The Patient Population at Homeopathic Outpatient Clinics across India: A Clinical Data Collection Study.

BACKGROUND: Even though several initiatives have been undertaken in different locations worldwide to collect clinical data in homeopathy, it is important to further investigate these aspects in the context of health care in India. OBJECTIVE: The study aimed to gather and analyze patients' clinical data and to derive insights into homeopathic treatment using an internet-based software program for data storage, retrieval and repertorization. METHODS: A multi-center observational study was conducted across 14 homeopathy outpatient clinics in India that are affiliated with the Central Council for Research in Homoeopathy (CCRH). Patient symptoms and demographic details were documented anonymously, and prescriptions were guided by repertorial suggestions from the Vithoulkas Compass software. During follow-up visits, treatment outcome was also recorded using an online assessment form. A retrospective analysis of data on patients' demographics, follow-up visits, morbidity (International Classification of Diseases 11th Revision), rubrics used, prescribed medicines and the level of improvement was achieved using Microsoft Excel-generated pivot tables. RESULTS: Throughout the study duration of one year a total of 2,811 patients attended the 14 outpatient clinics, of whom 2,468 were new patients with a total of 2,172 initial homeopathic prescription entries. Across the study, there were 3,491 prescriptions and 1,628 follow-up consultations for 868 follow-up patients, all of which data were thoroughly analyzed. The highest frequency of patients was in the 20-49 age group, and a higher proportion of the patients overall was female. Musculoskeletal, dermatological and respiratory complaints were the most frequently reported. The rubrics "Desire for sweets" and "Desire for spices" emerged as the most commonly used in the repertorizations. Further, Sulphur stood out as the most commonly prescribed medicine overall. With homeopathic treatment, some degree of clinical improvement was reported in 86% of the follow-up cases. CONCLUSION: Homeopathy is prescribed in CCRH outpatient clinics for a wide range of ailments in people across India, with at least some clinical improvement noted in a high proportion of those patients. The large-scale systematic data collection in these clinics has provided clear insights into the use and clinical value of homeopathy in India, with the potential to build a substantive nationwide data inventory over time.

Stereoselective analysis of chiral pesticides: a review.

Chiral organic pollutants, including pesticides, herbicides, medicines, flame retardants, and polycyclic musk, represent a significant threat to both the environment and human health. The presence of asymmetric centers in the structure of chiral pesticides introduces stereoisomers with distinct distributions, fates, biomagnification capacities, and cytotoxicities. In aquatic environments, pesticides, as persistent/pseudo-persistent compounds, have been detected in substantial quantities, posing severe risks to non-target species and, ultimately, public health through water supply and food exposures. In response to this environmental challenge, stereoselective analytical methods have gained prominence for the identification of pesticide/drug enantiomers in recent years. This review examines the environmental impact of chiral pesticides, emphasizing the distinct biological activities and distribution patterns of their stereoisomers. By highlighting the advancements in liquid chromatography for enantiomeric analysis, the review aims to underscore the urgent need for a comprehensive understanding of these pollutants to facilitate informed remediation strategies and ensure the safer dispersal of chiral organic pollutants in the environment, thereby addressing the potential risks they pose to ecosystems and human health. Future research should focus on developing sustainable and efficient methodologies for the precise analysis of stereoisomers in complex matrices, particularly in sewage water, emphasizing the importance of sewage processing plants in ensuring water quality.

Purification and characterization of a high molecular weight serine protease from Microbacterium paraoxydans sp. SKS10.

Alkaline proteases from microbial sources have been found suitable for diverse industrial applications, with serine proteases being the most common enzymes used in the detergent industry. In the present study, we have purified and characterized an extracellular alkaline serine protease from Microbacterium paraoxydans sp. SKS10. The protease was purified using ammonium sulfate precipitation followed by different chromatography techniques (fold purification 6.919). Km and Vmax for the protease were determined to be 0.183 mg/mL and 4.904 U/mL, respectively. This enzyme is a thermostable high molecular weight (∼109.4 kDa) protease which has maximal activity at 60°C, and above pH 10. Inhibitor assays revealed the enzyme to be a serine protease whose activity increased by 2.5-fold in the presence of EDTA. This enzyme remained active in the presence of various metal salts and organic solvents and was compatible with commercially available laundry detergents highlighting its potential for use in the detergent industry.

Epsilon poly-lysine in buffalo semen extender: A step towards reducing the development of antibiotic resistance.

The use of antibiotics in semen extenders can contribute to the development of antibiotic resistance. The objective of the study was to evaluate epsilon-polylysine (Ɛ-PL) as a substitute for antibiotics in the buffalo semen extender. For this, 20 semen ejaculates were collected from four Murrah buffalo bulls. Each ejaculate was divided into three equal aliquots and extended into an egg yolk-based semen extender containing either antibiotics (strepto-penicillin) or different concentrations of Ɛ-PL (0.64 and 1.28 g/L) to make the final concentration 80 million sperm/mL and cryopreserved as per the standard procedure. The antibiogram sensitivity test confirmed that Ɛ-PL is an effective antimicrobial against microbes present in buffalo semen ejaculates. Furthermore, the addition of Ɛ-PL in the semen extender significantly reduces the colony forming unit (CFU)/mL in cryopreserved semen equivalent to strepto-penicillin. The sperm motility and kinematic parameters assessed by a computer-assisted sperm analyser showed that Ɛ-PL did not inhibit either sperm motility not kinematic parameters of cryopreserved sperm. The flow-cytometric evaluation of frozen-thawed sperm revealed interesting results. The extender supplemented with Ɛ-PL protected sperm acrosome and mitochondrial membrane potential greater than the extender supplemented with strepto-penicillin. Further, Ɛ-PL reduced significantly the production of superoxide anions from mitochondria during the cryopreservation process. In this way, Ɛ-PL may be a suitable alternative to antibiotics in semen extenders. In conclusion, Ɛ-PL at a concentration of 0.64 g/L acts as an effective antimicrobial as well as antioxidant in semen extender for cryopreservation of buffalo sperm.

Homeopathic Medicines in the Management of Dermatophytosis (Tinea Infections): A Clinico-epidemiological Study with Pre-post Comparison Design.

BACKGROUND: Dermatophytosis is a common fungal infection of the skin and nails. Insufficient data exist regarding the clinico-epidemiological profile of dermatophytosis and the usefulness of individualized homeopathic medicines (IHMs) for patients visiting a homeopathy outpatient department (OPD). OBJECTIVES: This article undertakes a clinico-epidemiological profiling of dermatophytosis and the usefulness of IHMs in its management. METHODS: This open-label, pre-post, comparative observational study was conducted in a homeopathy OPD from November 2018 to February 2020. IHMs were prescribed based on symptom totality and repertorization. A numeric rating scale (NRS) and the Dermatology Life Quality Index (DLQI) patient questionnaires were used, and results were analyzed using SPSS-IBM version 20. RESULTS: Data from a total of 103 patients, mean age 29.65 ± 15.40 years, were analyzed. Tinea cruris was the most common infection (29.1%), followed by tinea corporis (13.6%). After 3 months of treatment, significant reductions in NRS and DLQI scores were observed (8.51 ± 1.24 to 0.59 ± 0.83, p < 0.001, and 16.28 ± 5.30 to 1.44 ± 1.56, p < 0.001, respectively), with Sepia (15.5%), Sulphur (14.6%), Calcarea carbonica (11.7%), Natrum muriaticum (9.7%) and Bacillinum (8.7%) being the most frequently prescribed medicines. There was no significant correlation between occupation, sex, home location or marital status and the clinical types of dermatophytosis. No adverse events were reported. CONCLUSION: T. cruris and T. corporis were prevalent dermatophytic infections. The decrease in NRS and DLQI scores associated with homeopathy indicates its usefulness as an integrative treatment option for dermatophytosis. Further research in larger and more diverse population samples is needed.

Genetic analysis for semen quality traits in buffalo bulls.

This study was attempted to estimate the genetic parameters of semen quality traits in buffalo bulls. The study data consisted of 10975 ejaculates from 45 Murrah buffalo bulls (aged 24-72 months) used for breeding program during year 2010 to 2020. Semen quality traits (ejaculate volume, concentration of sperm, mass activity, initial and post-thaw motility, number of sperms per ejaculate, motile sperm number and discard rates) were studied. It was observed that average ejaculate volume was 2.82 ± 1.45 mL with mean concentration of 1040.12 ± 523.26 million/mL. Higher heritability was observed for number of sperms per ejaculate, number of motile sperm and sperm concentration. Significant phenotypic correlation was obtained between volume and number of sperms per ejaculate as well as volume and number of motile sperms. Likewise, significant phenotypic correlation was evident between sperm concentration with sperm number per ejaculate. Highest phenotypic correlation was obtained between sperm count per ejaculate and motile sperm count. Estimated genetic trends showed significant change in volume and motile sperm number. In conclusion, this study ascertains that genetic parameters of semen traits can be considered during the selection of buffalo bulls in breeding program.

Cu-catalysed transamidation of unactivated aliphatic amides.

Direct transamidation is gaining prominence as a ground-breaking technique that generates a wide variety of amides without the requirement of acid-amine coupling or other intermediate steps. However, transamidation of unactivated aliphatic amides, on the other hand, has been a long-standing issue in comparison to transamidation of activated amides. Herein, we report a transamidation approach of an unactivated aliphatic amide using a copper catalyst and chlorotrimethylsilane as an additive. In addition, we used transamidation as a tool for selective N-C(O) cleavage and O-C(O) formation to synthesise 2-substituted benzoxazoles and benzothiazoles. The reactions were carried out without using any solvents and offered wide substitution scope.

In-vitro cytotoxicity of nickel oxide nanoparticles against L-6 cell-lines: MMP, MTT and ROS studies.

In the present work we synthesize nickel oxide nanoparticles (NiO NPs) using Rhododendron arboretum (flower) (RNi), Tinospora cordifolia (stems) (GNi), Corylus jacquemontii (seeds) (CNi), and Nardostachys jatamansi (roots) (NNi) extracts by co-precipitation method. The synthesized NiO NPs were characterized in detail in terms of their morphological, crystalline nature, structural and antiproliferative activity against rat skeletal myoblast (L-6) cell lines. Morphological studies confirmed the formation of nanoparticles, while the structural and compositional characterization revealed the well-crystallinity and high purity of the synthesized nanoparticles. For biological applications and cytotoxicity examinations of the synthesized NPs, the rat skeletal myoblast (L-6) cell lines were subjected to study. By detailed cytotoxic investigations, it was observed that among the four kinds of NiO NPs prepared through different plant extracts, the Tinospora cordifolia (stems) showed strong antiproliferative activity against rat skeletal myoblast (L-6) cell lines and the calculated IC50 was 1.671 mg/mL. The observed antiproliferative activity towards different NiO NPs were in the order of GNi > NNi > RNi > CNi. The present studies demonstrate that simply synthesized NiO can efficiently be used as antiproliferative agents.

Enantioseparation of linezolid and tedizolid using validated high-performance liquid chromatographic method.

This paper reports the separation of two chiral antibacterial agents namely, linezolid and tedizolid using a validated high-performance liquid chromatographic method. In the current work, glycopeptide-based chiral column, CHIROBIOTIC® V2 (5-µm particle size, L × I.D. 25 cm × 4.6 mm) was employed with a mobile phase containing methanol and 0.15% aq. trifluoracetic acid (75:25%, v/v) in isocratic elution approach at flow rate of 1 ml min-1 . The separation condition was customized (in terms of resolution values and retention times) was carried out by changing the content of the mobile phase, column temperature, flow rate, and so on. Results showed that the chromatographic separation was achieved within 15 min and average resolution values were 4.6 and 4.8 for tedizolid and linezolid, respectively. The detection limit values were 14.85 and 14.16 ng ml-1 , respectively, for tedizolid enantiomers. Further, validation of separation parameters was performed by considering the international conference on harmonization guidelines, and ultimately, the mechanism of chiral recognition was also established.

Effect of mitochondria-targeted antioxidant on the regulation of the mitochondrial function of sperm during cryopreservation.

Sperm mitochondrion is one of the major susceptible organelles that get damaged during cryopreservation. The study aimed to minimize mitochondrial dysfunction and oxidative stress during sperm cryopreservation using mitochondria-specific antioxidants. For this, semen was collected from five buffalo bulls (3 ejaculates/bull). The ejaculates were diluted in an low-density lipoprotein-based extender and divided into four equal aliquots. Mitochondria-targeted antioxidant (MitoQ) was added at a final concentration of 0 (control), 0.02, 0.2 and 2 µM separately in each aliquotes and cryopreserved. The addition of MitoQ at a concentration of 0.02 µM improved post-thaw sperm motility, plasma membrane integrity and able to sustain sperm motility for a longer time. To investigate MitoQ's effects on mitochondrial function, we measured mitochondrial membrane potential (MMP) using JC-1 dye, superoxide production using Mitosox assay, and lipid peroxidation by TBARS assay. The supplementation of 0.02 µM MitoQ in the extender prevented the significant reduction of MMP and reduced superoxide production resulting in lower lipid peroxidation of sperm plasma membrane after cryopreservation. Further, we found that a higher concentration of MitoQ decreases MMP and increases mitochondrial superoxide production. In conclusion, MitoQ @ 0.02 µM can alleviate oxidative stress by regulating mitochondrial functionality in spermatozoa during cryopreservation.

Is addition or removal of seminal plasma able to compensate for the dilution effect of buffalo semen?

The present study aimed to compensate dilution effect using additional seminal plasma (SP) in conventional (80 million (M) spermatozoa/ml) dose and low spermatozoa/dose (8M spermatozoa/ml). We also attempted to confirm whether removal of SP before the extension of ejaculates affects post-thaw sperm quality of buffalo semen. For this, semen ejaculates (N = 15) were divided into four groups: control (CON), removal of SP by centrifugation (NSP), resuspension of the centrifuged semen pellet into SP (CEN) and extra supplementation of SP (ESP). All groups were diluted into two different semen doses to 20 and 2M spermatozoa/0.25 ml using tris egg yolk extender and subsequently cryopreserved. We found that neither addition nor removal of SP affected sperm motility, kinematics, longevity, mitochondrial superoxide production and high mitochondrial membrane potential (MMP). Further, the addition or removal of SP was not able to compensate dilution effect in 2M groups resulting in a significantly (p < .05) reduction in sperm motility, kinematics, sperm longevity, membrane integrity, MMP, and an increase production of mitochondrial superoxide. In conclusion, it appears that role of SP in the sperm cryopreservation process is insignificant.

Impact of socio-demographic variables on antenatal services in eastern Uttar Pradesh, India.

We investigated the impact of socio-demographic variables on antenatal care (ANC) utilization and the low birth weight of a child. Data were collected from 300 pregnant females. Only 22.5% of females received full antenatal care (≥4 visits). Our results showed that female's age at marriage and education plays a significant role in improving ANC. We observed an overall decrease in the utilization of services provided during each antenatal visit. ANC visits from the first trimester decrease the risk of having a baby with low birth weight. Awareness programs and educating families about pregnancy care are recommended to improve ANC utilization.

Duplications in 19p13.3 are associated with male infertility.

PURPOSE: To identify genomic imbalances and candidate loci in idiopathic male infertility. METHODS: Affymetrix CytoScan 750K Array was used to analyze genomic imbalances and candidate loci in 34 idiopathic infertile cases of different phenotypes (hypo-spermatogenesis, n = 8; maturation arrest, n = 7; and Sertoli cell-only syndrome, n = 13, severe oligozoospermia, n = 6, and 10 normozoospermic fertile men). Ten ethnically matched controls were screened for comparison. RESULTS: The cytogenetic array analysis detected a genomic gain at the 19p13.3 region in 9 (26.47%) cases, with the highest frequency in patients with Sertoli cell-only syndrome (SCOS) (38%). Its complete absence in the control group suggests its likely pathogenic nature. In addition to Y-classical, micro, and partial deletions, the duplication in 19p13.3 could serve as a unique biomarker for evaluation of infertility risk. The common region across the individuals harboring the duplication identified STK11, ATP5D, MIDN, CIRBP, and EFNA2 genes which make them strong candidates for further investigations. The largest duplicated region identified in this study displayed a major network of 7 genes, viz., CIRBP, FSTL3, GPX4, GAMT, KISS1R, STK11, and PCSK4, associated with reproductive system development and function. The role of chance was ruled out by screening of ethnically matched controls. CONCLUSION: The result clearly indicates the significance of 19p13.3 duplication in infertile men with severe testicular phenotypes. The present study underlines the utility and significance of whole genomic analysis in the cases of male infertility which goes undiagnosed due to limitations in the conventional cytogenetic techniques and for identifying genes that are essential for spermatogenesis.

Pretreatment optimisation and kinetics of batch anaerobic digestion of liquidised OFMSW treated with NaOH: Models verification with experimental data.

The enormous generation of municipal solid waste (MSW) due to increased urbanization is causing threat to the environment. MSW is a mixed waste and it comprises of organic fraction as the key fraction called organic fraction of municipal solid waste (OFMSW) along with other fractions. The pretreatment of OFMSW is necessary step to increase the biogas yield. In the present work, NaOH hydrolysis of mechanically liquidised OFMSW was carried out to reduce its complexity and improve the biogas production. Furthermore, hydrolysis parameters were optimised by RSM model for NaOH pretreatment. Optimised conditions achieved from RSM analysis were 0.46 N NaOH loading, 72 h reaction time and 36.05 °C operating temperature. The RSM predicted values of response sCOD and VFA at optimum condition were in good agreement with experimental data signifying the model adequacy. The kinetic of batch anaerobic digestion of OFMSW treated with NaOH at different concentrations and optimised condition had been studied to see the suitability of first order model and modified Gompartz model. The experimental results obtained were best fitted using normalized root mean square error analysis. Biogas production after pretreatment at 0.1, 0.5, 0.9 N NaOH concentration and RSM optimised condition was 369.24, 435.24, 327.84 and 465.67 NL/kg VS, respectively.

Etiological and clinical profiles of patients with dysphagia: A teaching institution experience.

Background: Dysphagia can involve any structure from the mouth to the lower esophageal sphincter. The etiologies vary from benign causes to malignant lesions. There is dearth of data regarding dysphagia in our population. Methods: A total of 208 patients with complaints of dysphagia were screened for the study. After ruling out neurological/local oropharyngeal causes of dysphagia, 200 patients with suspected esophageal dysphagia (ED) were recruited in the study. Dysphagia was graded as per the dysphagia scoring system. All patients underwent upper gastro-intestinal endoscopy and were evaluated for the presence of mechanical and non-mechanical causes of ED. Results: The mean age of patients with dysphagia was 53.8 ± 15.4 years. with males and females being 82 and 118, respectively. The mean duration of the symptom was 7.2 ± 10.6 months (median 3 months). Ninety-eight patients (49%) having dysphagia were in the age group of 56-65 years. The dysphagia score was 0 among 58, and 4 among 26 subjects. Foreign body sensation was the most frequent chief complaint in 90 (45%) patients. Ninety-six (48%) and 104 (52%) patients had mechanical and non-mechanical causes of dysphagia, respectively. Among mechanical causes of dysphagia, 68 patients (70.8%) had esophageal growth and 28 (29.2%) had esophageal stricture. Sixty-seven patients had squamous cell carcinoma. Among non-mechanical causes, 50 (48.1%) had globus sensation, 24 (23.1%) had hiatus hernia, and 16 (15.4%) functional dysphagia. Conclusion: Dysphagia is a common problem with varied etiologies. The esophageal growth and globus sensation are among the predominant causes of ED. We stress that all patients of dysphagia must be meticulously investigated.

Correlation of Venous Blood Sugar Measured by Lab Method and Capillary Blood Sugar Measured by Glucometer in Neurosurgical Patients Receiving Dexamethasone.

Background Brain is vulnerable to extreme blood glucose levels that may occur due to multiple factors in neurosurgical patients; perioperative use of dexamethasone is the most common. Thus, frequent monitoring of blood sugar levels is advocated. This study aimed to assess correlation between venous blood sugar measured by lab method and capillary blood sugar by glucometer at various time intervals. Materials and Methods This prospective and observational study was conducted in 20 adult patients of either sex, American Society of Anesthesiologists grade I to III, scheduled to undergo brain tumor resection. The patients who were already on dexamethasone and received intraoperatively 8 mg dexamethasone were enrolled. Standard anesthesia technique and intraoperative monitoring were followed in all patients. Venous sample was withdrawn and blood sugar analyzed in laboratory, while at the same time capillary blood sugar was tested by glucometer. The sampling was done at baseline, 1 hourly after dexamethasone administration till 4 hours and then 8, 12, and 24 hours. The correlation between the two values was assessed. Results During the study, 160 venous and 160 capillary blood sugar levels were analyzed. Though capillary blood sugar levels were slightly higher than venous sugar levels, there was strong correlation between the two (Pearson correlation coefficient) with p -value less than 0.05 except at 24 hours when two values were not correlated. Conclusion Capillary blood sugar levels by glucometer have good correlation with venous sugar levels; therefore, this method may be adopted routinely for frequent blood sugar estimation as it is reliable, easy, and practical.

Comparison between Air Q and intubating laryngeal mask airway as intubation conduits in patients with simulated fixed cervical spine: a prospective observational study.

The intubating laryngeal mask airway (ILMA) can be used for ventilation and oxygenation between intubation attempts, but there is a varied success rate ranging from 33% to 96%. Air Q is a relatively new entrant. Parker flex tube aids in atraumatic intubation. The primary aim of this study was to compare Air Q intubating laryngeal airway with ILMA as intubation conduits in patients with simulated fixed cervical spine using a Parker flex tube. It was a single-blinded, randomized, prospective, and comparative study conducted on 91 patients aged between 18 to 60 years of either sex, scheduled to undergo elective surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status I and II. Out of 45 patients in each group, Air Q was successfully placed in 43 patients and ILMA was successfully placed in 44 patients. 35.56% of the patients required maneuvers for placing the Air Q, whereas, for placing the ILMA, only 15.56% of the patients required maneuvers. Intubation through the AIR Q was successful in 39 patients and through the ILMA in 44 patients, but there was no significant difference between the two groups. The number of attempts and the time of device insertion were comparable. There were a similar number of attempts, maneuvers required, and time is taken for endotracheal intubation. The incidence of cough and sore throat was comparable in both groups. We conclude that ILMA has a higher success rate than Air Q for tracheal intubation with Parker Flex tube in patients with simulated fixed cervical spine. More optimized maneuvers were required for the placement of Air Q.

Psychological trauma and depression in recovered COVID-19 patients: a telecommunication based observational study.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. OBJECTIVES: The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. METHODS: This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. RESULTS: The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). CONCLUSION: This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects.

Practice, prescription habits, experience and perception of Indian homeopathic practitioners in treatment of diabetes mellitus: An online observational study.

BACKGROUND: Studies have shown homoeopathy to effectively control blood sugar levels and improve quality of life (QOL), though a standard treatment protocol is required. OBJECTIVE: This study intended to assess the homoeopathic practice, prescription habits, experience, and perception of Indian Homeopathic Practitioners (HPs) in treating DM. METHODOLOGY: A web-based cross-sectional with a snowball sampling method was conducted between 30th July 2021 and 18th August 2021. A questionnaire to record clinical attributes of Indian HPs in the management of DM was formed after the consensus of the subject experts and pilot testing for feasibility. RESULTS: Participants were 513 HPs with mean age [Standard Deviation (SD)] of 40.44 years (11.16) and a mean duration of the homoeopathic medical practice of 14.67 years [95% Confidence Interval (CI) = 13.71-15.63]. The majority of HPs made classical homoeopathic prescription (201, 39.2%) though the success in the management of DM was better among HPs who prescribed more than one potentized medicine [vs classical prescription, Odds Ratio (OR) = 2.34, p = 0.032]. As perceived by the HPs, homoeopathic treatment resulted in a major improvement in QOL of the diabetic patients (418, 81.5%) with very few adverse effect (100, 19.5%). The blood sugar level was controlled better when homoeopathy was given alongside conventional medicine (348, 67.8%). CONCLUSION: The clinical experience of HPs in this study has shown that homoeopathic treatment can benefit DM patients in preventing complications and improving QOL. It further reported that homoeopathy can be an important adjuvant to conventional treatment in managing DM.

Effect of Normal Saline versus PlasmaLyte on Coagulation and Metabolic Status in Patients Undergoing Neurosurgical Procedures.

Background The choice of intraoperative fluid in neurosurgical patients is important as we need to maintain adequate cerebral perfusion and oxygenation and also avoid cerebral edema. Normal saline (NS) is commonly used in neurosurgeries, but it leads to hyperchloremic metabolic acidosis, which may result in coagulopathy. Balanced crystalloid with physiochemical composition akin to that of plasma has favorable effects on metabolic profile and may avoid the problems associated with NS. Against this background, the present study aimed to compare the effects of NS versus PlasmaLyte (PL) on coagulation profile in patients undergoing neurosurgical procedures. Methods This prospective, randomized, double-blinded study was conducted in 100 adult patients scheduled to undergo various neurosurgical procedures. Patients were randomly allocated in two groups of 50 each to receive either NS or PL intraoperatively and postoperatively till 4 hours after the surgery. Hemoglobin, hematocrit, coagulation profile (PT, PTT, and INR), serum chloride, pH, blood urea, and serum creatinine were measured prior to induction (baseline) and 4 hours after completion of surgery. Results Demographic characteristics were statistically similar between the two groups. Coagulation profile parameters were comparable between the two groups at baseline as well as 4 hours after surgery. pH was significantly lower in the NS group as compared to the PL group at 4 hours after surgery. Postoperatively blood urea, serum creatinine, and serum chloride levels were significantly raised in the NS group as compared to the PL group. Hemoglobin and hematocrit values were similar between the two groups. Conclusion Coagulation profile parameters were normal and statistically similar with intraoperative infusion of NS versus PL in patients undergoing neurosurgical procedures. However, use of PL was associated with a better acid-base and renal profile in these patients.