CLINICAL EVALUATION OF MEDADUSTI IN PRAMEHA W.S.R. TO ITS THERAPEUTIC MEASURES WITH MUSTAK

Introduction: Agni (digestive and metabolic energy) is the main factor for digestion and metabolism. Meda (a type of body tissue i.e., fats) is formed from the Mamsa (a type of body tissue i.e., muscle) with its own Ushma (heat) in addition to the Snigdhatva (unctuousness) & Dravadtva Guna (liquidity) of Apa Mahabhuta (one of the fundamental components of this universe i.e., water). Due to impairment of Dhatvagni (metabolic energy), Medadusti (impair- ment of fats) takes place and in turn may result in Prameha (diabetes mellitus), Sthaulya (obesity) etc. Prameha is one of the leading diseases in the present era. The aggravated Kapha afflicts Meda, Mamsa and Kleda (moisture elements of the body) and in due course of time, Kaphaja Meha (a type of Prameha) is converted into Pittaja Meha (a type of Prameha), followed by Vataja Meha (another type of Prameha) if not treated properly. Aim: The present study was carried out to evaluate the concept of Meda and the role of Medadusti in the pathogenesis of Prameha along with the efficacy of the selected drug Mustak (Cyperus rotundus Linn.) to combat the situation. Material & Methods: In selected 35 patients of Prameha having the Medadusti Lakshan based on inclusion and exclusion criteria, Mustak (Cyprus rotundus Linn.) was administered in stipulated dose (12 grams in two divided doses with plain warm water) for two months. Result: The subjective parameters for Medadusti is clinically present in a max- imum number of Prameha patients. The result also reveals the significant efficacy of Mustak on relevant subjective and objective parameters with a 'p-value <0.001 in all subjective and objective parameters. Conclusion: The Nidan (aetiology) of Medadusti has a definite role to cause Prameha. In all the patients of Prameha, Medadusti Lakshan (features of impaired fatty tissue) is clinically present. The patients suffering from Prameha can be treated with the drug response to arrest the Medadusti like Mustak. Keywords: Medadusti, Mustak, Prameha

A PHYSIOLOGICAL STUDY OF SHUKRA DHATU W.S.R. SEXUAL HORMONES

Ayurveda has described three basic physiological constituents of the human body, viz., Dosha, Dhatu and Mala. In Ayurvedic Science, the one who has balanced Doshas, balanced Agni, properly formed Dhatus, proper elimina- tion of Malas, well-functioning of bodily processes and whose mind, soul, senses are full of bliss is called a healthy person1. So, the formation of Dhatu is also a good indicator of good health there are seven Dhatus ex- plained in Samhitas, those are Rasa, Rakta, Mamsa, Meda, Ashti, Majja and Shukra among all Dhatus, Shukra is considered as the sara of all other Dhatus2. Shukra Dhatu is one of the seven Dhatus in the body and Shukra is white, pure, excellent Dhatu, which is considered as best among all seven Dhatus. According to many Acharyas of Ayurveda, Garbhotpadana (reproduction) is the chief function of Shukra Dhatu, and the important fact is Shukra Dhatu also shows its effect all over the body in the form of Shukradhatusarata because Shukradhatuis located in the entire body. Sperm along with spermatic fluid and male sex hormones are also one part of Shukra Dhatu. Anu Shukra Dhatu (primordial germ cell) is essential for the Shukra Dhatu (Testosterone, Estrogen). Vi- tiation of Shukra dhatu shows Shukra dhatudusti (pathology) in the form of Vriddhi (hyper state) or Kshaya (wan- ing). This vitiation may lead to main infertility and many other physical as well as psychological disorders. All Dhatus have their definite locations in the body; they are present in every cell in subtle form. Every cell possesses the capacity to divide or reproduce itself. Thus, one has to interpret the Garbhotpadana (reproduction) function of Shukra Dhatu. In future, it may be achievable that with the development of the facts; we will discover any content in the cell whichpossesses a definite role in cell division.Sperms along with spermatic fluid and male sex hor- mones are also one Partofshukra, parallel to which females possess Artava. Stri-Shukra excreted during coitus is nothing but the secretions of bartholins, cervical and endometrial glands emergence at theendoforgasm. Keywords:Ayurveda, Stree-Shukra, Shukra Dhatu, Artava, hormones.

Sclerosi tuberosa ed everolimus: una nuova storia

Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder, due to inactivating muta-tions of TSC1 or TSC2 mTOR pathway genes and is characterized by variable multisystem manifestations ranging from hamartomas to malignant neoplasms. It frequently associated to seizures, intellectual disability and behavioural disorders. Surgical treatment has traditionally been used to manage subependymal giant cells astrocytomas (SEGA). The introduction of mTOR inhibitor rapamycin, with its definite role both as primary and as adjuvant treatment, has significantly modified the management opportunities in the clinical practice. It is important to consider both treatment options in a balanced way and not only the SEGA, but also the individual patient and their associated comorbidities. The pros and the cons of both options should be discussed by a multidisciplinary team before establishing an individualized treatment recommendation. The paper reports the case of a patient with an asymptomatic SEGA who was treated with everolimus. The treatment was effective in reducing the size of the tumour, it was safe and well tolerated.

The Role of Interleukin-27 in Atherosclerosis: A Contemporary Review

Atherosclerosis is a chronic inflammation characterized by an imbalance between inhibitors and stimulators of the inflammatory system that leads to the formation of atherosclerotic plaques in the vessel walls. Interleukin (IL)-27 is one of the recently discovered cytokines that have an immunomodulatory role in autoimmune and inflammatory diseases. However, the definite role of IL-27 in the pathogenesis of atherosclerosis remains unclear. Recent studies on cardiomyocytes and vascular endothelium have demonstrated mechanisms through which IL-27 could potentially modulate atherosclerosis. Upregulation of the IL-27 receptor was also observed in the atherosclerotic plaques. In addition, circulatory IL-27 levels were increased in patients with acute coronary syndrome and myocardial infarction. A regenerative, neovascularization, and cardioprotective role of IL-27 has also been implicated. Future studies are warranted to elucidate the biologic function and clinical significance of IL-27 in atherosclerosis.

Role of Zoo-Housed Animals in the Ecology of Ticks and Tick-Borne Pathogens—A Review

Ticks are ubiquitous ectoparasites, feeding on representatives of all classes of terrestrial vertebrates and transmitting numerous pathogens of high human and veterinary medical importance. Exotic animals kept in zoological gardens, ranches, wildlife parks or farms may play an important role in the ecology of ticks and tick-borne pathogens (TBPs), as they may serve as hosts for local tick species. Moreover, they can develop diseases of varying severity after being infected by TBPs, and theoretically, can thus serve as reservoirs, thereby further propagating TBPs in local ecosystems. The definite role of these animals in the tick–host-pathogen network remains poorly investigated. This review provides a summary of the information currently available regarding ticks and TBPs in connection to captive local and exotic wildlife, with an emphasis on zoo-housed species.

Effect of Agnikarma along with Panchatikta Guggulu in the management ofJanusandhigatavata (Osteoarthritis of Knee Joint)

Background: Vatavyadhis has been mentioned as one of the Ashtomahagada due to its notorious nature. Being a Vatavyadhi, located in Marma Asthi and Sandhi and its occurrence in old age makes it Kashta sadhya.Osteoarthritis is most common degenerative,disabling disorder in majority of people in 5-6 th decade of life.There is only conservstive treatment giving short term relief in pain and surgical intervention with lots of side effects..Sushruta has mentioned Agnikarma as best treatment for vata Kaphaj Vyadhis.Charaka, has mentioned Basti made up of Tikta Dravya, Ghrita and Kshira in Asthidhatu Dushti,. Keeping all these things in view Agnikarma and Panchatikta guggulu were selected for the treatment of Janusandhigatavata. Aim and objective: To evaluate the efficacy of Agnikarma and Panchatikta Guggulu in management of Janusandhigatavata ( osteoarthritis of knee joint). Materials & Methods: Total 43 diagnosed cases of osteoarthritis were registered out of which 41 patient completed the study .In group A 4 sittings of Agnikarma was done in 21 patients with Panchadhatu Shalaka.In group B 4 sittings of Agnikarma was done in 20 patients with Panchadhatu Shalaka along with Panchatikta Guggulu orally for 1 month. Result: The result was assessed by using wilcoxan, paired t test, Mann Whitney and unpaired t test.Significant relief was observed in both groups in all parameters. Clinically and percentage wise group B had shown better results. Conclusion: Study was concluded that Agnikarma alone has a definite role in reducing the knee joint pain and tenderness but addition of Panchatikta Guggulu found convincing results in stiffness, swelling and (ROM) of knee joint.

Medical management of COVID-19: treatment options under consideration

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China in December 2019. Despite the worsening trends of COVID-19, currently, no drugs are validated to have significant efficacy in the clinical treatment of COVID-19. The drugs currently being explored are hydroxychloroquine, antivirals like remdesivir, favipiravir alone or in combination, antibiotics like azithromycin and doxycycline. Low dose corticosteroids, either oral or intravenous, have also shown promising results in reducing mortality. On the other hand, Immunomodulators and biologics are found to be very effective in some cases. Autopsy finding of patients with COVID-19 shows the evidence of endothelial damage and formation of microthrombi with multiorgan involvement and, ultimately, multiorgan failure; hence anticoagulants also seem to have a definite role in preventing microvasculature clogging and multiorgan dysfunction. Pulmonary vasodilators acting via the cGMP/cAMP pathway may also prove to be beneficial in reducing airway hyper inflammation. In this review, authors have attempted to summate the potential drugs therapies with emphasis on convalescent plasma, and at last, the most awaited thing of this pandemic, COVID-19 vaccine.

Neuroanesthesia Practice during COVID-19: A Single-Center Experience

The coronavirus disease 2019 (COVID-19) pandemic is a challenge for all health care providers (HCPs). Anesthesiologists are vulnerable to acquiring the disease during aerosol-generating procedures in operating theater and intensive care units. High index of suspicion, detailed history including travel history, strict hand hygiene, use of face masks, and appropriate personal protective equipment are some ways to minimize the risk of exposure to disease. Neurologic manifestations of COVID-19, modification of anesthesia regimen based on the procedure performed, and HCP safety are some implications relevant to a neuroanesthesiologist. National and international guidelines, recommendations, and position statements help in risk stratification, prioritization, and scheduling of neurosurgery and neurointervention procedures. Institutional protocols can be formulated based on the guidelines wherein each HCP has a definite role in this ever-changing scenario. Mental and physical well-being of HCPs is an integral part of successful management of patients. We present our experience in managing 143 patients during the lockdown period in India.

The regulation of E3 ubiquitin ligases Cbl and its cross talking in bone homeostasis

: The E3 ubiquitin ligases Cbl has been found play an important role in regulating cellular proliferation and migration. Whereas the excessive differentiation of osteoclast and/or its over expressing of resorptive functions could lead the pathological bone homeostasis by overly bone matrix degradation. Since the first time of the important role of Cbl in the regulating osteoclast differentiation (also named osteoclastogenesis) has been reported in decades ago. The extensively studies have been conducted for in-depth exploring the Cbl’s definite role during osteoclastogenesis, as well as its cross talking with other signaling pathways (such as: Src and PI3K signaling) in bone homeostasis. Herein, our current study aim to briefly conclude the current studies of osteoclastogenesis and the regulatory role of Cbl, as well as its cross-talking in bone homeostasis.

An Update on the Neurochemistry of Essential Tremor

Background: The pathophysiology and neurochemical mechanisms of essential tremor (ET) are not fully understood, because only a few post-mortem studies have been reported, and there is a lack of good experimental model for this disease. Objective: The main aim of this review is to update data regarding the neurochemical features of ET. Alterations of certain catecholamine systems, the dopaminergic, serotonergic, GABAergic, noradrenergic, and adrenergic systems have been described, and are the object of this revision. Methods: For this purpose, we performed a literature review on alterations of the neurotransmitter or neuromodulator systems (catecholamines, gammaaminobutyric acid or GABA, excitatory amino acids, adenosine, T-type calcium channels) in ET patients (both post-mortem or in vivo) or in experimental models resembling ET. Results and Conclusion: The most consistent data regarding neurochemistry of ET are related with the GABAergic and glutamatergic systems, with a lesser contribution of adenosine and dopaminergic and adrenergic systems, while there is not enough evidence of a definite role of other neurotransmitter systems in ET. The improvement of harmaline-induced tremor in rodent models achieved with T-type calcium channel antagonists, cannabinoid 1 receptor, sphingosine-1-phosphate receptor agonists, and gap-junction blockers, suggests a potential role of these structures in the pathogenesis of ET.