Objective Symptoms Research Articles

Effect of integrated Ayurvedic approach for management of ankylosing spondylitis: A case report

Abstract Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy that mainly affects the spine and further involves various sacroiliac joints and articular structures. Human leukocyte antigen-B27 and tumor necrosis factor are said to be contributing factors. In this context, the etiology of the disease might be unknown or unclear. To date, conventional medicine has not provided a satisfactory treatment for this condition, but integrated Ayurveda regimens, such as oral medications, Panchakarma therapies, Yoga, and diet, could be beneficial for these manifestations and aimed at enhancing an individual’s quality of life. Ayurveda regimen, such as oral medications, Panchakarma therapies, Yoga, and diet, could benefit in this symptomatic presentation. A 27-year-old female presented with complaints of progressive neck pain and sacroiliac pain along with stiffness of the spine and hip for 6 years, associated with restricted movement of the spine. The condition was diagnosed as AS and treated for 6 months with Ayurveda treatment, Yoga, and diet. This therapeutic protocol was directed toward alleviating symptoms, reducing severe disability, and improving quality of life. The patient’s condition was assessed for symptoms of Asthimajjagata Vata, Ankylosing Spondylitis Quality of Life Scale score, and AS Disease Activity Score showed substantial improvement. After a 1-year follow-up in September 2022, C-reactive protein and erythrocyte sedimentation rate levels were within the normal range, and no subjective or objective symptoms were observed. This case study shows that cases of AS can be successfully managed with Ayurveda treatment.

Impact of dry eye disease treatment on patient quality of life.

Dry eye disease (DED) is a common multifactorial disease affecting a substantial proportion of the population worldwide. Objective tests and subjective symptoms evaluation are necessary to assess DED. Although various treatments have been introduced, accurately evaluating the efficacy of those treatments is difficult because of the disparity between diagnostic tests and patient-reported symptoms. We reviewed the questionnaires used to evaluate DED and the improvements of quality of life with various treatments. In addition, we highlighted the importance of patient-reported outcomes (PRO) assessments for evaluating the effect of DED treatments. Given that the assessment of DED treatment effectiveness substantially relies on individual ocular experiences, acquiring qualitative PRO data is essential for comprehensive evaluation and optimal treatment management. Clinicians should not only focus on improving objective symptoms but also prioritize the well-being of patients in clinical management.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C–reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

Introduction Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars. This study aimed to correlate salivary PGE2 levels and serum C-reactive protein levels with subjective and objective symptoms after surgical extraction of the mandibular third molar and their relationship with drug therapy. Methods The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar. Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C–reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). Conclusion The proposed study is expected to show a favorable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery. The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C–reactive protein, which are reliable inflammatory markers. The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Patient satisfaction after elective implant removal of the lower extremity — a retrospective cohort study

PurposeThe topic of elective implant removal (IR) in healed fractures of the lower extremity remains controversial, particularly when unspecific symptoms of discomfort, which cannot be quantified, are the primary indication. This study aims to assess indications and outcomes of elective IR of the lower extremity, focusing on unspecific symptoms of discomfort and patient satisfaction postoperatively.Materials and methodsThe retrospective cohort study was conducted at a single level I academic trauma center. We included patients who underwent elective IR for healed fractures of the ankle, foot, patella, and proximal tibia from 2016 to 2021. All patients were followed-up for a minimum of 6 weeks after IR. Our outcomes of interest were patient satisfaction, complications, and alleviation of complaints.Results A total of 167 patients were included in the study. Unspecific symptoms of discomfort were the most common reason for IR in all investigated anatomical regions of the lower extremity (47.9%), followed by pain (43.1%) and limited range of motion (4.2%). 4.8% of patients experienced a combination of pain and range of motion limitation. Among all patients, 47.9% reported subjective improvement after IR. IRs based on unspecific symptoms of discomfort were significantly less likely to show alleviation of complaints after IR (27.5%, OR 0.19, p ≤ 0.01). Patients who reported limited range of motion (OR 1.7, p = 0.41) or pain (OR 6.0, p = 0) were significantly more likely to be satisfied after IR. Patients who reported sensitivity to cold weather also showed a decrease of complaints after IR (OR 3.6, p = 0.03). Major complications occurred in 2.1% of cases. The minor complication rate was 8.4% (predominantly impaired wound healing). Smoking patients showed a significantly higher risk of complications after IR (OR 5.2, p = 0.006). Persistent pain postoperatively was detected in 14.7%.ConclusionWhen elective IR for consolidated fractures of the lower extremity is primarily motivated by patients’ subjective symptoms of discomfort, the risk for postoperative dissatisfaction significantly increases. Objective symptoms on the other hand are associated with higher satisfaction after IR. While the procedure is generally safe, minor complications such as wound healing disorders can occur, especially in smokers. Patient education and well-documented informed consent are critical.

A Comparative Clinicopathological Study on Powder of Aegle marmelos Leaf and Withania coagulans Flower in the Management of Madhumeha

Background: In view of Ayurveda, abnormal and profuse excretion of urine in general is called as Prameha. If we do not treat the Prameha, it leads to Madhumeha. There are many herbs mentioned in Ayurveda that have Madhumehahara property. Hence, to control Madhumeha two effective Ayurvedic drugs, namely, “Aegle marmelos” and “Withania coagulans” were selected for the present study. The study aimed to study the efficacy of A. marmelos leaf and W. coagulans flower powder in the management of Madhumeha. Materials and Methods: For the present study, 40 patients of Madhumeha were randomly selected according to the Inclusion criteria. The prepared medicine was trailed in two groups (Groups A and B) each having 20 Patients. The assessment was in every 10 days of intervals. Discussion and Conclusion: Statistically, A. marmelos leaf powder provided no significant results and W. coagulans flower powder provided significant results in improving subjective and objective signs and symptoms of Madhumeha.

Mānuka oil based ECMT-154 versus vehicle control for the topical treatment of eczema: study protocol for a randomised controlled trial in community pharmacies in Aotearoa New Zealand

BackgroundEczema is a chronic, relapsing skin condition commonly managed by emollients and topical corticosteroids. Prevalence of use and demand for effective botanical therapies for eczema is high worldwide, however, clinical evidence of benefit is limited for many currently available botanical treatment options. Robustly-designed and adequately powered randomised controlled trials (RCTs) are essential to determine evidence of clinical benefit. This protocol describes an RCT that aims to investigate whether a mānuka oil based emollient cream, containing 2% ECMT-154, is a safe and effective topical treatment for moderate to severe eczema.MethodsThis multicentre, single-blind, parallel-group, randomised controlled trial aims to recruit 118 participants from community pharmacies in Aotearoa New Zealand. Participants will be randomised 1:1 to receive topical cream with 2% ECMT-154 or vehicle control, and will apply assigned treatment twice daily to affected areas for six weeks. The primary outcome is improvement in subjective symptoms, assessed by change in POEM score. Secondary outcomes include change in objective symptoms assessed by SCORAD (part B), PO-SCORAD, DLQI, and treatment acceptability assessed by TSQM II and NRS.DiscussionRecruitment through community pharmacies commenced in January 2022 and follow up will be completed by mid-2023. This study aims to collect acceptability and efficacy data of mānuka oil based ECMT-154 for the treatment of eczema. If efficacy is demonstrated, this topical may provide an option for a novel emollient treatment. The community-based design of the trial is anticipated to provide a generalisable result.Ethics and disseminationEthics approval was obtained from Central Health and Disability Ethics Committee (reference: 2021 EXP 11490). Findings of the study will be disseminated to study participants, published in peer-reviewed journal and presented at scientific conferences.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001096842. Registered on August 18, 2021 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382412&isReview=true).Protocol version2.1 (Dated 18/05/2022).

Disentangling effects of remote mild traumatic brain injury characteristics and posttraumatic stress on processing speed and executive function in veterans.

Mild traumatic brain injury (mTBI) and posttraumatic stress are prevalent in military service members and share objective and subjective cognitive symptoms, complicating recovery. We investigated the effects of remote mTBI characteristics and current posttraumatic stress symptoms on neuropsychological performance in 152 veterans with a history of remote mTBI and current cognitive concerns. Participants completed clinical neuropsychological evaluations within a Veterans Affairs Level-II TBI/Polytrauma outpatient clinic (i.e. tertiary trauma care center for US military veterans outside of a research or teaching hospital setting). Archival data analysis of mTBI injury characteristics, clinical diagnoses, scores on the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and performance on tests of processing speed, attention and executive function was conducted. Hierarchical linear regression demonstrated that elevated PCL-M scores were associated with slower performance on trail making test (TMT) Parts A and B (p < .016). PCL-M symptoms moderated the effect of alteration of consciousness (AOC) on TMT performance, with endorsement of AOC associated with better performance, but only when PCL-M scores were high (p < .005). Follow-up mediation analyses demonstrated that PCL-M score fully mediated the relationship between AOC and TMT-A performance and partially mediated the relationship between AOC and TMT-B performance. Post-hoc analyses meant to separate the impact of processing speed on TMT-B were all non-significant. Remote mTBI characteristics, specifically AOC, were not associated with decrements in cognitive performance. Posttraumatic symptoms were associated with worse processing speed, suggesting that psychological distress and psychopathology are contributing factors in understanding and treating persistent cognitive distress following remote mTBI.

FEATURES OF COVID-19 IN PATIENTS WITH DIABETES MELLITUS

Introduction: Diabetes mellitus and COVID-19 are nosologies that pose new challenges in the field of medicine, and after their combination, have already outlined their importance and potentially large impact on the health of people around the world. Each of these pathologies individually has a significant impact on the lives and well-being of patients, and together they create complex conditions for medical practice and healthcare organization. The study of the mutual influence of diabetes mellitus and COVID-19 on the clinical picture, features of the course, diagnosis and treatment of patients is of great importance and relevance for both the scientific community and applied practical medicine, and its continuation and expansion is a scientific and public need. Materials and Methods: А total of 53 patients with COVID-19 were examined. Their medical records were reviewed. To assess the clinical parameters, epidemiological data, physical and psycho-emotional state of patients, the author's own questionnaire "Form of Communication-1" was created and used. Based on the data obtained, statistical indicators were calculated: Pearson's test for qualitative indicators, Mann-Whitney U test was used as a non-parametric analysis method, Student's t-test for values that corresponded to the normality of distribution, respectively. Results: Patients with COVID-19 were divided into two groups: with diabetes mellitus (20 patients, 37.7%) and without this pathology (comparison group) (33 patients, 62.3%). Most of those studied were women (57%), aged (59.2 ± 12.5) years. Patients were hospitalized on days 4-5 of the disease. Among the concomitant pathologies, arterial hypertension and coronary heart disease were more frequently detected in the group of patients with diabetes mellitus (85% each), in the comparison group (55% and 52%, respectively (p &lt; 0.05). The coronavirus disease began acutely with chills and fever up to (38.3±0.18) °C. Generalized weakness was experienced by 96 % of patients. Among the complaints in the comparison group, ague (33 %) and hoarseness of the voice (52 %) prevailed (p &lt; 0.05). Severe COVID-19 was observed in 85% of patients with diabetes mellitus, and in the comparison group - in 33% of patients. On the contrary, moderate severity prevailed in the comparison group (64 % of patients) (p &lt; 0.05). The blood glucose level in patients with COVID-19 in the setting of type 2 diabetes was (9.9 ± 6.8) mmol/L and was higher than in the comparison group (5.8 ± 1.4) mmol/L, indicating hyperglycemia due to impaired glucose tolerance (p &lt; 0.05). Conclusions: Women (57%) of middle age (59.2 years) predominate among patients. Severe COVID-19 predominates in the group of patients with diabetes mellitus. The clinical picture is not significantly different in the compared groups, but laboratory data (elevated C-reactive protein, changes in platelet size, elevated levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, urea, creatinine), objective symptoms (changes in general condition, severe course, auscultatory abnormalities) indicate more pronounced changes in patients with COVID-19 and diabetes mellitus. SARS-CoV-2 induces changes in glucose metabolism and contributes to the severity of COVID-19, which in turn leads to hypercytokinemia, cytokine storm, tissue and airway damage.

Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups.

Oral food challenges (OFCs) are used to confirm or reject a diagnosis of food allergy. However, younger children may encounter difficulties in consuming all offered doses during an OFC in the absence of symptoms, resulting in inconclusive outcomes. Our aim is to assess the eliciting dose for objective symptoms among various age groups and determine the necessity of consuming the final dose step during an uneventful OFC to avoid false negative outcomes. OFCs for common food allergens performed between 2012 and 2019 were analyzed retrospectively. The primary outcome was the association of age with stop dose for OFCs with inconclusive outcome. Secondary outcome measures were the association of age with eliciting dose and the potential number of false negative outcomes. A total of 1327 OFCs were performed in 707 patients. Of these, 514 (38.7%) were positive, 589 (44.4%) negative, and 224 (16.9%) inconclusive. In OFCs with inconclusive outcome, age appeared to be a significant predictor of the stop dose only for almond (p = .005). Objective symptoms occurred after the last dose step in 2%-13% of all OFCs with positive outcome. In our cohort, potential false negative outcomes may have been drawn in 27.6% of uneventful OFCs. Two third of children under 6 years of age successfully consumed all the provided doses during OFCs with a negative outcome. The eliciting dose for objective symptoms was not associated with age, and in a substantial number of OFCs with positive outcome, symptoms occurred after eating the final dose. These findings suggest that in case of an uneventful OFC, the outcome should be drawn only after a cumulative dose of 4.4 g has been consumed to avoid the risk of a potential false negative outcome.

Changes in corneal sensory nerves activity and the protective mechanisms during ocular surface pathologies

The prevalence of dry eye complaints due to tear production disorders is steadily increasing, mainly due to increased life expectancy and changes in lifestyle (contact lens wear, increased time spent in front of computer screens). However, the prevalence of subjective complaints and clinical symptoms of tear production disorders is variable, with only 10%–30% of the population having both subjective complaints and clinical symptoms. A number of in vivo confocal corneal microscopy (IVCM) studies have been performed to qualitatively and quantitatively examine the corneal nerve network in patients with dry eye disease in an attempt to elucidate the changes in corneal innervation and their clinical significance in the disease. Most studies have reported a decrease in nerve density, which may lead to nerve damage, followed by altered sensitivity of the regenerated nerves in patients with dry eye disease, resulting in hyperalgesia or allodynia. This presentation will summarize the role of corneal sensory nerves in the control of tear secretion in healthy eyes and the changes in some pathologies, particularly in dry eye disease. The changes in corneal sensory function in dry eye disease will be described in detail based on animal and human clinical studies. Knowledge of these changes will help to understand the contradictory relationship between objective symptoms and subjective complaints in dry eye patients.

Влияние барьерных методов профилактики острых респираторных вирусных инфекций на функциональное состояние назального цилиарного эпителия у детей с рецидивирующей бронхиальной обструкцией

Aim. Study effect of cellulose powder on the functional state of the ciliary epithelium in children with bronchial obstruction. Design. Open prospective non-randomized clinical study. Material and methods. The study involved 60 children from 3 to 11 years, with a history of frequent acute respiratory viral infections (ARVI), occurring with bronchial obstruction or exacerbation of bronchial asthma. Motor activity of the ciliary epithelium was registered with the digital high-speed videomicroscopy method initially and 3 months after the start of the three-month course of its application. Patients were also assessed for the frequency of acute respiratory viral infections; the objective and subjective symptoms of ARVI episodes were evaluated with a point scale during the follow-up period. Results. After completing the three-month course of cellulose powder with wild garlic extract usage, it was revealed that 55 (91.7%) children did not get ARVI during follow-up, 5 (8.3%) children had ARVI once. There was a reduction in the duration of the disease, a decrease in the severity of symptoms compared with those in previous years, on the scale of severity assessment of symptoms in patients with ARVI: in previous years — 17 (16; 18) points, when interviewed after the use of the studied drug — 9 (7; 10) points (p &lt; 0.05). Of the five children who were ill, only one child developed obstructive bronchitis on the background of a viral infection. The relative number of cells with motile cilia: the middle nasal concha (MNC) — 25% (20%; 30%), the inferior nasal concha (INC) — 25% (15%; 30%); 3 months after the start of taking the cellulose powder: MNC — 40% (30%; 45%), INC — 35% (35%; 45%) (p &lt; 0.01). Ciliary beat frequency in patients initially: MNC — 4.7 (4.2; 5.9) Hz, INC — 4.9 (4.2; 5.7) Hz; 3 months after MNC — 5.9 (5.7; 7.9) Hz (p &lt; 0.01), INC — 6.2 (5.5; 7.2) Hz (р &lt; 0.05). Conclusion. The use of cellulose powder for preventive purposes prevents infection with ARVIs, protects against reinfection, and also helps to reduce the duration and the severity of the disease manifestations. There is a positive dynamics in the functional status of the ciliary epithelium of the upper respiratory tract, which may reflect a more complete restoration of the mucosa against the background of the absence of ARVI. Keywords: ciliary epithelium, cilia, prevention of acute respiratory viral infections, children, fine cellulose powder.

A clinical study on the effect of Lodhradi Kashaya on Madhumeha with special reference to Diabetes Mellitus (Type-2)

Introduction: Ayurveda describes Prameha as a disease entity which involves a number of diseases with various physical and chemical changes in urine. Madhumeha is included under Vatik Prameha where astringency is associated with sweetness in urine. The manifestation of metabolic abnormality as well as urinary tract pathology are included in two symptoms: Prabhuta Mutrata (excessive urination) and Avila Mutrata (urine turbidity). Sedentary life style, indulgence of Kapha-meda Vardhaka Ahara, avoidance of regular exercise, day sleep indicate Santarpanajanya origin of the disease. Methods: Lodhradi Kashaya with Lodhra, Musta, Katphal and Haritaki as described in Vasavarajeeyam is taken for this clinical study on 60 patients and its efficacy was compared with a standard drug metformin. Results: During the study it was found that both Lodhradi Kashaya and Metformin provided significant result in improving Signs and Symptoms like polyuria, turbid urination, Polydipsia, polyphagia, burning sensation, numbness, weakness, lassitude, pruritus, muscle cramps, and increased sweating. The test of significance shows that both the trial drug and control drug were highly significant at 0.1% level with p-value &lt;0.001 to improve glycosuria, FBS, PPBS and HbA1c in patients. Comparative analysis of the effectiveness of Lodhradi Kashaya and metformin w.r.t. objective sign and symptoms showed that both the treatments are almost equally effective to improve glycosuria, FBS, PPBS and HbA1c while Lodhradi Kashaya gives better clinical improvement than metformin in long term use in Diabetes. Lodhradi Kashaya is an efficient anti diabetic drug.

MINDFULNESS-BASED STRESS REDUCTION (MBSR): TREATMENT FOR COGNITIVE IMPAIRMENT POST CHEMOTHERAPY (CT)

Abstract The purpose of this R01 trial was to evaluate the efficacy of MBSR(BC) compared to the Breast Cancer Education Support program(BCES) or Usual Care(UC) regimens for improvement in cognitive functioning among breast cancer survivors(BCS) who received (CT), or CT and radiation. Methods: BCS (212) were randomized to MBSR(BC) (n=91) or BCES(90) or UC (n = 31) with MBSR(BC) and BCES participants attending a 6-week program. Measures of neuropsychological and perceived cognitive performance, psychological and physical symptoms were collected at baseline, 6, 12, and 26 weeks. Linear mixed models assessed the MBSR(BC) effects over time. Characteristics at baseline were tested as moderators of MBSR(BC) program effects. Results: 212 BCS had a mean age of 57, 73% were White, non-Hispanic, 78% received CT and radiation; and 22% CT alone. All BCS improved across the study on all measures. For most measures, cognitive and symptom improvement effects followed the hypothesized pattern favoring MBSR(BC), followed by BCES and UC groups. Effect sizes were generally small, particularly for measures of cognition. The largest week 26 effect sizes were observed in the physical symptom fatigue, where the MBSR(BC) group improved with a 0.45 Cohen’s d effect over BCES and 0.65 over UC. Type of CT, radiation treatment, time since treatment, and informal and formal practice techniques of MBSR(BC) moderated the effects of MBSR(BC). Conclusions: Although effects were modest, BCS receiving the MBSR(BC) and BCES groups improved in objective and subjective cognitive functioning and symptoms compared to UC. Longer follow-up studies are needed to determine sustained effects.

Experience with clindamycin and lactic acid in the treatment of bacterial vaginosis

Background. Currently, the search for the most effective methods to treat bacterial vaginosis remains relevant because of the high recurrence rate and resistance of the associated bacteria to antimicrobial drugs, along with the potential side effects of antibiotic therapy. This study aimed to assess the effectiveness and tolerability of using clindamycin and lactic acid sequentially, in comparison to lactic acid monotherapy, for women with bacterial vaginosis.&#x0D; Materials and methods. An open, randomized, comparative clinical study was conducted with 20 women (aged 18–45 years) who had bacterial vaginosis diagnosed according to R. Amsel criteria. The patients were randomly allocated into two groups, each comprising 10 patients. Group 1 took lactic acid, whereas group 2 employed clindamycin and lactic acid. After 14 days, clinical and laboratory efficacy was assessed based on Amsel criteria.&#x0D; Results. Objective and subjective symptoms such as vaginal discharge of whitish-gray color with unpleasant odor were not observed in both groups 2 weeks after the end of treatment. Positive dynamics of vaginal pH was recorded in both groups; however, a more pronounced effect was observed in women who used clindamycin and lactic acid.&#x0D; Conclusions. Both sequential clindamycin and lactic acid monotherapy demonstrated high clinical efficacy and good tolerability. Posttreatment pH values did not differ significantly between the two groups; however, a greater pH deviation was observed in the clindamycin and lactic acid sequential group. Further evaluations of long-term results are necessary.

Allogeneic mesenchymal stem cell therapy for dry eye disease in patients with Sjögren's syndrome: A randomized clinical trial

PurposeThis double-blinded randomized clinical trial aimed to evaluate the efficacy of injecting allogeneic adipose-derived mesenchymal stem cells (ASCs) into the lacrimal gland (LG) for the treatment of dry eye disease (DED) secondary to Sjögren's syndrome (SS). MethodsFifty-four participants with severe DED secondary to SS were included and allocated to either ASCs (n = 20), vehicle (n = 20), or a non-randomized observation group (n = 14). The intervention groups received a single injection of either ASCs or an active comparator (vehicle, Cryostor® CS10) into the LG in one eye, while the observation group received lubricating eye drops only. The primary outcome measure was changes in Ocular Surface Disease Index (OSDI) score and secondary outcome measures were non-invasive tear break-up time, tear meniscus height, Schirmer's test, and Oxford score within a 12-month follow-up. ResultsA significant reduction in OSDI score was observed in the ASCs and vehicle groups compared to the observation group. In addition, the ASCs group demonstrated a significant increase in non-invasive tear break-up time compared to the vehicle group at the 4-week follow-up and to the observation group at the 12-month follow-up. A significant improvement in ocular surface staining, tear osmolarity, and Schirmer test score from baseline was also observed in the ASCs group; however, these changes were not significant compared to the other groups. ConclusionImprovement of subjective and objective signs and symptoms of DED was observed in both intervention groups following injection into the LG compared to the observation group. Future studies should investigate the mode-of-action of both injection treatments.

Santri dan Gudig: Studi Analisis Pendidikan dan Kesehatan di Pondok Pesantren Kabupaten Tegal

Gudik or its Latin name Scabies is a skin disease characterized by intense itching and caused by a small tick called sarcoptes scabiei. These fleas/bacteria secrete saliva, eggs and feces. gudig or scabies infects most students/students who live in dormitories or boarding schools, this can be caused by several possibilities including lack of personal hygiene, starting from body hygiene to the clothes they wear every day. This research is field research with a case study, namely a study conducted at the Tarbiyatul Mubtadiin Danawarih Islamic Boarding School, Balapulang Subdistrict, a place chosen as a location to investigate objective symptoms that occur at that location. The approach taken is a qualitative approach and the data collection techniques of this research are observation, interview and documentation. The results of this study show that: 1. This secabies disease mostly attacks new students, but it does not rule out the possibility that old or senior students are also affected by sacabies 2. Scabies among the boarding school also does not affect these students to continue to study diligently because the students at the Tarbiyatul Mubtaidiin Islamic Boarding School believe that scabies or gudig disease is one of the tests that must be passed.

Safety and efficacy of microwave ablation for symptomatic benign thyroid nodules in children.

To evaluate the efficacy and safety of microwave ablation (MWA) for the treatment of symptomatic benign thyroid nodules in children. A retrospective study of MWA for the treatment of 34 symptomatic benign thyroid nodules in 25 children was conducted. Volume reduction ratio (VRR), technique efficacy, symptom score, cosmetic score, and thyroid function were used to evaluate the efficacy of the technique. The associated complications and side effects were recorded. The participants were followed for at least 6months (median 12months, range 6-48months). After MWA treatment, the volumes of the targeted nodules decreased gradually (median volume 5.86mL before MWA and 0.34mL at the final follow-up assessment), the VRR achieved was up to 85.03% at the final follow-up assessment, and the technical efficacy at this time was 91.2%. The subjective and objective nodule-related symptoms were also ameliorated. The circulating hormone concentrations reflecting thyroid function remained within their normal ranges in all the participants after one month of follow-up. The procedure had no major complications. MWA seems to be an effective and safe technique for the treatment of symptomatic benign thyroid nodules in pediatric patients. Microwave ablation is a safe and effective method to treat symptomatic benign thyroid nodules in pediatric patients. This treatment may be selected if the patient or parents are not suitable or refuse to undergo surgery. • Microwave ablation is effective in reducing the volume of benign thyroid nodules and ameliorating nodule-related symptoms in pediatric patients. • Microwave ablation is a safe method in children, with low complications. • Microwave ablation does not affect the circulating thyroid hormone concentrations of children.

Dermatitis Kontak Akibat Kerja pada Pengrajin Batik di Kecamatan Pelayangan Kota Jambi

Dermatitis in batik workers is a common problem that often occurs due to exposure to chemicals and dyes in the batik production process. Batik workers who are directly exposed to these materials are susceptible to skin irritation or even allergic reactions. Long-term exposure to textile dyes, binders, and solvents can cause rashes, redness, itching, swelling, and scaly skin. The aim of this research was to determine the characteristics of DKAK among batik craftsmen workers in Pelayangan District, Jambi City. This research method is a cross sectional design research. The sampling technique was purposive sampling with a total of 40 respondents. Data was obtained by interviews and filling out questionnaires as well as examinations assisted by community health center people. The results of this study showed that there were two risk factors that were related in this study, namely length of exposure (p = 0.001). The most common clinical characteristics based on subjective symptoms are itching, objective symptoms are redness, and a predilection for the fingers and toes. The most common causes of irritants and allergens are synthetic dyes and wax. Exogenous and endogenous risk factors showed that the majority of respondents had no history of atopic eczema, age and skin anatomical condition. Conclusion: From these data there is a relationship between the factors of length of exposure and the incidence of DKAK in batik craftsmen in Pelayangan District, Jambi City.

A Case Study of Ayurvedic Therapies for Polycystic Ovarian Disorder

Background: Endocrinopathies are involved in the complex heterogeneous illness known as polycystic ovarian disease (PCOD). Although the symptoms resemble Vata and Kapha Dosha involvement, Ayurveda does not link the condition to a specific disease or syndrome. By addressing fundamental metabolic abnormalities and restoring ovulation naturally by accelerating follicle growth, Ayurveda cures polycystic ovarian disorder. The course of treatment for a PCOS patient varies on the patient's body type, underlying causes, and manifested symptoms. Case study: A 25-year-old woman who was visiting the Prasuti Tantra evam Streeroga OPD with her 28-year-old husband complained of dysmenorrhea, insufficient menses, delayed menses, acidity, hairfall, and general weakness. Her ovaries seemed polycystic in her ultrasound reports. She had sparse, painful periods every two days for 45 days with minimal clots. No obstetric history existed. For four months, the patient received Kuberaksha vati, Kalaonji powder, Rasapachak kwatha, Granthiraja powder, and Navayas Churna, with monthly follow-ups.The patient's menstrual cycle was progressively reset to normal, or 28 days, after treatment. Her menstrual cycle was getting closer together. Dysmenorrhea and clot concerns saw a significant improvement. Even her USG results showed that her ovaries looked normal following treatment. In conclusion, this instance demonstrates the value of customized treatment options for polycystic ovarian syndrome. Additionally, it highlights the value of Kuberaksha vati, Kalaonji powder, Rasapachak kwatha, Granthiraja powder, and Navayas Churna in lowering subjective as well as objective Polycystic Ovarian Disorder signs and symptoms. For further inferences, more extensive clinic trials should be conducted.

Evaluation of enterohepatic circulation of the bile acids in patients with non-alcoholic fatty liver disease

The aim. To study the clinical manifestations and features of changes in the spectrum of the bile acids in bile and blood in patients with non-alcoholic fatty liver disease. Materials and methods. 54 patients with non-alcoholic fatty liver disease at the stage of steatosis were examined. The median age was 50 years (45; 55). Complaints, objective symptoms and the results of laboratory and instrumental studies of the liver were used to verify non-alcoholic fatty liver disease. The content of the bile acids in bile and blood was determined using an AmazonX mass spectrometer (Bruker Daltonik GmbH, Bremen, Germany). Results. The majority of the examined patients (77,8%) with non-alcoholic fatty liver disease had subjective and objective symptoms of damage to the hepatobiliary system and intestines. According to the results of mass-spectrometry, a decrease in the total amount of primary free bile acids (cholic, chenodeoxycholic) and an increase in the total content of conjugated bile acids (glycocholic, glycodeoxycholic, taurocholic, taurodeoxycholic, ursodeoxycholic) in portions “B” and “C” bile, as well as blood compared with the control group. The concentration of acids conjugated with glycine was higher than that of taurine conjugates, while the correct ratio of glycine conjugates to taurine was observed (3: 1 and higher). Conclusion. Changes in the spectrum of the bile acids in bile and blood, firstly, is an indicator reflecting the violation of enterohepatic circulation, and, secondly, demonstrates the increasingly obvious importance of the bile acids in the pathogenesis of non-alcoholic fatty liver disease.