Lukewarm Water Research Articles

A Comparative Clinical Study of Gokshuradi Guggulu with Anupanabheda in The Management of Vatarakta with special reference to Gout

Gout is condition in which person become immobile and inactive due to joint pains and swelling. Gout occurs, when urate crystal deposition of in the joints. Vatarakta is considered as a vata pradhana vyadhi and rakta dushti. Gokshuradi Guggulu is having vatahara and raktashodhak properties. Guduchi kwatha selected as anupana because of its Rasayana, Vatashamaka, Balya, vedana sthapana and Ama pachana properties will help to disrupt the Samprapti vighatana of vatarakta. The objectives of the study were to evaluate the effect of Gokshuradi Guggulu with Anupanabheda in the management of Vatarakta and to compare the result of both groups. This study was randomized, parallel comparative clinical trial of two groups each of 20 patients. From OPD of DBACH Mandigobindgarh; 40 patients of vatarakta taken which were randomly divided into two groups. Group A, 20 patients for 60 days received Gokshuradi Guggulu 1 gm. BD with lukewarm water and Group B,20 patients received Gokshuradi Guggulu 1gm BD with Guduchi Kwatha for 60 days. In Group A, among 20 patient’s 55% patients showed moderate response and 45% patients showed mild response. In Group B among 20 patients, 95 % patients showed moderate response and 5 % patients showed mild response. Both shows statistically highly significant results in both subjective and objective except erythema & discoloration. Treatment modality in Group B (i.e. Gokshuradi Guggulu with Guduchi Kwatha) is effective in comparison of treatment modality in Group A (i.e. Gokshuradi Guggulu with lukewarm water).

MANAGEMENT OF PERINEAL AND PERIANAL WARTS THROUGH AYURVEDA: A CASE REPORT

Warts are the commonest benign, viral condition found in day to day practice and it is more common in young females. In Ayurveda warts may be compared with Charmakeel. As per Acharya Sushruta Agnikarma has been described as superior para-surgical procedures among all the measures used in Ayurveda, as the disease treated by it usually did not relapse. In present case report 33 years old female patient visited in Outpatient department (OPD) of Shalya Tantra having complaints of numerous growths in perineal and peri-anal region with itching and occasional pain since 6 months. The swelling was gradually increasing in size with local itching and discomfort. So the case was diagnosed as external genital warts and Chedana (excision) of the warts with cautery was planned. Orally two tablets (500mg each) Triphala Guggulu thrice in a day with luke warm water was advised for one month. Daily cleaning with Panchavalakal Kwath and dressing with Thumari Taila was performed till complete healing of the post-operative wound. Within 3 weeks wound was healed completely. Follow-up was done up to 10 months and patient had no any complaints or recurrence of warts. This case demonstrates that warts can be managed through Ayurveda without any complications, no recurrence and cost-effectively.

Role of Panchamooladya Choorna in Grahani Roga (irritable bowel syndrome)-pilot study

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.

Severe infestation of Ornithonyssus bursa in a commercial poultry layer farm and its successful management

Mites are obligatory haematophagous ectoparasites that infesting commercial poultry farms in tropical countries. This study reports a severe infestation of Ornithonyssus bursa in a commercial poultry farm and its successful treatment. A poultry farmer approached with the samples containing mites, which were creating annoyance to the birds as well as farm workers in the sheds. After repeated usage of chemical acaricides, the mite menace was not controlled. On visit, it was noticed clusters of mites near bird cages, water pipelines, feeders, egg trays, particularly in the cobwebs and also on the birds. All most 90 percent of the flock (about 4.0 lakh) which was spread over in eight sheds was showing severe mite infestation. Based on the morphological features, the mites were identified as Ornithonyssus bursa. Preventive measures, including clearing of cobwebs by home use vacuum cleaners were advised before the acaricidal spray. Sponging with malathion in lukewarm water was done for the cages, water pipelines, feeders and other farm equipment and sprayed on poultry manure. Deltamethrin spray was applied directly on birds and on farm equipments which were close to the birds. Besides these, blow lamping was done on the walls and crevices of poultry sheds. The above treatment was done for thrice with an interval of 2 weeks and the condition was improved satisfactorily and the mite infestation was controlled completely.

EFFECT OF TRIPHALA GUGGULU AND PUNARNAVA MANDOOR IN THE MANAGEMENT OF OBESITY: AN OBSERVATIONAL STUDY

Obesity has become an increasing global health problem among all socio-economic groups and leading to various complications like diabetes, cardiovascular diseases and osteoarthritis knee which are responsible for morbidity and mortality. Ayurvedic approach is to provide solution in managing rising cases of obesity among population. Aim of this study was to assess the clinical efficacy and safety of an Ayurvedic preparations Triphala guggulu and Punarnava mandoor in the management of obesity through clinical sign and symptoms, body mass index (BMI), measurement of abdomen, chest, thigh, arm circumference and laboratory investigation. The trial was conducted on 58 subjects aged between 12-60 years of both sexes of obesity. Triphala guggulu 1 g (2 tablets of 500 mg) and Punarnava Mandoor 500 mg (1 tablet of 500 mg) thrice daily with lukewarm water for 12 weeks were used in all study participants. Clinical sign and symptoms, BMI and circumference of body parts reduced from baseline to the end of the treatment in completed 47 subjects out of 58.

AN AYURVEDIC MANAGEMENT OF EKAKUSHTHA (PSORIASIS VULGARIS) THROUGH VIRECHANA KARMA (PURGATION THERAPY) AND SHAMANA CHIKITSA (PALLIATIVE THERAPY): A CASE STUDY

A 21 years old female patient had complained of silvery scaly skin lesions all over body with reddish discoloration having severe itching, burning sensation since 15 years back that got aggravated during each rainy and cold season. Examination- 1. Severe silvery scaly lesions shaded down on rubbing all over the day, 2. Characterized by sharply demarcated and erythematous papulosquamous lesions (Dry, thin, silvery-white scales), 3. Irregular, discoid and oval in shape. 3. Small areas of bleeding where the involved skin is scratched, 4. Scaly plaques on the scalp, 5. Auspitz Sign-positive, 6. Candle grease sign-Positive, 7. Grattage Test-Positive. Aims and Objectives: To prove the role & efficacy of Virechana drugs, Virechana Karma, Sansarjana Karma & Sanshamana chikitsa. Materials and Methods: 1. Dadimashtaka Choorna was given 5gm twice a day with lukewarm water continuously for 3 days as Aama Dosha Pachanartha, 2.Guggulutiktakaghritama was given 25ml, 50ml, 75ml, 100ml, 125ml, 150ml & 200ml with lukewarm water for next 7 days as Snehana Karma, 3. Bahya Snehana with Dashamoola Taila and Bahya Sarvaanga Swedana with Dashmoola Kwatha were applied for next 3 days, 4.Virechana Karma was done after Samyaka Snehana & Swedana. 5. Sansarjana Karma was done after Samayaka Virechana for 7 days. Differential Diagosis-Sidddham, Mandalkushtha & Ekakushtha. Provisional Dignosis-Ekakushtha, Final Diagnosis-Ekakushtha (Psoriasis vulgaris). Result: Significantly improvements were observed in treatment of Ekakushtha (Psoriasis vulgaris). Discussion: Deepana & Pachana chikitsa is responsible for Aama Dosha Pachanartha. Snehana is responsible for Srotosamamardawama. Swedana is responsible for Srotomargavishodhanam. Virechana is responsible for pacifying vitiated Pittaja as well as Kaphaja Dosha and Vyadhi.

POTALA KATUROHINYADI KWATHA IN KAPHAJA YAKRIT DALLUDARA (NON-ALCOHOLIC FATTY LIVER DISEASE): A CASE STUDY

Non- alcoholic fatty liver disease (NAFLD) is also otherwise termed as Hepatic steatosis and Kaphaja yakrit dalludara in Ayurveda. 34 years male patient, highly educated from a high socio-economic group of Non vegetarian diet habit came to hospital with complain of anorexia, indigestion and distention for three months. The clinical findings revealed that he is slightly obese, hyperglycaemia and dyslipidimia along elevated liver enzymes with fatty liver in USG and Fibro scan. The case was treated with Patolakaturohinyadi Kwatham (PKK) in the dose was 30ml Kasaya with equal quantity of luke warm water twice daily in empty stomach preferable morning and evening for six months. This study proved that PKK can significantly reduced blood sugar, serum Lipids and liver enzymes within three months along with reduction weight and BMI, but change in liver architecture required six months in this therapy. The BARD score and NAFLD score changed to normal after six months of therapy. The patient was kept in observation for further one year without medication and advised to practice yoga, exercise and low carbohydrate and fat diet to study the recurrence of disease. The liver architecture as well as biochemical profile of liver is maintained after one year also. PKK may correct the metabolic dysfunction by increase Agni, digest Ama which helped in the correction of hyperglycaemia and dyslipidaemia. PKK is safe in for six months of use in recommended dose (30ml BID) as there was no adverse sign and symptom observed and no change in biochemical and Haematological profile of Patients.PKK is safe and effective in this case of Kaphaja Yakrit dalludara (NAFLD). It can study further in large population to generated evidence for its efficacy and efficacy in larger group.

A COMPARATIVE CLINICAL STUDY TO ASSESS THE EFFICACY OF KARIMBIRUMBADI KASHAYAM AND VASAGULUCHYADI KASHAYAM IN PANDUROGA WITH SPECIAL REFERENCE TO IRON DEFICIENCY ANEMIA IN THE REPRODUCTIVE AGE GROUP OF WOMEN

This study is an attempt to clinically analyze the independent effect of Karimbirumbadi kashayam and Vasaguluchiadi kashayam in Panduroga and also compare their efficacy. Aims and Objectives: To evaluate the comparative efficacy of Karimbirumbadi kashayam and Vasaguluchyadi kashayam in Panduroga with special reference to iron deficiency anemia in the reproductive age group of women. Methodology: Among 46 registered subjects, 22 were registered in group A and 24were registered in group B. Out of which 20 subjects of A group and 20 subjects of B group completed the study. Group A was administered with 25ml of Karimbirumbadi kashayam with 40ml of luke warm water twice daily before food for 2 months and Group B was administered with 25ml of Vasaguluchyadi kashayam with 40ml of luke warm water and 10ml of Madhu as Anupana twice daily before food for 2 months. Objective and subjective parameters were analyzed using paired T test and Wilcoxon signed rank test respectively. Independent T test and Mann-Whitney U test were used to compare the parameters between the groups. Result: There was statistically significant improvement in the objective and subjective parameters (p<0.05 was observed). Conclusion: The study shows that both Karimbirumbadi kashayam and Vasaguluchyadi kashayam are effective in relieving the symptoms of Panduroga. Symptomatic relief was seen in both the group A & B, but there was no statistically significant difference between the groups in relieving these symptoms.

ROLE OF KARPASABEEJA CHURNA IN THE TREATMENT OF STANYAKSHAYA - A PILOT STUDY

Background: Stanyakshaya is the common problem noticed in about 40% patients in our clinical practice. Due to adaptation of Western culture, women get exposed to stress and strain. Lactation is the process as-sociated with psychosomatic condition and lifestyle. Breast milk is the perfect food for a normal neonate. It is the best gift a mother can give her baby. Breast feeding is the ideal form of infant feeding and is cru-cial for lifelong health and wellbeing. Design: This was a single pilot study. 10 patients(lactating mothers, both primi and multi gravida) who ful-filled the eligibility criteria were selected for the study and the assessments were made before the treatment on the 1st day and after the treatment on the 30th day and follow up was done on 20th day after the comple-tion of treatment. Intervention: Karpasabeejachurna (6gms) was administered with lukewarm water as the Anupana after food twice a day for one month and follow up carried out on 20th day after the completion of treatment. Results: Karpasabeejachurna showed statistically significant results in the Stanamlanata, Stana/milk ejec-tion, breast feeding, weight of the baby and breast engorgement with p<0.001. Conclusion: Karpasabeejachoorna showed to be effective in increasing the Stanya and it is a Stan-yajanakadravya.

Origami microfluidics for radiant cooling with small temperature differences in buildings

Design and fabrication methods translated from microfluidics, microelectromechanical systems, origami, and biologically inspired engineering may offer efficiency improvements for water-based thermoregulation in buildings. This paper introduces foldable radiant cooling devices that are fabricated by lamination with integrated microfluidic water-circuits. These devices produce more surface convection because of their geometry and because they have more surface area than flat panels. As a result, lukewarm water instead of chilled water may be sufficient for cooling a room, leading to potential savings in primary energy use and lifecycle greenhouse gas emissions. Analytical models and physical experiments show a 55–67% improvement in thermal performance when comparing these novel folded surfaces to flat surfaces, mainly due to the improved convection heat transfer.

Comparative study of diabetic self-care management “educational intervention among family members on diabetic individuals”, in rural field practicing area, a cluster randomization study

Background: To achieve optimal blood glucose levels educating diabetic patient alone may not be sufficient but the entire family must have access to proven preventive measure. The present study was done to assess the outcome of self-care management practices educational intervention among family member on diabetic individuals.Methods: This prospective interventional cluster randomization study was conducted in rural field practice area, attached to department of Community medicine of Hassan Institute of Medical Sciences. Clusters were formed among the population based on the sub-centres and four clusters were randomly selected. Two clusters were assigned for family intervention and two clusters with individual intervention.Results: Consuming 5 or more serving of fruits and vegetables for more than 5 days a week, increased in the FIC after education and the difference in increase was statistically significant (p<0.02). Physical activity with specific exercise sessions increase after the intervention and the increase was statistically significant in the FIC (p<0.08). Adherence to medication and testing attained statistically significant increase in the FIC. Also washing of foot daily with luke-warm water increase was statistically significant in both the Intervention Clusters (p<0.0002). On subsequent follow up there was a significant improvement in BMI of family intervention cluster (p<0.03) as compared to individual intervention cluster.Conclusions: Health education intervention activity at the community involving the supportive members of the family can drive-in to bring about behavioural change in the desired direction.

Management of Pilonidal sinus by partial sinus excision along with Ksharsutra ligation

Pilonidal sinus is a disease of a midline pit situated in mid gluteal cleft at post anal region associated with hairs. Continued sitting, obesity, hairy part, family history which increases the risk of diseases. The prevalence rate in males is more (Male & Female ration 3:1) and incidence is about 26 per 100,000 population. The treatment of pilonidal sinus includes excision and primary closure, excision with reconstructed flap technique etc. In Ayurveda pilonidal sinus is correlated with Nadivrana and it can be considered under shalyaj Nadivrana and Shushruta has explained Shastrakarma with intervention of ksharsutra as one of the treatment of Nadivrana (sinus) excision. In this case study, a case of pilonidal sinus, 21yr / Male patient diagnosed and treated successfully with integrated approach i.e. partial sinus excision adjuvant to Ksharsutra therapy. Partial sinus excision followed by Ksharsutra ligation in the remaining intact tract was performed under local anaesthesia, Patient was asked to attend surgical OPD for dressing on alternate days, and Seitz bath with lukewarm water was advocated before dressing. The Ksharsutra was changed weekly for 3 sitting. To reduce pain, inflammation and control infection, Analgesic,anti-inflammatory and oral antibiotic drug were also prescribed for 5 days. Observation revealed that sinus- track cut through and healed by 4 weeks. Patient was under observation for period of one year to check for recurrence. This innovative partial sinus excision along with Ksharsutra ligation under local anesthesia, proved an effective ,time conserving and non-recurrent, minimal invasive treatment alternative for pilonidal management.

CLINICAL EVALUATION OF EFFICACY OF NAVAKA GUGGULU AND TRIPHALA KWATHA IN THE MANAGEMENT OF MEDOROGA WITH SPECIAL REFERENCE TO OBESITY

Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and hypertension. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low and middle-income countries, particularly in urban settings. A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. Medodhatuvridhi causes Snigdhata of Shareera, Udara-parshvavridhi, Kasa, Shwasa, Hikka and Daurgandhya of Shareera. The Medovaha Srotas moola means the organs closely related to the functions of Medodhatu or the important sites related to beginning or ending of the channels of Medodhatu. The Acharya (Charaka, Sushruta and Vagbhata) considered Vrikka as Moola of Medovaha Srotas and also considered Vapavahana, Kati and Mamsa as second Moola respectively. The present study was conducted on 30 clinically diagnosed patients of 'Medoroga' (Obesity). The patients of ‘Medoroga’ (Obesity) were randomly divided into three groups of 10 patients in each. In Group A, 10 patients were treated with ‘Navakaguggulu’ 2 tab (each tab. of 500mg) three times a day with lukewarm water for 30 days. In Group B, 10 patients were treated with ‘Triphala Kwatha’ 50ml two times a day (morning and evening) for 30 days and in Group C, 10 patients were treated with ‘Navakaguggulu’ 2 tab (each tab. of 500 mg) three times a day with lukewarm water and ‘Triphala Kwatha’ 50ml two times a day (morning and evening) for 30 days. After completion of trial, Group C has shown the best result followed by Group A and B while in lab parameters Group A has shown highly significant result only in Triglyceride level. Similarly Group Cprovided better results in majority of the parameters.

Efficacy of Bibhitakavaleha in Management of Kaphaja Kasa with special reference to Chronic Bronchitis

Kasa is the disease of Pranavaha strotas. It may develop as an independent disease, symptom or complication. In Kaphaja Kasa Kasavega is associated with Bahala Ghana Nishtivana. It can be correlated with Chronic Bronchitis due to similarities of signs and symptoms. Chronic Bronchitis is characterized by productive cough associated with sputum for at least 3 consecutive months for more than two successive years. The initial symptoms are repeated attacks of productive cough which shows a steady increase in severity during the winter months and present all the year round with recurrent respiratory infections. Ayurveda described many herbomineral formulations for management of Kasa. One such formulation Bibhitakavaleha is mentioned in Gadanigraha, which consists of Bibhitaki (Terminalia bellerica Roxb.), Gomutra (Cow urine) and Madhu (Honey). Methods: In this case series 30 patients having classical symptoms of Kaphaja Kasa were treated with Bibhitakavaleha 10gm twice a day with lukewarm water for 15 days with the aim to prove the efficacy of it in the management of Kaphaja Kasa. Subjective criteria like Kasavega, Kasa nishtiva, Shwaskricchrata, Peenas, Shirshool and Aruchi with Laboratory parameters like TLC (Total Leukocyte Count), Neutrophils, Absolute Eosinophil Count (AEC) and ESR (Erythrocyte Sedimentation Rate) were assessed before and after treatment. Result: Significant improvement was observed in all parameters after treatment. Bibhitaki possesses Kashaya Rasa, Madhura Vipaka, Ushna Veerya & Laghu, Ruksha Guna which plays a major role in relieving Kasa. Conclusion: Hence it can be concluded that Kaphaja Kasa can be effectively treated with Bibhitakavaleha.

Study in the Effect of Yavavati in the Management of Dyslipidemia

Dyslipidemia is considered as metabolic disorders related to lipoprotein metabolism, manifested as rise in plasma levels of total Cholesterol, Triglyceride (TGs), or both, or a decrease in high density lipoprotein level or all three together that contributes to the formation of atherosclerosis. It can be included under santarpanjanyavyadhi. Various conditions like Shonitabhishyandana, Rasagata SnehaVriddhi (raised plasma lipid levels), Rasaraktagata Snehavriddhi (raised plasma and blood lipid levels), Medovriddhi (elevation of generalized fat), Medoroga (obesity), Aam Medodhatu (abnormal form of adipose tissue) can be correlated with Dyslipidemia due to resemblance of their etiopathogenesis and clinical features. Total 30 patients of dyslipidemia fulfilling the diagnostic criteria were selected and treated with Yavavati 1.5 gm twice a day before meal with lukewarm water for 30 days. In this study it was observed that incidence of Dyslipidemia was more in advanced ages,female gender, middle socioeconomic group individuals having vatapittajaprakruti, madhyamagni and madhyamaakruti. In present study, sedentary lifestyle, day sleep, association of other diseases like hypertension, DM, hypothyroidism and hemiplegia are the main causative factors for Dyslipidemia. Yavavati showed significant improvement in BMI, total cholesterol, S.Triglicerides, S.VLDL and HDL level. This improvement may be due to its ruksha, lekhana, kaphamedahar, agnivadhaka and apatarpana properties of Yavavati. Hence from this study it can be concluded that, Yavavati is effective and can be safely used in the management of Dyslipidemia.

Ayurvedic Management of Type-2 diabetes mellitus on Insulin- A Case Study

Background: This case report is based on our experience to treat, with Ayurveda drugs, a case of diabetic type -2 who was put on insulin and how Ayurvedic treatment has given him relief and maintain normal glucose levels with no associated complications. Brief case report: A 38 year’s male patient with clinical history of DMT2.Who was taking 32(20/12) units of insulin/day in 2 divided doses. The prakriti (nature) of this patient was Kapha-Pitta. By considering the Dosha and Dusya, a judicial combination of 4 primary Ayurveda drugs- Gudmar, Jamun, Nagarmotha, Sudarshan was advised to take orally in morning and evening with lukewarm water. Observations: At the beginning, his HbA1c was 11.1%. and after taking the prescribed Ayurvedic treatment along with insulin for 12 weeks, his HbA1c level reduced to 5.6%. At this stage, the insulin was withdrawn and patient continued on Ayurvedic treatment and monitored on weekly interval. After the Ayurveda treatment, need of further insulin or oral hypoglycemic agent drugs was not felt. His HbA1c was regularly monitored and it has come to normal range with improved quality of life. Conclusion: The prescribed combination of 4 drugs showed good response by maintaining normal blood sugar levels in DMT2 case, even after withdrawing insulin after 12 weeks of initial ayurvedic treatment. However, if this study is conducted in large number of patients it would help to understand the public health significance of this finding.

Tensile Strength and Solubility Studies of Edible Biodegradable Films Developed from Pseudo-cereal Starches: An Inclusive Comparison with Commercial Corn Starch

Edible biodegradable films were prepared from amaranth, buckwheat and commercial important corn starches by casting method. Starch, glycerol and carboxymethyl cellulose (CMC) were used to prepare filmogenic starch solutions in potable luke warm water, followed by ultra-sonication for homogenous mixing of the mixed ingredients. After this, heating was applied to starch based slurried solutions until it turned into gel solutions. These filmogenic gel solutions were then dried and films were peeled off and stored in desiccator. Stored films were analyzed for functional properties viz., tensile strength, solubility and water vapor permeation. Amaranth starch based edible biodegradable films presented considerable clarity values however buckwheat starch and corn starch based films exhibited good tensile strength and better solubility values. Developed edible biodegradable films from amaranth starch were analysed for surface structure examination by SEM. Evaluation of surface revealed uniformity, homogeneity with no surface crack on the surface of developed edible biodegradable films.

Prevalence and Clinical Characteristics of Aquagenic Pruritus among Medical and Pharmacy Students in Lomé (Togo).

Objective The aim of this study was to determine the prevalence and clinical characteristics of aquagenic pruritus (AP) in medical students in Lomé (Togo). Methods This was a prospective and descriptive study conducted among medical students in Lomé from June 1st to August 30th, 2019. The data collection questionnaire was anonymous composed of sociodemographic variables, bathing habits, and history of allergy responding to the concept of aquagenic pruritus and its characteristics. Results In our study, 129/591 medical students had AP, giving a prevalence of AP to 21.8%. The average age of students with AP was 23.9 years, and the M/F sex ratio was 1.5. AP was not present after each bath in 100% of the medical students who suffered from it and lasted an average of 9.09 minutes. It was characteristically pruritic (60.5%) or tingling (38.0%) and localized (45.0%) or generalized (55.0%) in respondents with history of AP. There was a significant association between the presence of AP and a personal history of allergic rhinitis (p < 0.01) and the presence of AP and a family AP (p < 0.01). Twenty-six (20.2%) respondents with AP feared taking a bath. Bathing with warm or lukewarm water (29.5%) or applying menthol ointment (27.1%) were the main precautions taken to reduce AP. Conclusion Aquagenic pruritus is a common condition in medical students in Togo. It occurs mainly in males and can be familial.

The effects of testosterone on the physiological response to social and somatic stressors

Higher testosterone levels in males have previously been linked to decreased stress reactivity, but in other cases, testosterone has been reported to increase the stress response. We addressed these inconsistencies in a placebo-controlled single-dose testosterone administration study, in which 120 male participants were randomly assigned to undergo a cold-pressor test (CPT, a non-social somatic stressor), a socially evaluated cold-pressor test (SECPT, a social-somatic stressor), or a lukewarm water test (LWT, a non-stressful control condition). Throughout the experiment, blood pressure and interbeat intervals were measured continuously, and saliva samples for hormonal analyses were taken repeatedly at predefined time points. When comparing the groups treated with placebo, the SECPT elicited a larger increase in the systolic blood pressure than CPT, in agreement with previous studies. However, testosterone administration altered this pattern. Compared to placebo, testosterone increased systolic blood pressure during the CPT, whereas the opposite effect was found during the SECPT. Cortisol reactivity was not affected by testosterone administration. The CAG repeat polymorphism of the androgen receptor gene was unrelated to the effects of testosterone on the stress response, but it was correlated with blood pressure across the whole sample. Our findings demonstrate that testosterone’s effects on the stress response are dependent on the social context. Testosterone’s ability to flexibly influence the response to stressors may be an important mechanism through which the hormone promotes adaptive behavior. Our results are also in line with research showing that testosterone decreases social anxiety and suggest it may help to modulate the effects of stress in socially challenging situations.

Transanal irrigation with Peristeen in neurogenic bowel dysfunction: audit of impact on symptoms and quality of life

Background: Spinal cord injury often results in neurogenic bowel dysfunction (NBD). NBD is associated with constipation and faecal incontinence, as well as loss of sensation, faecal loading and faecal leakage, and it has a severe impact on healthcare resources and patient quality of life. NBD is treated conservatively with medication, suppositories, physiotherapy, digital rectal stimulation and digital removal of faeces. Conservative options are not always effective and long-term may lead to haemorrhoids, rectal bleeding, mucosal prolapse and faecal soiling. The National Institute for Health and Care Excellence recommends the use of the Peristeen transanal irrigation system, which instills lukewarm water into the colon via a balloon catheter to stimulate regular and complete bowel movements. Aim: To assess the impact of transanal irrigation with Peristeen on the symptoms and treatments of NBD, as well as patient quality of life and satisfaction, in a regional spinal injury centre. Method: Patients were asked to complete an adapted NBD assessment at consultation when they were prescribed Peristeen and at 8-week follow up. Answers to 10 questions on symptoms and treatment were individually weighted to provide a bowel dysfunction score, excluding two Likert-type questions on quality of life. Results: Patient numbers undergoing digital evacuations once or more a week decreased by more than 50%, and medication use decreased slightly. Patients reported a decrease in the following symptoms: peri-anal skin problems (9%); uneasiness, sweating or headaches (20%); uncontrollable flatus (27%); rectal bleeding (30%); faecal soiling (37%) and involuntary defecation (46%). Mean total bowel dysfunction score decreased by 11.6 from 20.4 to 8.8, and those with dysfunction categorised as severe decreased by 64% from 80% to 16%. Average negative emotional wellbeing improved from 4.0 to 1.2, and mean satisfaction increased from 3.2 to 7.3. Conclusion: According to the study findings, Peristeen is observed to improve quality of life in spinal NBD, and it is effective at reducing both associated symptoms and the need for digital rectal stimulation and digital removal of faeces.