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INVITED EDITORIAL: Totally drug resistant-tuberculosis in India: The bad just got worse
Zarir F Udwadia
The Journal of Association of Chest Physicians, Year 2016, Volume 4, Issue 2 [p. 41-42]
DOI: 10.4103/2320-8775.183836
ORIGINAL ARTICLE: Comparing the impact of acupuncture and pethidine on reducing labor pain
Zahra Allameh, Hatav Ghasemi Tehrani, Mojdeh Ghasemi
Advanced Biomedical Research, Year 2015, Volume 4, Issue 1 [p. 46]
DOI: 10.4103/2277-9175.151302 PMID: 25789272
Background: Generally 50 to 70 percent of women suffer from a severe and unbearable pain during their childbirth. Abnormal fetal heart patterns, an increase of caesarian delivery rate, prolonged labor and low APGAR score in newborn are some of adverse effects of labor pain. Disagreement between different studies regarding the efficiency and effectiveness of acupuncture on labor pain led us to do this study. Materials and Methods: This is a clinical trial study. Sampling was done randomly in Esfahan, Shahid Beheshti Hospital, based on the subjects' characteristics. Patients were classified into three groups of control, Pethidine and acupuncture (27-30 women in each group). All women with a first and second pregnancy.VAS pain ruler was used as data collection tool. Data were analyzed in SPSS software, and using ANOVA and kruskal-Wallis tests. Results: The average pain score in control group 30 min after intervention was 7.80, while in Pethidine and acupuncture groups respectively were 6.87 and 5.77. Kruskal-Walis test showed that three groups in pain severity had significant difference at this time. The average length of the active phase of labor in Pethidine and acupuncture groups was 175 min while this time in control group was 243 min that ANOVA test showed a significant difference (P = 0.000). Conclusion: Results showed that acupuncture can significantly reduce labor pain in 30 min after intervention, while it had no effect on labor pain at full dilatation. However, both in Pethidine and acupuncture groups, the length of the active phase has been considerably shortened.
ORIGINAL ARTICLE: Hepatoprotective evaluation of Arogyavardhini Rasa against paracetamol-induced liver damage in rats
Yuga Raj Sapkota, Prashant Bedarkar, Mukesh B Nariya, Pradeep K Prajapati
BLDE University Journal of Health Sciences, Year 2017, Volume 2, Issue 1 [p. 44-49]
DOI: 10.4103/2468-838X.207421
Introduction: Liver is termed as Yakrut in ayurvedic classical literature, is one of the major organs for maintaining homeostasis, and is involved more or less with all the biochemical pathways in the body. Arogyavardhini Rasa (AVR) is one of the widely practicing ayurvedic herbo-mineral formulations in liver disorders. It has been used for the management of diverse types of Jvara (fever), Kushtha (skin disorders), Medoroga (altered lipid profiles associated with obesity), and other Yakrit vikara (liver disorders). In this study, AVR was prepared as per the 13th-century classical text Rasaratna Samuchaya. On the other hand, heavy metals causing toxicity, especially mercury present in this formulation, are an issue of concern. Aim of the Study: Hepatoprotective effects of formulation were evaluated by paracetamol (PCM)-induced liver damage in rats to substantiate the role of metal mineral in the classical AVR formulation. Materials and Methods: Effects of formulation were assessed on serum and liver tissue biochemical parameters and histopathological studies. Results: PCM produced significantly impaired the liver and kidney functions as assessed through an increase in liver and kidney marker enzymes. Arogyavardhini-treated group significantly (P = 0.05) prevented this hepatotoxicity and strongly supported by histopathological examinations that revealed AVR shows the protection of liver tissue from PCM-induced hepatotoxicity. Conclusion: The observation of the present study has stalwartly supported the hepatoprotective action of AVR against PCM-induced hepatotoxicity in rats.
COMMENTARY: Much ado about AYUSH notification
Yogendra Shrivastava
Medical Journal of Dr. D.Y. Patil Vidyapeeth, Year 2021, Volume 14, Issue 2 [p. 243-245]
DOI: 10.4103/mjdrdypu.mjdrdypu_710_20
SPECIAL ARTICLE: Effect of common herbal medicines on patients undergoing anaesthesia
Yatindra Kumar Batra, Subramanyam Rajeev
Indian Journal of Anaesthesia, Year 2007, Volume 51, Issue 3 [p. 184-192]
Herbal medicines are the oldest known remedies to mankind. Herbs have been used by all cultures throughout history but India has one of the oldest, and most diverse cultural living traditions associated with the use of medicinal plants. The use of these agents may have perioperative implications, which often is a result of various factors. The constituents of these medications may not be adequately described. Conventional agents like ste­roids, oral hypoglycaemic agent, nonsteroidal anti-inflammatory agents and antihistamines are frequently added to herbal medicines. Toxic materials like arsenic, mercury, lead, etc. have been detected from time to time in some herbs. The use of herbal medicines can result in drug interactions, most of which are less well defined. The interactions that are most important in the perioperative period include sympathomimetic, sedative, and coagulopathic effects. Less than 50% of patients admit to taking these medicines, which compounds the prob­lem. It is imperative that anaesthesiologists obtain a history of herbal medicine use from patients and anticipate the adverse drug interactions. In case of any doubt, it may be prudent to stop these herbal medicines atleast 2­3 weeks prior to anaesthesia and surgery.
ORIGINAL ARTICLE: Drug-resistant tuberculosis: Study of clinical practices of chest physicians, Maharashtra, India
Yatin Dholakia, Zahir Quazi, Nerges Mistry
Lung India, Year 2012, Volume 29, Issue 1 [p. 30-34]
DOI: 10.4103/0970-2113.92359
Background: Patients suffering from drug-resistant tuberculosis (DR TB) avail of private care since Programmatic Management of DR TB (PMDT) is not universally available in India. Management of DR TB is challenging and involves great expertise. Chest physicians (CPs) play a major role in this area. The study was undertaken with the objective to see whether the practices of CPs comply with current guidelines and to identify areas where they could be involved to improve access to PMDT. Materials and Methods : For this cross-sectional study, CPs from Mumbai and Nagpur, Maharashtra, India, were given pretested questionnaires to be filled in and returned. Observations : Of 70 enlisted CPs, 29 (41%) responded. Twenty-six (89%) respondents used the drug susceptibility test (DST) for diagnosis: private labs and hospitals were preferred; 9 (31%) used standard treatment, 15 (51%) switched to individual treatment after starting standard therapy and 12 (41%) started empirical treatment later switched to individual treatment as per the WHO guidelines. Seven consultants (10%) used in addition drugs from alternative systems of medicine for immune modulation and adverse drug effects. Eighty-six per cent CPs monitored treatment by smear examination, 51% by culture and 93% used X-rays. Reported case holding in the form of regular follow-up consultation visits was around 70%, treatment success estimated to be between 30% and 70%, and deaths around 30%. Adverse drug reactions were reported in around 30% cases. Conclusion : This study shows that most private CPs generally comply with current guidelines for management of DR TB. Accreditation of private labs for DST, involving CPs in diagnosis, treatment and monitoring of patients through public private partnerships can improve access to PMDT.
REVIEW ARTICLE: Phytopharmacological review of Andrographis paniculata (Burm.f) Wall. ex Nees
Yadu Nandan Dey, Suman Kumari, Sarada Ota, N Srikanth
International Journal of Nutrition, Pharmacology, Neurological Diseases, Year 2013, Volume 3, Issue 1 [p. 3-10]
DOI: 10.4103/2231-0738.106973
Andrographis paniculata [Burm. F] Nees is a potent drug used in Ayurveda, Siddha and Homoeopathy in many formulations and is effective in the treatment of various diseases like malaria, diabetes, viral hepatitis, cirrhosis, liver cancer, etc. For the long-term use in these conditions, establishment of safety of any given intervention is crucial. Hence in the present review the various journals, e-books, monographs, books, data base on medicinal plant, etc. from 1986 to 2010 and Ayurvedic classical text/ earliest literature on Indian Medicine like Charaka Samhita (400-500 A.D.), Sushruta Samhita (400-500 A.D.), Nighantus (500-1600 A.D.), etc. were searched manually and electronically for extracting the complete information about the plant. The particulars of pharmacological activities, drug interactions and contraindications were extracted from the published preclinical and clinical study reports focusing on the keywords, i.e. reported adverse effects and safety profile of the plant. Finally, the therapeutic safety of the plant extracts was concluded. The literature showed that in some preclinical animal studies, due to the bitter taste when the herb was given in very high dose it caused gastric discomfort, vomiting, loss of appetite, etc. However there are no adverse effects reported clinically when the plant is administered in human beings.
ORIGINAL ARTICLE: Prevalence of hypertension among professional drivers: Evidence from 2000 to 2017—A systema...
Y Krishnamoorthy, G Sarveswaran, M Sakthivel
Journal of Postgraduate Medicine, Year 2020, Volume 66, Issue 2 [p. 81-89]
DOI: 10.4103/jpgm.JPGM_297_19 PMID: 32134003
Background: Hypertension is one of the leading causes of premature deaths worldwide. Drivers have an additional risk of hypertension when compared to the general population because of the nature of their profession. Hence, the current review was done to estimate the global burden of hypertension among professional drivers. Methods: We conducted a systematic search for articles on the prevalence of hypertension among drivers published from 2000 to 2017 in Medline and Embase. Meta-analysis was performed using the random-effects model and pooled prevalence of hypertension was reported. Heterogeneity was assessed using the likelihood ratio (LR) test and publication bias was assessed using Egger's test. Results: In total, 26 studies with 15,702 drivers were included. The pooled prevalence of hypertension among the drivers worldwide was 34% (95% confidence interval [CI]: 27–40%). World Health Organization (WHO) region-wise estimates showed that prevalence was highest among the drivers in the Western Pacific region (56%) and lowest in the Eastern Mediterranean and African region (21%). Studies showed significant evidence of heterogeneity (χ2 = 1816.1,P < 0.001) but there was no significant publication bias (P = 0.967). Conclusion: More than one-third of drivers have hypertension globally which is in excess of the general population. Hence, more focus needs to be given for allocating resources and developing workplace interventions for prevention and control of hypertension.
ORIGINAL ARTICLE: Changes in thyroid antibody and T lymphocyte subsets after radiofrequency ablation of thyroid nod...
Xiaoyin Tang, Ping Li, Bo Zhai, Xiaoli Zhu
Journal of Cancer Research and Therapeutics, Year 2021, Volume 17, Issue 3 [p. 638-643]
DOI: 10.4103/jcrt.JCRT_1421_20 PMID: 34269293
Settings and Design: The aim was to study the changes in thyroid antibody and T lymphocyte subsets after radiofrequency ablation (RFA) of thyroid nodules in patients with autoimmune thyroiditis. Subjects and Methods: Patients (n = 135) with autoimmune thyroiditis and thyroid nodules were treated by RFA. The indices of thyroid function and thyroid antibody and T lymphocyte subsets were examined preoperation and on the 1st day and the 1st month after ablation. Any complications were recorded. Statistical Analysis: The software SPSS 17.0.0 (version: 2008-8-23) running under Windows 8 was used for statistical analysis. The measurement data were expressed as x ± s, with P < 0.01 indicating a significant difference in the statistical data. Results: Levels of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were in the normal range before ablation, and no significant changes occurred on the 1st day or in the 1st month after ablation. The change in the percentage of CD8+T cells and the absolute value of B cells were not statistically significant (P > 0.01), and the values were in the normal range. Compared with values recorded preoperation, the value of TG-Ab, TPO-Ab, CD4+/CD8+, the percentage of CD4+T cells, the absolute values of lymphocytes, T cells, CD4+T cells, and CD8+T cells decreased significantly at the 1st day after ablation (P < 0.01) and then recovered to preoperative levels during the first 30 days after ablation (P > 0.01). Within 1 month after ablation, none of the patients had complications such as active bleeding, infection, recurrent laryngeal nerve injury, parathyroid gland injury, skin scald, and so on. Conclusions: After RFA of thyroid nodules in patients with autoimmune thyroiditis, thyroid function is not affected and no serious complications occurred. TG-Ab and TPO-Ab levels can be significantly decreased, and the distribution of T lymphocyte subsets can be changed in the short term after ablation.
REVIEW: Nonpharmacological treatment of epilepsy
VS Saxena, VV Nadkarni
Annals of Indian Academy of Neurology, Year 2011, Volume 14, Issue 3 [p. 148-152]
DOI: 10.4103/0972-2327.85870 PMID: 22028523
Nonpharmacological treatment of epilepsy includes surgery, vagal nerve stimulation, ketogenic diet, and other alternative/complementary therapies, e.g., yoga, Ayurveda, electroencephalography (EEG) biofeedback technique, aerobic exercise, music therapy, transcranial magnetic stimulation, acupuncture, and herbal remedies (traditional Chinese medicine). Alternative therapies, despite the term, should not be considered as an alternative to antiepileptic medication; they complement accepted drug treatment. Alternative therapies like yoga, through techniques that relax the body and mind, reduce stress, improve seizure control, and also improve quality of life. Ketogenic diet is a safe and effective treatment for intractable epilepsies; it has been recommended since 1921. The diet induces ketosis, which may control seizures. The most successful treatment of epilepsy is with modern antiepileptic drugs, which can achieve control of seizures in 70-80% cases. Patients opt for alternative therapies because they may be dissatisfied with antiepileptic drugs due to their unpleasant side effects, the long duration of treatment, failure to achieve control of seizures, cultural beliefs and, in the case of women, because they wish to get pregnant Surgical treatment may lead to physical and psychological sequelae and is an option only for a minority of patients. This article presents supportive evidence from randomized controlled trials done to assess the benefit of non-pharmacological treatment.
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