CLINICAL EFFICACY OF DASHMOOL KWATH NASYA IN THE MANAGEMENT OF MANYASTAMBHA WITH SPECIAL REFERENCE TO CERVICAL SPONDYLITIS

Background: Nasya is an essential therapeutic procedure as many of the courses of Ayurvedic treatment. It comes under the Panchashodhana karmas. It is necessary in all Urdhwa jathru vikaras. Nasya is effective for inducing immediate results and serves as a permanent cure. Cervical spondylotic change is frequently found in many asymptomatic adults, with 25 the age of 40, 50% of adults over the age of 40 and 85% of adults over the age of 60 showing evidence of disc degeneration. Cervical spondylosis can be compared with Manyastambha based on signs & symptoms. Nasya is the simple techniques and ingredients are readily available & economical. Also, these are indicated in the management of Manyastambha and have no proven adverse effects. This study was intended to assess the efficacy of the Dashmool Kwath Nasya in the management of this disease. Method: Randomly, 30 patients of Manyastambha were selected and paired “t” test was used. Result: Statistically significant improvement was found in this study on post-follow-up. Conclusion: Dashmool Kwath Nasya is having a prolonged action as it is having highly significant results post follow up of treatment as compared to after treatment.

DIAGNOSTIC BRONCHOSCOPY FOR EVALUATION OF CONGENITAL STRIDOR:A CASE SERIES

Introduction: Stridor is a noise mechanically produced through partially occluded airway. Airway obstruction may be extrathoracic or intrathoracic. Stridor may be congenital or acquired. Timing in respiratory cycle determines anatomic location of lesion – inspiratory, biphasic, or expiratory. Gold standard for diagnosis is bronchoscopy which requires general anaesthesia in infants and small children. Major anaesthetic concerns are – possible difficult airway, sharing of an already compromised airway, airway oedema. Case Description: 40 infants, 0 - 6 months age, with history of noisy breathing suggestive of congenital stridor, planned for diagnostic rigid bronchoscopy with or without therapeutic procedure, over one year period. Preoperative treatment – humidified oxygen, nebulization, dexamethasone, antibiotics, anti-reflux medication. Not premedicated, standard monitors applied. Induction of anaesthesia with inhalational oxygen and sevoflurane or intravenous propofol, fentanyl 1 mcg/kg, dexamethasone 0.5 mg/kg. Topical lidocaine 2% sprayed at vocal cords. 100% oxygen with propofol infusion for maintenance with spontaneous ventilation via nasopharyngeal airway. Patients requiring surgical intervention intubated using microcuffed endotracheal tube. Patients observed post-operatively. If ventilation was inadequate, intubated to control airway during recovery, extubated on restoration of spontaneous ventilation. After surgical intervention, babies shifted to ICU for elective ventilation for 48 hours. Discussion: On bronchoscopy, laryngomalacia was the finding in majority of cases. Others had subglottic stenosis, tracheomalacia, vocal-cord paresis, laryngeal cyst. Out of 40 patients, 9 underwent therapeutic procedure and were electively ventilated, 26 resumed spontaneous breathing, 2 patients had delayed recovery and 2 had severe chest retractions and desaturations and they were managed accordingly. One baby aged 6 months diagnosed with grade III subglottic stenosis desaturatedand tracheostomy had to be done. Conclusion:Anaesthesia for rigid diagnostic bronchoscopy is a significant challenge. Rigid bronchoscopy under general anaesthesia requires multidisciplinary approach and close cooperation between all team members.

Demographic and Clinical Factors Associated with Reactivity of Anti-SARS-CoV-2 Antibodies in Serbian Convalescent Plasma Donors

Passive immunotherapy with convalescent COVID-19 plasma (CCP) is used as a therapeutic procedure in many countries, including Serbia. In this study, we analyzed the association between demographic factors, COVID-19 severity and the reactivity of anti-SARS-CoV-2 antibodies (Abs) in Serbian CCP donors. Individuals (n = 468) recovered from confirmed SARS-CoV-2 infection, and who were willing to donate their plasma for passive immunization of COVID-19 patients were enrolled in the study. Plasma samples were tested for the presence of IgG reactive to SARS-CoV-2 spike glycoprotein (S1) and nucleocapsid antigens. Individuals were characterized according to age, gender, comorbidities, COVID-19 severity, ABO blood type and RhD factor. Total of 420 candidates (420/468; 89.74%) reached the levels of anti-SARS-CoV-2 IgG that qualified them for inclusion in CCP donation program. Further statistical analysis showed that male individuals (p = 0.034), older age groups (p < 0.001), existence of hypertension (p = 0.008), and severe COVID-19 (p = 0.000) are linked with higher levels of anti-SARS-CoV-2 Abs. These findings will guide the selection of CCP donors in Serbia. Further studies need to be conducted to assess the neutralization potency and clinical efficiency of CCP collected from Serbian donors with high anti-SARS-CoV-2 IgG reactivity.

Gotowość do zmiany formy nauczania dzieci ze spektrum autyzmu

The article deals with the issue of readiness to change the form of teaching of children with autism spectrum disorders and is an attempt to answer questions about the methods of therapy and education of these people. The VB-MAPP Program will be presented as a example of a comprehensive diagnostic and therapeutic procedure that facilitates making a professional decision to change the form of teaching. Considerations are to be accompanied by an issue that is more and more often present in the scientific discourse and among practitioners, teachers, therapists and parents: Is the education system in Poland responding to the special needs of children and is inclusion always the right way?

INTERCORRENCES WITH THE MISUSE OF TYPE A BOTULINUM TOXIN

Botulinum Toxin type A has become a great ally in aesthetic procedures because it is a very efficient non-surgical, aesthetic-therapeutic procedure. Known and much sought after for the result it provides in facial harmonization, by smoothing expression lines caused by repeated contractions carried out over the years, it has increased the demand for the technique, and with that, some complications and light, but transient complications arose. Thus, the objective of this article is to understand the process of application of botulinum toxin type A, its effects and complications (intercurrences) that may arise when not performing the technique as recommended, in addition to reviewing the literature and the protocol for applying the Botulinum toxin type A. The bibliographic research method, literature review of articles from the year 2000, in English and Portuguese, in search platforms of Scielo, Pubmed, Academic Google, atlas, dissertations and theses. Respecting the reapplication time is essential not only for complications, but also the patient's individuality, outlining a safe and effective path to avoid unwanted effects, thus ensuring a successful and attractive procedure both in the eyes of the professional and in the eyes of the clients .

Phototherapy in Dermatology

Phototherapy is a therapeutic procedure in dermatology. Phototherapy uses certain ultraviolet wavelengths classified into 3 types,broadband UVB (BBUVB), narrowband UVB (NBUVB), and psoralen UVA (PUVA). The most widely used is NBUVB for treating psoriasis, atopic dermatitis and vitiligo. The mechanism of action of phototherapy is to reduce epidermal proliferation, suppress the immune system, reduce the inflammatory process, and induce repigmentation. Before starting phototherapy, the dose adjustment depends on skin type and minimal erythema dose (MED). Frequency of use is recommended based on the severity of the disease, continuously administered needed. Besides of this therapeutic effect, some contraindications and side effects that need to be considered in the use of phototherapy such as drug interactions, photoallergic and risk of skin malignancy.

AN OBSERVATIONAL CLINICAL STUDY ON LIPID PROFILE CHANGES BEFORE AND AFTER SHODHNARTH SNEHPAN

Background: Snehan(oleation) has a great role in all Panchakarma procedures. The therapeutic procedure by which greasiness is imparted to the body using different kinds of fat (Ghrita, Tail, Vasa, Majja etc) is called Snehan. Snehpan where fat substances are given in increasing doses by Ayurveda physicians, patients may have a fear that it will increase their cholesterol levels, there is this belief that if you consume ghrita, oil etc, it will in- crease your cholesterol levels and also increases the risk of heart disease. We conducted lipid profile reports be- fore and after Shodhnarth Snehpan in 10 patients in Janseva Ayurvedic Hospital, Surendranagar, Gujarat, India. Objectives: to observe Lipid Profile changes before and after Shodhanarth Snehpan. Management and Out- come: S. cholesterol, Triglycerides, LDL, VLDL in all 10 patients were decreased. HDL however increased which is good cholesterol. Conclusion: The study requires a large group for more specific data. From this study, we can say Snehpan does not increase S.cholesterol levels. Keywords: Lipid profile changes, Shodhanarth snehpan.

Role of Balloon Pulmonary Valvuloplasty in the Management of Pulmonary Stenosis

Although there is definitive evidence for pressure gradient relief both immediately after and at follow-up after balloon pulmonary valvuloplasty (BPV) for pulmonary stenosis (PS), the progression of pulmonary insufficiency (PI) at late follow up emerged as a concern. To address the concern for development of PI during late follow-up, balloon/annuls ratio used for BPV was reduced to 1.2 to 1.25. Recurrence of stenosis was seen in nearly 10% of patients. The causes of recurrence were identified to be balloon/annulus ratio less than 1.2 and immediate post-BPV gradients in excess of 30 mmHg. Recurrent obstructions can be effectively relieved by repeat BPV. The BPV procedure is safe and effective in fetal, neonatal and adult subjects as well. The BPV is also effective in palliating cyanotic congenital heart disease patients with valvar PS. Despite the limitations, BPV is currently considered as therapeutic procedure of choice in the management of congenital PS in both the pediatric and adult populations. BPV provides an excellent alternative to surgical intervention and has become the preferred intervention for initial treatment for PS in neonates, infants, children, adolescents, and adults. Careful follow-up to detect development of significant PI and investigate methods to prevent PI are recommended.