Anthelmintic efficacy of Phlogacanthus thyrsiflorus leaf extract on juvenile and adult worms of Hymenolepis diminuta (Cestoda).

The leaves of Phlogacanthus thyrsiflorus are used as an anthelmintic remedy by the tribal communities of upper Assam in India. The present study was carried out to validate the anthelmintic credentials of this plant. Mature and larval Hymenolepis diminuta worms were exposed to varying concentration of methanolic leaf extract of plant and parasites were observed for paralysis and mortality. At the end of the experiment, worms were collected and processed for scanning electron microscopy (SEM) study to observe the effect of extract on tegument of parasite. The in vivo study was carried out in H. diminuta-rat model with 200, 400 and 800 mg/kg concentrations of extract. The in vivo anthelmintic efficacy was assessed by reductions in egg per gram (EPG) and worm counts after necropsy of animals. In vitro studies revealed the earliest mortality of larval worms in 1.05 ± 0.04 h by 30 mg/ml concentration and of adult worms in 2.05 ± 0.08 h. SEM study revealed extensive damage to the suckers, body tegument and microtriches of worms treated with 30 mg/ml concentration of extract. In in-vivo studies, 800 mg/kg dose of extract showed highest efficacy, with 59% and 54.25% reduction in EPG counts and worm count against juvenile worms, and 63.16% and 66.75% reduction in EPG counts and worm counts, respectively against adult worms. Although the effects were comparatively less than the reference drug, nevertheless this study reveals that P. thyrsiflorus possess anthelmintic efficacy and justify its use in traditional medicine against intestinal-worm infections.

Analysis of sociodemographic profile of glaucoma patients with risk factors, subtypes, and disease severity in a tertiary eye care facility in Northern India.

PURPOSE: To study the different subtypes of glaucoma and to analyze the demographic and clinical profile of glaucoma patients along with associated risk factors in a multi-locational North Indian study. METHODS: Newly diagnosed and known glaucoma patients on treatment were enrolled in the study. Complete history was taken, and clinical evaluation was done by senior glaucoma experts. RESULTS: Five hundred and eighty-six patients (1121 eyes) were included with 383 males (65.4%) and 203 females (34.6%). Of these, 508 (86.7%) had primary glaucoma and 78 (13.3%) had secondary glaucoma. Also, 263 (44.9%) patients had primary open angle glaucoma (POAG) and 172 (29.4%) had primary angle closure glaucoma. Four hundred and fifty-one (77%) were graduates or postgraduates and 293 (50%) were dependents on family income. One hundred and forty-one (24%) had a positive family history. Secondary glaucoma patients had a lower average age (52.6 ± 16.8 years) and higher average intraocular pressure (IOP; 34.23 ± 13 mm) compared to primary glaucoma patients (26.6 ± 9.7 mm) (P < 0.0001). Thirty-three (47.8%) out of 78 secondary glaucoma patients had advanced disease. Seventy-four (12.6%) were first-time diagnosed and 18 had advanced disease. In addition, 161 eyes had one or more glaucoma surgeries done (128 trabeculectomy and 28 phacotrabeculectomy). Ninety-five (16.2%) patients were advised surgery at our centers (46 trab, 26 phacotrab, 15 phaco, five Ahmed glaucoma valve implantation, and three pars plana vitrectomy). Disease progression was noted in 62 patients reporting good compliance to medicines. CONCLUSION: POAG was the most common variant in this study. Secondary glaucoma patients were youngest in age and had the highest IOP. Trabeculectomy was the most performed surgery. A good literacy rate did not prevent late presentations.

The Indian Health and Demographic Surveillance System Network: Opportunity to Generate Evidence for Public Health Policy.

The Health and Demographic Surveillance System (HDSS) is a valuable longitudinal cohort study that tracks the health and demographic changes of a geographically defined population, serving as a platform for research and evidence-based policymaking. In India, there are nearly 20 HDSS sites covering diverse areas and populations totaling around two million. To foster collaboration, the Indian HDSS Network (IHN) was formed, comprising 19 sites from 16 institutes, covering a population of 1.5 million. The IHN aims to standardize data collection processes while allowing site-specific autonomy, generating high-quality longitudinal health, and demographic data. To ensure effective coordination, a governance structure with a rotating secretariat and working committee was proposed. The IHN envisions conducting robust multicentric research, supporting data-driven efforts to improve population health, and promoting research-policy synergy. The network's outcomes have the potential to optimize health research funding, generate epidemiological data, and provide evidence for public health policy. Collaboration within the IHN strengthens HDSS sites in newer technologies and community-based research, fostering capacity building. Seed funding is being sought to formalize and support the day-to-day functioning of the network, which holds promise for advancing population health and informing policymaking in India.

Comparison of analgesic effects of pericapsular nerve group block and fascia iliaca compartment block during hip arthroplasty: A systematic review and meta-analysis of randomised controlled trials.

Background and Aims: Postoperative pain for patients having hip arthroplasty ranges from moderate to severe. Many regional anaesthesia procedures treat postoperative pain to improve functional ability and quality of life. Evidence comparing the analgesic effects of the pericapsular nerve group (PENG) block and fascia iliaca compartment block (FICB) remains unclear. The analgesic efficacies of PENG and FICB in hip arthroplasty were compared to determine which technique is associated with superior analgesia. Methods: The electronic databases (PubMed, Cochrane Library, Google Scholar and Web of Sciences) were searched for published randomised controlled trials (RCTs) till 5 April 2023 comparing PENG block vs. FICB following hip arthroplasty. The primary outcome was pain scores [numerical rating scale (NRS) or visual analogue scale (VAS)] between 0 and 10 at rest and during movement at 24 h. Secondary outcomes included pain scores at rest and during movement within 30 min, at 6 h and 12 h, time to first rescue analgesia and cumulative postoperative opioid use in 24 h. We assessed the risk of bias using the Cochrane Collaboration Risk-of-Bias 2 tool. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), the certainty of the evidence was assessed. Subgroup analysis was performed to explore the source of heterogeneity. Results: We included 12 RCTs examining 644 patients. Pain scores at rest at 24 h (standardised mean differences (SMDs): 0.17; 95% confidence interval (CI): -0.90 to 1.23; P = 0.76, moderate certainty) and during movement at 24 h (SMD: -0.58, 95% CI: -1.53 to 0.38, P = 0.24, moderate certainty) were not different in both PENG block and FICB. Pain scores at rest and during movement within 30 min may be lower with PENG block than FICB. However, the pain score at rest and during movement at 6 h and the time to first rescue analgesia were not different between the two treatment arms. The mean opioid consumption in oral morphine equivalents (mg) in 24 h may be lower with PENG than FICB. Conclusion: We observed no difference between the PENG block and the FICB at 24 h for pain at rest and movement with a moderate degree of certainty. However, PENG block showed improved analgesia within 30 min at rest and during movement, and reduce postoperative opioid consumption in 24 h with moderate certainty of evidence. Further large-scale and high-quality RCTs are required to supplement the present findings.