC: A COMPREHENSIVE REVIEW OF CARDIOVASCULAR MANIFESTATION, AND FUTURE PROGNOSIS , Warda Shahnawaz*, Warda Ali Naqvi, Yassin Ibrahim Hamad, Muhammad Wali Saleem, Zoha Khalid, Tooba Ali, Justice Echezona Obiora, Fatema Tasnim, Gibson Anugwom, Eslam Amr Ahmed Fathi Abdelaziz, Ahmed Ali
The pandemic of the coronavirus disease-19 (COVID-19), the causative agent of the severe acute respiratory syndrome-2 (SARS-CoV-2), has become a public health emergency of the international concern. The majority of the population is exhibiting signs and symptoms similar to the flu and common cold. Despite that, alveolar damage result in progressive lung failure has also been reported. Although COVID-19 has been reported principally to affect the respiratory system, other system‟s involvement has also been reported. Cardiovascular involvement has also been underlined in the literature. Cardiovascular involvement in SARS-COV-2 usually corresponds to three situations: (a) cardiac manifestation of the acute coronary syndrome, (b) cardiovascular manifestations of COVID-19 in myocardial injury, myocarditis, arrhythmia, and cardiac arrest (c) cardiac manifestation in patients with comorbidities. The actual disease pathogenesis is unknown; however, direct viral invasion to cardiomyocyte, inflammation of cardiomyocyte due to cytokine and inflammatory markers, activation of the complement system, and lung injury from the virus causing hypoxia leading to oxidative stress, increased oxygen demand, and myocyte injury. Patients with cardiac involvement usually experience a wide range of signs and symptoms such as dyspnea, chest pain, nausea, vomiting, diaphoresis, hypercapnia, tachypnea, and elevation in cardiac biomarkers. The pandemic of SARS-CoV-2 has become a unique challenge for the cardiologist. Various renal manifestations have been observed and reported in many cases, and even renal features may precede the classical respiratory signs and symptoms. In this review, we have summarized the information from published literature including, case reports and open-source data sets, to describe the spectrum of cardiovascular manifestation and complication observed in COVID-19 cases.
625 THE ASSOCIATION OF HIGH MOBILITY GROUP BOX-1 PROTEIN WITH DEEP VEIN THROMBOSIS , Mustafa Bilge ErdoÄŸan, Necla Benlier, Fevzi Sarper Türker* and Orhan Tarhan
Aim: We aimed to investigate relation between high mobility group box-1 protein (HMGB1) levels in peripheral blood and deep vein thrombosis (DVT). Materials and Methods: For this study, HMGB1 levels were compared between lower extremity acute-subacute DVT patients and healthy volunteer subjects. Fifty-three patients (18 to 65 years of age) presenting to the cardiovascular surgery clinic of Private Gaziantep Medikal Park Hospital between April 2018 and April 2019 and 47 controls were included in the study. Biochemical analyses were conducted by the hospital laboratory using the ELISA method. The SPSS for Windows, version 25.0 software was used for statistical analyses of the study data. Results: Increased HMGB1 protein levels were found both in the entire patient group and in patients with proximal and distal DVT versus healthy controls. In the patient group, HMGB1 levels did not significantly differ in relation to age, gender and comorbidities. Conclusion: Increased HMGB1 protein levels as detected in patients with acute/subacute deep vein thrombosis compared to the normal population may be due to inflammation caused by the disease itself as well as the effects of HMGB1 on platelet functions to promote thrombus formation.
626 A RARE CASE OF SCROTAL EXTRAMAMMARY PAGET’S DISEASE IN ELDERLY MALE IN DISTRICT HOSPITAL , Mohd. Shafiq Rahman* and Norly Salleh
Background: Extramammary Paget (EMPD) disease is a rare cancer related to Paget's disease of the breast, but found around the anus and genitals of both men and women. EPMD is rare and made up of only 6.5% cases of all cutaneous Paget’s disease. Case Presentation: An 80-year-old male presented with three years history of left scrotal redness and irritation. Examination revealed widespread erythema over left scrotum and left inner thigh with two small nodules. Excision biopsy was performed. Histopathology confirmed the diagnosis of EMPD. He was subsequently referred to Plastic Surgery team for wide local excision. Conclusions: EMPD is rare and may take years before diagnosis is made. Awareness of this condition is important for prompt diagnosis to be made and managed accordingly.
627 INCIDENTAL PULMONARY EMBOLISMS IN CT ANGIOGRAMS IN PATIENTS IMAGED AS PER STROKE CODE PROTOCOL: INCIDENCE AND DETECTION RATE , Abdul Rehman AlMutairi*, Syed Zubair Ayoub, Mohammed AlAhmadi, Yasir AlJadhi and Sofia Muzafer
PE is a preventable cause of death among hospitalized patients. The mortality related to PE can be as high as 24% but early treatment is highly effective. A standard CTA stroke protocol examines the neurovasculature from the aortic arch to the vertex of the head, providing additional information on the angiography of the upper lobes of the lung including the hilum. Our study is a hospital based retrospective study, about 327 CT scans were studied done over a period of 3 months with properly followed CT stroke code protocol as per the department policy. Out of the studied 327 cases, 322 (98.5%) were negative and 5 (1.5%) cases were positive. Out of the 5 positive cases 3 (0.9 %) were detected by the first reporting neuroradiologist and 2 (0.6%) were missed on initial reporting. These 2 cases were retrospectively detected by the team which consisted of two neuroradiologist, a fellow and a 3rd year resident.
628 IMPORTANCE OF SANDHI SHARIR: A REVIEW ARTICLE , Dr. Ishan Malhotra*, Dr. Sakshi and Dr. Subhash Upadhyay
The meaning of word Sandhi is “the meeting point of two or more structures.” According to modern joint is a point where two or more bones are articulates with each other. Aacharya Sushruta has quoted that although there are nume rous Sandhi in our body which cannot be coun ted so only Asthi Sandhi should be considered while enumerating Sandhis. There are two hundred a nd ten Sandhi in the human body. Sushruta has class ified Sandhi on the following basis: (a) On the basis of function (movements) are classified into Cheshtavanta and Sthira Sandhi while Aacharya G ananatha Sen has classified Sandhis on the basis of m ovements as Bahucheshta, Alpacheshta, Acheshta. (b) On the basis of structure are classified into 8 types i.e. Kora, Ulukhala, Samudga, Pratara, Tunnasevani, Vayasatunda, Mandala and Shankhavarta. A thorough knowledge of the structur e and function of the joint is required to diagnose and treat the diseases of joints. So the knowled ge of anatomy of joints should be known.
629 LITERARY REVIEW OF VRANABANDHANA ACCORDING TO ACHARYA SUSRUTA , Tarun Meena*
Tieing knot is of three kinds viz above, at the sides and below the wound. Thick wick of drugs should be kept on the wound and a soft pad kept on it. The paste of drugs inside the wick should not be very unctuous or dry, very unctuous paste gives rise to exudation and very dry paste causes abrasion of the wound, That with suitable unctousness helps healing. If the wick is not placed properly it causes friction of the edges, makes for more flow, so the physician should apply the wick of paste in the proper manner, knowing the nature of the wounds. In wound produced by pitta or rakta the wick should be applied once only and in wounds of kapha and vata origin, it may be applied many times. All kinds of bandaging ending with the tight kind should be applied appropriately. This is the procedure even for joining of damaged lips. Bandaging should be done with good knowledge, in such a way that the wound will not cause any trouble to the person for getting up, lieing down, sleeping, walking, riding etc.
630 LITERARY REVIEW OF VRANABANDHANA ACCORDING TO ACHARYA SUSRUTA , *Dr. Tarun Meena and Dr. Rajesh Gupta
Tieing knot is of three kinds viz above, at the sides and below the wound. Thick wick of drugs should be kept on the wound and a soft pad kept on it. The paste of drugs inside the wick should not be very unctuous or dry, very unctuous paste gives rise to exudation and very dry paste causes abrasion of the wound, that with suitable unctousness helps healing. If the wick is not placed properly it causes friction of the edges, makes for more flow, so the physician should apply the wick of paste in the proper manner, knowing the nature of the wounds. In wound produced by pitta or rakta the wick should be applied once only and in wounds of kapha and vata origin, it may be applied many times. All kinds of bandaging ending with the tight kind should be applied appropriately. This is the procedure even for joining of damaged lips. Bandaging should be done with good knowledge, in such a way that the wound will not cause any trouble to the person for getting up, lieing down, sleeping, walking, riding etc.
631 THERAPEUTIC USES OF LATAKARANJA (CAESALPINIA CRISTA LINN.) WITH A NOTE ON IT’S PHARMACOLOGICAL ACTIONS. -A REVIEW , Dr. N. M. Khan* and Dr. P. P. Surve
Traditional system of medicinal plant consists of various medicinal and pharmacological uses. Medical practitioners are using medicinal plant widely for curing various diseases in their day to day practices, Latakaranja (Ceasalpinia crista linn) of family febaceae is a moderately size one among found deciduous forest of India. expressed a valuable tank of new bioactive molecules. The present review aimed to compile complete information of pharmacological action of Latakaranja (Caesalpinia crista linn)with special emphasis on its various classical and scientifically documents. Plant mainly contains, flavonoids, tannins, proteins, alkaloids, carbohydrate reducing sugar, phytosteroids, saponins, coumarins, triterpenoids, cassane –diterpenes, neo cassane-diterpenes, nor cassane –diterpenes, and many other bioactive compounds. Is commonly used in Ayurvedic Preparations. Different parts of this plant are traditionally used for the treatment of jwara, Sula, Atisara, Raktatisara, diabetic, leprosy, malatia, skin disease, antifungal, anti tumour, hepatoprotective.
632 ROLE OF RAKTAMOKSHANA (SIRAVEDHANA) IN INSTANT PAIN MANAGEMENT , Dr. Prabhat Kumar Rai*, Dr. Anantkumar V. Shekokar, Dr. Kanchan M. Borkar and Dr. Priyanka Rai
Acharya Sushruta considered Siravedhana as half of all the therapeutic measures (Ardhachikitsa) in Shalya Tantra like Basti Karma in Kaya Chikitsa. Siravedha is mentioned as a surgical procedure of puncturing the vein and accomplishing the Raktamokshana (Bloodletting). It is very prominent procedure used for the management of those diseases in which there is vitiation of Rakta dhatu. Conditions in which Rakta dhatu is predominantly vitiated along with other doshas are easily curable with the help of Raktamokshana. Acharya has emphasized that Siravedhana helps in the elimination of vitiated dosha from the veins. They clarified that in emergency if due to lack of the time one cannot be able to perform the fivefold purification procedures, Raktamokshana will serve the purpose. They specially mentioned about Siravedhana in surgical conditions with poor venous drainage. It leads immediate alleviation of symptoms along with pain in various diseases like Vatarakta, Gridhrasi etc. where ever Raktamokshana is indicated, Siravedhana is an important technique to do so. My paper is focused on effect of Siravedhana in the management of pain in certain disorders.
633 A CONCEPTUAL STUDY OF MUTRAVAHA SROTOMULA , *Dr. Kaumik Verma, Prof. H. K. Rai, Dr. Arvind Kumar and Dr. Divya Nidhi
Ayurveda is one of the world’s oldest holistic healing therapies. It was developed thousands of years ago in India. Dosha, Dhatu and Mala are considered as the basis of our human body. Other than these structures, Srotas is another important entity that is the basis of the body. Mutravaha Srotas is the important one because the body’s metabolism is based on the drainage of waste products by these Srotasas. The Ayurvedic approach to urinary system is highly logical, conceptual and scientific. The pathology, clinical manifestation and restorative options in renal physiology are very well interconnected with fluid, blood and digestive system. Present study emphasises on the proper understanding of the concept of Mutravaha Srotomula in systematic and well organised manner, so as to understand the functions carried out by it, Srotodushti and Srotoviddha characters and the clinical importance of this Srotomula.
634 ABC TRANSPORTERS: AT BLOOD BRAIN INTERCONNECTION AND THEIR FUNTION IN VARIOUS NEUROLOGIAL AND METABOLIC DISEASES , Sachin Kumar*, Pranav Gupta and Sarabjot Singh
BBB is commonly considered as a mechanism for protecting the brain from undesirable activities resulting from substances in the blood and keeping up brain homeostasis by means of observing the section or efflux of compounds. ATP Binding Cassette (ABC) transporters structure an exceptional group of layer proteins, described by homologous ATP-binding, and enormous, multispanning transmembrane domains. ATP-binding cassette (ABC) group of transporters including P-glycoprotein (P-GP) and breast cancer-related protein (BCRP), broadly communicated in the luminal layer of the micro vessel endothelium and in the apical film of the choroids plexus epithelium, assume significant parts in the capacity of BBB. Nonetheless, these transporters are easily altered by certain diseases. ABC transporters have been affirmed to be closely related to the pathogenesis of infections, for example, metabolic sicknesses and Alzheimer's disease dependent on their transport abilities. In recent years, there have been numerous epidemiological and clinical studies that have indicated the useful impacts of organic compounds, for example, Verapamil, Berberine, Fascalpsyn, Oleocanthal and some more, on these neurological pathologies. In spite of the fact that these compounds follow up on an alternate objective to fix the illness headway yet as of late, the function of these compounds has been recognized as a modulator of different ABC Transporters Likewise, the necessary remedial impacts in neurological issues can be accomplished by safe medication conveyance into brain parenchyma. Yet, because of an intense barricade arrangement of BBB through ABC transporters, the transportation of drug is controlled. This review gives a general overview of the human ABC transporters, their structure, their demeanor, limitation and fundamental mechanism of action. Then we shortly deal with the role of ABC Transporters in several neurological and metabolic diseases. Besides, we featured some human ABC carriers as focuses of helpful therapeutic in medication, including atherosclerosis and other metabolic disorders, and also in Alzheimer’s disease.
635 CRITICAL ANALYSIS OF KASAHARA MAHAKASHAY OF CHARAK SAMHITA ON THE BASIS OF RASAPANCHAKA: A REVIEW , *Vd. Nitin Bhirud and Vd. Nitin C. Jadhav
An Ayurvedic physician observed many more cases of respiratory disorders in his routine OPD as well As IPD practice. In which kasa is the most prominent symptoms observed in respiratory disorders. As we all know the criticalness of current scenario of pandemic COVID 19 very well. The whole world is looking toward this completely unsolved problem and many more medical sciences trying their best to solve this problem. Kasa is one of the most important symptoms in pandemic COVOD 19.Kasa is a pranavahasrotos vyadhi having origin in amashaya. As we look into the samprapthi of kasa there is obstruction to movement of pranavata by nidanas like dhoomarajaadi which in-turn becomes the mechanical or chemical irritant to pranavahasrotas. The samprapthi explained in the Samhita are indicating the cough reflex, which has both sensory and motor pathway, involving both prana and udanavata. Here is an attempt made to explain that the therapeutic use of kasahara mahakashay explain by the Acharya Charak regarding different aspects of Ayurveda.
636 DRUG ABUSE AND ADDICTION- A REVIEW , Dr. Khushboo Karte*, Dr. S. R. Inchulkar and Dr. Yuvraj Kaushik
Drugs are commonly used to denote medicine in medical parlance which produces physiological and psychological effects on human but drug abuse refers not to drugs used by physicians but drugs used for intoxication purpose. Nowadays, words addicion and addict are not used in medicine due to their derogatory implication, instead of abuse or harmful use or dependence is used. Drug dependence includes both addiction and habituation. Drug abuse is the use of illegal drugs or the use of prescription or over the counter medications in way other than recommended or intended. Tobacco use & Alcohol problem are sometime included in the definition of drug abuse.
637 IMPORTANCE OF DIET AND LIFE STYLE IN THE ETIOPATHOGENESIS ON AMLAPITTA , *Dr. Bhagirath Singh and Dr. Pallavi Gune
Today's life style is completely changed. Most of the people cannnot parfect in their food habits. They have bad food habits like irregular intake of food, eating of fired foods, excessive use of chillies & masalas in food etc. The improper living style and faulty diet habits generates the imbalance of the body elements vata, pitta & kapha and thus various disorders may occurs. Due to this change life style, many people are suffering from dyspepsia. Gastric dyspetic disorders are mainly caused by dietetic pattern, mental stress and strain which is related our digestion, charaka and kashyana have clearly indicated that the Grahani Dosha and Amlapitta occur in the persons who could not check the temptation of food. The Nidana sevana create Mandagni & due to Mandagni, Ajirna is developed and it leads Amavisha production. This Amavisha mixed with pittadi Doshas and lodes in Amashaya then it produces the Amlapitta diseases.
638 EFFICACY OF CHARKOKTA GANA IN URTECARIA , Dr. Sagar Ashokrao Gorde* and Dr. Vikram Supugade
Skin is largest sense organ of body. Not only ladies but men are also fond of fair, glowing and healthy skin. Our day to day lifestyle, changed eating habits are leading cause of skin diseases such as eczema, urticaria etc. Urticaria is very wel known skin disease. As per modern science urticaria is allergic skin disease, which is caused due to excessive secretion of histamine due to some triggoring factors. Urticaria is having symptoms such as rashes and itching. According to Ayurveda urticaria is compared with Sheetpitta, which is due to imbalance in kapha and pitta. Itching is mainly due to kapha dushti and rashes, itching, daha is due to imbalance in pitta. In Charak Samhita Sutrasthan adhyaya 4 – Shad virechanashatashreetiya Charakacharya had listed 50 different group of 10 herbs each with common action. Kandughna gana is having 10 different Kandughna drags such as Chandana, Nalad, Aargwad, Karanj, Neemba, Kutaja, Sarshap, Madhuka, Daruharidra, Musta. Sheetpitta is having kapha and pittaj dushti. Here in this study going to study conceptual study of efficacy of Charkokta Kandughna Gana in urticarial.
639 AYURVEDA PERSPECTIVE ON DRUG DOSAGE FORMS AND GENERAL CONSIDERATIONS OF DRUG DOSING IN KAYACHIKITSA , Dr. Dhananjay Shivaji Khot* and Dr. Amit Raghunath Pawar
The concepts of drug dosing and route of administration of drug play vital role towards the biological efficacy of drugs. The selection of proper dosage forms and frequency of drug administration are very essential for acquiring desired biological effects of drugs. In Ayurveda the term Kalpana resembles various dosage forms i.e; liquid, semisolid and solid dosage forms. Kalka, Vati, Bhasma, Asava/ Arishta, Kwatha and Churna, etc. are various dosage forms utilized in ayurveda therapies mainly for the purpose of internal administration of drugs. The specific dosage form in particular quantity for fixed interval period of repetition offers desired effects without any adverse events. The deviation in drug dosing or inadequate frequency of administration can leads lack of therapeutic response or toxic effects. Considering importance of concept of “drug dosing” present article summarizes some key points related to the various Ayurvedic dosage forms and their suggested quantity for administration in patients of different age group.
640 A REVIEW ON HEALTH APPROACHES OF AYURVEDA IN RATRICHARYA (NIGHT REGIMEN) , *Prof. Dr. Milind M. Godbole, Prof. Dr. Kalpana K. Jadhav and Dr. Siddharth Rajaram Gupta
In Ayurvedic science of life health (Arogya) is considered as the most vital aspect for the accomplishment of the Purusarth chatustya (Four aims and objectives of life). Health (Arogya) was considered as the prime factor over the four aims and objectives of life. In the present era of wealth and technologies peoples are living their life only to earn money in pursuit of prosperity to live responsible family life but they have left their physical activity, dietary schedule and sleep pattern etc. which leads them to suffer from lifestyle diseases. Ayurveda being a holistic health science emphasizes the importance of healthy lifestyle for the prevention of lifestyle diseases. Ayurveda believes that the sarira (body), indriya (sensory and motor organs), sattva (manas or psyche) and atma (soul) jointly constitute the life principle in each individual. (C.Su.1/42) So, Ayurveda prescribes certain rules for maintaining a healthy state of mind. They are called Sadvritta (ethical regimen). Sad means good and vritta means conduct. This is good conduct for the keeping good or balanced condition of mind. Present paper encompasses various aspects of SADVRITTA (CODE OF CONDUCTS) described in Ayurveda and their application in present scenario for maintenance of good health.
641 IMMUNE SYSTEM TRAFFIC CONTROL BY NUCLEIC ACID VACCINATION , *Kushal Nandi, Dr. Dhrubo Jyoti Sen and Dr. Dhananjoy Saha
DNA vaccination is a technique for protecting against disease by injection with genetically engineered plasmid containing the DNA sequence encoding the antigen(s) against which an immune response is sought, so cells directly produce the antigen, causing a protective immunological response. DNA vaccines have theoretical advantages over conventional vaccines, including the ability to induce a wider range of immune response types. Several DNA vaccines have been tested for veterinary use. In some cases, protection from disease in animals has been obtained, in others not. As of August 2016, no DNA vaccines had been approved in the US for human use. Research is ongoing over the approach for viral, bacterial and parasitic diseases in humans, as well as for several cancers. An RNA vaccine or mRNA (messenger RNA) vaccine is a new type of vaccine for providing acquired immunity through an RNA containing vector, such as lipid nanoparticles.
642 SIRAVYADHA: PERSPECTIVE FROM SUSHRUTA SAMHITA W.S.R TO AVEDHYA SIRA , Dr. Shrutika Ishwarlal Nikhade*, Dr. Prashant P. Pimpalkar, Dr. Alka S. Charde and Dr. Nirmala Chandrabhanji Apaturkar
Sushruta Samhita is considered to be the most advanced compilation of Surgical practices prevalent in India around thousands years ago. Aacharya Sushruta explains the Importance of Blood in the body, diseases caused due to vitiation of blood and treatment for the same. Main principle of treatment is Bloodletting to be considered as Raktamokshana in Ayurveda. Raktamokshana means letting out of blood which is mainly indicated in certain illness and there is variety of modes for Raktamokshana. Aacharya Sushruta advocate that if all the fivefold purificatory procedure cannot be performed due to lack of time then, even ‘Raktamokshana’ can serve the purpose. Siravyadha is the most important method in all conditions where Rakthamokshana is indicated and considered as a ardha chikitsa in all theurapetic procedures mentioned in shalya tantra (surgery).[1] Sushruta applied this technique therapeutically as well as prophylactically. The superficial veins are considered to be most suitable for Siravyadha. Practice of siravyadha requires a good degree of anatomical knowledge regarding vedhya- avedhya siras, the exact sites where siravedhan could be done and also the other vital structures to be avoid from injury.[2] The present study focuses on literary perspective of Siravyadha from sushruta Samhita with a brief knowledge on Avedhya sira.
643 PANCHAKARMA FOR THE MANAGEMENT OF AGEING RELATED DISORDERS , Dr. Vijayata Kanungo* and Dr. Neeraj Kanungo
Jarachikitsa is the branch of Ashtang Ayurveda which is concerned with the treatment of various Jara vyadhi and care of the old-age people. It deals with the anti-ageing care and on the other hand it provides the management for the age related disorders. According to the report of United Nations, it is estimated that share of old age people (60 years of age) in India’s population is estimated to rise by twenty percent in 2050. Such high number suggest us to develop new strategies to deal with the geriatric disorders. Vriddha vastha is the last stage of a life span characterised by the physical and mental degeneration. Jara vyadhi occur due to the deteriorating changes in cellular and tissue structures such as cardiovascular disorders, liver disorder, respiratory disorders etc. Ayurveda provides great management for the ageing related problems through Rasayana and Panchakarma therapy. Panchakarma is the therapy of purification procedures which help in the normal functioning of the body by removing various toxic materials and stagnant Doshas out of the body.
644 GASTRO INTESTINAL STROMAL TUMORS – A REVIEW OF LITERATURE , Geetha A/P Das, *Purushotham Krishnappa, Dhanashri Kshitij Panse and Rashindra Ravindran
Gastro intestinal stromal tumours (GIST) are the most common mesenchymal tumour of the gastrointestinal tract. These tumours can arise in any part of the gastrointestinal tract but are more commonly seen in stomach. It is recognised with recent studies that these tumours arise from interstitial cells of Cajal. These tumours show expression for CD117 and CD34 on immunohistochemical staining. The prognosis of the patients with these tumours correlates well with tumour size, its location and mitotic activity. The genetic markers like telomerase activity and KIT mutation are also the important prognostic factors. Tumours with KIT mutation show better response to tyrosine kinase inhibitor like imatinib. The histochemical markers are useful in diagnosing GIST with malignant potential accurately. This article reviews the epidemiology, pathogenesis, morphological features, clinical presentation and differential diagnosis of GIST.
645 REVIEW ARTICLE ON SKIN: KRIYA SHARIR AND CHIKITSA POINT OF VIEW , Dr. Mohit Kumar* and Dr. Balkrishan Panwar
Skin is called "Twak," which covers the entire body. Joseph Listre said "skin is the best dressing," so a detailed study of Twak is important as it is the seat for all Twacha Rogas. The conceptual aspect of skin needs to be understood as skin disorder is the outer display of some sort of internal pathology. Skin, the human body's largest organ, plays an important role in maintaining normal physiological condition in humans. Ayurveda ancient science has noted its characteristics ages back. This article highlights the known and lesser known skin functions, their correlation with the anatomical and physiological aspect of Ayurvedic science w.r.t. The thermoregulatory skin modality is analyzed in depth. A list of different clinically proven Ayurveda indigenous drugs is also briefly discussed. Skin's significance as a tool for assessing the patient's health status is a boon of Ayurvedic diagnostic methodology, which is described in detail in this article. This article is the simple and sincere attempt by Kriya Sharir and Chikitsa to explain the skin.
646 AYURVEDA AND MODERN PERSPECTIVE ON VISARPA AND ITS MANAGEMENT THROUGH CLASSICAL APPROACHES , Dr. Ranjit Singh* and Dr. Upasana Priya
Skin is the outermost covering of the body serving as a barrier between the external and internal environment. It is the largest organ of the body which acts as a first line of defense in providing resistance to the body. The aggravation of various Dhatus and Doshas result in skin diseases. More than one-fifty skin related diseases are mentioned in various Ayurvedic texts. They are categorized as Visarpa, Kustha, Shotha, Upadansh etc. Visarpa is a very common disease mentioned in Ayurvedic texts which spreads in body in various directions. It is said to be caused by Varicella zoster virus as per modern concept. It manifests as Daha, Jwara, Anunnatashopha and Vedana. Ayurveda consider Raktmokshan (blood sucking) and Pradeha (local application of drugs) as the best suitable treatment modalities for Visarpa. Virechana can help in faster healing of the lesion and provide the relief for various symptoms. The details about Visarpa, its modern perspective and classical treatment are described here.
647 AYURVEDA SIGNIFICANCE OF CONCEPT OF SWASTHAVRITTA W.S.R. TO PREGNANCY AND NEONATAL CARE: A REVIEW , Dave John*
Ayurveda aimed primarily to preserve the health of whole mankind and in this regards Ayurveda texts encompasses several preventive principles which resist invasion of diseases or disease causative factors. The theories and principles described in Ayurveda for general maintenance of health come under the subject of Swasthavritta. The Ayurveda aspect of Swasthavritta can be correlated with preventive, therapeutic, social and community medicine. The concept of Swasthavritta helps to build healthy society by restoring normal health and preventing occurrence of pathological conditions. Ayurveda Swasthavritta gives prime importance to the health of pregnant women and suggested various regimens for antenatal and postnatal care. The considerations of Ayurveda guidelines are not only important during pregnancy to complete pregnancy period successfully but also important to ensure healthy delivery of baby. Considering importance of health of Garbhini this article presents health benefits of concept of Swasthavritta.
648 NUTRITIONAL POTENTIAL OF MAIZE (ZEA MAYS L.) AND MILLET (PENNISETUM GLAUCUM) CEREALS FERMENTED AND GERMINATED , Amandou Ouattara, Gbocho Serge Elvis Ekissi*, Nestor Kouakou Kouassi, Didier Aristide Ikpe Kouamé and Denis Yao N’dri
Present study was conducted to investigate the effects of germination and fermentation on nutrient composition of two cereals (maize, millet) flours. Maize and millet grains were soaked in both tap and boiled waters respectively for 24h and 6h and germinated / fermented for 4 days. Native maize and millet flours were used as control. The samples were analyzed for biochemical properties using standard methods. Nutrient compositions of germinated and fermented cereals flours were dominantly increased when compared with the raw sample. Protein content of flours varied between 9.33±0.05% (RwMaF) and 15.83±0.02% (GMaF) for maize and 7.32±0.07% (RwMiF) to 12.15±0.41% (FMiF) for millet. Germination and fermentation lead to a decrease in reducing and total sugars. Ash content of germinated maize flour increase while that of fermented maize millet flours decreased. Fibers content of flours varied between 3.37±0.00% (RwMaF) and 5.45±0.92% (FMaF) for maize and 2.25±0.01% (RwMiF) to 4.43±0.26% (FMiF) for millet. Vitamin C content of maize and millet flours increased sharply after fermentation and germination. Germination greatly increased the tannin content from 219.52±4.37 to 315.21±4.23% (maize), 189.24±1.78 to 287.56±5.40% (millet), total polyphenols from 127.15±2.15 to 143.17±5.72% (maize), 190.17±6.21 to 275.15±8.74% (millet). Fermentation lowered contents of total polyphenols, tannins and flanoids in maize and millet flours. These two processing technologies (germination and fermentation) could be used to improve the nutritional properties of complementary foods for infants and young children.
649 A PROSPECTIVE STUDY ON PRESCRIBING PATTERN OF ANTI- DIABETIC DRUGS IN TYPE 2 DIABETES MELLITUS IN THE INPATIENTS OF GENERAL MEDICINE DEPARTMENT OF A TERITARY CARE HOSPITAL , Sara Shreen*, Dr. Maryam, Mohammadi Fizza Khan, Ramsha Farheen, Nazish Ahmed and Madiha Khan
Background: This study aims to evaluate the prescribing pattern of Anti-diabetic drugs in patients with type 2 diabetes mellitus in a tertiary care hospital. Methods: Before the subjects enter into the study, the study was briefly explained to the subjects and an informed consent form was made to sign by the patient or the patient care taker by their willingness to participate in the study. The patient was then screened for the eligibility criteria to enter into the study. The subjects were followed (treated, monitored) according to the study design. The prescribing patterns and the co morbidities were checked and treatment was given according to their condition. The patients final data was analyzed and final reports were submitted. A total of 100 patients were enrolled into the study. Results & Conclusion: The patients were divided based on age groups, of which 55% of the patients belonged to age group 51-65 followed by 28% belonging to the age group of 36-59 and lowest with 17% blonging to age group of 66-80.The prescribing pattern of monotherapy was found to be 24%, dual therapy was found to be 57% and triple therapy was found to be 19%.
650 QUALITY OF LIFE AFTER NECK DISSECTION: A SYSTEMATIC REVIEW OF LITERATURE , *Dr. Jaspreet Singh Badwal, Dr. Nitin Khunteta and Dr. Prakhar Katta
Background: To review the literature on quality of life after neck dissection so as to help in practical decision making when faced with various clinical situations, such that the reader can comprehend the role of RND, MRND and SND in this current era and the indications for each, when judged in relation to quality of life after neck dissection. Materials and methods: An electronic search was conducted using the search terms “Head and Neck Neoplasms”, “Neck Dissection”, “Quality of Life” and “Postoperative”. Clinical studies were retrieved from the electronic databases of PubMed, EMBASE and SCOPUS. Results: From a comprehensive review of the literature, it can be asserted that MRND and SND are the preferred procedures for early stage head and neck cancer. There is a paucity of well-designed prospective studies and randomised controlled trials that could provide level I evidence. Conclusion: Though most of the studies report better functional results for selective or modified radical neck dissections compared to radical neck dissection, it cannot be established that all the motor and sensory deficits associated with RND can be ascribed to sectioning of SAN.
651 PROSPECTIVE OBSERVATIONAL STUDY ON PAIN MANAGEMENT IN PATIENTS WITH CANCER , Dr. Basavanna P. L.*, Dr. Muhammad Nabeel, Dr. Priya George and Dr. Raslimarva C.
Cancer is a major public health problem worldwide. Pain is among the most common symptoms in patients with cancer. Hence we aimed to assess cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of Mysore teaching hospital. A prospective observational analysis of cancer cases admitted to k r hospital over a period of 6 month from November 2019 to April 2020 was carried out with a sample size of 120 patients demographic data were collected by using patients data collection form and severity and interference on functioning was carried out by using brief pain inventory short form and numeric pain rating scale. Data obtained was analyzed by using spss version 20. In our result majority of the patients were female (n=72) and age group was 31-45 yrs. Breast cancer (n=44, 36.7%) was the major type of cancer and stage 2 (n=47) was the major stage of cancer and followed by stage 3 (n=37). Most of the patients shows nociceptive type of pain (n=64) and moderate pain (n=51). 51 patients shows mild pain interfere on functioning. Non opioid +_ adjuvant was the commonest analgesics prescribed for the pain management. ie, paracetamol and/or diclofinac (n=61, 50.8%) followed by weak opioid + non opioid +_ adjuvant (n=38, 31.7%). 63 (52.5%) were receiving inadequate cancer pain treatment. Therefore it is vital to anticipate and assess pain of the cancer patients as routine clinical practice to optimize analgesic therapy and to identify and overcome barriers to adequate pain management.
652 CORRELATION BETWEEN METFORMIN USAGE AND PLASMA LACTATE LEVEL OF TYPE II DIABETES MELLITUS PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL , Anchu C.*, B. Ajith2, Dawn V. J. and Sivaranjini S.
Background: Metformin is a widely used anti-hyperglycemic agent recommended for Type II Diabetic patients regardless of age. The most serious adverse effect associated with metformin is acknowledged to be lactic acidosis. The objective of the study was assess correlation between Metformin usage and plasma Lactate level of Type II Diabetes mellitus patients in a tertiary care teaching hospital. Method: This was a prospective observational study including 193 patients for a period of 6 months in Government Medical College, Trivandrum. Patients of age ≥30 who had type 2 Diabetes Mellitus with all co-morbidities enrolled in this study. The demographic data, disease data and laboratory data fasting plasma lactate was noticed. Pearson correlation was used to assess relationship between metformin and fasting plasma lactate. Results: The study population was predominantly female (59.5%) and nearly a third (59.5%) belonged to the age group of 51-60 years. Pearson correlation coefficient of plasma lactate with duration of metformin therapy was 0.479 the scatter gram indicated that there is a moderate positive relationship between two variables. Plasma lactate concentration increases with increasing duration of metformin therapy. This result was found to be statistically significant at the P value of 0.000 (P<0.01). Conclusion: In Conclusion, this study suggests that metformin therapy may be associated with small increase in serum lactate level seems to be duration of therapy and not affected by daily dose of metformin.
653 AN OBSERVATIONAL STUDY ON TYPE 2 DIABETES MELLITUS PATIENTS: TO ASSESS TREATMENT REGIMEN, GLYCEMIC CONTROL, AND MEDICATION ADHERENCE, IN PATIENTS ADMITTED IN A CORONARY CARE UNIT WITH ACUTE EVENTS , A. Anisur Rahman*, Greena C. George, Tiny Elna Mathew, Selva Balambigai, R. Srinivasan, T. Siva Kumar
654 PSORIASIS (EKA KUSHTHA) THROUGH AYURVEDA – A CASE STUDY ,
Today, Modern medical science, have lots of facilities and upgraded technologies for treatment portion of patient, even though many diseases may still in progressive phase in the society. Psoriasis is one of such kind of disorders, which has substantial psychological and social impact on a patient’s life. Being skin manifestations psoriasis goes beyond a cosmetic problem. Psoriasis is a non-infectious, chronic inflammatory disease that produces plaques of thickened, scaling skin. Psoriasis is commonly affecting the skin of elbow, knees & scalp. Some people may have severe Psoriasis is involving their entire body. The quality of life of patient with Psoriasis is often diminished because of the appearance of skin. However the treatment options available in contemporary system of medicine are not much satisfactory. Psoriasis is a disease difficult to cure by its nature, so it is a difficult task for the patients as well as ‘chikitsaka’ in ayurveda. It can be co-related with kitibha kushta / ekkushta /vata-kaphaj kushta. In Ayurved system of medicine numbers of drugs /preparation are mentioned. Various herbal drugs and Herbo-mineral act as an rejuvenator for skin. The present work has been under taken to study-Ayurvedic management of chronic Psoriasis- A case study.
655 MANAGEMENT OF EK-KUSHTHA W.S.R PSORIASIS THROUGH AYURVEDA– A CASE STUDY ,   Dr. Twinkle Gupta* and Dr. Radhika Gupta
 Today, Modern medical science, have lots of facilities and upgraded technologies for treatment portion of patient, even though many diseases may still in progressive phase in the society. Psoriasis is one of such kind of disorders, which has substantial psychological and social impact on a patient’s life. Being skin manifestations psoriasis goes beyond a cosmetic problem.Psoriasis is a non-infectious, chronic inflammatory disease that produces plaques of thickened, scaling skin. Psoriasis is commonly affecting the skin of elbow, knees & scalp .Some people may have severe Psoriasis is involving their entire body. The quality of life of patient with Psoriasis is often diminished because of the appearance of skin. However the treatment options available in contemporary system of medicine are not much satisfactory. Psoriasis is a disease difficult to cure by its nature, so it is a difficult task for the patients as well as ‘chikitsaka’ in ayurveda. It can be co-related with kitibha kushta / ekkushta /vata-kaphaj kushta.In Ayurved system of medicine numbers of drugs /preparation are mentioned.Various herbal drugs and Herbo-mineral act as an rejuvenator for skin. The present work has been under taken to study-Ayurvedic management of chronic Psoriasis- A case study.
656 ROLE OF TEEKSHNA KHAR IN MANAGEMENT OF HAEMORRHOIDS - A SINGLE CASE STUDY ,  *Dr. Jitendra Kumar Yadav and Dr. Arun Kumar Singh
Haemorrhoids (Arsh), also known as piles, are swelling containing enlarged blood vessels. Swollen and inflamed veins in the rectum and anus. Arsha (piles) is a condition in which a fleshy mass of variable size, shape and colour appears (due to varicocity of veins) in the anus. Haemorrhoids are usually caused by straining during bowel movements, obesity or pregnancy. From the treatment point of view, Arsh may be divided in to two groups viz. Shushkarsh (dry piles) and Shravi Arsh (exudating piles). Management of haemorrhoid are Ksharpatan, IRC, MIPH, Band ligation, DGHAL, FGHAL, LASER etc. Ahara (diet), vihar (lifestyle) and home remedies (aharkalpana) play an important role in prevention as well as cure Arsh vyadhi. Diet rich in green vegetables and fruits are beneficial.
657 KAP STUDY REGARDING ANTENATAL CARE AMONG PREGNANT WOMEN , Dr. Sameen Sabir* and Dr. Saddam Sharif
Background: Maternal mortality rate is very high worldwide. Every minute a women is dying due to pregnancy related complication in the world. The risk of maternal mortality is 200 times more in developing or low income countries than developed or high income countries. The health of mother can only be improved to proper checkup during pregnancy at antenatal clinics, early detection of pregnancy related complications and prompt treatment can reduce mortality rate. Antenatal Care (ANC), is given different meanings by different scholars, "Antenatal Care means care before birth and includes education, counseling, screening and treatment to monitor and to promote the well-being of the mother and fetus”. Developing countries this shows that the Antenatal care activity is very weak in developing country. The main reasons that hinder the use of Antenatal Care are different from Country to Country. In our country antenatal services are not available to all the patients and lack of awareness and education among people regarding antenatal many women develop pregnancy related complications. Maternal mortality rate of Pakistan is 178/100,000, which is very high. Aim of study: This study will help to know how much percentage of women came to benefit from this very important service of women’s health. And to assess knowledge and attitudes of pregnant women regarding the benefits of Antenatal care utilization at tertiary care unit of out hospital. Method: It is a cross-sectional study conducted at tertiary care unit, Nishtar hospital Multan from March 2016 to August 2016. Total 130 women were selected through random sampling technique. Data was collected in the form of questionnaire. Informed consent was taken from all the respondents. Pregnant women from age 15 to 45 years were enrolled in the study. Results: Total 130 candidates were enrolled in the study. 68 (52.3%) pregnant women were from age group 15-25, 33% (44) from 26-35 years age group and 17.6% (23) from 36-45 years. 72 respondents were housewife, 58 were working women. 70.9% respondents (candidates) were from urban areas and 29.1% from rural areas. 61% of the candidates were having monthly income less than 15000 PKR. Results showed that 125/130 women said that antenatal care is essential for them remaining 5 were not having any knowledge about ANC. 104 respondent were in favor of atleast 4 visits. Only 55/130 candidates were having knowledge regarding screening for infectious disease. 122 candidates (respondents) said that vaginal bleeding during pregnancy is an alarming sign, 105 pregnant women said that severe abdominal pain is a sign of danger, mostly women had no knowledge about remaining dander signs. 108 respondents said that hospital is better place for delivery. 98 women were having positive response and support regarding antenatal care from husband or family. All the respondents were against smoking and alcohol consumption during pregnancy. About 100 pregnant ladies were having no information regarding inj. Tetanus Toxoid. Only 57 candidates knew about iron and folic acid supplements importance. During assessment of attitude regarding antenatal care among pregnant women, almost 128/130 women showed positive response and 2 women having negative reviews regarding ANC. 60 candidates agreed that Blood Pressure monitoring is essential during pregnancy but very less percentage of women do this practice. Result calculated from the questionnaire showed that approximately 65-70% (84.6 +/- 5.54) pregnant women were having Knowledge about Antenatal Care. Approximately 59% (76.7 +/-3.4) respondents showed positive response regarding antenatal care, 22% showed negative and remaining 19% were neutral. The frequency of practice regarding antenatal care dropped to 47%. Conclusion: The antenatal care utilization is more among educated women and women from urban areas. Most of the women cannot follow antenatal care because of transport problems for patients from village, lack of family support and poor socioeconomic status. The overall knowledge and attitude was good among pregnant women, but there was lack of antenatal care practice. Government should provide easily accessible Antenatal care facilities to all rural areas, in order to improve maternal health.
658 CLINICAL PROFILE, LABORATORY AND RADIOLOGICAL FINDINGS IN ACUTE APPENDICITIS , Dr. Sadaf Khan, Dr. Sameen Sabir*, Dr. Saddam Sharif
Background: Appendicitis is the inflammation of the appendix. It is a disease of the young, with 40% of cases occurring between the ages of 10 and 29 yrs. The present study involves diagnostic study of clinical, laboratory and radiological findings in acute appendicitis. Materials and methods: It was a prospective analytical study carried out at department of surgery, Nishtar hospital Multan. To study diagnostic accuracy and value of clinical, laboratory and radiological findings in acute appendicitis, conducted during the period from October 2018 to October 2019. Results: It was observed that majority of patients belonged to age group 21-30 years (34%) followed by 31-40 years (26%). The proportion of male cases was 58% while that of female cases was 42%. All patients presented with pain in abdomen and tenderness in right iliac fossa (100%), followed by vomiting (82%). Conclusions: Acute appendicitis is more a clinical diagnosis rather than radiological. It is better to use radiological investigations only to confirm the diagnosis of acute appendicitis rather to diagnose it primarily because it is clear from the present study that a significant number of positive cases had been missed radiologically.
659 FORMULATION AND EVALUATION OF IMMEDIATE RELEASE PELLETS USING EXTRUSION SPHERONIZATION , Ms. Shramika A. Chore*, Dr. Sachin J. Dighade, Ms. Sanjeevani S. Deshkar and Mr. Abhijit Patil
Drug delivery systems (DDS) are a strategic tool for expanding markets/ indications, extending product life cycles and generating opportunities. Oral administration is the most popular route for systemic effects due to its ease of ingestion, pain, avoidance, versatility and most importantly, patient compliance. Tablet/Pellets are the most popular among all dosage forms existing today because of its convenience of self-administration, compactness and easy manufacturing, however in many cases immediate onset of action is required than conventional therapy. Immediate release solid oral dosage forms are classified as either having rapid or slow dissolution rates. Immediate release dosage forms are those for which ≥85% of labelled amount dissolves within 30 min. Disintegrating agents are substances routinely included in tablet formulations and in some hard shell capsule formulations to promote moisture penetration and dispersion of the matrix of the dosage form in dissolution fluids. In the present case, immediate release may be provided for by way of an appropriate pharmaceutically acceptable diluents or carrier, which diluents or carrier does not prolong, to an appreciable extent, the rate of drug release and/or absorption. Thus, the term excludes formulations which are adapted to provide for “modified”, “controlled”, “sustained”, “prolonged”, “extended” or “delayed “release of drug. Many dosage forms are designed to release the drug immediately or at least as quickly as possible after administration. This is useful if a fast onset of action is required for therapeutic reasons. The general term “granulation” and “pelletization” are sometimes used synonymously, the unit obtained are referred to as granules, pellets, agglomerates or spheroids without making any clear distinction among them. Generally, if a size-enlargement process produces agglomerates of a size distribution within the range of 0.1 mm to 2.0 mm and a high porosity ( about 20-50%),the process may be called “granulates”. “pelletization” is often referred to as a size-enlargement process that involves the manufacture of agglomerates with a relatively narrow size range ,usually with mean size from 0.25 to 2.0 mm, named “pellets”. Pellets have free-flowing properties and a low porosity ( about 10%).
660 FORMULATION AND EVALUATION OF RECTAL IN SITU GEL FOR AN ANTI-INFLAMMATORY DRUG , Ms. Shramika A. Chore*, Dr. S. J. Dighade, Prof. Sanjeevani S. Deshkar and Ms. Seema S. Borkar
The rectum has been an accepted site of drug delivery. Its principal applications have been for local therapy. Some populations are less willing to accept this route as a standard method for drug delivery, but it is the most easily accessible area of the lower GI tract.[1,3] Diclofenac sodium is the most popular NSAIDs have a relatively high therapeutic index in comparison to other NSAIDs. Its half-life is 2 hours. It is a non-steroidal anti- inflammatory drug (NSAID) with analgesic and antipyretic properties. Diclofenac is used to treat pain, dysmenorrhea, ocular inflammation, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and actinic keratosis. In the present study, various in situ gelling rectal formulations using Poloxamer 407 with and without microemulsions were prepared. Different formulations of Diclofenac sodium using Poloxamer 407 in concentration of 15-20% w/w (B1-B10) were prepared with and without microemulsion addition. Further, different formulations of poloxamer 407 (18%w/w) were also prepared by combining with HEC in concentration of 0.5 %w/w (B13) and HPMC E50 LV in concentration of 0.5 %w/w (B14). All these rectal formulations were evaluated for appearance, clarity, pH, gelling ability, viscosity and percent drug release. The formulations showing transparent and clear appearance, quick and stable gelation, shear thinning properties, excellent sustained drug release up to 82- 98% after 8hrs were selected for further characterization. The selected formulations were then subjected for studying the stability to refrigerated condition (5°±3). The optimized formulations, B4 (18%w/w poloxamer with drug microemulsion), B13 (18%w/w poloxamer, 0.5 %w/w HEC and drug microemulsion) and B14 (18%w/w poloxamer, 0.5 %w/w HPMC E50 LV and drug microemulsion) were found to be very clear, transparent, forming quick and stable gels with shear thinning behavior. The optimized formulations B4, B13 and B14 showed excellent mucoadhesion and sustained drug release.
661 A RETROSPECTIVE STUDY ON ADVERSE EVENTS FOLLOWING IMMUNISATION (VACCINE VIGILANCE) AT A TERTIARY CARE TEACHING HOSPITAL , Dr. Basavanna P. L.*, Dr. Joicy James, Dr. Albin M. Antony and Dr. Joann Mary Jose
Background: A vaccine is a way to build our body’s natural immunity to a disease before one get sick. This keeps us from getting and spreading the disease. Vaccination is an injection or a procedure or a treatment with a vaccine to produce immunity against a disease, where they make the body stronger against a particular disease. Vaccinations are an important part of family and public health, vaccines prevent the spread of contagious, dangerous, and deadly diseases. Adverse events following immunization(AEFI) main role is to observe immunization safety, detect and respond to adverse events; correct unsafe immunization practices, reduce the negative impact of the health and contribute to the quality of immunization activities. Most of them are mild and do not last for long. Some of the serious adverse reactions to vaccines are serious allergic reactions, immune thrombolytic purpura, febrile seizures, etc., Among them common ones are febrile seizures, injection site reactions and allergic reactions. Objectives: The main objective was to identify and evaluate the adverse reactions following vaccination. Materials and Methods: A retrospective study in the pediatric department of Cheluvamba Hospital, Mysore Medical College and Research Institute, Mysore from over a period of 3 months. Data collected from 2017 January to 2019 December with a sample size of 115 cases. The data obtained was analyzed by using SPSS version 20. Result: Among 115 patients 72(62.3%) were male and 43 (37.4%) patients were female. In this study 75 (65.2%) patients were at age group 1month-1year. The most commonly reported AEFI is febrile seizures of about 37.4% (n=75). Adverse events were related to Pentavalent (47.8%) followed DPT (19.1%) vaccines. 7 deaths were reported followed by pentavalent vaccination. Conclusion: The study was conducted to identify and evaluate the most common Adverse events following immunization. In the modern era of science and technology, no child should suffer from a disease which can be prevented by a vaccine. So it is very important to provide vaccination awareness among the population. All the tertiary care centres should maintain detailed information’s about all vaccinated children and reports of adverse events associated with it, to overcome underreporting of AEFI.
662 MANAGEMENT OF FILAMENTARY KERATOPATHY AND CORNEAL ULCERS W.S.R. SAVRANA SHUKLA WITH JALAUKAVACHARAN, ASHCHYOTANA & NASYA – A CASE STUDY , *Dr. A. B. Deshmukh and Dr. Snehal U. Shelar
Background: A vaccine is a way to build our body’s natural immunity to a disease before one get sick. This keeps us from getting and spreading the disease. Vaccination is an injection or a procedure or a treatment with a vaccine to produce immunity against a disease, where they make the body stronger against a particular disease. Vaccinations are an important part of family and public health, vaccines prevent the spread of contagious, dangerous, and deadly diseases. Adverse events following immunization(AEFI) main role is to observe immunization safety, detect and respond to adverse events; correct unsafe immunization practices, reduce the negative impact of the health and contribute to the quality of immunization activities. Most of them are mild and do not last for long. Some of the serious adverse reactions to vaccines are serious allergic reactions, immune thrombolytic purpura, febrile seizures, etc., Among them common ones are febrile seizures, injection site reactions and allergic reactions. Objectives: The main objective was to identify and evaluate the adverse reactions following vaccination. Materials and Methods: A retrospective study in the pediatric department of Cheluvamba Hospital, Mysore Medical College and Research Institute, Mysore from over a period of 3 months. Data collected from 2017 January to 2019 December with a sample size of 115 cases. The data obtained was analyzed by using SPSS version 20. Result: Among 115 patients 72(62.3%) were male and 43 (37.4%) patients were female. In this study 75 (65.2%) patients were at age group 1month-1year. The most commonly reported AEFI is febrile seizures of about 37.4% (n=75). Adverse events were related to Pentavalent (47.8%) followed DPT (19.1%) vaccines. 7 deaths were reported followed by pentavalent vaccination. Conclusion: The study was conducted to identify and evaluate the most common Adverse events following immunization. In the modern era of science and technology, no child should suffer from a disease which can be prevented by a vaccine. So it is very important to provide vaccination awareness among the population. All the tertiary care centres should maintain detailed information’s about all vaccinated children and reports of adverse events associated with it, to overcome underreporting of AEFI.
663 EXPLORATION OF CONCEPT OF LASIKA: A REVIEW ARTICLE , Vd. Mayuri Narayanrao Manwatkar*, Vd. P. V. Kulkarni
Ayurveda has underlined the importance of knowledge of body both anatomy and physiologically. It is done with the help of analysis of every body component. With the help of this analytical knowledge of body components, one can know the factors that are healthy and unhealthy for these components and ultimately to the body. Classical texts had described that there are innumerable body components. Out of these few components are explained grossly which should be studied in detail and with the help of these components the factors which are not explained should also be learned by clever physicians. Lasika is one of the important body components which is a part of udak dhatu(water component in the body) and is a seat of Pitta. It is having prime involvement in causation of diseases like Prameha(diabetes mellitus) , Kushtha(skin diseases),Visarpa(erysipelas) . So, with the purpose of understanding the nature, characteristics and importance in the context of disease pathology is studied in this article.
664 JANAPADODHWANSA AND ITS TREATMENT W.S.R TO GLOBAL PANDEMIC: COVID-19 , Dr. Jitendra kumar Pradhan, Dr. Manohar Ram and Dr. Ramnihor Tapsi Jaiswal*
Janapaodhwansa literary means destruction of large population. The principles which we explained vide Janapaodhwansa in Ayurveda synchronized with this COVID-19 pandemic. Generally the causes of disease is mainly Sadharan (common) and asdharana (uncommon) factors. Causative factor which are relating to group of people or community in comes under sadharana.(Factors responsible for the spread of new, re-emerging infection include change in human demographic and behavior, impact of new technologies and industries, economic development and changes in land use, increased international travel and commerce). A number of new infections agents emerged in the last two to three decade causing out-break or epidemic in various countries with rapid spread across the globe, main example is COVID-19. Changes in environment plays major role to out-break of new infection. Factors which are common to the population are following air, water, land and season. When there is any changes occur these 4factors, then destruction of people will occur, that is called Janapadodhwansa.
665 EPIDEMIOLOGY OF SOME KEY FACTORS RISK OF IRON DEFICIENCY IN DRUG USERS , Mamasaliev Ne’matjon Solievich* and Usmonov Burkhonjon Umarovich
articles by B.U. Usmonov et al. "Epidemiology of some major risk factors for iron deficiency in drug addicts" To the greatest extent, the relative risk of IDD development in drug addicted populations occurs with alimentary risk factors, 2 times less for epidemiological factors and 6 times less for comparatively alimentary factors in the presence of associated pathological conditions.
666 SOCIO DEMOGRAPHIC PROFILE OF END STAGE RENAL DISEASE PATIENTS ATTENDING TERTIARY CARE TEACHING HOSPITAL OF INDIA , *Abas Khan, Farooq A. Jan and Haroon Rashid
Chronic kidney disease (CKD) is a worldwide public health problem, both for the number of patients and the cost of treatment involved. A retrospective study of 2 years was conducted among CKD Stage-V (End stage renal disease) patients admitted in nephrology wards, those undergoing dialysis and kidney transplantation in SKIMS between 1st October 2015 and 30st September 2017. In our study, majority of the ESRD patients belonged to the age group 41-60 years (44%).The present study had males more than females (68%). In the present study, it was observed majority of the patients were from rural areas (74%). It was observed 80% patients were living below poverty line.
667 ACUTE POISONING PRESENTED AT EMERGENCY DEPARTMENT OF A TERTIARY CARE UNIT , Dr. Bareera Ajmal*, Dr. Muhammad Talha Shabbir and Dr. Muhammad Shahzad
Background: Objective: The aim of our study is to evaluate the pattern, demographics, etiologies, survival and mortality of acute poisoning at a tertiary care center in Dera Ghazi Khan, Punjab. Periodic epidemiological studies are necessary to understand the pattern of poisoning in each region. Methodology: It is a descriptive, cross-sectional study. Duration of study was 6 months from August 2017 to January 2018. Non-probability random sampling technique was used to enroll cases for this study. The data was collected from patient case sheets using data collection forms. The variables e.g. Gender, age and outcome was presented as frequencies and percentage. Results: A total of 122 patients were included in the study and of those Patients were females 77 (63.1%) and 45 (36.8%). The male/female ratio was 1:1.7 and the mean age of the patients was 30.4±13.75 years. The most common age group presented with account poisoning was 15-30 years with 49/122 patients. The analyses showed that in 28 patients the cause of poisoning was paraphenylene diamine, organophosphates in 22 patients, Aluminum phosphide in 12 patients, in 16 patients drugs, opioids in 8 patients and in 18 patients the cause of poisoning remained unknown. Overall survival rate was 79.5% and mortality rate was 25%. This high mortality rate was mainly due to poor prognosis of Aluminum phosphide poisoning (100% mortality among 12 patients). Out of 122 cases, 50% were married. Level of education among 122 poisoning cases was very low, 41 were illiterate, 27 primary education and only 23 patients were graduated. According to mode of poisoning, 41 were accidental cases, 58 suicidal, 32 homicidal and 18 stupefying. Most of the patients were young female students and farmers. Conclusion: It has been clear that there is no doubt in increase in the incidence of the poisoning cases. According to the results of our study, the most common agents of suicide used in our region and those who were reported at our setup were paraphenylene diamine (kala pathar), pesticide, wheat pill and benzodiazepine. Most attempts were to cause deliberate harm to self, and most common in the younger patients. Female patients were more as compared to male. It is recommended that preventive measures and psychological counseling to be done of these patients.
668 GLYCEMIC CONTROL IN SURGICAL PATIENTS ADMITTED AT DERA GHAZI KHAN TEACHING HOSPITAL , Dr. Muhammad Shahzad Khan*, Dr. Muhammad Talha Shabbir and Dr. Bareera Ajmal
Background: Surgeons are performing millions of operations on diabetic patients daily, and lack of awareness among diabetic patients is leading to complications. Objective: To determine chronic glycemic control in general surgical patients admitted at a tertiary care hospital. Methodology: This was a cross-sectional study conducted from June 2018 to January 2019, on fifty-seven consecutive patients, suffering from diabetes and needing surgical intervention in any form were included in this study. Diabetes status in terms of HbA1c, causes of admission to the surgical ward, and intervention done were noted. Data were analyzed by using SPSS 20. Results: Among these diabetic patients, 46 (80.70%) were male, and 36 (63.16%) were known diabetics. HbA1c level was normal in 9 (15.79%) patients, pre-diabetic in 13 (22.81%) and uncontrolled diabetic in 35 (61.4%) patients. Aetiologically diabetic foot was seen in 36 (63.16%) patients, abdominal catastrophe 12 (21.05%), leg swelling 7 (12.09%), 5 (8.77%) scrotal abscess, carbuncles 4 (7.02%), miscellaneous 5 (8.77%). Incision drainage and closure were done in 10 (17.54%), drainage wound debridement, decompression of compartment syndrome, and constructive procedure in 11 (19.3%), laparotomy 8 (8.77%) and watchful conservation in 4 (7.01%) patients. Two patients were saved from the mortal blow of the diabetic coma. Hypertension and nephropathy were seen in 8 patients each, and 5 patients have Hepatitis C, and 1 patient has ischemic heart disease. Conclusion: This study showed that many patients did not know their diabetes status, two-third of patients were having uncontrolled diabetes. There is a need for proper assessment and management of diabetic patients by consultants and young doctors in every discipline of medicine, especially surgery.
669 PATTERN OF MEDICINE PRESCRIPTION IN STABLE ANGINA AT A TERTIARY CARE HOSPITAL , Dr. Aatir Farhan*, Dr. Shafaq Jameel and Dr. Muhammad Fahad Iqbal
Background: Stable angina is widespread diseases in Pakistan so; this study was designed to evaluate the prescribing trends and to find out the most prescribed drug in Stable angina in public sector hospital Multan, Pakistan and assessing its prevalence in both genders. The purpose of the study was to identify the therapeutic agents being prescribed majorly in Pakistan and to analyze that whether the current prescription patterns are in accordance with evidence based guidelines. Materials and Methods: A cross-sectional study was conducted from January-2019 to April-2019, through collection of data from prescriptions of patients suffering from stable angina in public sector hospitals of Multan Pakistan. Data observations from the total 200 prescriptions collected from the hospitals of Multan graphically demonstrated the trends of drug classes per prescription. Results: The study identified that in the treatment of stable angina Antiplatelet are the most frequently prescribed drug class in Multan and adjacent areas. Followed by CCBs on 2nd rank and nitrates on 3rd rank, ACE inhibitors and ARBs on 4th number, after which statins occupy the 5thposition, lastly comes the position of beta blocker i.e. 6th and diuretics are the least prescribed class. Results: The study identified that in the treatment of stable angina Antiplatelet are the most frequently prescribed drug class in Multan and adjacent areas. Followed by CCBs on 2nd rank and nitrates on 3rd rank, ACE inhibitors and ARBs on 4th number, after which statins occupy the 5th position, lastly comes the position of beta blocker i.e. 6th and diuretics are the least prescribed class. Conclusion: The anti-platelet blocker drugs were the most prescribed drug class followed by calcium channel and vasodilators occupying the second and third rank respectively. The study also revealed that men are 1.5 times more vulnerable to the development of angina than the females. The study is also showing sound evidence that there is need to follow guidelines for proper treatment.
670 EFFECT OF BODY MASS INDEX ON PREVALENCE OF SCIATICA , Dr. Muhammad Salman Abid*, Dr. Muhammad Haleem and Dr. Syed Hasnain Ali
Sciatica is a health condition characterized by pain going down the leg from the lower back. This pain may go down the back, outside, or front of the leg. Onset is often sudden following activities like heavy lifting, though gradual onset may also occur. A total of 91 patients were included in this study. There were 52 males and 39 males in this study. The mean age of the patients was 35.12±2.56 years, with minimum age of 21 years and maximum age of 52 years. The mean BMI of all the patients was 23.12±1.34. The analysis of the data revealed significant relation of BMI with the prevalence of sciatica (p = 0.01).
671 CAUSES OF ACUTE INTESTINAL OBSTRUCTION PRESENTING TO SURGICAL EMERGENCY DEPARTMENT OF TERTIARY CARE HOSPITAL , Dr. Alam Raza*, Dr. Areef Haider and Dr. Saad Majeed
Objective: To determine the etiological spectrum of acute intestinal obstruction in surgical emergency department of our hospital. Methodology: The study cross sectional study was conducted in department of surgery, Nishtar hospital, Multan. Duration of study was 6 months. Diagnosed cases (age above 15 years) of intestinal obstruction with the help of X-ray and Ultrasonography were included in the study. All the patients were selected by non-probability purposive sampling technique. All patients were initially assessed after resuscitation in emergency room. The decision, to operate or manage conservatively, was taken by a consultant. Emergency laparotomy was done and operative findings were recorded. Results: Total 130 patients were enrolled in the study .78 patients were male and 52 were female. 43 patients were in age group 26-40 years, 36 patients were in 41-55 years. The cardinal signs and symptoms were present in almost all the patients. Abdominal pain was present in 128 patients, vomiting in 102 patients, tenderness in 118 patients, absolute constipation in 112 patients and abdominal distension in 119 patients. Out of 130 patients 96 patients were having intestinal obstruction due to mechanical causes like Adhesions were present in 21 patients, Hernias in 26 patients, Malignancy in 10 patients and intestinal tuberculosis in 17 patients. Remaining 34 patients were having non-mechanical (adynamic) intestinal obstruction. Out of these 34 patients 18 patients developed paralytic ileus due to gastrointestinal tract perforations (ileum, duodenal, appendix etc.). 26 patients were managed conservatively and 104 patients underwent surgery. Most common post-surgical complication was wound infection and wound dehiscence. The outcome observed in patients were as, 106 patients improved, 12 patients developed morbid condition, 6 lost to follow up and 6 patient died.
672 FREQUENCY OF ANXIETY AND DEPRESSION AMONG PATIENTS WITH PULMONARY TUBERCULOSIS , Dr. Hina Iqbal*, Dr. Muhammad Naeem Akhtar and Dr. Muhammad Nadim Saqib
Objective: To assess the frequency of anxiety and depression among patients of pulmonary tuberculosis. Material and methods: This was a cross-sectional, observational study conducted at Pulmonology department, Nishtar hospital Multan from March 2018 to May 2018 over the period of 3 months. Total 100 diagnosed cases of TB either male or female having age range from 20-60 years were included in this study and anxiety and depression was assessed in selected patients. Results: Total 130 patients of TB were selected and anxiety and depression was assessed. Mean age of the patients was 43.12 ± 12.009 years. Out of 130 patients, anxiety and depression was noted in 89 (68.5%) patients and 78 (60%) patients respectively. Out 130 TB patients, 40 (31%) patients were normal, mild anxiety was noted in 80 (61%) patients followed by moderate 4 (3%) patients and severe in 6 (5%) patients. Mild depression was found in 60 (46%) patients, moderate in 8 (6%) patients and severe in depression was noted in 8 (6%) patients. Conclusion: Results of present study showed a higher rate of anxiety and depress in TB patients. 41-60 years age group was the most common age group. But age of the TB patients was not significantly associated with development of anxiety and depression. Most of the TB patients were male. Area of residence was significantly associated with development of anxiety and depression.
673 FREQUENCY OF PREECLAMPSIA IN PATIENTS ATTENDING OBSTETRICAL CLINICS AT NISHTAR HOSPITAL MULTAN , Dr. Usama Afzal*, Dr. Taskeen Faisal and Dr. Rida Fatima
Pre-eclampsia is diagnosed when a pregnant woman develops i.e. blood pressure ≥140 mmHg systolic or ≥90 mmHg diastolic on two separate readings taken at least four to six hours apart after 20 weeks' gestation in an individual with previously normal blood pressure and proteinuria ≥ 0.3 grams (300 mg) or more of protein in a 24-hour urine sample. A total of 230 females were included in this study. The mean age of the patients was 30.23±2.45 years. The mean systolic blood pressure of all the patients was 129.45±3.45mmHg and the mean diastolic blood pressure was 85.23±2.89mmHg on two readings. Out of 230, only 68 (29.65%) patients had ≥140 mmHg systolic or ≥90 mmHg diastolic blood pressure on two separate readings. These patients were subjected to urine dipstick for proteinuria. The final diagnosis of preeclampsia was confirmed in 45 (19.56%) patients.
674 FREQUENCY OF VAGINAL BIRTH AFTER CESAREAN SECTION , Dr. Rida Fatima*, Dr. Taskeen Faisal and Dr. Usama Afzal
Once a cesarean, always a cesarean, this statement reflected most of US obstetricians’ management of patients with a prior cesarean delivery. Although attempts at a trial of labor after a cesarean birth (TOLAC) have become accepted practice, the rate of successful vaginal birth after cesarean delivery (VBAC), as well as the rate of attempted VBACs, has decreased during the past 10 years. A total of 167 patients were included in this study. The mean age of the patients was 30.12±2.36 years. The mean inter pregnancy interval was 1.56±0.45 years. All the patients underwent trial of labor. Sixty-six patients (39.52%) patients were shifted for section due to certain reasons i.e. scar tenderness, fetal distress, malpresentation etc. The rest of the patient were delivered vaginally i.e. 101 patients (60.47%).
675 EFFICACY OF OCTREOTIDE IN UPPER GASTROINTESTINAL BLEEDING DUE TO VIRAL HEPATITIS INDUCED LIVER CIRRHOSIS , Dr. Muhammad Nadim Saqib*, Dr. Muhammad Naeem Akhtar, Dr. Imran Saeed
Introduction: Upper gastrointestinal bleeding can be a deadly and life threatening condition and need intensive emergency treatment to keep away from undesirable morbidity and mortality. Octreotide has great viability and safety profile. Objective; To determine the efficacy of octreotide in cases of upper GI bleed due to liver cirrhosis. Methodology: In this study there were total 50 cases of upper GI bleed within last 24 hours due to liver cirrhosis of both genders falling in the age range of 30-70 years presenting to medical wards and emergency department. The octreotide 100mcg bolus injected then 800mcg in 400ml normal saline infusion given over the period of 24 hours. This therapy was given for 2 to 5 days. The efficacy was labeled as yes when there is no bleeding episode over 24 to 48 hours. Results: In this study there were total 50 cases out of which 35 (70%) were males and 15 (30%) females. The mean age and duration of cirrhosis were 49.45±6.85 years and 4.87±2.01 years respectively. The efficacy was almost equal in both genders (p= 0.95). The efficacy was slight better in age group 30-49 years where 16 (69.56%) out of 23 cases had it (p= 0.12). The efficacy was significantly better in Class A where 4 (80%) out of 5 cases had it as compared to Class B and C where it was almost equal with p= 0.01. Conclusion; octreotide has good efficacy in treating upper GI bleed in cases with liver cirrhosis and this is significantly better in cases with Child Pugh Class A.
676 PREVALENCE OF ARTHRITIS IN PATIENTS PRESENTING IN THE OUTDOOR DEPARTMENT OF DERA GHAZI KHAN HOSPITAL , Dr. Saad Majeed*, Dr. Areef Haider and Dr. Alam Raza
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types of arthritis, other organs are also affected. Onset can be gradual or sudden. This cross-sectional study was conducted in the outdoor department of Dera Ghazi Khan Teaching Hospital. A total of 134 patients between 40 to 65 years of age, presenting in the outdoor department were included in this study. The demographic data of the patients i.e. name, age, gender, disease history, disease duration, or any other symptoms or clinical findings were noted on a proforma. The analysis was done using Microsoft excel and Medcalc Ver. 19.0. Out of 134, sixty seven (50%) were females and sixty-seven (50%) were males. The mean age of the patients was 49.23±2.89 years, with a minimum age of 41 years and the maximum age of 59 years. Out of 134, only 52 patients had arthritis. The minimum duration of the disease was 5 years and the maximum duration was 15 years. Out of 52 patients, 31 commented that the pain is usually mild and it settles by using medication. Five patients told that they cannot get up the bed early in the morning.
677 DENTAL ABSCESS AS ONE OF THE MAJOR CAUSES OF DENTAL PAIN IN PATIENTS PRESENTING IN OUTDOOR DEPARTMENT , Dr. Zaryab Zaki*, Dr. Ijaz Hussain, Dr. Komal Baneen
Dental pain, is pain in the teeth or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases. When severe it may impact sleep, eating, and other daily activities. This observational study was conducted in Nishtar Institute of Dentistry, outdoor departments. All the patients presenting with dental pain were included in this study and the reason of their pain was noted after proper examination. Relevant investigations were carried out. A total of 247 patients were included in this study. The mean age of the patients was 25.34±4.37 years. The mean duration of disease of 28.12±3.23 days. There were 145 males and 102 females in the study. Among the main causes of dental pain, there were tooth abscess (15%), tooth decay (12%), gum disease (10%), tooth fractures (9%), temperature sensitivity (9%), damaged fillings or dental sealants (8%), teeth grinding (8%) and improper brushing or flossing (7%) and various others.
678 FREQUENCY OF DEPRESSION AND STRESS AMONG MEDICAL AND DENTAL STUDENTS , Komal Baneen*, Ijaz Hussain and Rabia Khan
Depression is a state of low mood and aversion to activity. It can affect a person's thoughts, behavior, motivation, feelings, and sense of wellbeing. It may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. This survey study was conducted among MBBS and BDS of Nishtar Medical University. The relevant information about their personal life, presence of stress and depression and their causes were collected on a predefined proforma. A total of 125 medical and dental students participated in the study. Out of 125 students, 67 told that they have faced occasional stress. Five students responded that they always remain in stress. There were multiple reasons for this i.e. family issues, hostel life issues and educational problems.
679 PREVALENCE OF URINARY TRACT INFECTION AND RISK FACTORS AMONG PATIENTS , Muhammad Fahad Iqbal*, Shafaq Jameel and Aatir Farhan
Urinary tract infections are among the most common bacterial infections in humans both in the community and hospital settings, and they occur in all age groups, and usually required urgent treatment. All the patients presenting with history of burning micturition and dysuria were included in this study. A total of 108 patients including male and female of ages between 18 to 60 years were included. There were 58 (53.70%) females and 50 (46.30%) males in the study. The mean age of all the patients was 35.34±2.12 years. The mean time for onset of symptoms was 23.89±3.45 days, with the minimum of 7 days and the maximum of 52 days. The symptoms were of greater duration in female patients than the male patients.
680 STUDY OF CORRELATION BETWEEN BODY MASS INDEX AND BLOOD GLUCOSE LEVEL AMONG MEDICAL STUDENTS , Sana Bahadur*, Ammar Abdul Rahman and Muhammad Ramzan
Objective: To study the correlation between serum glucose and BMI in undergraduate students. Material and methods: This cross sectional study was conducted at Department of Medicine, Sheikh Zayed Hospital Rahim Yar Khan in month of December 2019. Total 166 students either male or female having age from 18 years to 24 years were selected. Serum blood glucose was measured and BMI was calculated. Results: Minimum age of students was 17 years and maximum age was 23 years. Mean age of the students was 19.17 ± 1.5 years, mean BMI was 24.65 ± 6.196 and mean serum glucose level was 126.23 ± 25.56mg/dl. The Pearson correlation test showed that the level of level of serum glucose increased with increasing BMI. This positive correlation was statistically significant (r= 0.625, P= 0.000). Conclusion: Findings of current study showed a positive correlation between BMI and serum glucose levels. Significant different between mean serum glucose levels and different age groups was detected. Results of this study also showed that there is insignificant difference between serum glucose levels of male and female students.
681 STRESS AS A RISK FACTOR OF ACID PEPTIC DISEASE , Dr. Syed Hasnain Ali*, Dr. Muhammad Haleem and Dr. Muhammad Salman Abid
Common causes of acid peptic disease include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Other causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease, and liver cirrhosis. This cross-sectional study was conducted in the outdoor department of Nishtar Hospital Multan. The relevant data i.e. name, age, gender, history of the disease, its relation with the stress, and duration of disease were collected on a predefined proforma after informed consent. This data was analyzed with SPSS version 23.0. The qualitative variables were presented as frequency and percentage. The quantitative variables were presented as mean and standard deviation. A total of 100 patients presenting with the symptoms were enrolled in this study. All the other patients were excluded from this study. The mean age of the patients was 32.45±3.89 years. There were 23 males and 73 females in this study. Out of 100 patients, 53 patients commented that the disease aggravates when they are under stress. Out of these 53, fourteen were smokers, two were alcoholics and twelve were also using NSAIDs.
682 THE PREVALENCE OF GESTATIONAL HYPERTENSION AMONG PATIENTS PRESENTING IN OBSTETRICAL CLINICS , Dr. Muhammad Ramzan*, Dr. Ammar Abdul Rahman and Dr. Sana Bahadur
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes generally results in few symptoms; however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section. A total of 105 females were included in this study. After taking the informed consent, basic demographic data, and history i.e. name, maternal age, gestational age, previous birth history, whether they know about gestational diabetes or not, do they take precautionary measures for this etc. was taken and entered on a predefined proforma. The mean age of the patients was 29.34±2.13 years. The minimum age was 24 years and maximum age was 38 years. All the women were in their last trimesters of their pregnancies. Eighty-five patients said that they have knowledge about gestational diabetes and that they keep it being checked on regular basis. Out of 105 patients, 23 were suffering from gestational diabetes. Out of these 23, 3 patients also suffered from this disease in the previous pregnancy.
683 A REVIEW ON SIGNIFICANCE OF NIDRA (SLEEP) TOWARDS MAINTAING THE HUMAN HEALTH , Dr. Nilam Deore* and Dr. Sudhirkumar Pani
Nidra (Sleep) The second factor helpful to replenish depleted body constituents is sleep. The body is continuously being bombarded by various sensory stimuli, which have to be accepted, analyzed, acted upon stored in memory for further use etc. This results in the fatigue of the sensory motor apparatus. This fatigue results in inability to perceive their respective stimuli. The bonds between sensory organs and the mind by Prana Vayu, Udana Vayu, Vyana Vayu, Sadhaka Pitta, Tarpaka Kapha and Rasa Dhatu get depleted. This leads to a state in which mind, retracts itself, known as sleep. This total retraction of mind helps the body to replenish the vitality of the body and depleted functional capacity of the mind. The depth of sleep is directly proportional to the retraction of the mind.
684 CORRELATION BETWEEN CORTISOL AND INSULIN RESISTANCE IN METABOLIC SYNDROME OF IRAQI PATIENTS , Zainab Qassim Abd-Ali, Fadhil Jawad Al-Tu’ma* and Mohamed Tariq Jebir
Background: Metabolic Syndrome (MS), understood as a complex set of cardiovascular risk factors, related to abdominal fat accumulation and resistance to insulin, is strongly associated with high cardiovascular mortality. Chronic glucocorticoid (GC) exposure in humans is well known to result in whole-body insulin resistance and obesity. Objective: The aim of this study is to evaluate the effect of biochemical parameters changes such as cortisol in sera of patients with metabolic syndrome and then assessment their correlations with insulin resistance. Materials and Methods: Sample size of the study was 149 persons of both gender selected randomly enrolled in the study which divided into two groups, 80 with metabolic syndrome patients and 69 of apparently healthy individuals as control with their age ranged from (40 to 60) years throughout the period between May. 2019 to Aug., 2020. Results:. There was a significant difference between BMI and biochemical parameters (blood glucose, HbA1c, total cholesterol, TG, VLDL-C, LDL-C, Cortisol) in sera of metabolic syndrome patients and healthy control groups (P ≤ 0.01). The statistical analysis were used in present study was showed a statistical significant between male and female (P value ≤ 0.01). Conclusion: There is a significant effect of clinical factors on the incidence and progression of metabolic syndrome disease. There is a significant difference in the cortisol levels between male and female MtS patients.
685 ASSOCIATION BETWEEN OXIDATIVE STATUS AND GESTATIONAL DIABETIC PATIENTS OF IRAQI WOMEN , Eman Abdul Ameer Jabor*, Fadhil Jawad Al-Tu’ma and Wasan Ghazi Al-Safi
Background: Risk factors for GDM include obesity, advanced maternal age, type 2 diabetes mellitus (T2DM), family background, prior diagnosis of GDM, recent adverse pregnancy results. At present, the prevalence of GDM is gradually rising, especially in Asia. Highly reactive molecules formed inside the cell are highly reactive oxygen species. Aim: The current study aimed to detect the correlation between the oxidants and antioxidants status determined in gestational diabetes mellitus (GDM) patients in holy Kerbala city, Iraq. Materials and Methods: This study include 46 gestational outside diabetic patients obtained from gynecological and obstetric teaching hospital, Kerbala health directorate / Kerbala – Iraq in addition to 47 women as apparently control group during Nov., 2019 to Sep., 2020 with matched age ranged between 25 – 45 years. The links between oxidative status and gestational diabetic patients were examined. Results: Total reactive oxygen species (TROS) was significantly different between the study groups. It was significantly higher in GDM (70.50 ± 16.01) μmol/L compared to pregnant without GDM (56.05 ± 19.48) μmol/L, with P value (p< 0.05) was 0.002. TAO was no significantly different between the study groups. It was no significant different in GDM (1104.50 ± 464.95) μmol/L compared to control (1201.83 ± 422.58) μmol/L with (P < 0.05). The GDM patients have higher fasting blood glucose, insulin, HMOA, TROS, HbA1c compared with control. There was a positive significant correlation between HMOA-IR and TROS. There was a significant correlation between HMOA-IR and insulin in GDM patient. Non significant association between the parameters studied in the control group except insulin and HMOA-IR. Conclusion: There is a non-significant differences in TAO between control and GDM, TROS was significantly higher in GDM as compared with control. There was strong correlation between HMOA-IR with each of TROS and insulin in GDM patients and control group.
686 MATRIX METALLOPROTEINASE-2 LEVELS IN IRAQI BREAST CANCER WOMEN AND ITS ASSOCIATION WITH GENE SNPS AND OTHER TUMOR MARKERS , Yamamah Jawad Abbas*, Fadhil Jawad Al-Tu'ma and Alaa Fraq Al-Hemerri
Background: Matrix metalloproteinases (MMPs) are a family of extracellular matrix-degrading proteinases. Owing to their matrix-degrading abilities and high expression in advanced tumors, MMPs were originally implicated in cancer progression, invasion, and metastasis. Objective: The present work aims to investigate the role of the matrix metalloproteinase levels in pathogenesis of Iraqi breast cancer patients of breast cancer and to study its association with MMP-2 gene polymorphism and another tumor markers such as carcinoembryonic antigen (CEA) and cancer antigen 15.5 (CA15-3). Materials and Methods: Forty one women with breast cancer with age ranged between (16 – 82) years and 45 apparently control women with age ranged between (18 – 50) years were included in this case-control study performed during Oct., 2019 and July, 2020. All samples were obtained from Imam Al-Hassan Oncology Unit, Al-Hussein Teaching Hospital, Al-Hussein Medical City, Kerbala Health Directorate / Kerbala – Iraq. The relation between the levels of various tumor markers including MMP-2, CEA and CA15-3 and clinical pathological parameters were determined. The MMP-2 gene polymorphism was analyzed in order to interpret its roles in pathogenesis of breast cancer and correlation with tumor markers studied. Results: The amplicon size of the MMP-2 gene was 304 base pair, and the amplification results for amplification of the MMP-2 SNP gene rs243865 showed one wild type (CC), heterozygous (CT) and homozygous (TT) bands, after amplification reactions by allelic specific polymerase chain reaction. Non-significant association was found between serum levels of MMP-2, CEA and CA15-3 (P> 0.05). Elevated levels of serum CEA and CA15-3 of 41 postmenopausal patients were determined in (63.74%) and CAE (21.3%), respectively. Larger tumor size, advanced axillary lymph nodes and TNM stage showed higher incidence of elevated CEA and CA15-3 levels. The elevation of CA15-3 levels was significantly greater in patients with HER2-positive tumors 10 (24.39%), and the elevation of CA15-3 levels was significantly greater in ER 36 (87.8%) patients with breast and PR status 29 (70.7%). A lower sensitivity to CEA compared to CA15-3 in diagnosing breast cancer was determined. Conclusions: In the present study, the relation between levels of MMP-2 gene polymorphism and serum marker of CA15-3, CEA and well clinic pathological features of breast carcinoma was shown, whereas the prognostic importance of CA15-3 and CEA was shown in the follow-up of patients with breast cancer.
687 A CLASSICAL REVIEW ON TAMRA , Dr. Muneesh Sharma* and Dr. Shweta Chauhan
“Rasashastra” is the branch of Ayurveda which is the science of life.In this branch of Ayurveda,we deal with medicinal preparations made out ofmetals, minerals, poisons, precious stones, aquatic origin substances. Thesepreparations may be potentially toxic if not dealt with properly. Proper careright from raw material to final product and storage is must. Or else thefinal product can even be life taking. Tamrapreparation of has alwaysbeen difficult as far as practical aspect is considered, if not preparedproperly it is highly toxic and even after preparation after few days it mayagain become Utthita(toxic form).
688 PREVALENCE OF VITAMIN D DEFICIENCY AMONG PREGNANT FEMALES , Dr. Farwa Naseem*, Dr. Aqsa Ibraheem and Dr. Ayesha Saddiqa
Vitamin D is a group of fat-soluble vitamin responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol). A total of 67 patients presenting in outdoor department of obstetrical department were included in this cross-sectional study. Informed consent was taken. The demographic data of the patients was recorded on a predefined proforma. Vitamin D level were sent to laboratory. Later, the reports were collected from the Lab. All the data was entered and analyzed with SPSS Ver. 22.0. The mean age of the patients was 28.68±2.56 years. The minimum age was 23 years and maximum age was 36 years. Out of 67 patients, 34 patients were in second trimester and 33 were in third trimester of their pregnancy. Twenty-three patients were vitamin D deficient, thirty one had insufficient levels and thirteen patients had optimal vitamin D levels.
689 IMPORTANCE OF MAXILLOFACIAL PROSTHESIS AMONG PATIENTS OF ORAL CANCER , Dr. Hafiza Hina Irshad*, Dr. Huma Yousaf and Dr. Aamir Waheed
Objective: The aim of this study is to emphasize the importance of maxillofacial prostheses in the treatment of oral cancer after surgical resection. Study Design: An Observational study. Place and Duration: In the Oral and Maxillofacial department of NID, Multan for one-year duration from February 2019 to February 2020. Methods: Of 2036 cancer patients, 125 were found to have oral cancers and were included in the study. Surgically treated patients were examined and analyzed for possible prosthetic rehabilitation. Oral cancer was found in 6% of all cancer patients. The most common tongue cancer in 33 (26.4%) cases; 21 (16.8%) had cheek cancer, 20 (16%) had parotid cancer, and 15 (12%) had oral and nasal cancer. The cancer of lip (4.8%) ear (2.4%) and soft palate (1.6%) made a little contribution. Results and Conclusion: The results of this study showed that at least half of the surgically treated patients with oral cancer could have been successfully rehabilitated with various prostheses, but many never did.
690 HYPOTHYROIDISM IN WOMEN HAVING MENSTRUAL PROBLEMS , Dr. Zofshan Majeed*, Dr. Hafiza Abeer Ilyas and Dr. Sehrish Liaqat
Background; Menstrual disorders frequently affect the quality of life of adolescents and young adult women, especially those who suffer dysmenorrhea and heavy menstruation. Different studies have associated thyroid dysfunction with menstrual problems. This study was conducted to document the frequency of hypothyroidism in women with menstrual problems. Objective: To determine frequency of hypothyroidism in women having menstrual problems at a tertiary care hospital. Material and methods; All the study cases (227) who meet inclusion and exclusion criteria of my study were taken from OPD of the Department of Gynecology and Obstetrics, Sheikh Zayed Hospital, Rahim Yar Khan. Once registered, 5 ml venous blood sample was taken and sent to the central laboratory of the Sheikh Zayed Hospital, Rahim Yar Khan for serum TSH and T4 levels by a pathologist having minimum 5 year experience after post-graduation. Hypothyroidism was determined on laboratory report after serum analysis for TSH and T4. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was noted to be 24.08± 4.65 years. Of these 227 study cases, 134 (59 %) were married while 93 (41%) were unmarried. Mean body mass index (BMI) of our study cases was 22.31 ± 2.70 kg/m2 , 160 (70.5%) were normal weight, 51 (22.5%) were overweight and 16 (7%) were obese. Secondary amenorrhea was noted in 25 (11%), oligomenorrhea in 42 (18.5%), polymenorrhea in 16 (7%), heavy menstrual bleeding in 59 (26%) and irregular menstrual bleeding in 85 (37.5%). Mean serum TSH level of our study cases was 4.85 ± 0.91 mIU/L while mean T4 level was noted to be 86.90 ± 38.81 nmol/L and hypothyroidism was noted in 176 (77.5%) of our study cases. Overt hypothyroidism was noted in 75 (33 %) and subclinical hypothyroidism in 101 (44.5%) of our study cases. Conclusion; Very high frequency of hypothyroidism was noted in women having menstrual problems in our study. Hypothyroidism was significantly associated with residential status, obesity, poor socioeconomic status, level of education and type of menstrual problem. Subclinical hypothyroidism was more prevalent as compared with over hypothyroidism. Our study results suggest that women presenting with menstrual problems must be screened for thyroid hormones for proper management of these patients.
691 RECURRENCE OF BREAST CANCER IN PATIENTS UNDERGOING MODIFIED RADICAL MASTECTOMY , Dr. Tehreem Fatima*, Dr. Sidra Noor and Dr. Saba Mustafa
Objectives: To study the recurrence of breast cancer in patients undergoing modified radical mastectomy at tertiary care hospital. Material and methods: In this cross-sectional study total 150 women with breast cancer were selected from Department of Surgery, Sheikh Zayed Hospital, Rahim Yar Khan, from March 2019 to September 2019 over the period of 6 months. Age of the selected patient was between 20-60 years. All the selected were undergone modified radical mastectomy. Recurrence of breast cancer was assessed in selected. Results: Total 150 females with breast cancer were selected and MRM was performed in all patients. After 6 months of MRM, recurrence of breast cancer was noted in 43 (29%) patients. Out of 83 (55.33%) primiparas, recurrence of breast cancer was noted in 24 (28.92%) patients. While out 67 (44.67%) multiparas, recurrence of breast cancer was found in 19 (28.26%) patients. Difference of recurrence of breast cancer between primiparas and multiparas was statistically insignificant with p value 1.000. Conclusion: In present study patients of breast cancer were managed with modified radical mastectomy. After 6 months follow-up, higher number of patients reported with recurrence of breast cancer. Association of recurrence of breast cancer with age group was found to be significant. Most of the patients were primiparas but no association of recurrence with parity was detected.
692 XYLAN AND CARBOXYMETHYLCELLULOSE DIGESTIVE ENZYMES ISOLATED FROM THE ABDOMEN OF THE SMALL SOLDIER OF THE TERMITE MACROTERMES SUBHYALINUS , Dr. Fagbohoun Jean Bedel*, Yapi Jocelyn Constant, Deffan Kahndo Prudence, Ekissi Gbocho Serge Elvis and Kouame Lucien Patrice
By low pressure Chromatographic techniques two isoform enzymes (Ab-CX1 and Ab-CX2) were isolated from the abdomen of the small soldier of the termite Macrotermes subhyalinus. These enzymes are bifunctional because they have the ability to hydrolyze both xylan and carboxymethylcellulose substrates. Their detection by electrophoresis under native conditions revealed a protein band for each. the relative molecular weights determined by SDS-PAGE and gel filtration suggest that the enzyme Ab-CX1 is tetrameric and Ab-CX2 dimeric. The physicochemical characterization of the enzymes Ab-CX1 and Ab-CX2 shows that they are acids with a stability at pH 4.6-5.6. They exhibit maximum activity at a temperature of 50 and 55°C respectively for the enzymes Ab-CX1 and Ab-CX2. The Cu2+ cation have inhibitory effects while Mn2+, Na+, K+. Also, we find that EDTA has no effect on the catalytic activity of these biocatalyses.
693 A CASE OF POSTOPERATIVE RECURRENCE OF JUVENILE LUNG CANCER SUCCESSFULLY TREATED WITH ANAPLASTIC LYMPHOMA KINASE-TYROSINE KINASE INHIBITOR SEQUENTIAL THERAPY , Hiroshi Hashimoto*, Kazuyuki Komori, Shinichi Taguchi and Yuichi Ozeki
Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKIs) have been approved for the treatment of postoperative recurrence of non-small cell lung cancer (NSCLC) caused by ALK rearrangement. A 38-year-old man underwent left upper lobectomy with mediastinal lymph node dissection for lung cancer (pT2aN2M0, stage IIIA). A gene mutation analysis showed negative epidermal growth factor receptor mutations and an ALK-positive translocation (fluorescence in situ hybridization-positive, ALK iScore 3 by iAEP immunohistochemistry). Crizotinib was administered postoperatively. Seventeen months later, computed tomography and positron emission tomography revealed paratracheal lymph node metastases. Crizotinib was discontinued, and treatment with a second-generation ALK-TKI, alectinib, was begun. Two months later, a partial response was achieved. No severe adverse events were observed. We continued the treatment with alectinib for more than 48 months, and a near-complete response was achieved. This patient’s management suggests that ALK-TKI sequential therapy (crizotinib to alectinib) may be safe and effective in ALK-positive NSCLC.
694 INTRATUMORAL LIPIODOL ACCUMULATION PATTERN AND TUMOR RESPONSE IN TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION (TACE) FOR THE TREATMENT OF UNRESECTABLE HEPATOCELLULAR CARCINOMA (HCC) PATIENTS , Ali M. Moshibah and Dr. Zubair Ayoub Syed*
Hepatocellular carcinoma (HCC) is a commonly occurring hepatic malignancy. Transarterial chemoembolization (TACE) has proved to be an effective method of palliative therapy for unresectable multifocal HCC without vascular invasion or metastasis. The study design is a retrospective record of all patients that underwent Transarterial chemoembolization (TACE) procedure for advanced stage hepatocellular carcinoma (HCC) over a periode of one year in a single center in Saudi Arabia. There are four types of lipiodol deposition, according to classification defined as follows: type 1, diffuse homogeneous opacification of the tumor focus and around it; type 2, homogeneous opacification of the majority of the mass; type 3, weak heterogeneous opacification; type 4, very weak or no opacification of the tumor focus. 9 (26.47%), 5 (14.7%), 10 (29.41%) and 10 (29.41%) patients showed types I, II, III, and IV lipiodol deposition, respectively. Univariate analysis demonstrated that local tumor response and intra-tumoral lipiodol covering is a significant predictor of tumoral response at (P<0.05).
695 HUGE UNRUPTURED ANEURYSM OF THE LEFT VENTRICLE AFTER SILENT INFARCTION: DIFFICULTIES OF MANAGEMENT THROUGH A CASE , Jaafar Rhissassi*, Hicham Wazaren, Hanae Bouhdadi, Chakib Benlafqih, Rochde Sayah and Mohammed Laaroussi
Aneurysm of the left ventricle is rare with a prevalence of 0.05%. Transthoracic echocardiography is the main means of diagnosis. These are the works of Dor on the importance of maintaining kinetics and an elliptical ventricular geometry that had developed left ventricle repair. This is a 67-year-old male who was admitted with dyspnea. Transthoracic echocardiography revealed a large apical aneurysm of the left ventricle. Magnetic resonance imaging confirmed the diagnosis of the aneurysm. The coronarography revealed a left anterior descending artery occlusion and tight stenosis of the right coronary artery. The surgical correction consisted of the technique of DOR.
696 COVID-19 PANDEMIC: NEUROLOGICAL MANIFESTATIONS, COMPLICATIONS AND FUTURE PERSPECTIVE , Syed Iftikhar Ur Hasaan*, Tooba Ali, Shafaq Taj, Fatema Tasnim, Warda Ali Naqvi, Moyosoreoluwa Onobun and Ahmed Ali
The Severe Acute Respiratory Syndrome Coronavirus Disease-2 (SARS-CoV-2) is the causative agent of coronavirus disease-19 (COVID-19). The World Health Organization has declared this outbreak a pandemic condition, and it has become a public health emergency of international concern. Most of the population is experiencing signs and symptoms similar to the flu and common cold. Despite that, alveolar destruction resulting in progressive lung failure has also been underlined. Although SARS-CoV-2 has been underlined principally to affect the lungs, other system involvement has been described too. Neurological involvement has also been emphasized in the literature. Neurological involvement (central nervous system and peripheral nervous system) in SARS-COV-2 usually corresponds to the following situations: (a) Neurological manifestation of the acute viral infection, (b) neurological manifestations of the post-COVID-19 infection, (c) neurological image of COVID-19 in patients with comorbidities. The actual disease pathogenesis is unknown; however, direct viral invasion of neuronal cells, followed by significant inflammation due to cytokine and inflammatory markers, activation of the complement system, and hypoxia resulting from viral-mediated lung injury leading to oxidative stress, and neuronal cell injury are the proposed mechanisms. Patients with neurological involvement usually experience a wide range of signs and symptoms such as headache, nausea, drowsiness, seizures, altered sensorium, vomiting, and hyposmia. The pandemic of SARS-CoV-2 has become an unprecedented challenge for the physicians and neurologists. Various neurological manifestations have been observed and reported in many cases, and neurological symptoms may precede classical respiratory signs and symptoms. This review summarized the data from published literature, including case reports and open-source data sets to describe the spectrum of neurological manifestations and complications observed in COVID-19 cases.
697 ETHNOMEDICINAL USES OF ACALYPHA INDICA L. IN WESTERN ODISHA, INDIA , Sunil Kumar Sen* and Lalit Mohan Behera
The present study was conducted to provide information on the ethnomedicinal uses of Acalypha indica, a flowering plant belonging to family Euphorbiaceae. It is a weed herb, found mostly in waste places on road sides as well as forest localities. It is a valuable medicinal plant with multifarious drug properties and hence the tribals and people of other communities use this plant to cure several diseases and ailments. The voucher specimen collected has been preserved in the herbarium of Botany Department, Panchayat College, Bargarh.
698 SURGICAL TREATMENT OF POST-TRAUMATIC ARTHRITIS OF THE WRIST IN 9 CASES , Tarik El Mountassir*, Karim El Hammiri, Yassine Moubadi, Anass Lahlou, Moncef Boufettal, Reda Allah Bassir, Mohamed Kharmaz, Moulay Omar Lamrani and Mohamed Saleh Berrada
Osteoarthritis is a chronic, non-inflammatory process due to the degenerative cartilage. On the wrist, it is most often post-traumatic and concerns usually the peri-scaphoid region; they affect young subjects, often manual workers or sportsmen. The etiologies of osteoarthritis are dominated by carpal instability scapholunar and pseudarthrosis of the scaphoid. Evolutionary schemes constants of this osteoarthritis have been identified according to the etiology: These are the SLAC (Scapho-Lunate Advanced Collapse) and SNAC (Scaphoid Non Union Advanced Collapse). The classification of watson and ballet is the most used First row carpal resection (RPRC) and arthrodesis of the 4 bones internal procedures with scaphoidectomy are the most widely used procedures. We present the clinical observation of 9 patients their diagnostic and therapeutic management with review of the literature.
699 STAGE AT PRESENTATION OF BREAST CANCER IN HOSPITAL SEGAMAT - A DISTRICT HOSPITAL RETROSPECTIVE REVIEW , Norly Salleh*, Maszuraidah Md. Charep, Aida Surya Othman and Mastura Hasanal Bashri
Background: Breast cancer is the leading cause of cancer-associated death in women. Malaysian women tend to present late and this poses a challenge to the healthcare provider. B-Care or Breast Cancer Resource Centre is a walk in clinic that was established in our hospital since 2014. One of the reasons of its establishment is to overcome the accessibility problem that our patients might have, therefore, improving the stage at presentation and subsequently the prognosis. This study was done to characterize breast cancer at presentation for our population since the introduction of B-Care. Methods: This is a retrospective, observational study of all newly diagnosed breast cancer patients presented to our centre from January 2017 till January 2019. Patients with recurrent or previous contralateral breast cancers were excluded. Patients were identified from our database. Secondary data was collected and analysed. Results: A total of 73 patients were included in the study. The mean age at diagnosis was 54.1 ± 10.8 year (range 24-83 years). Most of them had no known risk factors. More than forty seven percent of patients presented with early stage of breast cancer (Stage 0-II) and 39.7% presented with late stage (stage III-IV). Most patients had surgery done. Modified radical mastectomy was performed in 56 patients (76.7%), 3 had toilet mastectomy (4.1%) and 10 had wide local excision of cancer (13.7%). Conclusions: The introduction of B-Care has improved the stage at presentation of our breast cancer patients’ in Hospital Segamat.
700 BLADDER PERFORATION AFTER THA REVISION WITH ACETABULAR PROTRUSION: CASE REPORT AND LITERATURE REVIEW , Karim El Hammiri*, Tarik El Mountassir, Anass Lahlou, Yassine Moubadi, Moncef Boufettal, Reda Allah Bassir, Mohamed Kharmaz, Moulay Omar Lamrani and Mohamed Saleh Berrada
Intrapelvic protrusion is a severe complication that can occur during acetabular loosening of total hip arthroplasty. Cement, screws and the cup may threaten noble organs and expose to vascular lesions and damage to the pelvic organs. To be secure, the removal of intrapelvic material is based on a precise preoperative assessment, safeguarding of the muscle and bone stock and reconstruction of the pelvic anatomy. We present the clinical observation of a 52-year-old woman with protruse total hip arthroplasty, the postoperative complications with review of the literature.
701 A LITERARY REVIEW ON POTENTIAL HEALTH RISKS OF “SOFT DRINKS” , A. H. Ayshah Fazeenah*
“Flavored carbonated beverages” are popularly known as “Soft Drinks” which typically contain carbonated water, a sweetener and a flavoring agent. It may also contain caffeine, colouring, preservatives and other ingredients including less than 0.5% of alcohol of the total volume if the drink is to be considered non-alcoholic. Soft drinks are the beverage of choice for millions of people, second only to water. The first marketed soft drinks in the Western world appeared in the 17th century, which were made of water and lemon juice sweetened with honey. There are no nutritionally beneficial components in soft drinks. Soft drinks mostly consist of filtered water and refined sugars. A recent report ind