Pediatric Autoimmune Encephalitis Following COVID-19 Infection

Similar to the pathogenesis of autoimmune disease, SARS-CoV-2 (COVID-19) infection has been shown to be associated with dysregulated and persistent inflammatory reactions and production of some antibodies. We report 3 pediatric patients found to have serum SARS-CoV-2 antibodies who presented with neurologic findings suggestive of postinfectious autoimmune-mediated encephalitis. All 3 cases showed lymphocytic pleocytosis on cerebrospinal fluid studies and marked improvement in neurologic symptoms after high-dose intravenous corticosteroids. The manifestations of SARS-CoV-2 infection in the pediatric population are still an evolving area of study, and these cases suggest autoimmune-mediated encephalitis as yet another SARS-CoV-2 related complication.

CLINICAL EFFICACY OF ARDHAMATRIKA BASTI IN GRIDHRASI

Gridhrasi, one among the Nanatmaja Vikara, specific Nidana and Samprapti is not explained in classics so that the general Vata Vyadi Nidhana Samprapthi can be considered. The Chikitsa of Gridhrasi includes Sneha, Sweda, Bastikarma and Agni karma. Generally, Basti is the best line of treatment for Vata dosa. References from Acharya Charaka also explain Basti as one of the treatment modalities. With the support of Niruhadikara in Chakradhatta, we have the reference of Ardhamatrika Basti, which is one among Kashaya Basti, here he explains the practical utility along with many added benefits of Bala, Varna, Vrushatha and Pumsavanathva which gifted by Atreya Maharshi. Ardhamatrika Basti, one among Madhutailika Basti (having an equal quantity of Madhu and Taila), can be clinically explored where neither Parihara Kala nor Purva karma like Sneha, Sweda are necessary. The study design selected for the study was a comprehensive clinical trial. The sample size for the present study was 30 patients suffering from Gridrasi as per the selection criteria. Patients were randomly selected irrespective of sex and were treated with Ardhmatrika Basti as a yoga Basti for eight days. Among 30 patients taken for study, marked improvement in the symptomatology of the disease is obtained. 26.7% of patients got complete Shamana, 36.7% achieved Prayika shamana, 30% reported Amsika shamana, and 6.6% had Kinchit shamana. In the assessment criteria taken in patients, Ruja BT - 2.68 after follow up reduced to 1.8, Spandana BT - 2.38 after follow up reduced to 1.73, Sakthana Utksepa-nigraha BT - 2.82 after follow up reduced to 1.58, Gourava BT - 2.5 after follow up reduced to 1.7, Arochaka BT - 2.22 after follow up reduced to 1.87. This result shows that the present study of Ardhamatrika Basti has given a marked improvement in treating Gridhrasi.

Case Report: A Case of COVID Vaccine-Induced Thrombotic Thrombocytopenia Manifested as Pulmonary Embolism and Hemorrhagia. A First Reported Case From Slovakia

COVID-19 vaccine-induced thrombotic thrombocytopenia (VITT) is a rare complication of adenoviral vector (ChAdOx1 nCoV-19) vaccine administration. It is presented as thrombocytopenia and thrombotic manifestations in various sites, especially in cerebral veins. Pulmonary emboli have been reported rarely. We present a case of a young male patient who developed severe thrombocytopenia and pulmonary embolism 12 days after the first dose of the vaccine. Severe thrombocytopenia, skin hematomas, and segmental pulmonary emboli were detected. Anti-platelet factor 4 (aPF-4) antibody was highly positive supporting the diagnosis of VITT. Prompt treatment with fondaparinux, intravenous immunoglobulin, and prednisone led to a marked improvement of clinical condition and thrombocytes count. We report the first known case of VITT in Slovakia.

Motion tomography via occupation kernels

<p style='text-indent:20px;'>The goal of motion tomography is to recover a description of a vector flow field using measurements along the trajectory of a sensing unit. In this paper, we develop a predictor corrector algorithm designed to recover vector flow fields from trajectory data with the use of occupation kernels developed by Rosenfeld et al. [<xref ref-type="bibr" rid="b9">9</xref>,<xref ref-type="bibr" rid="b10">10</xref>]. Specifically, we use the occupation kernels as an adaptive basis; that is, the trajectories defining our occupation kernels are iteratively updated to improve the estimation in the next stage. Initial estimates are established, then under mild assumptions, such as relatively straight trajectories, convergence is proven using the Contraction Mapping Theorem. We then compare the developed method with the established method by Chang et al. [<xref ref-type="bibr" rid="b5">5</xref>] by defining a set of error metrics. We found that for simulated data, where a ground truth is available, our method offers a marked improvement over [<xref ref-type="bibr" rid="b5">5</xref>]. For a real-world example, where ground truth is not available, our results are similar results to the established method.</p>

Management of Vataja abhishyanda (Allergic conjunctivitis) with Gutika anjana and Punarnavadi eye drops: A comparative clinical study

Background: Vataja Abhishyanda is characterized by Toda (Pricking pain), Sangharsha (foreign body sensation), Achchasruta (watery discharge), Alpa Shopha (mild chemosis), Vishushka Bhava (feeling of dryness), Parushya (roughness) etc which are very similar to the most of signs and symptoms of the Allergic Conjunctivitis. It is one of the most common type of eye allergy and is widely experienced by global population. Aims and Objective: . To evaluate and compare the efficacy of Punarnavadi eye drops and Gutika Anjana in the management of Vataja Abhishyanda(Allergic conjunctivitis). Materials and methods: Total 104 patients diagnosed with symptoms and signs of Vataja Abhishyanda were selected from the outpatient department of Shalakya tantra. The selected patients were assigned randomly into two groups, group A (Punarnavadi eye drop) having 51 and group B (Gutika Anjana) having 50 patients. Duration of treatment was 8weeks with follow up for one month after the trial. Result: In Group A, 96.08% got complete relief after the completion of treatment, 03.92% got marked improvement. In Group B, 98% got complete relief after the completion of treatment, 2% got marked improvement. Conclusion: Gutika Anjana shows better relief in all sign and symptoms on the basis of percentage. The reason may be Anjana has maximum absorption due to more contact of time with the tissue which is responsible for better bioavailability.

The Evaluation of the Detection of Cr(VI) in Leather

The topic of hexavalent chromium (Cr(VI)) in leather has been debated throughout the whole supply chain for years. However, its significance has recently increased due to proposed changes in European legislation concerned with skin-sensitising substances suggesting that acceptable Cr(VI) concentrations in leather goods should be lowered from 3 mg kg−1 to 1 mg kg−1. The proposition of a stricter limit and current analytical difficulties created the need for a review of current standard test methods. The research presented in this paper investigates both the colorimetric (Part 1) and chromatographic (Part 2) methods under BS EN ISO 17075. The focus of the study was to identify possible sources of interference leading to large statistical variance in results and to define the limit of quantification with respect to the proposed new compliance limit. This study into the colorimetric method has shown that the presence of Cr(III), dyes, and proteins can be significant interferences, becoming critical at low Cr(VI) concentrations. Dilution factors worsen the problem of detecting low concentrations: a reliable quantitative detection of 0.01 mg kg−1 and 0.003 mg kg−1 Cr(VI) in solution are required at the 3 mg kg−1 and 1 mg kg−1 compliance limits in leather, respectively. BS EN ISO 17075 part 1 was shown to be incapable of reliably resolving to 3 mg kg−1 or below in leather. Part 2 shows a marked improvement in detection limits and reliability; however, data suggest that 1 mg kg−1 Cr(VI) is not reliably detectable in leather. Suggested improvements to the established test methods and a possible alternative are discussed.

An Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue

Chronic fatigue syndrome and fibromyalgia (CFS/FMS) affect 2.1% of the world’s population and ~10–25% of people who have had COVID-19. Previous clinical data suggested that a unique Panax ginseng (C.A. Meyer, family Araliaceae) root extract (HRG80™ Red Ginseng) often resulted in marked improvement. We aimed to study this hydroponic form of red ginseng root, containing high levels of rare ginsenosides, for improving energy, cognition, and stamina. This open-label prospective study included participants with severe CFS/FMS who took a daily supplement of HRG80 capsules (200–400 mg) or tablets (100–200 mg) for one month. A total of 188 subject patients completed the one-month treatment trial. Of these, 60.1% rated themselves as improved, with 13.3% rating themselves as being much better. In this group, the mean composite score improved from 11.9 to 18.8 (p < 0.001), with a 67% average increase in energy, 44% average increase in overall well-being, 48% average improvement in mental clarity, 58% average composite improvement in the previous three measurements (primary outcome measure), 46% average improvement in sleep, 33% average decrease in pain, and 72% average increase in stamina. Our study showed that HRG80 red ginseng root powder resulted in a marked improvement in people with CFS and fibromyalgia. This included the subgroup with post-viral CFS/FMS.

COMPARISON OF ISOCONAZOLE NITRATE VERSUS NYSTATIN FOR TREATMENT OF OTOMYCOSIS

Objective: To compare isoconazole nitrate versus nystatin for treatment of otomycosis. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Bahawalpur and Combined Military Hospital Mardan, from Jan to Dec 2018. Methodology: Total 204 cases fulfilling the inclusion criteria were selected from outpatient department of Combined Military Hospital Bahawalpur and Mardan. They were divided into 2 groups of 102 each using random number tables. Group A cases were given Isocona-zole nitrate for application in external auditory meatus and group B cases were given Nystatin. All the cases were examined two weeks later and outcome was compared in terms of clinical improvement and symptoms resolution. Results: Out of 204, 125 patients were females and rest 79 were males. Age range was from 12-87 years with mean age 31 ± 2.4. Both groups were identical in terms of gender. In group A patients, 74 (72.5%) showed marked improvement after two week, 15 (14.7%) showed moderate improvement and 13 (12.7%) showed minor improvement. However, in group B, 55 (53.9%) showed marked improvement after two week, 23 (22.5%) showed moderate improvement and 24 (23.5%) showed minor improvement. Group A treatment was found significantly better than group B treatment (p=0.021). Conclusion: Isoconazole nitrate ointment was found significantly more effective for treating otomycosis than nystatin.

Differential Effects of Treatment Strategies in Individuals With Chronic Ocular Surface Pain With a Neuropathic Component

Background: Dysfunction at the ocular system via nociceptive or neuropathic mechanisms can lead to chronic ocular pain. While many studies have reported on responses to treatment for nociceptive pain, fewer have focused on neuropathic ocular pain. This retrospective study assessed clinical responses to pain treatment modalities in individuals with neuropathic component ocular surface pain.Methods: 101 individuals seen at the University of Miami Oculofacial Pain Clinic from January 2015 to August 2021 with ≥3 months of clinically diagnosed neuropathic pain were included. Patients were subcategorized (postsurgical, post-traumatic, migraine-like, and laterality) and self-reported treatment outcomes were assessed (no change, mild, moderate, or marked improvement). One-way ANOVA (analysis of variance) was used to examine relationships between follow up time and number of treatments attempted with pain improvement, and multivariable logistic regression was used to assess which modalities led to pain improvement.Results: The mean age was 55 years, and most patients were female (64.4%) and non-Hispanic (68.3%). Migraine-like pain (40.6%) was most common, followed by postsurgical (26.7%), post-traumatic (16.8%) and unilateral pain (15.8%). The most common oral therapies were α2δ ligands (48.5%), the m common topical therapies were autologous serum tears (20.8%) and topical corticosteroids (19.8%), and the most common adjuvant was periocular nerve block (24.8%). Oral therapies reduced pain in post-traumatic (81.2%), migraine-like (73%), and unilateral (72.7%) patients, but only in a minority of postsurgical (38.5%) patients. Similarly, topicals improved pain in post-traumatic (66.7%), migraine-like (78.6%), and unilateral (70%) compared to postsurgical (43.7%) patients. Non-oral/topical adjuvants reduced pain in postsurgical (54.5%), post-traumatic (71.4%), and migraine-like patients (73.3%) only. Multivariable analyses indicated migraine-like pain improved with concomitant oral α2δ ligands and adjuvant therapies, while postsurgical pain improved with topical anti-inflammatories. Those with no improvement in pain had a shorter mean follow-up (266.25 ± 262.56 days) than those with mild (396.65 ± 283.44), moderate (652 ± 413.92), or marked improvement (837.93 ± 709.35) (p &lt; 0.005). Identical patterns were noted for number of attempted medications.Conclusion: Patients with migraine-like pain frequently experienced pain improvement, while postsurgical patients had the lowest response rates. Patients with a longer follow-up and who tried more therapies experienced more significant relief, suggesting multiple trials were necessary for pain reduction.

EFFECT OF POLYHERBAL FORMULATION IN SHEETAPITTA (URTICARIA): A CASE STUDY

Aim: Urticaria is a common condition in children for which Paediatricians are consulted. In Ayurveda, it can be correlated with Sheetapitta which is a Tridoshaja vyadhi. The present study is aimed to show the effect of Polyherbal formulation in Sheetapitta (Urticaria) in children. Background: Urticaria is defined as a transient eruption of cir- cumscribed oedematous and usually itchy swellings of the dermis. As per Ayurveda, Urticaria can be correlated with Sheetapitta in terms of clinic features, causative factors and pathogenesis. Case Description: A 14-year-old female patient with her mother from Haridwar district came in OPD of Department of Kaumarbhritya, Rishikul Campus, Uttarakhand Ayurved University, Haridwar with the presenting complaints of red rashes all over the body along with itching, burning sensation and swelling since 2 years also having associated complaints like nasal con- gestion, sneezing and swelling B/L eyes from 2 months. On examining upper respiratory tract left-sided nasal hy- pertrophy, chapped lips, white-coated tongue, rt. sided slightly enlarged tonsils were found. On examining the In- tegumentary system, maculopapular lesions were present mainly over the upper limb, lower limb, chest and back. Swelling underneath B/L eyes was also present. The effect of the treatment was assessed on the basis of relief in itching and clearance of lesions. Conclusion: After the intervention of the polyherbal formulation for 45 days, there was a marked improvement in symptoms like Kandu, Vidaha and Shotha etc. So, it was concluded that internal use of Polyherbal formulation along with external use of Anu taila and the local application of Urtiplex lotion is highly effective in the management of Sheetapitta (Urticaria). Keywords: Urticaria, Sheetapitta, Kandu, Allergic disease