bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of Groundnut Shell Powder as Potential Super Disintegrant in Chronotherapeutic Delivery of Sacubitril–valsartan
Authors: Aleti Rajeswari , Nijhawan Monika , Gunnam Sailaja , Bakhatwar Mohammad , Thota Pavan Kumar , Adireddy Krishna Kishore , Baratam Srinivasa Rao
Published: October 2024

ABSTRACT

Context:

Chronotherapeutic delivery of antihypertensives plays a potential role in the treatment by providing a therapeutic amount of drug at the target site in the body. Sacubitril–valsartan (SV), an angiotensin receptor neprilysin inhibitor, has been indicated for the treatment of hypertension. The study explores the formulation and evaluation of compression-coated tablets (CCTs) of SV using a natural super disintegrant in the core tablet for chronotherapeutic drug delivery.

Aim and Objective:

The main objective of the current investigation is to study the applicability of groundnut shell powder (GSP) as super disintegrant and its role in chronotherapeutic drug delivery.

Materials and Methods:

Core tablets of SV were prepared using different concentrations of natural excipient (GSP) and compression coated. The CCT was evaluated for the postcompression tableting properties, in vitro drug release, Fourier transform infra red spectroscopy (FTIR), and stability studies and compared the disintegrating property with a synthetic excipient (crospovidone).

Results:

The results of the in vitro dissolution performance of core tablets indicated that the incorporation of GSP as a super disintegrant significantly reduced the disintegration time. Optimized core tablets were subjected to compression coating using a graded concentration of cellulose acetate phthalate as coating polymer and evaluated tableting properties and dissolution performance. Among all the formulations, CCT5 with 8% GSP in the core, coated with 300 mg coating polymer shown 6 h lag time followed by the rapid release of the drug within 1 h. Accelerated stability studies on optimized formulation revealed that there were no significant changes in the tableting parameters after storage indicating the stability of the formulation.

Conclusion:

The use of natural disintegrant in the core tablet offers a promising approach for rapid release of drug from CCT after a lag time of 6 h to achieve chronotherapy of SV.
Phytochemical profiling and anticancer potential of Cymbopogon citratus extract
Authors: Almutairi Bader O. , Almutairi Mikhlid H. , Al-Dahmash Badr A. , Alkahtani Saad , Alarifi Saud , Rady Ahmed
Published: October 2024

Objective:

To evaluate the anticancer potential of Cymbopogon citratus extract.

Methods:

GC-MS analysis was used to identify phytocomponents in the methanolic extract of Cymbopogon citratus. A fractionation method was employed to isolate and assess the bioactivity of different fractions and their cytotoxic activities against cancer cell lines HCT116, LoVo, Caco-2, and HT-29 were investigated. A dual staining method with acridine orange and ethidium bromide was used to assess the effect of the extract on cell apoptosis. Additionally, the expression levels of Bax and TP53 were quantified using realtime PCR in Caco-2 cells treated with the ethyl acetate fraction of Cymbopogon citratus extract. A protein array was employed to profile key pro- and anti-apoptotic proteins in Caco-2 cells. Moreover, molecular docking studies were conducted to investigate the interactions between key compounds of Cymbopogon citratus extract and specific apoptosis-related protein domains (PDB IDs: 7wql and 4bkx).

Results:

A significant growth inhibition was observed in Caco-2 cells treated with Cymbopogon citratus extract. Among the seven fractions of the plant extract, the ethyl acetate fraction showed the highest cytotoxicity against Caco-2 cells with an IC50 value of (6.16 ± 0.01) μg/mL. The immunofluorescence assay showed that the ethyl acetate fraction could induce apoptosis of Caco-2 cells. Moreover, the fraction upregulated the gene expressions of Bax and TP53 in a dose-dependent manner. The docking analysis demonstrated the interaction of five compounds isolated from the ethyl acetate fraction with key proteins in Caco-2 cells, indicating their anticancer properties.

Conclusions:

Cymbopogon citratus extract shows anticancer activity against Caco-2 cells by inducing apoptosis. It may be a promising candidate for the treatment of colon cancer, which needs further investigation.
B3 lesions of the breast and upgrade risk: Predicting patients at low risk
Authors: Russell Michael , Bindra Vanshay , Zhou Lifeng , Ramsaroop Reena , Gerred Susan
Published: October 2024

Abstract

Introduction:

B3 lesions of the breast are a heterogeneous group of pathologies, which are indeterminate for malignancy. They vary in their risk of upgrade to malignancy from 8% to 25%. Standard practice in New Zealand is for routine surgical excision of these lesions to rule out malignancy. There is concern that this approach may constitute overtreatment for a large group of patients. This has prompted research into methods to predict those patients at low risk of upgrade who may be suitable for less invasive management strategies.

Materials and Methods:

A retrospective audit was carried out on all B3 lesions diagnosed at a large tertiary breast surgery service over 10 years from January 2010 to December 2019. The rate of upgrade was calculated for each B3 lesion subtype and in those subtypes with sufficient numbers. Logistic regression analysis was performed.

Results:

A total of 524 patients were identified as appropriate for analysis, overall the risk of upgrade to pre-invasive or invasive malignancy was 17.6%. The risk of upgrade was highest in atypical ductal hyperplasia (29.2%) and lowest for fibroepithelial lesions (1.96%). Logistic regression revealed that patient age was associated with the risk of upgrade, and lesion size approached statistical significance. For the subgroup of papillary lesions (PL), histological atypia was strongly associated with upgrade risk. A predictive model was created for these lesions, this has identified that the group of patients with PL without atypia, lesion size <10 mm and age <60 years have a very low risk of upgrade.

Conclusion:

B3 lesions pose a diagnostic challenge due to their variable risk of upgrade, with the risk of overtreatment of a large number of patients when pursuing routine surgical excision. Patients with PL without atypia, lesion size <10 mm and age <60 years have a very low risk of malignancy and should be managed with less invasive methods, such as vacuum-assisted biopsy.
Delivering high value breast care—Editorial commentary
Authors: Chintamani
Published: October 2024

Abstract

Optimum and high-value breast care although desirable but is difficult to define. Breast care needs to be tailored to the patient, provider and the centre. Considering the diversity in terms of the available health-care facilities, there certainly is no one and only method to achieve the desired goal. There is a need to have a world wide emphasis on the structured training of care providers in this regard. The article highlights the challenges and some ways to overcome the bottlenecks to provide a good quality breast care uniformly across the globe.
A questionnaire survey of current practice in the management of phyllodes tumour
Authors: Anam Jay Rashmi , Garach Niharika Rajan , Chitkara Garvit , Rao Manjula , Kirti Karishma , Chaudhary Neha , Bindlish Ridhima , Maniar Vashishth , Maheshwari Udip D , Chordiya Nilesh
Published: October 2024

Abstract

Background:

Cystosarcoma phyllodes tumours are rare tumours that account for <1% of all breast masses. Because of their rarity, there are no standard guidelines for their management. The present survey study aimed to assess the current practices and perceptions of clinicians who treat phyllodes tumours of the breast in India.

Materials and Methods:

After validation, an online questionnaire that assessed the current practice and nuances of treating phyllodes tumours of the breast was sent to Indian clinicians who treat such cases. Information on the method of diagnosis and treatment, including surgery, radiotherapy, and chemotherapy, was evaluated.

Results:

A total of 146 clinicians participated in the survey. Most participants (87.7%) reported that they preferred a core needle biopsy for diagnosis along with other imaging modalities. The majority of the surgeons (80.2%) were willing to offer breast conservation surgery even for malignant phyllodes tumours whenever possible. With respect to resection margins, participants preferred narrower margins (1 cm) for benign tumours and wider margins (≥1 cm) for borderline and malignant tumours. Furthermore, although most surgeons reported that they resected the overlying skin and underlying muscle, they refrained from axillary clearance. Finally, radiotherapy was offered by a majority of participants for recurrent and malignant tumours. About 12.3% of participants were offered adjuvant chemotherapy for malignant phyllodes tumours.

Conclusion:

This survey study reveals important aspects of the current practice of treating phyllodes tumours of the breast. The results of the study will help us to understand the current perceptions about the treatment.
Extreme oncoplasty - editorial commentary
Authors: Koppiker C B
Published: October 2024

Abstract

This is a short commentary on the editorial article by Prof. Melvin Silverstein, where he describes his surgical career including his experiences with Extreme Oncoplasty (EO). The editor in this commentary emphasizes the utilization of EO in the Indian scenario where most patients present with advanced stages and might need even extreme Oncoplastic Breast Surgery based clinical management.
Prevalence of post-intensive care syndrome: Observations from a tertiary care hospital in Eastern India
Authors: Chatterjee Rupak , Mukherjee Shatavisa , Kharbanda Mohit , Purkayastha Deboraj Dey , Pramanik Netai
Published: October 2024

Background:

Post-intensive care syndrome (PICS) refers to physical, cognitive and psychological symptoms that occur after a patient is discharged from the intensive care unit (ICU).

Aims:

The present study aimed to explore the prevalence of PICS among ICU survivors of a tertiary care setup in Eastern India.

Methods:

A single-centre prospective cohort study was conducted amongst patients admitted to the ICU. A predefined, structured interview in 1st month, 3rd month, 6th month after ICU admission was done. Baseline characteristics were noted. Physical and cognitive impairment, psychological distress and general health were assessed using the Barthel Index (BI), mini-mental state examination (MMSE) tool, Hospital Anxiety and Depression Scale (HADS) and EuroQoL Visual Analogue Scale.

Results:

Of the 150 patients included in the study, the mean Acute Physiology and Chronic Health Evaluation II score was 20.87. The leading cause of ICU admission was sepsis (40.7%), followed by acute exacerbation of chronic obstructive pulmonary disease and pneumonia (14%). The median stay in the ICU was 8 days. Mean BI significantly decreased from 79.20 at baseline to 60.17 and 64.33 in the 3rd and 6th months, respectively. The mean HADS-Depression score increased from 3.79 at baseline to 7.08 at 3rd and 5.92 at 6th month. Similarly, the mean HADS-Anxiety score increased from 4.37 at baseline to 7.44 at 3rd and 6.31 at 6th month. The mean MMSE score decreased from 24.61 at baseline to 22.26 at the 3rd and 6th months, respectively. Thus, PICS was recorded in 90% of cases in the 3rd month and 89.3% in the 6th month.

Conclusion:

The management of PICS involves a multidisciplinary approach, including physical rehabilitation, cognitive rehabilitation and psychological support.
Nurses care for everyone: But who cares for a nurse?
Authors: Olorunfemi Olaolorunpo , Akintoke Titilope Elizabeth , Owoyomi Deborah Oluwaseun , Orobode Oluwakemi Rita , Owadokun Janet Funmilola , Oahimijie Florence Onyemaechi
Published: October 2024

Nurses provide essential services across diverse healthcare settings, yet their own health and well-being are often overlooked. The physical, mental, and emotional demands of their profession can lead to burnout, stress, and various health issues. Ensuring nurses’ well-being is vital not only for their personal health but also for maintaining high-quality patient care. Therefore, this review seeks to explore the challenges nurses face in maintaining their own well-being This review synthesizes data from peer-reviewed journals, reports, and studies from the past decade. PubMed, Google Scholar, and CINAHL were searched using keywords like “nurse well-being,” “burnout,” “mental health in nursing,” and “occupational stress.” Relevant articles focusing on nurses’ well-being, challenges, and interventions were selected The findings of this review indicate that nurses face a range of challenges that adversely affect their well-being, including long working hours, inadequate staffing, exposure to traumatic events, and limited access to mental health resources. The review also highlights the significant impact of these challenges on nurses’ physical health, leading to musculoskeletal issues and chronic fatigue, as well as their mental health, resulting in burnout, anxiety, and depression. Several studies suggest that interventions such as workplace wellness programs, mental health support, flexible scheduling, and organizational changes aimed at reducing workload can positively influence nurse well-being. In Conclusion the well-being of nurses is a critical issue that requires immediate attention from healthcare institutions, policymakers, and society at large. This review demonstrates that while nurses are indispensable in caring for others, their health is often compromised due to the demands of their profession. To ensure the sustainability of healthcare systems, it is essential to implement comprehensive strategies that support the physical, emotional, and mental well-being of nurses.
An Observational Study on Female Genital Dermatoses and the Impact of Chronic Genital Dermatoses on Quality of Life in Adult Females
Authors: Nivalika A. S. A. , Prabhu Smitha S.
Published: October 2024

Background:

Female genital dermatoses (FGD) or vulvar dermatoses are a group of disorders that affect the vulva and contiguous parts. Most of the FGDs can be chronic or recurrent. Effects on Quality of life (QoL) in patients having dermatological conditions are well studied but this is not the case in vulvar dermatoses.

Aims:

We aimed to study the etiology of genital dermatoses in females attending the Dermatology Out Patient Department (OPD) and to assess QoL in females with chronic FGD (>6 weeks duration).

Settings and Design:

This was an observational study on female patients with vulvar complaints presenting to dermatology OPD. Both venereal and nonvenereal dermatoses were enrolled. QoL was assessed in females with chronic FGD using a self-administered Dermatological Life Quality Index (DLQI) questionnaire.

Statistical Analysis:

Sample size was calculated using the formula

JOURNAL/ijod/04.03/00076423-202409000-00004/inline-graphic1/v/2024-11-01T143959Z/r/image-tiff

Categorical variables were presented as numbers and percentages (%) and continuous variables were presented as mean ± standard deviation (SD) and median. The normality of the data was tested by the Kolmogorov-Smirnov test or non-parametric test. A t-test was used for the estimation of the mean.

Results:

Ninety-seven patients were included in our study; Vulvovaginal candidiasis was the most common dermatoses (22.6%); Lichen simplex chronicus (11.3%) the commonest non-venereal dermatoses. 57 (58.7%) had chronic FGD, among whom 43 (75.4%) had significant QoL impairment.

Conclusions:

Infectious etiologies predominated. There was significant impairment in QoL in females with chronic FGD.
Steri-Strip Sling Technique – A Simple Procedure for the Management of Ingrown Toenails – A Prospective Study
Authors: Ranjan Eeshaan , Arora Sandeep , Sharma Neha , Tripathy Durga M. , Neema Shekhar , Srivastava Shailendra , Agarwal Reetu
Published: October 2024

Background:

Ingrown toenail is a nail disorder that commonly affects great toenails. Surgical modalities are commonly used as first-line treatment. A conservative approach is preferable as surgical procedures lead to pain and affect routine activities. Our aim is to study the efficacy of a new conservative technique using steri-stripTM for the treatment of mild to moderate ingrown toenails as an outpatient procedure.

Methods:

Fifty patients presenting with stage 1–2 ingrown toenails were treated with the ‘steri-strip sling technique’. Steri-stripTM is inserted between the disto-lateral edge of the nail plate and nail fold and secured with an elastic bandage. The dressing is kept till the nail edge grows over the nail fold and stops penetrating the skin. Patients were reviewed every week for a month after the treatment and monthly thereafter. The final result was assessed at 6 months. The success of treatment was assessed clinically and by patient satisfaction levels.

Results:

Fifty patients were treated and followed up. Immediately after the procedure, all patients reported significant relief in pain. After 6 months, 46 out of 50 patients were satisfied with the treatment and showed no recurrence. No complications were reported.

Conclusion:

The ‘Steri-stripTM sling technique’ is a simple and effective outpatient procedure for the management of mild to moderate ingrown toenails.
A Multi-Centre Analysis of Serum IgE Levels in Atopic Dermatitis
Authors: Yu Xin , Li Linfeng
Published: October 2024

Objective:

To assess the characteristics of total immunoglobulin E (IgE) (tIgE) and allergen-specific IgE (sIgE) to 20 common allergens in 154 patients with atopic dermatitis (AD). To assess the correlation of clinical food allergy with positive food allergens’ sIgE results. We further discuss the significance of IgE as a potential biomarker for AD disease severity.

Methods:

A total of 154 AD patients were collected from 15 hospitals nationwide in China from 2019 to 2021. Serum IgE was measured using reverse-enzyme immuno capture test (REAST). Patients were required to have at least one positive sIgE (N ≥ 0.35 IU/mL). Patients were divided into groups according to different genders, ages, disease severity, and regions. SPSS 26.0 software was used for statistical analysis.

Results:

Compared with adolescent and adult AD, infancy and childhood AD showed significantly higher frequencies of positive sIgE to food allergens, including egg, cow milk, and wheat (P < 0.01). However, adolescent and adult AD showed significantly higher frequencies of positive sIgE to inhale allergens, dermatophagoides farinae, and house dust mite. In addition, sIgE in different sexes were different. Compared with women, men showed higher frequencies of positive allergen-specific IgE level to wheat, dermatophagoides farinae, and house dust mite. The most common food allergens with elevated sIgE levels were egg (71%), cow milk (39%) and wheat (32%). However, AD patients reported seafood, including crab, shrimp, and fish, as the most frequent food allergens which aggravate their AD disease in their daily life. Only 18 (12%) patients reported definite correlation of clinical practice with positive food allergens’ IgE results. Among 154 sIgE-positive patients, 99 patients had an increase of tIgE (≥60 IU/ml). TIgE levels were significantly different between mild (193 ± 239 IU/mL), moderate (170 ± 202 IU/mL), and severe (375 ± 343 IU/mL) forms of AD patients (P < 0.01). AD patients with accompanied allergic diseases showed significantly higher tIgE levels than those without accompanied allergic symptoms (280 ± 286 IU/mL vs 194 ± 248 IU/mL).

Conclusion:

Neither sIgE nor tIgE levels can be used to evaluate the condition or severity of AD. AD patients with accompanied allergic diseases showed significantly higher tIgE levels than those without accompanied allergic symptoms. Infantile AD patients are more allergic to food, while adolescents and adults are more allergic to environmental antigens. IgE tests must be interpreted by combining with clinical history to avoid unnecessary food avoidance. Early food allergen introduction for infants may be promising for the prevention of food allergies.
Clinicomycological Profile of Dermatophytosis in Tripura – An Institution Based Cross Sectional Study
Authors: Chakrabarti Syamal K. , Bhattacharjee Shibabrata , Goswami Bidhan , Sengupta Shauli , Bhattacharjee Bhaskar
Published: October 2024

Background:

In a small state like Tripura, a surge in prevalence of superficial dermatophytosis has been observed from April to September among the population of both tribal and non-tribal groups having different lifestyle, different food habit, and different socioeconomic status. Studies from different region reveal varying pattern of etiological distribution of the disease. But till date no research study has been initiated in Tripura on clinicomycological profile of dermatophytosis.

Objectives:

This study was undertaken with the objectives to estimate the proportion of different fungal species associated with dermatophytosis among the patients attending Dermatology Outpatient Department of a Tertiary care hospital of Tripura and also to determine possible association of different clinical parameters with fungal species if any.

Materials and Methods:

A total of three hundred and ninety-one (391) new cases of dermatophytosis attending Dermatology Outpatient Department of a Tertiary care teaching hospital of Tripura were included in this study from June, 2021 to May, 2022. All the specimens were assessed by direct microscopic examination and in vitro culture. Fungi were identified on the basis of their macroscopic and microscopic features with the help of lactophenol cotton blue staining and urease test.

Results:

There was a male preponderance among cases and maximum patients belonged to 21-40 years age group. Trichophyton schoenleinii was the most common fungal species (52.1%) grown in culture followed by Trichophyton rubrum (26.9%).

Conclusion:

In contrast to previous study results from different parts of India, Trichophyton schoenleinii was the most common isolated fungal species from this part of northeast India, and Tinea corporis (41.3%) was the most prominent clinical manifestation of dermatophytosis.
Hundred Most Cited Articles in Actinic Keratosis: A Bibliometric Analysis
Authors: Li Yizhi , Qi Zuoyao , Du Chichi , Jiang Guan
Published: October 2024

Many articles have been published on actinic keratosis. Bibliometric analysis helps identify the most influential studies in a particular field, Our article was to identify the 100 most frequently cited references on actinic keratosis through bibliometric analysis. As of March 1, 2020, actinic keratosis was searched in the Web of Science database and ranked in order of the total number of citations. The top 100 most cited articles in actinic keratosis were analysed. The top 100 most cited articles on actinic keratosis were published between 1982 and 2020. The largest number of articles were published in a single interval in 2001–2005. The average annual citations increased first and then decreased. The total citations were positively correlated with annual citations. The 100 articles were classified into different research focuses: pathogenesis (33%), treatment (24%), clinical features and diagnosis (15%), pathophysiology (8%), epidemiology (5%), associated diseases (2%) and others (13%). Among these 100 articles, 5 were clinical trials, 14 focused on the association between actinic keratosis and P53, and 9 reported the association between actinic keratosis and 5-aminolevulinic acid. The 100 articles were published in 38 journals by 87 different first corresponding authors from 15 different countries, mostly in the USA and Australia. Stockfleth, E from the University of Berlin published the most articles as the corresponding author. The top 100 cited references of actinic keratosis were identified and their bibliometric characteristics were analysed to lay a foundation for further research.
Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
Authors: Qiu Xiaonan , Ran Qiao , Pan Juanjuan , Tan Guozhen
Published: October 2024

Backgrounds:

A large proportion of patients with chronic spontaneous urticaria (CSU) are resistant to a standard dose of antihistamine. Acknowledged biomarkers for identifying these patients have not been determined. The neutrophil/lymphocyte ratio (NLR) has been considered as an important indicator of inflammation in chronic diseases.

Aims:

To explore whether NLR could serve as a biomarker for predicting the response to H1-antihistamine in patients with CSU.

Methods:

This hospital-based, retrospective study included 109 patients with CSU diagnosed from 2017 to 2020 in our clinic and divided them into two groups by their responses to the 2-week antihistamine therapy of standard-dose: 69 with H1-antihistamine-refractory and 40 with non-H1-antihistamine-refractory CSU. The laboratory test results were collected from the hospital information system and integrated with SPSS software.

Results:

Patients refractory to H1-antihistamine had significantly higher median NLR (P = 0.039), age (3 P = 0.021), complement C3 (P = 0.026), presence of elevated WBC (P = 0.026) and elevated monocytes (MONO) (P = 0.045) and significantly lower IgM (P = 0.022). The binary logistic regression model revealed that NLR was significantly associated with H1-antihistamine-refractory of CSU (odds ratio (OR) 1.717, 95% confidence interval (CI) 1.065–2.766, P = 0.026), which was consistent with that after adjusted for potential confounding factors including age, complement C3, presence of elevated WBC and MONO, and IgM (OR 1.681, 95% CI 1.019–2.773, P = 0.042).

Conclusion:

Our results showed a strong and significant association between higher NLR and H1-antihistamine resistance in CSU, suggesting that NLR may be a potential biomarker for predicting the response to H1-antihistamine therapy in patients with CSU.
Development and sensory evaluation of Moringa oleifera–enriched snack bar for micronutrients deficiency in adolescents
Authors: Sandhya Joseph Joy , Kanniammal Chinnathambi
Published: October 2024

Background: This study aimed to assess the sensitivity, texture, and nutritional quality of Moringa-enriched wheat bars to improve the nutritional status of the adolescent population. Moringa, which has gained a nutraceutical perspective from various pieces of research, is being incorporated into food product development. Moringa leaves from the “miracle tree,” a habitat of origin from South Asia, are enriched with macro- and micronutrients that combat both malnutrition and hidden hunger (micronutrient deficiency). The phytochemical properties of Moringa leaves, such as their antidiabetic, anticancer, antiulcer, antimicrobial, and antioxidant properties, make them a superfood. Purpose: This study aimed to develop a snack bar incorporating Moringa flour that aligns with adolescents’ snacking preferences while also providing an adequate supply of iron. Materials and Methods: Moringa leaves were processed using the conventional method to obtain sieved, coarse Moringa leaf flour. Moringa oleifera snack bars were prepared at concentrations of 15% (M1), 10% (M2), and 5% (M3). The snack bar that shows high acceptability was subjected to nutritional evaluation to determine the specific iron content. Results: Organoleptic evaluation of M3, M2, and M1 by 24 semitrained personnel identified M3, at a 5% concentration, as the most acceptable. The nutritionally analyzed M3 
M. oleifera snack bar contained protein (12.1 g), fiber (9.18 g), iron (10.1 g), magnesium (112 mg), calcium (345 mg), zinc (19.4 mg), and a good source of energy (447 kcal). Discussion:
Moringa, as a nutraceutical agent, in addition to its average dietary value utilized in nutritional snack bar development, aids in health promotion and disease prevention among adolescents with unhealthy food habits, such as consuming junk food. Conclusion: The M. oleifera snack bar supplies the recommended dietary allowance of micronutrients and macronutrients and contains antioxidants, such as flavonoids.
Quantitative analysis of the impact of seasonal cyclicality on serum 25-hydroxycholecalciferol concentration in Northwest Arctic
Authors: Kaniki Freddy R. , Jonathan Redlinski , Mann Denzel C.
Published: October 2024

Background: 25-hydroxycholecalciferol also known as 25-hydroxyvitamin D plays a vital role in numerous physiological functions within the human body, and its deficiency is associated with conditions such as osteoporosis, cardiovascular diseases, autoimmune disorders, and certain cancers. In Alaska, sunlight exposure is a critical factor that influences vitamin D levels in the population. Methods: This study involved a review of serum 25-hydroxyvitamin D [25(OH)D] levels from January 2014 to June 2018 for Alaska residents, including individuals aged 18 years or older who were permanent residents of the area. The exclusion criteria comprised acute or chronic liver or kidney dysfunction, anemia, cancer history, absorption deficiency, and vitamin D supplementation exceeding 500 IU/day within 90 days before the blood draw. Results: A total of 304 participants, including 107 males (35.2%) and 197 females (64.8%), with a mean age of 50.88, were included. The overall mean serum level of 25(OH)D was 22.7 ± 9.89 ng/mL. Females exhibited a higher mean level (23.40 ± 10.24 ng/mL) than males (21.03 ± 9.05 ng/mL) (P <0.05). Participants older than 60 years had a higher average level of 25(OH)D (26.52 ± 10.28 ng/mL) compared to those younger than 45 years (19.85 ± 9.27 ng/mL) (P < 0.05). Seasonal variations were observed, with levels below 20.0 ng/mL from October to March, below 30.0 ng/mL from April to May (insufficient), and slightly above 30.0 ng/mL (desirable) from June to August (P < 0.0001). No significant intercommunity differences were found. Only 24.3% of the participants had a desirable vitamin D level. The association between the 25(OH)D level and the solar zenith angle was linear and markedly negative (r = −0.924; P < 0.0001). Conclusions: This study demonstrates seasonal variations in 25(OH)D serum levels among the Alaska population. Further exploration of factors such as skin pigmentation, daily vitamin D intake, and body mass index is necessary to comprehensively understand the variation in 25(OH)D serum levels in this region.
A protocol for systematic review and meta-analysis on the efficacy and safety of nutraceuticals with special reference to Ahara Dravya (food articles) in type 2 diabetes mellitus
Authors: Shibna Muttungha Valappil , Harti Shivakumar S. , Kulkarni Medha , Kumar Anil
Published: October 2024

Different Aushadi (drugs) are indicated for Prameha (diabetes mellitus) in Ayurveda, with some serving as nutraceuticals. Still, their efficacy and safety need to be investigated. A systematic review will be conducted, including both published and relevant unpublished randomized controlled trials of selected nutraceuticals in diabetes mellitus. For the meta-analysis, only published studies will be considered. Searches will be executed in PubMed, Cochrane Central Register of Controlled Trials, Shodhganga: A reservoir for Indian theses, Digital Helpline for Ayurveda Research Articles, and AYUSH Research Portal, along with dissertation and thesis works in the public domain, unpublished studies from websites of university/institution, as well as other possible sources. Two reviewers will independently select studies, extract data, and synthesize results. A third reviewer will address disagreement. Robinson Risk of Bias 2 tool will be used to evaluate bias. Meta-analysis of extracted data will be performed through Review Manager Web software focusing on fasting blood sugar levels and glycosylated hemoglobin and reported adverse events if any. The strength of the shreds of evidence and reliability will be analyzed using the Grading of Recommendations, Assessment, Development, and Evaluation system. Findings will be presented using appropriate statistical methodology and interpreted accordingly. This study will comprehensively assess the selected nutraceuticals in type 2 diabetes mellitus (T2DM), demonstrating their efficacy and safety in preventing and managing T2DM. The conclusion may be drawn based on the resultant outcome of the impact of selected nutraceuticals on T2DM. PROSPERO registration number: CRD42024529448.
Medicinal use of the Dadima (Pomegranate) fruit in Ayurveda: A comprehensive review
Authors: Patel Vivek Kumar , Acharya Rabinarayan
Published: October 2024

Ayurveda describes Ahara (food) as the best preventive medicine and considered Mahabhaishajya, the superior medicine in Ayurveda. Dadima (Punica granatum L.) of family Lytheraceae is listed among the fruits in the Phala category, which is a type of Ahara Varga, and is recommended both as an Ahara and as Aushadha (medicine) for various health conditions. Use of Dadima as an Aushadha in 530 formulations with indications and a detailed review on the use of Dadima in Ahara Kalpana (dietetic preparations) mentioned in Ayurveda have already been reported. We aimed to review and compile the 530 Aushadha Kalpana (medicinal formulations) of Dadima. The present study involves a comprehensive compilation and analysis of information related to Dadima (Punica granatum L.) and its therapeutic uses as documented in 8 Samhita Grantha, 23 Nighantu and 44 ayurvedic compendias. The therapeutic uses of Dadima were then systematically classified based on the Srotasa (channels or systems). Among 530 Aushadha Kalpana of Dadima, Churna (159) is found maximum dosages form. A maximum of 158 formulations have been indicated in diseases of Annavaha Srotas. Sixteen (16) formulations are indicated in general medical conditions. Twelve formulations are indicated for the management of Urdhvajatrugata Vyadhi. One formulation is indicated for its use as Rasayana, while eight formulations are indicated for use as Vajikarana. Dadima, has been used both as food as well as medicine, with a wide range of clinical indications proving it to be a potent nutraceutical.
Development of ready-to-eat nutri bar from black soybean (Kala Bhatt) and millets: Exploring traditional foods of Uttarakhand
Authors: Gupta Divya , Harti Shivakumar Shankar
Published: October 2024

BACKGROUND:

Malnutrition, particularly insufficient intake of certain micronutrients, limits a child’s ability to survive, grow, and develop. It increases the rate of morbidity and mortality among the most vulnerable populations, which significantly lowers their productivity as an adult. While adopting strategies to tackle malnutrition, regional diets must also be considered.

METHODS:

Based on the nutritive values, some staple ingredients from Uttarakhand, such as black soybean, finger millet, and foxtail millet, have been utilized to develop a ready-to-eat (RTE) packaged nutri-bar. A sensory characteristic evaluation of the product has been carried out. The product has been evaluated in the laboratory for its proximate composition, some minerals, presence of heavy metals, pesticide, and shelf-life.

RESULTS:

The proximate composition of RTE nutri-bar includes protein content 18.16%, carbohydrate content 54.82%, total fats 12.13%, moisture 12.21%, and an ash value of 2.68%. Dietary fiber content is found to be 8.09%, and the energy evaluated for a 100-g sample is 401.09 Kcal. Calcium is present in very good amounts, that is, 478.44 mg/100 g. The amount of pesticide residues and added anti-oxidants are found below the level of quantification.

CONCLUSION:

The use of traditional foods in local communities has declined, but it may be revived with an appropriate framework, policy, and information sharing in conjunction with contextual food-based treatments.
Awareness, perception, and practices of Ayurveda doctors toward FSSAI (Ayurveda Ahara) Regulations Act 2022: A cross-sectional survey
Authors: Kapoorchand Hemalatha
Published: October 2024

BACKGROUND:

The Food Safety and Standards Authority of India (FSSAI; Ayurveda Ahara) Regulations Act 2022 was established by the FSSAI to regulate the safety, quality, and labeling of Ayurvedic food products. This Act is specifically designed to distinguish Ayurvedic food products from Ayurvedic medicines and proprietary drugs, ensuring that they meet strict standards of safety and authenticity. This study aims to assess the knowledge, attitudes, and practices of Ayurvedic doctors regarding the FSSAI (Ayurveda Ahara) Regulations Act 2022. It seeks to understand their level of awareness and implementation of these regulations in clinical practice and to identify areas for further education or training.

METHODS:

A cross-sectional online survey was conducted from April 4, 2024, to June 20, 2024, using Google Forms. The semi-structured questionnaire included 31 questions divided into four sections covering knowledge, attitudes, and practices toward the FSSAI Ayurveda Ahara regulations. The survey included 148 qualified Ayurvedic doctors from across India. Descriptive analysis of the data was performed, and the results were expressed as percentages.

RESULTS:

Out of 148 respondents, 85.1% were aware of the FSSAI Ayurveda Ahara regulations, but only 14.2% were thoroughly familiar with them. Most respondents had acquired knowledge through professional associations (83.7%) and medical journals (72.9%). While 81.8% of the doctors believed in the significant role of the regulations in public health, practical challenges such as the availability of compliant products and patient adherence were identified. Only 54.7% of doctors were likely to incorporate compliant Ayurvedic food products into their treatment recommendations.

CONCLUSION:

The study highlights the need for enhanced education and dissemination of detailed information about the FSSAI (Ayurveda Ahara) Regulations Act 2022. Despite positive attitudes toward the regulations, practical application is hindered by significant challenges. Addressing these gaps through targeted training programs, improved information dissemination, and supportive measures is essential for effective implementation.
A narrative review on the role of naturopathy in the management of diabetes mellitus
Authors: Mooventhan A. , Gowthami R. , Krishnamurthy Dhansri , Nivethitha L.
Published: October 2024

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Alternative therapies with antihyperglycemic effects are increasingly sought after by patients with diabetes. Some potential alternative treatments for diabetes include yoga and naturopathy, which encompass hydrotherapy, massage therapy, mud therapy, acupuncture, and more. While there are review articles on various alternative therapies for diabetes individually, no known reviews have reported the collective effect of naturopathy therapies, including acupuncture, on diabetes. This comprehensive review was conducted using PubMed/Medline and Google Scholar electronic databases, aiming to provide evidence-based effects of naturopathy therapies such as hydrotherapy, mud therapy, fasting therapy, diet therapy, massage therapy, magnetotherapy, acupuncture, and reflexology, commonly practiced in India, on the management of diabetes. The literature suggests that these treatment modalities significantly improve type 2 diabetes mellitus (T2DM). However, more studies are needed to understand the comprehensive effects of administering these treatments, either individually or in combination, in effectively treating T2DM.
A rare case of respiratory syncytial virus bronchiolitis with spontaneous bilateral pneumothorax in an infant
Authors: Mishra Reshmi , Rup Amit Ranjan , Jain Mukesh Kumar , Sahoo Bandya , Patnaik Sibabratta
Published: October 2024

The most common self-limiting viral infection of the lower respiratory tract in the pediatric population is bronchiolitis, which most commonly affects infants. In most cases, respiratory syncytial virus (RSV) is the causative agent. In general, the recovery occurs within 5–7 days without any complications. Spontaneous pneumothorax is one of the rare and less-reported complications of bronchiolitis. We report a case of a male child aged 5 months with bilateral spontaneous pneumothorax (PNO) with subcutaneous emphysema following bronchiolitis. The nasopharyngeal swab was positive for RSV, and all other investigations ruled out any underlying illness causing spontaneous PNO. Although it is a rare complication of bronchiolitis, it may occur late during the disease course. Pediatricians must be aware of this life-threatening complication, which may develop during the disease course despite an early clinical improvement.
Teflon flu: Is it a rising concern of only developed country?
Authors: Pati Sanghamitra , Das Dasarathi , Sinha Abhinav , Mahapatra Pranab , Turuk Jyotirmayee
Published: October 2024

Teflon flu also known as polymer fume fever is a temporary flu-like illness caused by inhaling fumes released when polytetrafluoroethylene (PTFE), the chemical used to make non-stick coatings like Teflon, is heated to very high temperatures. This condition typically occurs when non-stick cookware is overheated to above 500°F (260°C), releasing fumes that can cause symptoms in humans. Teflon flu is manifested with fever, chills, headache, body aches, cough, sore throat and shortness of breath which usually appear within a few hours of exposure and may last for a day or tw. Teflon flu is generally not considered dangerous for healthy individuals but repeated exposure could have more serious effects. Although in India cases are not widely reported as in countries like the U.S., India’s medical community, including the Indian Council of Medical Research has advised caution and advocated use of earthen pots for cooking. Here we discuss in detail the causes, and ways to prevent Teflon flu in Indian context.
Evaluation of Rajapravartani Vati and Saraswatarishta in dysmenorrhea: A study protocol for a single-arm, multicenter, and community-based study
Authors: Mata Sunita , Makhija Deepa , Manathottathil Aparna , Tripathi Arunabh , Rana Rakesh Kumar , Rana Kiran , Sharma Abha , Joshi Vandana , Chandrasekhara Rao Bhogavalli , Srikanth Narayanam , Acharya Rabinarayan
Published: October 2024

BACKGROUND:

Primary dysmenorrhea is one of the major public health concerns that affects about 50%–90% of women. Even though the condition is associated with psychosomatic symptoms, conventional management is mainly focused on reducing pain only. This study is designed to evaluate the potential of Ayurvedic management in dysmenorrhea, addressing both physical and psychosomatic aspects of the condition.

OBJECTIVE:

The study aims to assess the effectiveness and tolerability of Rajapravartani Vati and Saraswatarishta in dysmenorrhea.

MATERIALS AND METHODS:

This study is a prospective, single-arm, open-label, and multicenter clinical study involving 10 centers. According to pre-defined selection criteria, a total of 460 participants with primary dysmenorrhea in the age range of 14–25 years will be enrolled from the study sites. All participants will receive Rajapravartani Vati 500 mg twice daily orally starting from 7 days before the expected date of the menstrual cycle up to the third day of menstruation for three consecutive menstrual cycles. Saraswatarishta will be given, a 10 mL dose with 20 mL of lukewarm water at bedtime for 84 days. The participants will be followed for further 3 months to assess the sustained effect of the intervention. The change in pain, disease-specific symptoms, and psychosomatic status will be assessed for three consecutive cycles by using the Visual Analog Scale score, Working Ability, Location, Intensity, Days of pain, Dysmenorrhea score, and Moos Menstrual Distress Questionnaire, respectively. The tolerability of the drugs will be assessed through the occurrence of treatment-emergent adverse events during the study period, and compliance to study interventions.

DISCUSSION:

This study will help in providing evidence-based scientific data related to the clinical evaluation and tolerability of Rajapravartani Vati and Saraswatarishta in dysmenorrhea.

TRIAL REGISTRATION:

CTRI/2023/07/054617 dated July 3, 2023.
Management of varicose ulcer complicated with class II cellulitis through multimodal Ayurvedic interventions: A case report
Authors: Peethambaran Sinimol Thekkekkoottumughath , Sumedhan Varsha , Somaraj Lisha
Published: October 2024

This case report describes a 45-year-old female homemaker with a varicose ulcer complicated by class II cellulitis on her right lower limb. The ulcer, which appeared 26 days before presentation to OPD measured 7.5 cm × 3 cm × 0.2 cm and was located midway between the popliteal fossa and the ankle joint. It was associated with pain and serous discharge, and the surrounding skin exhibited erythema (redness), indicative of cellulitis. An emergency Doppler study of the venous system of the right lower limb was done, which ruled out deep venous thrombosis. As no relief was obtained from the external application of povidone-iodine ointment for about 2 weeks as suggested by conventional treatment, the patient came to the outpatient department of Regional Ayurveda Research Institute, Thiruvananthapuram, Kerala, India. A diagnosis of varicose ulcer complicated with class II cellulitis was established based on the clinical examination, relevant laboratory investigations, and detailed patient history. A comprehensive multimodal Ayurvedic treatment was administered, including internal medications like Panchanimbakwatha, Kaisoraguggulu, Triphalaguggulu, Punarnavadi Paneeya, and Madhusnuhi Rasayana for 20 days. Tablets Mahasudarshanam and AYUSH-64 were given for the first 2 weeks to manage cellulitis, which subsided during this period. The grading of venous insufficiency was C6 according to the “Clinical, Etiology, Anatomic, Pathophysiology classification” on day 1, improved to C1 by day 42 following treatment, indicating significant recovery. According to the “National Pressure Injury Advisory Panel Classification,” the ulcer was graded as Stage 3 on the day with significant improvement by day 42, where only mild discoloration of the overlying skin remained. The medications used for treatment had properties, such as Raktashodhaka (blood purifying), Krimighna (antimicrobial), Soolahara (anodyne), Vranashodhaka (wound-cleansing), Vranaropana (wound-healing), Sophahara (anti-inflammatory), and Pittahara (alleviate Pitta Dosha). In Ayurveda, venous ulcers can be considered as Siragranthijanyavran and cellulitis as Sirashotha. This case highlights the importance of timely intervention in the management of varicose ulcers complicated by cellulitis. The Ayurvedic therapeutic regimen demonstrated in this case offers an effective approach to managing complicated cellulitis in varicose ulcers, emphasizing the potential of Ayurveda in treating chronic conditions when addressed promptly.