Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine.

Objective We aimed to evaluate and compare the effectiveness of physical and yoga therapies as an adjuvant therapy along with standard pharmacologic treatment in patients with migraine. Materials and Methods A total of 61 consenting patients diagnosed to have migraine were randomized into three groups to receive either standard treatment alone, physical therapy along with standard treatment, or yoga therapy along with standard treatment. The respective adjuvant intervention was taught to the respective group of patients and they were advised to perform it daily for 3 months with weekly telephonic reminders and review of their activity logs. Outcome measures assessed were headache frequency, Short-Form McGill Pain Questionnaire (SF-MPQ), and Headache Impact Test-6 (HIT-6) at recruitment and once every month for 3 months. Statistical Analysis Statistical analysis of the study was done by using Stata 14.1 software. All the descriptive statistics, paired t -test was used to compare the difference between pre and postintervention values of headache frequency, SF-MPQ, and HIT-6 score within all the three groups. Analysis of variance test and post hoc test were used to compare the differences between all groups for outcome measures ( p < 0.05). Results Headache frequency and the visual analog scale before intervention compared during each month intervals for 3 months in all the three groups were significantly decreased in all the three groups ( p < 0.005). Yoga or physical therapy as an adjuvant to standard treatment leads to a higher reduction in headache frequency and severity. Sensory and affective pain ratings of SF-MPQ and HIT-6 also showed a significant improvement at 1 to 3 months of treatment compared with baseline in all the three groups. Conclusion Either physical or yoga therapy as an adjuvant to standard pharmacologic treatment may further improve the quality of life and reduce headache frequency in patients with migraine.

Optimization and kinetic study of ultrasound assisted deep eutectic solvent based extraction: A greener route for extraction of curcuminoids from Curcuma longa.

The use of deep eutectic solvents (DESs) as a new extraction medium is a step towards the development of green and sustainable technology. In the present study, nine DESs based on choline chloride acids, alcohols, and sugar were screened to study the extraction of curcuminoids from Curcuma longa L. Choline chloride and lactic acid DES at 1:1 M ratio gave the maximum extent of extraction. Further, DES based extraction was intensified using ultrasound. The impact of various process parameters such as % (v/v) water in DES, % (w/v) solid loading, particle size, ultrasound power intensity, and pulse mode operation of ultrasound was studied. The maximum curcuminoids yield of 77.13 mg/g was achieved using ultrasound assisted DES (UA-DES) based extraction in 20% water content DES at 5% solid loading and 0.355 mm particle size with 70.8 W/cm2 power intensity and 60% (6 sec ON and 4 sec OFF) duty cycle at 30 ± 2 °C in 20 min of irradiation time. Kinetics of UA-DES extraction was explained using Peleg's model and concluded that it is compatible with the experimental data. Additionally, anti-solvent (water) precipitation technique was applied, which resulted in 41.97% recovery of curcuminoids with 82.22% purity from UA-DES extract in 8 h of incubation at 0 °C. The comparison was made between conventional Soxhlet, batch, DES and UA-DES based processes on the basis of yield, time, solvent requirement, temperature, energy consumption, and process cost. The developed UA-DES based extraction can be an efficient, cost effective, and green alternative to conventional solvent extraction for curcuminoids.

Non-verbal Communication in a Neonatal Intensive Care Unit: A Video Audit Using Non-verbal Immediacy Scale (NIS-O).

Effective communication with parents is a very important skill for pediatricians especially in a neonatal setup. The authors analyzed non-verbal communication of medical caregivers during counseling sessions. Recorded videos of counseling sessions from the months of March-April 2016 were audited. Counseling episodes were scored using Non-verbal Immediacy Scale Observer Report (NIS-O). A total of 150 videos of counseling sessions were audited. The mean (SD) total score on (NIS-O) was 78.96(7.07). Female counseled sessions had significantly higher proportion of low scores (p < 0.001). No video revealed high score. Overall 67(44.67%) sessions revealed low total score. This reflects an urgent need to develop strategies to improve communication skills in a neonatal unit. This study lays down a template on which other Neonatal intensive care units (NICUs) can carry out gap defining audits.

Low-fidelity simulation to enhance understanding of infection control among undergraduate medical students.

BACKGROUND: Developing economies are stressing institutional care for better health outcomes but its advantages are dampened by healthcare-associated infections (HAIs). Besides other undesired complications, the economic cost of HAIs is enormous. Developing countries have higher HAI rates compared with Europe or the USA. The knowledge and practice of infection control is poor among medical students. Based on introspection of 'Infection Control Module' for undergraduates introduced in 2012, we tested emotional sensitization using low-fidelity techniques to enhance its effectiveness. METHODS: All medical undergraduate students in their second year (n=102) were randomly divided into three groups using balanced randomization (two test and one control). Test groups were made to realize the emotional, social and financial consequences of HAI on patients and their families through low-fidelity simulation in the form of case discussions and video demonstrations. Pre- and postintervention empathy scores were calculated using Toronto empathy questionnaire (TEQ) for all the 102 students. Postintervention, all students were subjected to an infection control module and knowledge test. Perceptions of the intervention groups were recorded. Descriptive statistics and ANOVA were applied for data analysis. RESULTS: Of the 102 students, 93 (91.1%) participated in the study. There was no significant difference in the pre-test TEQ score (p=0.87) but there was a significant difference in the post-test TEQ (p = 0.026) and knowledge test score (p = 0.016) among the groups. Both the simulation exercises were well appreciated by the students. CONCLUSION: Emotional sensitization using low-fidelity simulation served as a catalyst in understanding infection control among medical undergraduate students.

Intraprostatic ozone therapy: A minimally invasive approach in benign prostatic hyperplasia.

INTRODUCTION: Transurethral resection of prostate (TURP) remains the golden standard therapy since decades. There are various minimally invasive therapies (MITs) for the treatment of benign prostatic hyperplasia (BPH). Still, there is a need for therapy with lesser side effects and better outcome. We had studied the effect of intraprostatic ozone injection (IPOI) as an MIT for patients with BPH who have failed trial without catheter (TWOC). MATERIALS AND METHODS: Thirty elderly patients with BPH with a prostate size of 30 g or more were enrolled for the study. Forty milliliters of ozone at a concentration of 30 µg/dl was injected in prostate (20 ml in each lateral lobe) per rectally. Prostate volume (PV) by ultrasonography was assessed after catheter removal on the 7th day and after 1 month. OBSERVATIONS AND RESULTS: Totally thirty patients (mean age - 67.8 years) with mean prostatic volume (MPV) of 46.10cc received IPOI. MPV came as 44.96cc on the 7th day of postozone therapy (P = 0.008). Successful voiders showed a significant reduction in PV (mean = 13.12cc) as compared to unsuccessful voiders (mean = 2.61cc) after 1 month. CONCLUSION: Intraprostatic ozone injection helps to reduce the PV to some extent and can be helpful in patients who have failed TWOC even on alpha blockers and are unfit for TURP. Larger studies are required to assess the efficacy and long-term results of this technique.

Apparent seroprevalence, isolation and identification of risk factors for brucellosis among dairy cattle in Goa, India.

Brucellosis is a highly contagious zoonotic infection affecting livestock and human beings. The disease has been reported worldwide except in few countries where it has been eradicated. The prevalence of brucellosis among cattle from 11 farms having a history of abortions was studied. A total of 481 samples comprising of blood, milk, vaginal swabs, vaginal discharges, placental tissues and fetal tissues were collected from 296 animals. Clinical samples were processed for the isolation of Brucella. Serum samples (n=296) were tested by Rose Bengal Plate Test (RBPT) and indirect ELISA. A total of 90 (30.40%) and 123 (41.55%) samples were positive by RBPT and indirect ELISA, respectively. Also 27.02% samples were positive by both the tests. Brucella isolates (n= 8) were recovered from clinical samples using Brucella selective media. All the isolates demonstrated PCR amplification for the bcsp31 and IS711 genes. Amplification of Brucella abortus specific primer was demonstrated by all the isolates in AMOS PCR indicating isolates to be of either B. abortus biotype 1, 2 or 4. Risk factors for transmission of brucellosis among cattle population were studied by field surveys. It was observed that lack of awareness about brucellosis (OR=8.739, P=0.138) and inadequate floor space (OR=0.278, P=0.128) were crucial risk factors for transmission of bovine brucellosis.

Human brucellosis among pyrexia of unknown origin cases and occupationally exposed individuals in Goa Region, India.

BACKGROUND: Brucellosis is a widespread zoonotic infection. This disease is endemic in many parts of Asia, including India. Brucellosis is a major cause of pyrexia of unknown origin (PUO). Persons exposed to infected animals or contaminated animal products are at high risk. Seropositivity among animal handlers, veterinarians and dairy workers has been documented in India. Thus, the present study was aimed to determine prevalence of brucellosis among PUO cases and occupationally exposed individuals. METHODS: In this study, serum samples (n=282) from cases of pyrexia of unknown origin (PUO) (n=243), and occupationally exposed individuals (n=39) were collected and tested for brucellosis by Rose Bengal plate test (RBPT), serum agglutination test (SAT), indirect ELISA, IgG and IgM ELISA. Blood culture for isolation of Brucella was performed for 10 serologically positive patients using BACTEC 9050 automated blood culture system. Biochemical tests and PCR techniques were used for confirmation of the isolates. RESULTS: Of the samples tested, 4.25%, 3.54%, 6.02% and 4.96% samples were positive by RBPT, SAT, indirect ELISA and IgG ELISA, respectively. None of the sample was positive for IgM ELISA. Of the 10 blood samples cultured bacteriologically, one Brucella isolate was recovered. The isolate was confirmed as Brucella abortus. Amplification of the bcsp31 and IS711 genes was also observed. CONCLUSION: Seropositivity for brucellosis was observed among PUO cases, animal handlers and dairy workers in Goa, India. The serological tests showed variable results. One Brucella isolate was obtained by performing blood culture. Confirmation of the case was done rapidly using molecular tools. General awareness about clinical symptoms should be increased which will improve proper diagnosis within short time frame.

Synthesis and antibacterial activity of substituted 1,2,3,4-tetrahydropyrazino [1,2-a] indoles.

A series of substituted 1,2,3,4-tetrahydropyrazino [1,2-a] indole derivatives have been synthesized and tested against the Gram positive and Gram negative strains of bacteria namely Staphylococcus aureus (MTCCB 737), Salmonella typhi (MTCCB 733), Pseudomonas aeruginosa (MTCCB 741), Streptomyces thermonitrificans (MTCCB 1824) and Escherichia coli (MTCCB 1652). All synthesized compounds showed mild to moderate activity. However, compounds 4d-f were found to have potent activity against pathogenic bacteria used in the study. Their MIC ranged from 3.75 to 60 microg/disc. In vitro toxicity tests demonstrated that toxicity of 4d-f was not significantly different than that of gentamycin. However, at higher concentration (1000-4000 microg/ml) difference was highly significant.