bluuebunny/crossref_metadata_2025 huggingface dataset:
Trayamana (Gentiana kurroo Royle): A Substitution or an Adulteration to Katuki (Picrorrhiza kurroa Royle ex Benth.)
Authors: Karki Anila , Rath Sudipta Kumar , Sharma Tarun
Published: December 2023

ABSTRACT

Katuki (Picrorrhiza kurroa Royle ex Benth.) belonging to the family Scrophulariaceae, is one of the most important herbs found in the Himalayan Region at an altitude of 3000–5000 m above the Sea level. It has been used for the management of different diseases such as fever, diabetes, abdominal disorders, and hemorrhoids and most of the formulations such as Arogyavardhini vati, Kumaryasava, and Maha Sudarsana vati also have Katuki. The market demand of Katuki is more and the production is less, so it is either substituted or adulterated with different similar-looking and similar-acting drugs. Mostly, the root of Gentiana kurroo Royle is used in place of Katuki in the market. Katuki and Trayamana rhizomes are subcylindrical to quadrangular and rigid in shape. So, they look similar. Cork cells, tracheids, fibers, etc., are also present in both herbs. Both are bitter in taste and are used in fever, stomachache, dysentery, etc. Hence, an effort has been done to analyse whether Trayamana is actually a substitute or an adulteration depending on rasa, guna, veerya, vipaka, and karma and chemical compounds.
A Critical Review to Understand the Role of Ayurveda in Management of Opium Withdrawal
Authors: Kumawat Bindu , Sharma Anita , Kumawat Dinesh Kumar , Das Kishore
Published: December 2023

ABSTRACT

Addiction is defined as a persistent, uncontrollable psychological or physiological dependence on a substance or behavior. It is a long-term brain condition that results in obsessive drug use despite negative effects. Addiction has general as well as negative social effects on people. Any type of drug addiction that is abruptly stopped can result in a psychosomatic condition. Even though contemporary medicine has developed several methods and molecules to combat these, the desired result is far from reality. Hence, it is the need of the hour to find a better solution to combat this drug addiction by exploring the principles of Ayurveda and also by following the drugs and regimen mentioned by the Acharyas in the classics. The information for this article has been gathered from my personal clinical experiences as well as from several completed clinical studies about drug addiction, withdrawal, and its management that has been incorporated in index and nonindex journals. The Padanshik kram is a special technique mentioned in Ayurveda to stop any substance (dangerous or nondangerous) that is homologous to humans by the process of tapering gradually. To replace and tapper up Sameer Gaj Kesari Ras, Vishtinduk Vati in opium withdrawal treatment can be very much beneficial. Along with the above medication, following methods such as psychological counseling, Abhyanga, Shirodhara, Yoga, meditation, and Satvavajaya Chikitsa can also be very much beneficial. Thus, in addiction and withdrawal due to substances containing opium or its derivatives, the Ayurvedic way of treatment can be one of the most effective modes of treatment.
Ayurvedic Management of Psychogenic Nonepileptic Seizures - A Case Report
Authors: Mamidi Prasad , Gupta Kshama
Published: December 2023

ABSTRACT

Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal changes in behavior, consciousness, and autonomic function that resemble epileptic seizures (ES). Disturbances of motor, sensory, autonomic, cognitive, and emotional functions could be seen in patients with PNES. PNES is a heterogeneous condition and has a very diverse etiology. Patients with PNES are often misdiagnosed and are exposed to unnecessary antiseizure medications. The present case report deals with a patient diagnosed of having PNES and opted Ayurvedic treatment for better and sustained relief. The purpose of presenting this clinical case report is to explain the difficulties that are generally involved in the Ayurvedic diagnosis and management of PNES. Yoshapasmara or Yoshapatantraka is not a reliable and authentic Ayurvedic diagnostic entity for PNES. The comorbidity of ES and PNES is well recognized in Ayurveda. ES can be correlated with Doshaja Apasmara and PNES with Agantuja Apasmara. The Doshaja and Agantuja Apasmaras are not the discrete, independent diagnostic entities; rather, they are at the both ends of the same spectrum. The patient was diagnosed as having Agantuja Apasmara, treated with Ayurvedic medicines (Saraswata Choorna and Panchagavya Ghrita) and procedures (Nasya and Dhoomapana). The patient got clinically meaningful improvement with Ayurvedic treatment protocol, especially in headache, seizure episodes, and in depressed mood. Agantuja Apasmara is the most suitable Ayurvedic diagnosis for PNES and Ayurvedic treatment seems to be promising in the management of PNES. The present study findings cannot be generalized and further clinical trials with large sample size and with long term follow-up are required.
A Physiological Aspect of Saman Vayu in Relation to the Enteric Nervous System
Authors: Pandey Vinita , Vyas Suwarna Deepak , Vyas Deepak Manmohan
Published: December 2023

ABSTRACT

Ayurveda is the holistic science of life. Its basics revolve around the tridoshas, namely Vata, Pitta, and Kapha. A perfect balancing of the Tridosh is required for the body to function normally. However, even the slightest movements of Pitta and Kapha are governed by Vata that establishes the dependency of these two on the Prana of life. Saman Vayu is one of the five types of Vata which is situated nearer to the Jatharagni and is known to provide strength to it. It, therefore, aids in the process of digestion. The second brain (enteric nervous system [ENS]) of the human body has gained prime importance in recent years. It is due to the significance it holds in relation to many diseases. The ENS and its close communication with the brain, all together govern the physiological activity of the gastrointestinal tract. The basic functions of Saman Vayu such as Anna Grahan, Pachan, Vivechan, and Munchan can be correlated with the functions of ENS. The symptoms of Vaikrut Saman Vayu also seem to relate with the disorders affecting the enteric neurons. Thus, here is an attempt to formulate a functional correlation between Saman Vayu and ENS.
Study on Avascular Necrosis of Femoral Head in Ayurveda with Its Management – A Case Series Study
Authors: Narzary Jejulee , Baishya Anup , Das Chayanika
Published: December 2023

ABSTRACT

Avascular necrosis (AVN) often affects bones with a single terminal blood supply, such as the femoral head, carpals, talus, and humerus. Femoral head is one of the most common sites for AVN and its cause can be primary or secondary to other pathology. It occurs because of an interruption in the blood supply to the femoral head that causes bone death. It was first described in 1738 by Munro. Treatment depends on the severity of the disease, as well as the patient’s age and general health. Treatment outcomes correlate directly with the stage of the disease and no medical treatment has proven effective in preventing or arresting the disease process. Hence, in this case series study, four patients presenting with similar complaints of pain and stiffness in the hip joint (right/left/bilateral) and difficulty in walking and climbing stairs were studied. All of the patients were adults above 30 years and included two male and two female patients. Examinations of the patients were done both according to modern and Ayurvedic parameters. The subjective and objective criteria assessed before and after treatment included the number of joints involved, gait, muscle wasting, straight leg raise test, pain, tenderness, stiffness, and decreased range of motion. Astavidha and Dashavidha Pariksha were done for all the patients. Detailed history was taken to evaluate the specific Nidanas and based on the Lakshana and the Nidanas, the involved Dosha, Dushya, Agni, and Srotas were evaluated and the Samprapti was designed accordingly for each patient separately. Diagnosis was confirmed on X-rays or magnetic resonance imaging of the hip joints. These cases were studied taking the etiologies, the clinically manifested signs and symptoms into consideration and correlated with the disease Asthi-Majjagata Vata mentioned in the classics. Ayurvedic management principles were adopted accordingly such as Nidan Parivarjanam, Deepan-Pachana, Snehapana, Abhyanga, Nadisveda, and Basti along with internal medicines and mobilization exercises. The symptoms such as pain and stiffness improved with just 7 days of treatment and by the completion of the Tiktakshira Basti, the patient had significant improvement in the signs and symptoms such as pain, stiffness, tenderness, and restricted mobility. On discharge, all the patients had overall health improvement. Follow-up of the patients was advised after 15 days from discharge.
A Comparative Clinical Study on Efficacy of Ahiphenmochanadi Vati and Sameeragaja Kesari Rasa in Opiate Withdrawal Symptoms
Authors: Vishnoi Rinkesh , Sharma Anita , Kadu Vaidya Amol , Yadav Sunita
Published: December 2023

ABSTRACT

Background:

Ahiphen Vyasan (opium and its derivatives addicts) is a common addiction in Rajasthan, Punjab, and Haryana. The main symptoms of opiate withdrawal are Nadimandata (resting pulse rate), Swed Pravrutti (sweating), Arti (restlessness), Netratarak Vispharana (dialeted pupil size), Asthi or Sandhi Shoola (bone and joint pain), Nasasrava or Ashrusrava (running nose or tearing), Agnibaishamya (gastrointestinal upset), Kampa (Tramor), Jrimbha (Yawning), Vishada (feeling of unhappiness – depression), and Romanch (horripilation). Kuchla (Strychnos nux-vomica) has been mentioned as antidote for opium.

Aim and Objective:

The intention or aim here is to combat the opiate withdrawal effects by using opium in tapering method along with S. nux-vomica. For which the study refers to evaluate the efficacy of Ahiphenmochnadi Vati and Sameer Gaja Kesari Rasa in opium withdrawal symptoms.

Material and Method:

Open-labeled randomized clinical trial of thirty patients of either sex. Intervention: Group A (15 patients) was given Ahiphenmochnadi Vati, whereas Group B (15 patients) treated with Sameer Gaja Kesari Rasa. Duration: 1 month. Intragroup comparison of group A and Group B were found statistically extremely significant.

Result:

Intergroup comparison of Group A and B were found statistically significant.

Conclusion:

The present study supports the use of Ahiphenmochnadi Vati and Sameer Gaja Kesari Rasa in treating Ahiphen Vyasan with good acceptance by all treated patients.
Ayurvedic Management of Ekakushtha (Psoriasis) by Single-Drug Therapy
Authors: Kumar Bishan , Hooda Mamta
Published: December 2023

ABSTRACT

Well-defined erythematous plaques with silvery-white scales are the hallmarks of the chronic, noninfectious inflammatory skin disorder known as psoriasis. Due to recurrence, it has remained a serious problem. There is no treatment for this condition. The Ayurvedic diagnosis is Ekakushtha, which is a Vata-Kappa-predominant Kshudrakushtha. A 30-year-old female patient visited Ocean Healing Centre in Karnal, India, with complaints of Keshbhoomi rukshata (dryness of scalp), flanks/scales over the back, head, hands, and legs, and itching over the past 3 years. She has taken steroidal medication, but there has been no improvement. Kutaja Kwatha (Wrightia tinctoria), 40 mL BD, was used to treat the ailment before meal internally and Bruhath Dantphladi taila (W. tinctoria) for external application five times a day. The patient was advised to take a capsule of Mahatikta Ghrita once a day after treatment for 1 month. In Avara Satva or Avara Bala patients, Shodhan is contraindicated, in that condition, this Shamana chikitsa is very beneficial and easy to follow. As Kutaja is tikta rasa pradhan and having Rakta dhatu Shodhan property, that’s why Kutaja is used externally and internally in this study and Mahatikta Ghrita prevents dryness of skin as well as prevent relapsing of symptoms. The treatment protocol was found effective in the restoration of normal skin and prevention of recurrence of psoriasis.
Polycystic Ovarian Syndrome and their Management through Yoga Therapy: A Narrative Review
Authors: Mishra Shringarika , Patel Garima , Tiwari Mamta
Published: December 2023

ABSTRACT

Polycystic ovary syndrome (PCOS) is a common metabolic and endocrine disorder among women, with a prevalence ranging from 2.2% to 26%. PCOS is associated with unhealthy lifestyle and physical inactivity affects disproportionately. Yoga is mind-body stress-relieving therapy, and by the different interventions researchers are increasing their focus on the benefits of yoga for PCOS. It is also important for physicians and health -care professionals to understand the therapeutic efficacy of yoga intervention, in terms of its type, duration, and frequency on various PCOS risk factors. After discussing the pathogenesis of PCOS, the present review summarizes the current scientific understanding of the effects of yoga on PCOS and the risk factors associated with such as obesity, stress, and insulin sensitivity. An extensive search in Google scholar, Medline, PubMed, Scopus, and Cochrane Library was searched using the keywords “Polycystic Ovarian Syndrome,” “Obesity,” “Stress,” “Epidemiology,” “Pathophysiology,” “Diagnostic criteria,” and “Effect of yoga.” Based on these preliminary results, yoga therapy reduces the risk factor associated with the PCOS that may be suggested as a safer and affordable therapy for PCOS. More rigorous research and well-designed trials that have a higher standard of methodology and evaluate yoga’s long-term impacts on PCOS are needed. Understanding yoga’s biochemical and molecular mechanisms of action on various metabolic pathways is also needed.
Making Ayurveda a Dependable Health-care System in India – Challenges and Potential Solutions
Authors: Das Kishore , Sharma Anita , Kumawat Dinesh Kumar , Kumawat Bindu
Published: December 2023

ABSTRACT

The subject of mainstreaming Ayurveda has recently come to light in an effort to make the age-long traditional system of medicine as one of the most dependable, respectable, and responsible systems of medicine in India. To improve the health-care delivery scenario of India, mainstreaming of Ayurveda either in standalone or integrative way through scientific and rational approaches way is very much important. Variety of government strategies has been applied to achieve the goal but due to unclear policy and disparities in approach, the mainstreaming of Ayurveda is yet to reach the desired target. This article is an attempt to highlight the importance of Ayurveda in the present era in India with the challenges and potential solutions. The information regarding this article has been collected from various indexed and nonindexed journals along with information from relevant government websites. Proper utilization of the services of Ayurvedic physicians in the government sector, supply of adequate standard Ayurvedic drugs, evidence-based research, and proper skill development training of Ayurvedic physicians to cope up with the recent development in the medical field will not only help in mainstreaming of Ayurveda but will also boast up the health scenario of present India.
A Case Study on the Management of Beejadushtijanya Pandu (Thalassemia Major) in Children with Gandhakadi Yoga and Sharpunkha Vati
Authors: Chaudhary Naresh , Kori Virendra , Bhinde Sagar , Patir Nikita
Published: December 2023

ABSTRACT

Thalassemia is a genetically passed down blood disorder in which the body makes an abnormal form of hemoglobin that leads to anemia, several organ failures due to iron overload, and even death. Exact correlation with thalassemia is not available in Ayurveda; however, on the basis of symptomatology and prognosis, it may be correlated with Beejadushtijanya, Adibala Pravrutta (~hereditary anomalies), and Sahaja Vyadhi (~congenital disorder) and can be coined as Beejadushtijanya Pandu. It can be understood that Pitta Pradhana Tridosha affects the functions of Rasa Dhatu. In thalassemia major, iron overload occurs due to the early destruction of red blood cells, which results in high serum ferritin levels in the blood. Gandhakadi yoga is suggested for Loha Sevanajanya Vikara Prashamana (~iron overloading management) in Ayurveda Prakash. Moreover, Sharpunkha is mentioned to have Yakritaghna (~hepatoprotective), Pleehaghana (~splenoprotective), Vishapaha (~antipoisonous), and Jwarghna (~antipyretic) properties in Bhav Prakash Nighantu. The present case was of a 7-year-old female child who was diagnosed with thalassemia major before 6 years. Chief complaints were severe pallor, chronic fatigue, and enlarged liver and spleen. Other complaints were puffiness of the eye, loss of appetite, and loose motion. She is on regular blood transfusions every 20–22 days, deferasirox 500 mg once a day (OD), and folic acid 5 mg OD. The serum iron and serum ferritin values were above normal limits, according to the investigation. At the end of 12 weeks of internal administration of Gandhakadi Yoga and Sharpunkha Vati as adjuvants, her blood report and the symptoms of the disease showed very promising results.
Effect of pre-treatment on induction of anaesthesia with etomidate: A comparison between dexmedetomidine and midazolam–fentanyl combination
Authors: Sojitra Nalin P. , Kantharia Bansari N. , Nakum Rajesh , Padsala Krishna
Published: December 2023

Background:

Because of its prompt onset of action and clearance, the use of etomidate as an anaesthetic induction agent is increasing in clinical practice. However, etomidate-induced myoclonus (EIM) remains a prevalent issue. Such myoclonic activity can be prevented by the administration of drugs that inhibit subcortical neuronal activity.

Aims:

This study was designed to compare the effects of pre-treatment with dexmedetomidine and fentanyl–midazolam combination on EIM as well as on attenuation of pharyngolaryngeal reflex.

Materials and Methods:

One hundred adult patients with the American Society of Anesthesiologists Grades 1 or 2 posted for elective surgery were enrolled and were randomly divided into two groups of 50 patients each. Group D received dexmedetomidine (1 μg/kg) in over 10 min and Group F received midazolam (0.02 mg/kg) + fentanyl (2 μg/kg) intravenously. Haemodynamic variables, incidence and severity of myoclonus were recorded.

Results:

The incidence of EIM was lower in Group F (26%) when compared to Group D (40%), but the difference was not statistically significant (P = 0.28). Eighteen per cent of the subjects in Group F had Grade 1 myoclonus as compared to 32% of Group D, whereas 8% of the subjects in Group F had Grade 2 myoclonus as compared to 6% of Group D. None of the patients in Group F experienced myoclonus of Grade 3, whereas 2% of the subjects had Grade 3 myoclonus.

Conclusion:

Administration of a combination of fentanyl and midazolam, along with dexmedetomidine as a pre-treatment, has been found to be an effective strategy for mitigating the incidence of myoclonus.
Usage of artificial intelligence tools in community-level X-ray triaging for tuberculosis in Chennai, Tamil Nadu
Authors: Prabakaran J. , Sangeetha S. , Desamani Kiran Kumar , Sakthivel P. , Ravishankar K. , Lavanaya J.
Published: December 2023

Background:

The end tuberculosis (TB) strategy emphasises early and correct diagnosis of TB. Chest X-ray (CXR) is an essential tool for triaging and screening TB and confirming the diagnosis in fewer situations. Greater Chennai Corporation (GCC) implemented Mobile Diagnostic Units (MDUs) retrofitted with X-rays with artificial intelligence (AI).

Objectives:

The study’s objectives were to determine the X-ray triaging performance in MDU vans using AI tools in GCC, Tamil Nadu.

Materials and Methods:

AI is to increase access to quality TB screening diagnostics in high-risk locations. Genki AI-powered Public Health Screening Solution from Deeptek used for TB triaging after uploading CXR images from MDU. X-ray has been uploaded in AI software once taken, and the results were available immediately after uploading. The radiologist reports helped to take further courses of action.

Results:

A total of 79,462 CXR was taken from April 2019 to April 2022 from 7 MDU vans. Amongst 3.4% were identified as suggestive of TB, 1.4% old TB, 0.89% COVID (from 2020) and 7.2% other chest abnormalities. The sensitivity of CXR-AI was 0.98 (95% confidence interval [CI]: 0.97, 0.98), and the specificity was 0.96 (95% CI: 0.96, 0.97).

Conclusion:

AI helps in faster triage for further public health action and eliminates the challenges of the availability of functional X-rays, interpretation and reporting.
Wind turbines: Vacated/abandoned homes – Exploring participants’ descriptions of their personal views, effects on safety, security, trust, and social justice
Authors: Krogh Carmen Marie , McMurtry Robert Y , Johnson W Ben , Punch Jerry L , Dumbrille Anne , Alves-Pereira Mariana , Hughes Debra , Rogers Linda , Rand Robert W. , Gillis Lorrie
Published: December 2023

Introduction:

Some neighbors living in proximity to industrial wind turbines (IWTs) have described adverse health effects and contemplated vacating their homes. While the decision to vacate a home is reported by sources such as judicial proceedings, the scientific literature, media outlets, social media, and Internet websites, research on its extent and outcomes is limited.

Methodology:

This ethics-reviewed study used the qualitative Grounded Theory methodology. Sixty-seven consenting participants, 18 years or older, who had previously lived or were currently living within 10 km of IWTs were interviewed. Audio files were transcribed to text and the data were coded and analyzed using NVivo Pro (v. 12.6) software.

Objectives:

The objective is to explore participants’ descriptions of their personal views on wind turbines and their effects on safety, security, trust, and social justice, and generate a theory of influences contributing to these decisions.

Results:

Data analysis revealed primary and subthemes associated with environmental interference and altered living conditions. Descriptions of participants’ personal views associated with the use of wind energy and effects on safety, security, trust, and social justice are provided.

Discussion:

It is recommended that members of the public, government authorities, policymakers, researchers, health practitioners, and social scientists with an interest in health policy acknowledge these effects and seek resolution for those who are negatively affected when living or working near IWTs.

Conclusion: We conclude that using a systematic methodology, data analysis lends support that the Grounded Theory was applicable to this study as it assisted with the development of a coherent theory which explained participants’ housing decisions.
The Milan system for reporting salivary gland cytopathology – Assessment of utility and the risk of malignancy
Authors: Prakash Annu E. , Sukumaran Renu , Nayak Nileena , Lakshmi K. , Mathews Anitha , Kattoor Jayasree
Published: December 2023

Background:

Cytological diagnosis of salivary gland lesions furnishes several challenges to pathologists and clinicians owing to their diverse morphology and varying reporting terminology. The Milan system for reporting salivary gland cytopathology was proposed to overcome these defects. The aim of this study was to grade histopathologically diagnosed cases of salivary gland pathology using Milan system and to correlate Milan system with histopathological diagnosis. The study aims to assess the utility of the Milan system and the risk of malignancy in each category.

Materials and Methods:

This is a retrospective study of 4 years duration. All the cases of salivary gland pathology with fine-needle aspiration cytology findings from January 2015 to December 2018 were retrieved and classified according to the Milan system. Histopathology follow-up of these cases were reviewed from the archives, and risk of malignancy was calculated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using histopathological diagnosis as the gold standard.

Results:

Cytology slides of 151 cases were reviewed, and the Milan system was applied. Histopathology follow-up was obtained in 94 cases (attrition rate = 37.74%). The percentage of cases in each category were as follows: nondiagnostic = 9.27%, nonneoplastic = 4.64%, atypia of undetermined significance = 3.97%, benign neoplasm = 23.84%, neoplasm of uncertain malignant potential = 8.61%, suspicious for malignancy = 11.92%, and malignant = 37.75%. Sensitivity, specificity, positive predictive value, and negative predictive value of the Milan system were 94.20%, 96.00%, 98.48%, and 85.71%, respectively.

Conclusion:

The Milan system has high sensitivity and specificity in comparison with histopathology. This system proves helpful to the pathologist as well as the clinician in achieving uniformity of reporting terminology by classifying salivary gland lesions into subcategories with prognostic relevance.
Para testicular cellular angiofibroma (AF)/angiomyofibroblastoma (AMF)-like tumor: A case report of a rare diagnosis in an elderly male
Authors: Dave Vinayak N. , Sahetia Khushboo M. , Menon Santosh
Published: December 2023

Cellular angiofibroma (AF)/Angiomyofibroblastoma (AMF)-like tumor is a rare benign mesenchymal neoplasm. It is very challenging to distinguish benign versus malignant mass radiologically. It is of paramount importance to distinguish Cellular Angiofibroma (CAF) microscopically from its differential diagnoses. A 64-year-old man presented with scrotal swelling. Pathological examination showed features of cellular AF/AMF- like tumor, which shows positivity for CD34, with negativity for S-100 Protein, smooth muscle actin and desmin.
Assaying of p53 Autoantibodies in saliva for the detection of oral squamous cell carcinoma. A road not taken
Authors: Sreelatha S. V , Shetty Sukanya , Karnaker Vimal K. , Jacob Ankeeta M. , Chowdhury Chitta R.
Published: December 2023

Background:

Autoantibody detection is a promising approach to cancer screening. Serum p53 antibodies have been time tested in various cancers, including oral squamous cell carcinoma (OSCC). This study is aimed to detect and determine the level of p53 autoantibodies (p53-AAbs) in saliva. The association of clinicopathological features among patients with and without OSCC was also explored as a novel method for the detection of autoantibodies.

Methods:

One hundred preoperative saliva samples from patients with histologically confirmed OSCC and a hundred from normal healthy individuals were collected. Anti p53 detection kit assessed levels of salivary p53-AAbs. The cut-off value was 1.3 U/mL by Enzyme-linked immunosorbent assay (ELISA). The p53-AAb levels were expressed in terms of the median and interquartile range (IQR). Fischer’s exact test and Chi-square test were used to determine the association with clinicopathological features among patients with OSCC and healthy controls with tobacco consumption habits.

Results:

Median level of p53-AAb is 0.234 U/mL (IQR 0.18-0.37U/mL) in healthy controls and 0.285U/mL (IQR 0.16-0.58U/mL) in OSCC. p53-AAbs was positive in 15% of 100 patients with OSCC, which was statistically higher (P < 0.001) among OSCC, and controls were negative for p53-AAb. No significant correlation of p53-AAbs with the patient’s age, gender, site, clinical staging (TNM), and pathologic grade was observed. However, a significant association was seen between the node involvement and salivary p53-AAbs.

Conclusion:

Salivary p53-AAb positivity was seen in a higher proportion in OSCC patients than in healthy controls with tobacco consumption, and the levels did differ significantly among OSCC and healthy controls.
Role of Trigger Point Injection in the Management of Proximal Tensor Fascia Lata Myofascial Trigger Point in a Stage 4 Breast Cancer Patient
Authors: Kumar Sanjay , Singh Pratibha , Agarwal Anil , Singh Prashant Kumar
Published: December 2023

Pain is a common and devastating complaint in cancer patients. The etiology of pain in these patients is numerous and proper assessment is needed for treatment. Myofascial pain syndrome (MPS) is a common but often neglected cause of pain. Cancer patients are at risk of developing MPS. An accurate and early clinical diagnosis along with appropriate intervention is required to address this cause of pain in order to decrease the sufferings of these patients. Here, we report a patient of metastatic breast carcinoma with severe lower back and lower limb pain, significantly relieved with Minimally invasive pain and spine interventions (MIPSI) of the trigger point in the tensor fascia lata, which is often a missed cause of pain in this subgroup of the patient.
Randomized Comparative Study of Analgesic Effects of Ilioinguinal and Iliohypogastric Nerve Block with Levobupivacaine (0.25%) versus Diclofenac Suppository in Pediatric Patients Undergoing Inguinal Herniotomy under General Anesthesia
Authors: Mukhopadhyay Sayantan , Bhattacharya Dipasri , Rai Sagar , Piplai Gautam , Shailendra Kumar
Published: December 2023

Context:

Pain management intraoperatively and postoperatively in the pediatric age group is a matter of concern. On the one hand, children are poorer at precisely conveying the extent of pain all the while being more susceptible to pain-related complications such as laryngospasm. On the other hand, children are less suited to use of potent opioids due to associated complications which can often lead to catastrophe. Therefore, a multimodal approach is desirable to optimize pain management in children. A nerve block is a highly effective and popular modality nowadays. In this single-blinded, parallel group, monocentric, and randomized protocol study, we have compared the efficacy of pain control achieved in the use of nonsteroidal anti-inflammatory drugs as analgesic versus iliohypogastric ilioinguinal (IIIH) nerve block in herniotomy in pediatric age group.

Materials and Method:

The parallel-group prospective study recruited 104 participants who were randomly allocated into two groups of 52 each, such that both groups received 1 mcg/kg fentanyl and sevoflurane during induction of GA. For analgesia, Group 2 was given diclofenac suppository intraoperative after induction of GA. Group 1 was given IIIH nerve block under nerve stimulator guidance for perioperative analgesia. Both groups were studied for the following parameters which included: time to get the 1st dose of rescue analgesic, total dose of rescue analgesic, visual analog scale (VAS) score, and hemodynamic parameters.

Results:

We observed that Group 1 showed a statistically significant difference in the form of longer duration of analgesia after surgery (9.67 ± 1.80 h vs. 6.35 ± 0.84 h) and lower total dose of rescue analgesic requirement (69.23 ± 2 [22.77] vs. 106.23 ± 2 [21.49]) while having a better hemodynamic profile and lower cumulative VAS score (7.71 ± 1.39 vs. 12.04 ± 1.72).

Conclusion:

Based on the above findings, we deduce that preincisional nerve stimulator-guided IIIH block by levobupivacaine (0.25%, 0.3 ml/kg) and rectal diclofenac (2 mg/kg) is both safe approaches to provide postoperative analgesia in pediatric inguinal herniotomy under general anesthesia. However, nerve stimulator-guided IIIH nerve block by levobupivacaine is a safe and better choice as it provides more intense analgesia for a longer duration compared to diclofenac suppository in the immediate postoperative period.
Pain Education in India: Hope or Hype?
Authors: Jain Pradeep , Panday Bhuwan Chand , Dua Naresh , Usmani Hammad
Published: December 2023

Pain is known as an uncomfortable, sensory, and emotional experience, which is produced by imitating actual or potential tissue injury. Pain has a more profound effect on a patient’s life than any other neurological perturbation. Realizing the importance of pain, it is now considered the fifth vital sign. The declaration of pain relief as a patient’s basic human right and pain as a disease state reflects the importance of pain relief. Although it is a complex and tedious task, it gives the ultimate satisfaction when a patient’s agony is relieved. This article focuses on the current status of pain education, awareness, challenges, means to improve pain education, encouraging qualified pain specialists, and strategies for fostering growth before a wave of pain overwhelms the nation.
Analgesic Efficacy of Dexmedetomidine as an Adjuvant to Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Prospective Randomized Study
Authors: Singh Digvijay Prakash , Rai Sudhir Kumar , Maurya Ram Gopal , Rastogi Harshit , Singh Gyan P
Published: December 2023

Background and Aims:

The primary aim of this randomized controlled study was to evaluate the effect of the addition of dexmedetomidine to ropivacaine on the onset and duration of sensory and motor blockade and the duration of analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block.

Materials and Methods:

A total of 100 patients of age 18–55 years, planned for elective upper limb surgeries under supraclavicular brachial plexus block using a nerve stimulator, were randomly allocated into two groups. Group 1 (n = 50) received 30 mL 0.5% ropivacaine and 1 mL normal saline and Group 2 (n = 50) received 30 mL 0.5% ropivacaine and 1 μg/kg of dexmedetomidine. The onset and duration of sensory and motor block, duration of analgesia, and adverse events during the perioperative period were noted.

Results:

The onset of sensory and motor block in Group 1 (16. 26 ± 2.23 and 21.68 ± 2.90 min) was slower than those in Group 2 (9.12 ± 2.40 and 12.68 ± 2.62 min), (<0.001). The duration of sensory and motor block in Group 1 was significantly shorter than those in Group 2 (P < 0.001). The duration of analgesia in Group 1 (402.80 ± 28.21 min) was shorter than that in Group 2 (981.00 ± 92.26 min; P < 0.001). There was no statistically significant difference between the two groups in the incidence of the side effects, except in the incidence of sedation which is significantly higher in Group 2, (P < 0.001).

Conclusion:

Dexmedetomidine with ropivacaine for supraclavicular nerve block resulted in earlier onset and prolonged duration of the sensorimotor blockade and provided a longer pain-free postoperative period without significant hemodynamic alterations.
Old wine in new bottle: Lentigo transplant for beauty spot creation
Authors: Bhingradia Yogesh M , Salunke Tejaswini S
Published: December 2023

Melanocytic nevi especially on the face, neck, and chest are considered a sign of beauty since historic times. Since historic times and in various cultures, these nevi are associated with beauty and attractiveness, thus called beauty spots. Artificial beauty marks have been fashionable since the medieval era. it requires repetitive use easily making it a cumbersome process. Tattooed beauty marks by medical professionals or tattoo artists are commonly done but require frequent touch-ups with a risk of complications. So we came up with a very innovative technique of tissue grafting of an existing lentigines/melanocyte nevus to the desired site which gave a natural and permanent solution.
Does platelet-rich plasma promote facial rejuvenation? Revising the latest evidence in a narrative review
Authors: Neiva-Sousa Manuel , Carracha Clara , Nunes da Silva Luis , Valejo Coelho Paulo
Published: December 2023

Facial aging is characterized by progressive macroscopic, histological, and molecular changes. Due to its regenerative and rejuvenating properties, the use of platelet-rich plasma (PRP) as a facial antiaging agent has gained popularity over the last decade. In order to gather and evaluate the latest evidence focusing on the effect of PRP on facial skin rejuvenating, a search through MEDLINE (PubMed) using relevant keywords, inclusion, and exclusion criteria was performed. A total of 539 articles were initially retrieved, and from those, 16 were included in the review. Treatment protocols comprised the use of PRP both in monotherapy and in combination with other substances and by means of direct injection or topical application following skin permeation. The selected studies presented high variability regarding PRP preparation methods, administration protocols, and results assessment. In most studies, PRP seemed to improve to some degree the signs of facial aging, such has wrinkles, skin quality, and pigmentation, accompanied by significant histological and molecular responses. Optimizing treatment protocols should be the next step in assessing the full potential of PRP.
Surgical pearl: Simple techniques for achieving hemostasis on digital lesions
Authors: Mukhtar Muhammed
Published: December 2023

The fingers are highly vascular sites which bleeds profusely during procedure. Penrose drain and gasket are not readily available in the clinic. For this problem, we advocated the use of hand gloves and cotton gauze to achieve haemostasis at the site of finger.
Retronychia: A misdiagnosed cause of paronychia
Authors: Savitha Somaiah , Nagalakshmi Rajesh , Mariam Sankey Sana
Published: December 2023

Retronychia refers to the embedding of the nail into the proximal nail fold. Patients present with chronic paronychia in the setting of disrupted nail growth. Nail avulsion is curative and unlike other forms of ingrown nails, it does not tend to recur. We report a case of retronychia who presented with pain and swelling around bilateral great toes. Further examination showed growth of overlapping nail plates, which led to the diagnosis of retronychia. This article emphasizes the clinical features and treatment options available for retronychia, thereby avoiding misdiagnosis.
GSTs genetic polymorphism, gene–environment interaction and association with gallbladder cancer risk in North Indian population: A case-controlled study
Authors: Feroz Zainab , Tiwari Sonia , Vijayaraghavalu Sivakumar , Kumar Munish
Published: December 2023

Aim:

In the present case-controlled study, we explored the role of genetic polymorphism in three xenobiotic metabolizing genes, GSTM1, GSTT1 and GSTP1, and their association to gallbladder cancer (GBC) risk in a North Indian population. Its etiology is influenced by genetic, food habits, lifestyle, and environmental factors. GBC incidence is significantly higher in the Gangetic belt, India. Therefore, we explored the prognostic factors in the susceptibility of GBC through gene–gene and gene–environment interaction in this region.

Material and Methods:

Genetic polymorphism was analyzed in 108 GBC patients from Kamala Nehru Memorial Cancer Hospital, Prayagraj and 142 matched controls. GSTM1 and GSTT1 genotypes were analyzed by multiplex PCR method, while restriction fragment length polymorphism (RFLP) was performed to analyze GSTP1 genotypes. Logistic regression analysis calculating the odds ratio (OR) and 95% confidence interval (CI) was performed to analyze the GBC risk.

Results:

GSTT1 (null) genotype was at a significantly higher risk and susceptible to GBC (OR = 2.044, CI = 1.225–3.411, P = 0.006), while GSTM1 and GSTP1 genotypes did not show any association to GBC risk. After sex stratification, females diagnosed with GBC had higher GSTT1 (null) genotype (OR = 2.754, CI = 1.428–5.310, P = 0.003) compared to males. GBC patients dwelling in rural areas show higher GSTT1 (null) genotype with two-fold GBC risk (OR = 2.031, CI = 1.200–3.439, P = 0.008). Further, GBC patients with histopathology of adenocarcinoma also showed higher GSTT1 (null) genotype (OR = 2.113, CI = 1.248–3.578, P = 0.005). Gene–gene interaction between GSTT1 (non-null)/GSTP1 (Ile/Val + Val/Val), enhance the GBC risk (OR = 1.840, CI = 1.135–2.982, P = 0.013).

Conclusions:

The present study suggests that GSTT1 (null) genotype has higher susceptibility and risk towards GBC in North Indian population. Female patients, patients with histopathology of adenocarcinoma and rural dwelling GBC patients have higher GSTT1 (null) genotypes and may be at risk of developing GBC. The genotype combination GSTT1 (non-null)/GSTP1 (Ile/Val + Val/Val) has increased GBC susceptibility and may be considered as ‘at risk’ genotypes for GBC in North Indians.
Epidemiology of cancer in adolescents and young adults from a tertiary care hospital in Southern India
Authors: Darling HS , Mohan Raj , Sud Rahul
Published: December 2023

Purpose:

This study aimed to analyze cancer pattern among adolescents and young adults (AYA) in a tertiary care center in South India.

Materials and Methods:

A retrospective study was undertaken from January 2018 to December 2021 on AYA cancer patients (aged 15–39 years).

Results:

Totally, 369 cases of AYA cancers were identified for analyzing the frequency and pattern of cancer distribution. The most common cancers were breast cancer, thyroid cancer, and astrocytoma. All the cancers were more common in males than in females, except for breast, thyroid, gonadal cancers, and unspecified malignant neoplasms.

Conclusion:

Cancer distribution patterns are distinct among AYA in terms of epidemiology and biology.
A rare case of benign metastasizing leiomyoma at vertebrae
Authors: Kachhwaha Avni , Bharti Jyotsna Naresh , Solanki Akanksha , Soni Sweta , Pareek Puneet
Published: December 2023

Benign metastasizing leiomyoma (BML) is a rare disease that usually occurs in women of reproductive age, with a history of uterine leiomyoma treated with hysterectomy. This may present as lesions in lungs, lymph nodes, bones, brain, mediastinum, and soft tissues. However, the most commonly affected site is the lung. Here is a case report of a patient who presented with BML at vertebral body with distant metastasis to lungs, brain, and bones. A 37-year-old female, with no known comorbidities, presented with pain in the upper back, urinary and bowel incontinence, and weakness in the bilateral lower limbs. Radiological, multiple metastases were present at D2 and D9 vertebral bodies, multiple nodular lesions were present in the lungs, and solitary lesion was found in the right frontal lobe of the brain. Histology proved it to be of myoepithelial origin with low Ki-67 index. The treatment in this case was based on hormone production suppression and radiotherapy, with no signs of progression at follow-up.
Neuroendocrine carcinoma of tonsil presented with axillary lymph node metastasis: Management dilemma
Authors: Kamarudin Zalikha , Jamaluddin Nadia , Latar Nani Harlina Md , Pauzi Suria Hayati Md , Muhammad Rohaizak
Published: December 2023

High-grade neuroendocrine carcinoma (NEC) of the tonsil is rare and has a poor prognosis. The usual presentation is a neck mass with locoregional cervical lymphadenopathy. An axillary lymphadenopathy as a primary presentation of NEC of the tonsils is uncommon and challenging to treat. Tonsil neuroendocrine tumors display aggressive behaviors associated with early recurrence and metastasis after surgical resection. Managing this condition is demanding compared to NECs of gastrointestinal origin since, to date, the management of head-and-neck neuroendocrine tumors is still not well established. We present a 49-year-old female with a rare case of NEC of the tonsil presenting primarily with axillary lymph nodes metastasis. The patient’s axillary lymph node was biopsied and revealed a Grade III neuroendocrine tumor. A positron emission tomography (PET) scan was done in searching of a primary lesion and showed a highly metabolic mass of the left tonsil as well as a left axillary lymph node suggestive of metastasis. The patient has been managed with a multimodality approach, with a combination of chemotherapy regimen and surgical resection of the axillary lymph node. Subsequent PET scan evaluation showed a complete response of the primary tumor with residual left axillary lymph node metastasis. NECs of tonsil presented with axillary lymph nodes metastasis is rare and has a poor prognostic outcome. It poses a dilemma with regard to management, as surgical resection of the metastasis is not promising given the possibility of early recurrence.
Primary breast rhabdomyosarcoma in a 17-year-old girl
Authors: Singotia Laxmi , Haritha V.S.
Published: December 2023

Primary rhabdomyosarcoma (RMS) of breast is a very rare malignancy usually affecting adolescent girls with a poor prognosis and no definitive treatment established. Here, we report a case of a 17-year-old girl who presented to us operated for a right breast mass with histopathology suggestive of RMS. She had undergone wide local excision with nipple-areola complex along with axillary node dissection for positive nodes. Immunohistochemistry was done which showed tumor cells which were positive for desmin and myogenin and were negative for leukocyte common antigen, cluster of differentiation 34 (CD-34), and AE1/AE3 which confirmed the diagnosis of RMS. She was planned for adjuvant chemotherapy but refused taking treatment. Two months later, she presented with local site recurrence for which re-excision was done, and she was started on adjuvant chemotherapy with vincristine, Adriamycin, and cyclophosphamide regimen after metastatic workup. She then received radiation treatment following which she is at present under follow-up with no signs of disease until now.
Primary hyperparathyroidism and sarcoma: A case report and literature review
Authors: Zengin Burak Alper , Bahçecioğlu Adile Begüm , Erdoğan Murat Faik
Published: December 2023

The relationship between primary hyperparathyroidism (PHPT) and bone sarcoma is debatable, especially after wider use of teriparatide treatment, concerns have intensified on the issue. Extensive search in English literature revealed 10 cases reported having PHPT and sarcomas. Besides, three cases of bone sarcoma occurring after teriparatide treatment had been reported. Hereby, we report a 51-year-old woman with a prolonged history of PHPT. She was diagnosed with chondrosarcoma 9 years after refusal and lack of treatment for PHPT. She was cured surgically for both chondrosarcoma and parathyroid adenoma at 1-year interval. So far, large cohorts did not show an increase in the incidence of bone sarcomas in PHPT. Several case observations, including the current one, as well as data from in vitro and rat studies, pointed out prolonged parathormone exposure, may be a risk for bone sarcomas. Under these circumstances, a safer attitude on individual basis would be the prevention of prolonged parathormone exposures.
Perceived stress, anxiety, and depression in women with breast cancer: CIBC study
Authors: Vafaei Zamaneh , Najafian Jamshid , Shekarchizadeh Masood , Mohammadifard Noushin , Mostafavi Samaneh , Roohafza Hamidreza , Darakhshandeh Ali , Khosravifarsani Mohammadreza , Ashraf Farzaneh , Sharif Mehran , Emami Mohammad Hassan , Javanmard Shaghayegh Haghjooy , Hassannejad Razieh , Maracy Mohammad Reza , Sarrafzadegan Nizal
Published: December 2023

Background:

Many breast cancer (BC) patients experience psychological reactions and may have psychiatric morbidities, especially anxiety and depressive disorders. The aim of this study was to evaluate perceived stress and factors affecting this stress in women with BC in Isfahan.

Material and Methods:

This analytical cross-sectional study was carried out among 197 females with BC who were newly diagnosed and referred to Isfahan Cardio-Oncology Clinic. Stress was measured by the Perceived Stress Scale Standard questionnaire. Generalized linear models (GLMs) with gamma distribution and Log Link Function were used for data analyzing.

Results:

The mean age of the patients was 48.9 ± 10.9 years, and mean perceived stress in patients was 42.8 ± 16.5. The GLMs with Gamma distribution and Log Link Function showed interaction between anxiety and surgical type and also between depression and surgical type. Patients perceived stress with anxiety*nonsurgery were significantly 2.5% higher than normal anxiety and none surgery (P = 0.004), and patients with depression*lumpectomy had significantly 2% higher stress score compared to normal depression and nonsurgery (P =0.003).

Conclusions:

Early detection of anxiety and depression can contribute to managing the stress. Coordination between psychologists and oncologists in care and treatment of these patients is important for pursuing treatment and following the recommendations of doctors and ultimately affect the morbidity and survival in BC patients.