Relief Of Symptoms Research Articles

Refining cardiac resynchronization therapy: a comprehensive review on the role of advanced multimodality imaging

Cardiac resynchronization therapy (CRT) offers significant benefits in symptom alleviation, reduction of rehospitalization rates, and overall survival of patients with heart failure (HF) with reduced ejection fraction (rEF). However, despite its proven efficacy, precisely identifying suitable CRT candidates remains a challenge, with a notable proportion of patients experiencing non-response. Accordingly, many attempts have been made to enhance patient selection, and to identify the best imaging parameters to predict the response and survival after CRT implantation. This review article provides a comprehensive overview on the role of multi-modality cardiac imaging in selecting, optimizing, and predicting CRT response and outcomes in HFrEF patients, beginning with an exploration of dyssynchrony types and their impact on HF progression, and an emphasis on the utility of echocardiography in assessing cardiac dyssynchrony. Subsequently, the role of advanced techniques such as speckle tracking and three-dimensional echocardiography, as well as the visual assessment of apical rocking (ApRock) and septal flash (SF) are highlighted. Finally, cardiac magnetic resonance (CMR) scar data, and novel modalities like four-dimensional flow CMR, together with single-photon emission computed tomography offer additional insights, emerging as valuable predictors of CRT response, and potentially refining the identification of suitable CRT candidates.

The impact of single sessions of aerobic exercise at varying intensities on depressive symptoms in college students: evidence from resting-state EEG in the parietal region

BackgroundThe incidence of depression among college students is increasingly high, significantly impacting their daily lives. This study aims to utilize electroencephalography (EEG) to assess the effects of varying intensities of single-session aerobic exercise on depression symptoms in college students.ObjectiveThis study aimed to explore the effects of single sessions of aerobic exercise at varying intensities on depressive symptoms in college students through changes in BDI-II (Beck Depression Inventory-II) scores and resting-state EEG lateralization.MethodsDepressed college students were randomly assigned to low, moderate, high-intensity exercise, and control groups. The study investigated the relationship between BDI-II scores and resting-state EEG parietal region lateralization and the impact of single sessions of aerobic exercise at different intensities on depressive symptoms.ResultsBDI-II scores were negatively correlated with parietal region α2 (P < 0.01) and β1 (P < 0.05) lateralization in depressed students. Low-intensity exercise significantly reduced BDI-II scores (P < 0.05). Moderate-intensity exercise resulted in significant changes in BDI-II scores (P < 0.001), α2 lateralization (P = 0.002), and β1 lateralization (P = 0.006). Post-test comparisons showed significant differences in BDI-II (P = 0.048), α2 (P = 0.002), and β1 (P = 0.041) compared to the control group, and differences in α2 (P = 0.021) and β1 (P = 0.041) compared to the low-intensity group. High-intensity exercise also significantly altered BDI-II scores (P < 0.001) and α2 (P = 0.035). Post-test comparisons showed differences in BDI-II compared to low-intensity (P < 0.001), moderate-intensity (P = 0.01), and control groups (P < 0.001), and differences in α2 compared to the control group (P = 0.011). BDI-II changes were negatively correlated with changes in α2 (P < 0.01) and β1 (P < 0.05).ConclusionFrom the perspective of the BDI-II, various intensities of a single bout of aerobic exercise can alleviate depressive symptoms in college students. Additionally, regarding the lateralization of resting EEG in the parietal region, moderate-intensity aerobic exercise demonstrates a more comprehensive improvement. The alleviation of depressive symptoms in college students is, to some extent, associated with the synergy within the parietal region.Trial registrationThe study was registered in the Chinese Clinical Trial Registry (ChiCTR2400087920, 07/08/2024).

Tri-leaflet mitral valve in hypertrophic obstructive cardiomyopathy

AbstractA tri-leaflet mitral valve (MV) is an extremely rare phenomenon, often associated with significant mitral regurgitation (MR). It may represent a phenotypic expression of hypertrophic obstructive cardiomyopathy (HOCM). We present the case of a 69-year-old woman with HOCM, a tri-leaflet MV, and systolic anterior motion (SAM)–induced severe MR. Despite receiving optimal medical therapy, her refractory symptoms and significant MR prompted surgical consideration. The patient underwent surgical myectomy, resulting in improvement of left ventricular outflow tract obstruction, SAM-induced MR, and symptomatic relief. This case illustrates a unique presentation of HOCM with a tri-leaflet MV and significant MR, successfully managed with a tailored surgical myectomy.

Endoscopic Ultrasonography-Guided Drainage of the Pancreatic Duct (EUS-PD)—Indications and Results with a Literature Review

Background/Objectives: Drawing upon over twenty years of clinical experience in endoscopic and endosonographic procedures, along with comprehensive literature research, we present an overview on EUS-guided pancreatography and pancreatic duct drainage (EUS-PD) as an alternative approach, encompassing indications, procedural methods, and outcomes, including complications and the success rate. Methods: Narrative review. Results: (corner points): EUS-PD is indicated for cases, for which conventional methods are ineffective due to altered abdominal anatomy of the upper gastrointestinal (GI) tract, such as congenital or postoperative conditions that prevent access to the papilla or pancreatoenteric anastomosis. It is also considered if there is symptomatic retention of the pancreatic duct due to pathological changes in the papillary region or stenosis of the pancreatic duct or anastomosis, especially if surgery is not feasible or poses higher risks. EUS-PD has a technical success rate ranging from 25 to 92%, albeit with a complication rate spanning from 14 to 40%, primarily comprising bleeding, perforation, pancreatitis, and pain. Long-term clinical success, measured by pain and symptom relief, falls within a range of 65–85%. Conclusions: The method offers advantages such as minimal invasiveness, enhanced quality of life, the potential for endoscopic revision in the case of complications, and compatibility with most conventional endoscopic instruments requiring extensive expertise in interventional endoscopy and endosonography.

A Rare Case Report on Jaundice, Alcoholic Liver Disease with a History of Herbal Medicine Induced Liver Injury

Background: Alcoholic liver disease (ALD) is a complex condition caused by excessive alcohol consumption, affecting fatty liver, alcoholic hepatitis, and cirrhosis. Risk factors include alcohol intake, genetic predisposition, and co-existing liver conditions. Alcoholic fatty liver disease (AFLD) accumulates excessive fat in the liver, leading to steatosis and fibrosis. ALD complications include portal hypertension, liver failure, and hepatocellular carcinoma. The use of herbal medicines, such as tamarind and neem extracts, is also concerning due to potential liver damage. Increased awareness and caution are needed from patients and healthcare providers. Case report: A 33-year-old male patient presented with symptoms including right hypochondrium pain, yellowish discoloration of the sclera, fever, decreased urine output, light yellow tongue, and generalized weakness. He was a chronic alcoholic, consuming various alcoholic beverages for 15 years. His dietary routine was mixed, but he preferred non-vegetarian foods. His family suggested he consume traditional herbal medicine to treat jaundice. After collecting his history, lab tests were conducted to confirm his diagnosis of alcoholic liver disease (ALD) with herbal medicine-induced liver (DILI). LFT tests were alarming, and he was diagnosed with alcoholic liver disease with jaundice and DILI due to herbal medicine. To improve his symptoms and prevent liver failure complications, he was prescribed a list of medications to improve his symptoms and to prevent complications of liver failure. Discussion: A holistic treatment approach is needed for patients with alcoholic liver disease and herbal medicine-induced liver injury, focusing on symptom relief, liver function enhancement, and complication prevention. This includes lifestyle changes, nutritional support, and managing potential issues. Regular monitoring is crucial for adjustments. Conclusion: This case report highlights the complex relationship between alcoholic liver disease and herbal medicine-induced liver injury, especially in jaundice cases. It emphasizes the need for thorough patient histories, increased awareness of hepatotoxic potential, and educating patients about alcohol and herbal supplement risks. It calls for multidisciplinary collaboration, enhanced regulation, and safety evaluations of herbal medicines to protect public health. It also underscores the importance of continuous monitoring and monitoring patients with liver injury histories. Keywords: ALD, Herbal medicine, DILI, Liver failure, Patient care

Advanced Speckle-Tracking Echocardiography Could Play a Crucial Role in the Diagnosis of Post-Implanted Cardiomyopathy Associated with a Leadless Pacemaker System

Background: A leadless pacemaker (LP) is a modern alternative to a transvenous pacemaker, allowing certain complications to be avoided; however, some cannot be eliminated. Aim: To highlight the essential role of advanced speckle-tracking echocardiography (STE) in diagnosing pacing-induced cardiomyopathy (PICM) caused by an LP. Clinical case: A 79-year-old male, after LP implantation a year earlier, was admitted due to heart failure (HF). Left ventricular ejection fraction (LVEF) was 40%, global longitudinal strain (GLS) was −10%, and interventricular mechanical delay (IVMD) was 42 ms. All these parameters were significantly better before the operation. Myocardial work indices confirmed dyssynchrony due to the right ventricular (RV) stimulation pattern, and PICM was considered. To verify the impact of RV pacing on the LV, measurements were taken after restoring the native rhythm, showing an improvement in LVEF (45%), GLS (−13%), IVMD (7 ms), and myocardial work indices. After the next HF exacerbation with further deterioration of the LV function, a decision to convert the LP to a standard CRT-P system was made, with immediate relief in clinical symptoms and improved echocardiographic parameters. Conclusions: This case highlights the essential role of STE echocardiography in identifying the detrimental impact of RV pacing, diagnosing PICM, and selecting the appropriate treatment for patients with LPs.

Efficacy and safety of transcutaneous auricular vagus nerve stimulation in patients with constipation-predominant irritable bowel syndrome: a single-center, single-blind, randomized controlled trial.

Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising therapy for irritable bowel syndrome (IBS). This clinical trial aims to evaluate the influence of taVNS on autonomic functions, rectal sensation, and acetylcholine (Ach) levels and to explore potential mechanisms involving gut microbiota and metabolic profiles. This study was a single-center, single-blind, randomized controlled trial executed at the First Affiliated Hospital of USTC, Anhui, China. Individual patients' IBS-C-related symptoms and mental health were assessed and scored using questionnaires at baseline and at week 4. Levels of Serum Ach and nitric oxide (NO), anorectal manometry, and heart rate variability (HRV) were assessed both prior to and following the therapy. Fecal samples from each group were assessed to compare the gut microbiota, short-chain fatty acids, and gut microbiota-derived tryptophan metabolites. Between September 2023 and May 2024, 40 participants (n=20 in both taVNS and sham-taVNS group) completed the four-week study by performing an intention-to-treat (ITT) analysis. No differences in all parameters between taVNS and sham-taVNS groups at the baseline was found. The taVNS significantly improved the VAS score (P < 0.001), IBS Severity Scoring System (IBS-SSS) (P < 0.001), weekly frequency of spontaneous bowel movements (SBMs) (P < 0.001), weekly frequency of complete SBMs (CSBMs) (P = 0.004), Bristol Stool Form Scale (BSFS) (P < 0.001), Hamilton Anxiety Scale (HAMA) (P < 0.001), Hamilton Depression Scale (HAMD) (P < 0.001), and IBS-QOL scores (P < 0.001). Furthermore, taVNS improved rectal sensation in IBS-C patients, including improvements in the threshold volume for initial sensation (P = 0.033), the urge to defecate (P = 0.022), and rectoanal inhibitory reflex (P = 0.002). Moreover, taVNS elevated serum levels of Ach (P = 0.005) and reduced NO (P = 0.016) while also enhancing vagal activity (P < 0.001) as determined by spectral analysis of HRV. Three individuals in the taVNS group and two in the control group had adverse consequences, which were manageable. Additionally, taVNS led to a significant rise in the level of the genus Bifidobacterium (P = 0.038), increased levels of acetic (P = 0.003), butyric (P = 0.011), and propionic acids (P = 0.005). It also decreased tryptophan metabolism content, including 3-hydroxyanthranilic acid (P = 0.007), anthranilic acid (P = 0.026) and L-tryptophan (P = 0.002). The study manifested that non-invasive taVNS effectively improved constipation and abdominal pain symptoms in IBS-C patients. The alleviation of IBS-C symptoms may be attributed to the integrative effects of taVNS on rectal functions, mediated through vagal, cholinergic, and multi-omics mechanisms.

Current Trends in Treating Malignant Pleural Effusion: Evidence, Guidelines, and Best Practice Recommendations.

Malignant pleural effusion (MPE) is common in individuals with cancer and typically reflects advanced disease. Most cases are symptomatic, with dyspnea and pain having a severe effect on the patient's quality of life (QOL). The management of MPE aims to relieve symptoms, improve QOL, prevent repeated pleural interventions, and minimize hospital admissions. Common treatments for MPE that provide symptomatic relief include thoracentesis, chemical (talc) pleurodesis, or indwelling pleural catheters (IPCs). Talc pleurodesis and IPCs are the mainstay of treatment but represent very different treatment strategies: talc pleurodesis is an inpatient procedure, whereas IPCs are an ambulatory strategy. Given their similar efficacy, treatment decisions in MPE are often determined by other factors, such as the patient's clinical characteristics, individual treatment goals, and preferences for hospital-based or home-based care. We provide a summary of the evidence for different interventions for treating MPE and compare recommendations from the major American, European, British, and Spanish guidelines regarding when to consider each treatment. We highlight specific challenging treatment scenarios and key clinical considerations that may influence treatment decisions for different patients. There are barriers to accessing and receiving evidence-based care. Patients with symptomatic MPE would benefit from early referral from oncology teams to pleural services. We provide best practice recommendations for optimal referral and coordination of care to ensure that patients receive maximum benefits from their interventions.

The Beneficial Roles of Seaweed in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by severe pruritus and recurrent flare-ups, significantly impacting patients’ quality of life. Current treatments, such as corticosteroids and immunomodulators, often provide symptomatic relief but can lead to adverse effects with prolonged use. Seaweed, a sustainable and nutrient-dense resource, has emerged as a promising alternative due to its rich bioactive compounds—polysaccharides, phlorotannins, polyphenols, and chlorophyll—that offer anti-inflammatory, antioxidant, and immunomodulatory properties. This review explores the therapeutic potential of brown, red, and green algae in alleviating AD symptoms, highlighting the effects of specific species, including Undaria pinnatifida, Laminaria japonica, Chlorella vulgaris, and Sargassum horneri. These seaweeds modulate immune responses, reduce epidermal thickness, and restore skin barrier function, presenting a novel, safe, and effective approach to AD management. Further clinical studies are needed to confirm their efficacy and establish dosing strategies, paving the way for seaweed-derived therapies as natural alternatives in AD treatment.

Combination of Topical Heparin and Levomenol in the Treatment of Atopic Dermatitis: A SCORing Atopic Dermatitis (SCORAD) Analysis

Background/Objectives: A prior placebo-controlled, double-blind clinical study demonstrated the superiority of a topical combination of heparin and levomenol over the control and single active constituents. The effect on pruritus and the total SCORAD index were used to evaluate efficacy, but not the effect on the individual SCORAD items. This analysis investigates the overall efficacy of the treatment and the relative contributions of heparin and levomenol to symptom relief in atopic dermatitis, including the effects on the affected body area and its implications for sleeplessness. Methods: The ITT group (combination group A: n = 79; levomenol group B: n = 80; heparin group C: n = 78; placebo group D: n = 41) of the previously published study was re-analysed. Results: The combination significantly improved symptoms such as erythema, edema/papulation, excoriations, and skin dryness compared to the control after eight weeks of treatment. No significant differences were observed for oozing/crust and lichenification among the active groups. Levomenol and heparin exhibited significant advantages over the control for erythema and excoriations, while heparin improved edema/papulation significantly. The inflamed body area significantly decreased using the combination or single active constituents, and sleeplessness significantly improved with the combination or with heparin alone compared to the control. Conclusions: These findings highlight the efficacy of the combination and individual active constituents in addressing specific symptoms of atopic dermatitis, providing insights into their therapeutic effects. The combination’s advantage over the control is most evident in improving excoriations, skin dryness, inflamed skin area, and sleeplessness, justifying its documented use as an intervention in the early stages of atopic dermatitis episodes.

Effect of a Web-Based Heartfulness Program on the Mental Well-Being, Biomarkers, and Gene Expression Profile of Health Care Students: Randomized Controlled Trial.

Health care students often experience high levels of stress, anxiety, and mental health issues, making it crucial to address these challenges. Variations in stress levels may be associated with changes in dehydroepiandrosterone sulfate (DHEA-S) and interleukin-6 (IL-6) levels and gene expression. Meditative practices have demonstrated effectiveness in reducing stress and improving mental well-being. This study aims to assess the effects of Heartfulness meditation on mental well-being, DHEA-S, IL-6, and gene expression profile. The 78 enrolled participants were randomly assigned to the Heartfulness meditation (n=42, 54%) and control (n=36, 46%) groups. The participants completed the Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS-21) at baseline and after week 12. Gene expression with messenger RNA sequencing and DHEA-S and IL-6 levels were also measured at baseline and the completion of the 12 weeks. Statistical analysis included descriptive statistics, paired t test, and 1-way ANOVA with Bonferroni correction. The Heartfulness group exhibited a significant 17.35% reduction in PSS score (from mean 19.71, SD 5.09 to mean 16.29, SD 4.83; P<.001) compared to a nonsignificant 6% reduction in the control group (P=.31). DASS-21 scores decreased significantly by 27.14% in the Heartfulness group (from mean 21.15, SD 9.56 to mean 15.41, SD 7.87; P<.001) while it increased nonsignificantly by 17% in the control group (P=.04). For the DASS-21 subcomponents-the Heartfulness group showed a statistically significant 28.53% reduction in anxiety (P=.006) and 27.38% reduction in stress (P=.002) versus an insignificant 22% increase in anxiety (P=.02) and 6% increase in stress (P=.47) in the control group. Further, DHEA-S levels showed a significant 20.27% increase in the Heartfulness group (from mean 251.71, SD 80.98 to mean 302.74, SD 123.56; P=.002) compared to an insignificant 9% increase in the control group (from mean 285.33, SD 112.14 to mean 309.90, SD 136.90; P=.10). IL-6 levels showed a statistically significant difference in both the groups (from mean 4.93, SD 1.35 to mean 3.67, SD 1.0; 28.6%; P<.001 [Heartfulness group] and from mean 4.52, SD 1.40 to mean 2.72, SD 1.74; 40%; P<.001 [control group]). Notably, group comparison at 12 weeks revealed a significant difference in perceived stress, DASS-21 and its subcomponents, and IL-6 (all P<.05/4). The gene expression profile with messenger RNA sequencing identified 875 upregulated genes and 1539 downregulated genes in the Heartfulness group compared to baseline, and there were 292 upregulated genes and 1180 downregulated genes in the Heartfulness group compared to the control group after the intervention. Heartfulness practice was associated with decreased depression, anxiety, and stress scores and improved health measures in DHEA-S and IL-6 levels. The gene expression data point toward possible mechanisms of alleviation of symptoms of stress, anxiety and depression. ISRCTN Registry ISRCTN82860715; https://doi.org/10.1186/ISRCTN82860715.

Exploring the efficacy of integrative medicine for chronic conditions: The role of combining allopathy, ayurveda, homeopathy, naturopathy, diet and lifestyle

Chronic diseases are significant and increasing causes of illness and disability throughout the world with significant targeted implications for individual quality of life as well as health systems. Even though these medicines have been proven to be very effective in the so-called ‘acute ‘symptomatic relief ‘of ailments, the conventional biomedicine diagnosis and treatment regimens, particularly the drugs and medicines do not effectively address the chronic diseases that are lifestyle diseases with psychological connotations like cardiovascular diseases, diabetes mellitus or arthritis, etc. Thus, a treatment or therapy plan based on a patient’s constitution and lifestyle might be the solution to improved compliance as well as satisfaction with the integrative approach. However, this is a model that has some concerns of confusion with the pluralism of the treatment approach; thus, it may pose a threat to the modality and standardization while handled by specialized players. However, walking around various therapeutic modalities could initially amount to higher costs and although the costs could be higher, long-term implications such as lowered disease complications and hospitalizations could lead to more cost savings.

Analysis of gene therapy encoding aromatic L-amino acid decarboxylase (AADC) enzyme in the treatment of Parkinson’s disease

Parkinson's Disease (PD), a progressive neurodegenerative disorder characterized by dopaminergic neuron degeneration, leads to motor and non-motor symptoms that significantly impair quality of life. Conventional treatments, such as levodopa, provide symptom relief but are associated with long-term complications and do not halt disease progression. This review systematically evaluates the efficacy and safety of gene therapy targeting the aromatic L-amino acid decarboxylase (AADC) enzyme in treating PD and AADC deficiency, focusing on sustained dopamine production and motor function improvement. A systematic literature review was conducted using databases like PubMed, Scopus, and Embase, covering studies published over the past 32 years. Out of 52 articles identified, 25 met inclusion criteria, providing data on motor outcomes, dopamine production, and safety profiles. Findings suggest that AADC gene therapy may offer a durable therapeutic approach, reducing reliance on conventional dopamine replacement therapies and mitigating related complications. This review highlights gene therapy's potential in clinical practice, emphasizing a shift towards targeted treatment strategies for dopamine-deficient neurodegenerative disorders. Further research should address long-term efficacy and safety across diverse patient groups. Limitations include potential selection bias and language restrictions.

A narrative review of thalassotherapy and the health benefits of seawater and coastal climates.

Thalassotherapy refers to the therapeutic use of controlled exposure to marine environments and their natural elements for health promotion. This review aims to summarize evidence-based clinical applications of thalassotherapy. A narrative review was conducted, with PubMed searched in September 2024 for clinical studies evaluating the efficacy of thalassotherapy. Relevant evidence was summarized and critically analyzed. A total of 566 articles were identified, of which 16 studies met the inclusion criteria. Thalassotherapy was primarily studied for its effects on skin disorders, including psoriasis, atopic dermatitis, and vitiligo, as well as rheumatic conditions like fibromyalgia and ankylosing spondylitis. The intervention showed significant improvements in disease severity and patient quality of life, with the strongest evidence seen in psoriasis and fibromyalgia treatment. Thalassotherapy appears beneficial for symptom relief in several conditions, particularly skin and rheumatic disorders. However, further research is needed to quantify its effect size, evaluate long-term benefits, assess potential risks, and identify factors that may influence treatment outcomes.

Noninvasive Brain Stimulation for Improving Cognitive Deficits and Clinical Symptoms in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Objective: Noninvasive brain stimulation (NIBS) is a promising complementary treatment for attention-deficit/hyperactivity disorder (ADHD). However, its efficacy varies due to diverse participant profiles and methodologies. This meta-analysis, registered with PROSPERO (CRD42023457269), seeks to assess NIBS efficacy in improving cognitive deficits and clinical symptoms in individuals with ADHD. Methods: We systematically searched five databases (October 2024) for randomized controlled trials focusing on cognitive functions and clinical symptoms in individuals meeting the DSM/ICD criteria for ADHD. A meta-analytical synthesis was conducted using RevMan 5.4.1. Results: Meta-analyses found significant improvement in inhibitory control, working memory, and inattention in active transcranial direct current stimulation (tDCS) groups compared with sham groups. Conversely, repetitive transcranial magnetic stimulation (rTMS) did not demonstrate significant therapeutic benefits for ADHD symptoms. Additionally, four transcranial random noise stimulation (tRNS) and three transcranial alternating current stimulation (tACS) studies demonstrated promising improvements in executive functions and the alleviation of ADHD symptoms. Conclusions: The findings from this meta-analysis highlight NIBS as a promising adjunctive therapy for managing ADHD, advancing both theoretical knowledge and practical treatment options in this field.

Role of Daruharidra Rasakriya Lepa in the management of Dushta Vrana w.s.r. to Chronic Non-Healing Ulcer : A Clinical Study

Background: Vrana is an interruption of continuity of body tissue or part by physical, microbial, chemical or immunological causes, typically associated with loss of function. Vrana can be correlated with wounds and ulcers. Normally, Vranas are healed by itself if kept clean. Wound factors delay wound healing. The presence of infection, insufficient blood supply, tissue tension, radiation, malnutrition, diabetes, consumption of steroids etc. are the important factors which delay the wound healing process. Dushta Vrana is one of the Vranas which needs time for its healing. Acharya Sushruta mentioned Rasakriya under Shasti Upakramas for management of Vrana. Any drug formulation should possess two qualities for proper wound healing i.e., Vrana Shodhana (Making free from undesirable wound factors) and Vrana Ropana (Closure of the wound). Many formulations are in use for centuries. One of them is Daruharidrarasakriya. The objective of the present study is to evaluate the effect of Daruharidraraskriya on the basis of relief in signs and symptoms of Dushta Vrana. Materials and Methods: In this study, Lepa of Daruharidrarasakriya was applied on affected part of 25 patients selected from Shalya OPD, GAMC&amp;H, Akhnoor, for the management of Vrana. Results: The results observed based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz. Pain, Size of ulcer, Discharge, Base (granulation tissue) and were found significant on all the above parameters. Conclusion: It showed that Daruharidraraskriya significantly helped in reduction of the signs and symptoms of the Dushta Vrana, enhancing wound healing process and reducing the morbidity of the patients.

A clinical study to evaluate the efficacy of Shaliparnyadi Yusha in Garbhini Parshwagraha (Flank Rigidity with Lower Back Pain) During the Second and Third Trimester

This study investigates the efficacy of Shaliparnyadi Yusha, a traditional Ayurvedic formulation, in the management of Garbhini Parshwagraha (flank rigidity associated with lower back pain) during the second and third trimester of pregnancy. The study was conducted on 32 patients, with outcomes measured by reductions in pain and improvements in mobility. The results indicate significant relief of symptoms, supporting the use of this Ayurvedic therapy for pregnant women experiencing discomfort due to musculoskeletal strain.

Biliary sphincterotomy resets pancreaticobiliary pain refractory to intrasphincteric Botox injections in functional biliary pain.

The management of Type III sphincter of Oddi dysfunction or functional biliary pain (FBP) is challenging. A strategy of intermittent intrasphincteric botulinum toxin (Botox) injections into the sphincter of Oddi can alleviate pancreaticobiliary pain. In patients who lose response to intermittent Botox injections, endoscopic biliary sphincterotomy (ES) could potentially reset pain facilitating ongoing management of symptoms. A retrospective review of case notes over a seven-year period (2014-2021) was performed. All patients underwent blood tests, gastroscopy, trans-abdominal ultrasonography, cross-sectional imaging withmagnetic resonance cholangiopancreatography (MRCP)/computed tomography (CT) and endoscopic ultrasound (EUS)to rule out alternative causes for their symptoms of pancreaticobiliary pain. A diagnosis of FBP was made in patients with typical post-cholecystectomy pain and normal liver function tests and bile duct size on imaging. Patients with symptomatic FBP underwent intermittent endoscopic Botox injections to the sphincter of Oddi. Patients who lost response to Botox injections underwent ES and were followed up in an outpatient setting to assess response. One hundred and thirty (128 female, 2 male) patients with FBP underwent a mean of four (2-8) Botox injections over the study period. Of 130 (90%) patients, 117 reported a significant improvement in pain on post procedure review with 81% of patients managing to discontinue opioid medication post procedure. Fifty-one out of 130 (39%) lost response to Botox injections after a median of six (range 5-11) sessions (median eightmonths between sessions [range 6-18months]) and continued to have ongoing pancreaticobiliary pain and subsequently underwent biliary ES. Forty-one out of 50 (82%) reported a clinical improvement in their symptoms of pancreaticobiliary pain following ES, with response persisting at follow-up for up to mean of eight (5-15) months and no further hospital attendances due to severe pancreaticobiliary pain. ES can reset pancreaticobiliary pain in FBP once Botox injection therapy to the sphincter of Oddi becomes ineffective and may provide ongoing relief of symptoms.

A Study to Understand Miasmatic Evaluation of Bronchial Asthma and Its Homeopathic Management

Asthma as a clinical entity has been known to the medical world since antiquity. Many physicians have described its exact symptomatology with aggravating and ameliorating factors, its epidemiology at that time and some other factors, but they could not know the exact cause of this condition. Many hypotheses were formed for the causes of this condition, some of which include effects of evil eye, wrath of devils, bad effects of some food etc., even till date, there are many etiologies of this condition has been noted, the exact cause of asthma is not determined. There are many influences that act with each other to produce this condition. Modern system of medicine believes in local concept of disease. They believe in materialistic concept of disease. They believe that in any disease condition the organs and tissues affected are affected solely, and they don’t have any correlation with other parts. So they try to manage bronchial asthma with anti-inflammatory and anti-histaminic medicines as maintenance therapy and bronchodilators to curb the acute exacerbation. Steroidal agents which are used are the potent anti-inflammatory agents that suppress the inflammatory reaction, but in a way only suppressing manifestation of disease, weakening the immunity and constitution of the patient and thus making him prone to more life threatening conditions as manifested by airway remodeling, fibrosis of airway basement membrane and decreased responsiveness of the airway smooth muscles leading to emphysematous changes superadded to asthma. Same condition happens with anti-histaminics. These drugs act at local level and do not give permanent relief. These drugs give temporary symptomatic relief to the patient and do not remove the disease, i.e. the cause for hypersensitivity. Among all medical systems for treating diseases, homeopathic system is most efficacious. It is based on natural observations, rational experiments, and logical inferences. It works on the basis of similia similibus curenture, the nature’s law of cure. In homeopathic system of medicine we consider disease as a whole, with its causes, the process, along with constitutional totality of the person and not the local manifestations of disease. Mind, body and spirit, these are called trinity of life. When considered together, they form the constitution of the person. They are in interaction with one another and responsible for maintaining life. Any defect in function of any of them cause dis-ease. Medicine selected on these bases removes the disease permanently and corrects the constitutional deficit/ miasm from the person, as an ideal cure preached by our master, Dr. Hahnemann. Miasms are the fundamental cause of the chronic diseases. There are basically 3 miasms described by Dr. Hahnemann, namely psora, sycosis, and syphilis. Initially, during the early days of practice, Dr. Hahnemann faced some obstacles to the permanent cure in chronic cases. This miasmatic block can be removed with proper anti-miasmatic remedies.Thus, we have undertaken Asthma as our topic of study.

Omic characterizing and targeting gut dysbiosis in children with autism spectrum disorder: symptom alleviation through combined probiotic and medium-carbohydrate diet intervention - a pilot study

ABSTRACT Autism spectrum disorder (ASD) currently lacks effective diagnostic and therapeutic approaches. Disruptions in the gut ecosystem have been observed in individuals with ASD, suggesting that targeting gut microbiota through probiotic and dietary supplementation may serve as a potential treatment strategy. This two-phase study aimed to characterize the fecal metagenome of children with ASD and investigate the beneficial effects of a combined probiotic and medium-carbohydrate intervention in ASD. Fecal metagenomes of children with ASD were compared to those of typically developing children, revealing intestinal dysbiosis in ASD, characterized by reduced levels of Prevotella sp. Dialister invisus, and Bacteroides sp. along with increased predicted abundances of inosine, glutamate, xanthine, and methylxanthine. The gut bacteriome and phageome exhibited high cooperativity. In a 3-month pilot study, Bifidobacterium animalis subsp. lactis Probio-M8 (Probio-M8) was administered alongside a medium-carbohydrate diet to Chinese children with ASD. The primary endpoint was the Childhood Autism Rating Scale (CARS), while the secondary endpoint was the Gastrointestinal Symptom Rating Scale (GSRS). A total of 72 autistic children were initially recruited for the intervention study, but only 53 completed the intervention. Probio-M8, in combination with dietary intervention, significantly improved CARS and GSRS scores, increased fecal levels of Bifidobacterium animalis, Akkermansia muciniphila, Fusicatenibacter saccharivorans, and Sutterella sp. while also reducing Blautia obeum (Benjamini-Hochberg corrected p ≤ 0.05 for all cases). The intervention also modulated fecal metabolites associated with the metabolism of amino acids (lysine), neurotransmitters (glutamate, γ-aminobutyric acid), polyunsaturated fatty acids (arachidonate, myristic acid), and vitamin B3. In conclusion, Probio-M8 combined with medium-carbohydrate diet effectively improved ASD symptoms, with associated changes in the gut microbiome and metabolome, supporting its potential as an adjunctive therapy for ASD.