Minimally invasive retrieval of a bullet settling into the thoracic spinal canal in a pediatric patient: A case report

A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients.

Immune status determined as per guidelines of Ayurveda found associated with clinical outcomes of COVID-19 disease - Results of a cross-sectional pilot study

BACKGROUND

A key public health priority during the emergence of a novel pathogen is probing the factors contributing in clinical severity of the disease COVID-19. Moreover, analysis of the determined clinical outcomes is required and thus, modifiable predictor values need to identified. In Ayurveda, outcome of a disease is a multivariate function and this exploratory work is an attempt to identify one such factor "Vyadhiksamatwa" (immune status).

MATERIALS AND METHODS

A questionnaire-based, cross-sectional study was conducted in fifty diagnosed cases of COVID-19. Study participants were subjected to a questionnaire to assess relationship between the three determinants of the disease - exposure, clinical severity, and Vyadhiksamatwa.

RESULTS

Clinical severity was found strongly correlated with Vyadhiksmatwa with the value of Pearson Correlation - 0.740 significant at the 0.01 level (2-tailed).

CONCLUSION

In the determination of clinical severity of disease, there are two epidemiological factors responsible - extrinsic (exposure) and intrinsic (Vyadhiksamatwa). It has been observed that higher the value of Vyadhiksamatwa of an individual, lesser will be the clinical severity of the disease in that individual. Vyadhiksamatwa can alter the host response to infections.

An experimental study to evaluate Gunasankarya (combination of properties)

Introduction

Gunasankarya implies the combination or admixture of different Guna (properties) in a Dravya (substance). Every Dravya in this world is composed of different Guna varying in their quantity and potency. The final resultant action of the Dravya depends on the combination of Guna and their interaction with each other.

Aim

The present study was aimed to explain the manifestation of Karma (action) of a Dravya through its Guna (properties) and to evaluate the effect of the combination of Sheeta Guna (cool property) with different other Guna on digestion and metabolism in an animal model.

Materials and methods

The test drugs Usheera (Vetiveria zizanioides Linn.) and Bala (Sida cordifolia Linn.) were dried and powdered. A total of 18 adult healthy male and female Wistar strain albino rats were grouped randomly into three groups out of which the first was the control group and administered with distilled water. The second and third groups were fed with powder of Usheera and Bala, respectively, in the suspended form in distilled water. Test drugs were administered daily for 12 consecutive days. During the experimental phase, relative food intake, relative water intake, relative urine output, relative stool output, and food conversion ratio were recorded on the 3rd, 6th, 9th, and 12th day among which the 3rd day was considered as the initial day for the assessment, whereas body weight was measured from the 1st day of the study. Throughout the study, the main focus was on how these parameters change in Usheera and Bala-treated rats which are having different combinations of Guna with reference to the control group.

Results

Both Usheera and Bala groups showed a nonsignificant increase in relative food and water intake, nonsignificant increase in relative urine output, significant decrease in relative stool output, and significant increase in food conversion ratio. Body weight was nonsignificantly increased in Usheera group, whereas it was nonsignificantly decreased in Bala group. This study aimed to show how the Guna are interacting and resulting in Karma either by dominating or suppressing or giving a combined effect of Guna. This study provides initial data regarding the concept of Gunasankarya (combination of properties).

Conclusion

The study concludes that all the Guna in a Dravya interact and exhibit their resultant action, i.e., Karma based on Gunasankarya, with emphasis on example of assessment of the effects of Sheeta Guna Dravya, namely, Usheera and Bala on physiological parameters (digestion and metabolism) have been assessed experimentally in animal models to evaluation of the combination of Guna.

Total polyphenolic contents and in vitro antioxidant properties of eight Sida species from Western Ghats, India

Background:

Sida L., is a medicinally important genus, the species of which are widely used in traditional systems of medicine in India. Pharmacologically, roots are known for anti-tumor, anti-HIV, hepatoprotective, and many other properties. Phenolic antioxidants help in reducing oxidative stress occurring during treatment of such diseases.

Objective:

The study aimed to evaluate and compare polyphenol contents and antioxidant properties of eight selected species of Sida from Western Ghats, India.

Materials and Methods:

Methanolic root extracts (10% w/v) of Sida species, viz., S. acuta, S. cordata, S. cordifolia, S. indica, S. mysorensis, S. retusa, S. rhombifolia, and S. spinosa were analyzed.

Results:

Sida cordifolia possessed highest total phenolic content (TPC: 1.92 ± 0.10 mg Caffeic Acid Equivalent/g and 2.13 ± 0.11 mg Tannic Acid Equivalant/g), total flavonoid content (TF: 2.60 ± 0.13 mg Quercetin Equivalent/g) and also possessed highest antioxidant activities in 2,2-diphenylpicrylhydrazyl (DPPH) radical scavenging (51.31 ± 2.57% Radical Scavenging Activity, (RSA); Trolox Equivalent Antioxidant Capacity: 566.25 ± 28.31μM; Ascorbic acid Equivalent Antioxidant Capacity: 477.80 ± 23.89 μM) and Ferric Reducing Antioxidant Power assays (TEAC: 590.67 ± 29.53 μM; AEAC: 600.67 ± 30.03 μM). Unlike DPPH and Ferric Reducing Antioxidant Power (FRAP) activity, 2, 2′-Azinobis (3-ethyl Benzo Thiazoline-6-Sulfonic acid) ABTS⁺ antioxidant activity was highest in S. indica (TEAC: 878.44 ± 43.92 μM; AEAC 968.44 ± 48.42 μM). It was significant to note that values of AEAC (μM) for all the antioxidant activities analyzed were higher than that of TEAC.

Conclusion:

The high contents of phenolic compounds in the root extracts of selected Sida species have direct correlation with their antioxidant properties. Conclusively, roots of S. cordifolia can be considered as the potential source of polyphenols and antioxidants.

A review on balya action mentioned in Ayurveda

Medicinal and dietary substances have been used for various purposes including nutritional from time immemorial. Various activities such as immunomodulator, bulk promoting, nutritional, etc. that enhance strength, immunity, bulk of the body resulted by the use of medicinal or dietary substances are termed in total as Balya in Ayurveda. The term Balya originally stands for all those actions that enhance the "Bala". The word "Bala" refers to the strength and ability of the body or part of the body to cope up with various physical stressors. This term "Bala" refers to various body components and functions as per the science of Ayurveda. Even in the presence of modern scientific knowledge regarding body strength, Ayurveda concepts add varied dimensions to provide detailed explanation of Balya term. The balya action is critically analyzed and discussed in this review.

Applicability and importance of Caraka's concept of Aaturaparijnana Hetawah in understanding a patient

Many concepts in Ayurveda are untouched or unexplored till date. One of such concepts to understand the healthy and unhealthy persons is that of the Aaturaparijnana Hetawah (APH), which is only mentioned in Caraka Samhita. The descriptions about Dushya, Desha, Bala, Kala, Prakriti, etc. are mentioned very briefly in all the classics. But no standard figure or pattern is maintained while considering them. It is only in the description of Aaturaparijnana Hetawah mentioned in Vimana Sthana that all the factors are pre-arranged in a chronological order to understand an individual according to one’s Desha as from birth till grown up stage, and also to understand about the illness and most common disorders. In this article, it is aimed at presenting an in-depth evaluation about description of Aaturaparijnana Hetawah in Ayurveda. For this study, the references of Aturaparijnana Hetu have been collected through the Ayurvedic texts along with their commentaries. By making use of 14 factors described in Aaturaparijnana Hetawah, it is possible to have an in depth understanding about the patient’s nature and factors that may be contributing to his health and illness. Aaturaparijnana Hetawah helps in an in-depth understanding of a patient’s disease and heath status. More in-depth evaluation studies and application in the modern medical science should be done in order to avail the benefits of this approach.

Observations on Vamana procedure in healthy volunteers

Vamana Karma is one of the five Pradhana Karmas of Panchakarma which is successfully used in treating Kaphaj disorders. Panchakarma is also indicated in healthy states. (C.Su. 16/13-16) for Shodhana. Textual references are available in Ayurvedic classics, but the procedure needs to be validated in the modern times when Ahara Shakti, Bala and Agni of the individuals have decreased considerably. So the effect of procedure was observed in 30 healthy volunteers of age group 18 to 60 years. Lakshanik, Vaigiki, Maniki and Antiki Shuddhi were observed and vomitus was analyzed macroscopically, microscopically and chemically.