Objective: To compare the effectiveness of extra amniotic saline infusion (EAS) by intracervical Foley catheter with prostaglandin E2 (PGE2) gel for cervical ripening and labor induction in women with unfavorable cervices. Methods: This prospective randomized trial included 100 women with unfavorable cervices. Women were randomly assigned to receive either EAS by intracervical Foley catheter or PGE2 gel for cervical ripening and labor induction. Results: Both EAS by intracervical Foley catheter and PGE2 gel were effective in achieving cervical ripening and labor induction. However, EAS had a shorter induction-to-active labor interval and higher post-induction Bishop’s score compared to PGE2 gel. Conclusion: EAS by intracervical Foley catheter is an effective method for cervical ripening and labor induction in women with unfavorable cervices, with some advantages over PGE2 gel.

Zandu Haldi Drops are a one-of-a-kind recipe intended to promote immunity and overall health. It possesses the goodness of saffron, cinnamon, cardamom, black pepper, and Haldi. The present work was designed to estimate Curcumin (Turmeric) by High-Performance Thin Layer Chromatography (HPTLC) as well as Piperine (Pepper) through UV Spectrophotometry, with reference to the marker compounds. A standard curve was prepared separately for Curcumin and Piperine using methanol as solvent. HPTLC plate was scanned in scanner at 421 nm. Sample peak area values were compared with that of standard’s area to determine the extent of drug present. The standard plot for Piperine was prepared by scanning the known concentrations at 342 nm and the unknown sample concentration was determined from this curve. The concentration of Curcumin was found to be 5.6 µg/ml and the Piperine concentration in the formulation was 2.5%. From the obtained results, it can be concluded that the formulation of Zandu haldi drops confirmed the presence of labelled ingredients viz, Turmeric and Pepper.

Background & Objectives: Inappropriate antimicrobial use leads to antimicrobial resistance (AMR) resulting in increased morbidity and mortality with a significant economic burden. Because of the increasing concern about AMR, World Health Organization (WHO) instituted Point Prevalence Survey (PPS) methodology to collect data to help formulate hospital interventions to optimise antimicrobial use. The objective was to analyse the prevalence of antimicrobial use among hospitalized patients at a point of time. Material & Methods: This cross-sectional point prevalence survey modified from the WHO PPS protocol was conducted among hospitalized patients who received antibiotics before 9AM on the survey date. Data were collected from case files using a pre-structured and validated google form based on the WHO Methodology under the guidance of the National Centre for Disease Control (NCDC). Results: The prevalence of antimicrobial use was 81.39% of which 98.9% were empirical. 40% of patients received one, 36% received two and 24% received more than two antimicrobials. 47% of all antimicrobials prescribed were from the “Access” group, 51.8% from the “Watch” group, and 1.2 % from the “Reserve” group. The most frequently prescribed antimicrobial was ceftriaxone (76%), followed by Metronidazole (41.7%) and amoxiclav (21%). Conclusion: Overall hospital antimicrobial use prevalence is high with preference for empirical prescription from the Watch group. The antimicrobial prescribing behaviour must adhere to the standard treatment guidelines, and prescribe preferably from the Access group of antibiotics so as to promote antimicrobial stewardship.

Introduction: Spinal anaesthesia is commonly used as a safe anaesthetic technique for both elective and emergency operations. Shivering is known to be a frequent complication in patients undergoing surgery under neuraxial anaesthesia with incidence of 40–70%. Shivering is described as an involuntary, spontaneous, and repetitive muscular movement, caused by vasoconstriction in upper limbs compensating the lower limb vasodilation. Hypothermia is one of the frequent causes that lower the shivering threshold. Shivering causes increase oxygen consumption, increase the risk of hypoxemia, induce lactic acidosis, and catecholamine release. We used different pharmacological drugs to control post spinal shivering. Methodology: In this prospective observational study, 90 patients who are candidates for subarachnoid block undergoing surgeries with American Society of Anesthesiologist (ASA) I or II, between 18 to 60 years, who are scheduled for abdominal and lower limb surgeries and who developed shivering following spinal anaesthesia we will divide them into 3 groups. Group A will get low dose iv ketamine(0.25mg/kg), Group B will get iv tramadol(0.5mg/kg), Group C will get iv dexmedetomidine(5mcg/kg). Result: Shivering was controlled in 24 (80%) patients in the ketamine group and 22 (74%) patients in the tramadol group, whereas it was controlled in 27 (90%) patients in the Dexmedetomidine group. Conclusion: Low-dose ketamine (0.25 mg/kg) ,tramadol (0.5 mg/kg) and dexmedetomidine (0.5mcg/kg) intravenously is efficient in lessening the shivering in patients having lower abdominal surgery under subarachnoid anaesthesia. However, Dexmedetomidine is associated with higher effective rate of shivering control.

Background: Gestation, or pregnancy, involves three trimesters where a fertilized egg develops into a fetus. Early pregnancy is marked by symptoms such as missed periods, nausea, vomiting, hunger and fatigue. Significant health concerns arise during this period, notably anemia, particularly iron deficiency anemia, which affects around 60% of pregnant women in regions like Madhya Pradesh, India. Hypothyroidism also poses risks, as maternal thyroid hormones are crucial for fetal development. Understanding these conditions underscores the necessity for targeted healthcare interventions to ensure maternal and fetal well-being throughout pregnancy. Aim & Objective: To study serum hepcidin and thyroid hormones in anemic pregnant women. Compare between Cases and Controls all these parameters & examine their correlation. Materials and Method: Total 300 subjects were studied which were divided into two groups of 150 of anemic pregnant women as cases and 150 non-anemic pregnant women as controls. Healthy controls after defining proper inclusion and exclusion criteria. Thyroids hormone was estimated on C.L.I.A. a while Hepcidin was estimated by ELISA. Results: Anemic pregnant women had significantly lower serum Hepcidin and thyroid hormone levels compared to non-anemic pregnant women as controls, (all P < 0.05). No significant correlations were found between serum Hepcidin and thyroid hormones in the anemic pregnant women. Conclusion: Our study highlights that anemia in pregnant women is linked to lower serum hepcidin and thyroid hormone levels, which may negatively impact maternal and fetal health. Routine screening and nutritional support are essential for optimizing outcomes in region.

Introduction:  Cerebrovascular stroke is a leading cause of morbidity and mortality worldwide. It is clinically defined as an abrupt onset of neurological deficit due to a focal vascular cause. Symptoms include loss of sensory and/or motor function, change of gait, change of vision or inability to speak or understand spoken words, headache, nausea, vomiting, giddiness, convulsions, loss of consciousness etc. There are few studies which have proven the association between elevated levels of NT Pro-BNP and cardioembolic cerebrovascular stroke as well as post-stroke outcomes. Some studies have shown a positive association between elevated plasma NT Pro-BNP levels in Acute Ischemic Stroke with atrial fibrillation. Hence this study aims to find the association of elevated levels of NT Pro-BNP in cardioembolic ischemic cerebrovascular stroke.  Materials and Methods:  This is a cross sectional type of study, conducted in the department of medicine at B.J Medical college Ahmedabad during the time period of October 2020 to December 2022. We included a total of 40 patients with ischemic cerebrovascular stroke for study. Patients with hemorrhagic stroke and those with stroke recurrence were excluded from the study. All the details were recorded in standard case record form and all these data were entered in Microsoft Excel sheet. Results were presented as mean + standard deviation (SD) or percentages. Continuous variables were analysed for normalization and compared using the student t test. Inter group comparisons were made using chi-square test. A cut-off value of p<0.05 was considered statistically significant. Results:  In this study we tested 40 patients with ischemic stroke of different etiologies for elevated NT Pro-BNP levels. Among these 40 patients, 55% stroke were of cardioembolic origin (n=22), 32% were having large artery thrombosis as a cause of cerebral ischemia (n-13), 5% with lacunar stroke (n=2) and 8% were of undetermined etiology (n=3). A cut-off value of 125pg/mL for age for NT Pro BNP levels was selected based on previous studies and the diagnostic kit used. We found that 53% (n=21) of patients with ischemic stroke were tested positive for elevated levels of NT Pro-BNP. Of those 21 patients who tested positive for elevated NT Pro BNP levels, 90% (n=19) were having cardio-embolic origin of stroke whereas only 10% (n=2) were having large artery thrombosis, a value that has a high statistical significance with a p value of 0.000034. Out of 22 patients with cardio-embolic origin of stroke 86% (n=19) patients had an elevated level of plasma NT Pro BNP, a value that is statistically significant with a p value of <0.05(p = 0.000034.). Conclusion:  It is important to diagnose and classify stroke in its acute phase as it is associated with majority of adverse outcomes. NT Pro-BNP can be used as a biomarker for identifying cardioembolic origin of stroke. Also, it is useful for ruling out thrombotic stroke. It can be useful for differentiation of cardioembolic from other stroke subtypes for initiating proper treatment.

Background: The purpose of the study was to compare the effects of nebulization with ropivacaine (0.75%) and nebulization with Dexmedetomidine on the hemodynamic response to intubation in patients undergoing surgery under general anaesthesia. Introduction: Laryngoscopy and tracheal intubation are known to cause significant sympathetic stimulation, leading to hemodynamic fluctuations such as increased heart rate and blood pressure. This study aims to compare the efficacy of nebulisation with ropivacaine, a local anaesthetic, with nebulization by dexmedetomidine, an alpha-2 adrenergic agonist, in mitigating these responses. Methods: A prospective observational study was conducted with 120 randomised patients scheduled for elective surgery under general anaesthesia. Patients were divided into three equal groups: Group R received nebulization with ropivacaine (0.75%), Group D received nebulization with dexmedetomidine (1 µg/kg), and Group P received a placebo. Hemodynamic parameters, including heart rate (HR) and mean arterial pressure (MAP), were recorded at baseline, during intubation, and at different interims post-intubation and during extubation. The primary aim was to compare the outcomes of the above 3 groups in reducing the stress response to laryngoscopy and intubation. The secondary objectives were to compare the hemodynamic parameters during extubation, postoperative sore throat & cough reflex to extubation. Results: Demographically all groups were similar. Group R and Group D significantly attenuated the hemodynamic response at intubation and extubation compared to the placebo group. Group D demonstrated a more pronounced reduction in HR and MAP during intubation and extubation. Specifically, Group D had a mean MAP of 90 ± 18.4 mmHg compared to 92.4 ± 16.1 mmHg in Group R and 99.5 ± 15.9 mmHg in Group C. Additionally, both groups exhibited a significant reduction in cough response and postoperative sore throat compared to the placebo group. Conclusion: Nebulized dexmedetomidine and ropivacaine both effectively reduced the hemodynamic response to intubation in patients undergoing surgery under general anesthesia. Dexmedetomidine may offer superior control of HR and MAP, making it a preferable choice in clinical settings where hemodynamic stability is crucial.

Background: The pandemic of COVID-19 has shaken the entire world, which resulted in many forms of health crisis in India, even after a virtual lockdown with social distancing and a complete ban on the sale of liquor. Evidence from earlier studies, as well as the recent news, confirm some parallel cases of gender violence across the globe, which have significant linkages with substance abuse. Objectives: The paper targets to map the relationship between substance use and gender violence in the Indian context. This also attempts to identify the significant socio-economic determinants of gender violence in India. Methods: The paper uses the latest National Family Health Survey-4 (2015-16) dataset by applying the two-way, three-ways cross-tabulation methods, Principal Component Analysis (PCA), Kernel density function, and three logistic regression models with the STATA-13 software. The dependent variables are the intensity of gender violence, and the control variables include socio-economic, demographic characteristics, substance use, empowerment dummy, wealth quintile and sources of entertainment, etc. Results: The results of the cross-tabulations and regression models explain the objectives of the study in concordance with the literature. The socio-economic and demographic characteristics, substance use, the role of education, health infrastructure, and the empowerment of women are significant factors. Conclusions: The paper goes with futuristic perspectives using the evidence from the past. Since the findings of the paper explain the role of several factors of gender violence and substance use, appropriate planning is essential in this direction to avoid further adverse impacts that emerged from the COVID19 pandemic.