Background:Muscular atrophy is the universal feature in patients with ICUAW. Muscles of the lower limb are more prone to early atrophy. Measurement of fat thickness is used to assess malnutrition. This study was designed to evaluate if, subcutaneous fat also reduces along with muscle thickness and if it can be reliably used as an indicator of nutritional assessment in critically ill patients using point of care ultrasound.Materials and Methods:An observational clinical study of 100 patients admitted to multidisciplinary intensive care units (ICUs). Total anterior thigh thickness, thickness of the rectus femoris muscle, fat thickness, and the combined thickness of vastus intermedius and rectus femoris were taken on day 1, 3, and 7 of ICU admission.Results:There was progressive loss of muscle mass from day 1 to day 7. Muscle loss was not only limited to rectus femoris, but vastus intermedius also showed a significant decrease as indicated by the bone to muscle measurement. Skin to bone measurement which includes both muscle and fat compartment showed a decline.Conclusions:There is potential utility of ultrasound for early detection and probable corrective measures to prevent ICUAW. The rectus femoris thickness, skin to bone, and bone to muscle thickness show statistically significant difference on day 3, day 7 compared to day 1. Fat layer did not show statistically significant decrease.

Kartagener's syndrome (KGS) is an autosomal recessive disorder characterized by the clinical triad of bronchiectasis, sinusitis and dextrocardia (situs inversus). Reports of general anaesthesia in a child with KGS are rare in medical literature. We describe the case of a young boy who underwent lobectomy under general anaesthesia using a single lumen tube. Anaesthetic implications of this syndrome are mentioned. Key points in the management of anaesthesia in KGS are discussed.

OBJECTIVES:Rubia cordifolia L. (RC) is a well-known and highly valuable medicinal plant in the Ayurvedic system. The present study involves evaluating antioxidant and cardioprotective property of RC root extract.MATERIALS AND METHODS:The characterization of RC root extract was carried out using standard phytochemical and biochemical analysis. The functional groups were analyzed by Fourier transform infrared (FTIR) spectroscopy and phytotherapeutic compounds were identified using high-resolution mass spectrometry (HR-MS). Cardioprotective activity of RC root extract was investigated against cyclophosphamide (CP; 100 mg/kg, i.p)-induced cardiotoxicity in male albino Wistar rats. RC (100, 200, and 400 mg/kg, p.o) or silymarin (100 mg/kg, p.o) was administered immediately after CP on the 1st day and the next consecutive 10 days. Biochemical and histopathological analysis was performed to observe the cardioprotective effects of RC root extract.RESULTS:Phytochemical analysis revealed the presence of secondary metabolites that include alkaloids, flavonoids, saponins, and anthraquinones in RC root extract. FTIR analysis revealed the presence of several functional groups. Based on HR-MS analysis, eight major phytotherapeutic compounds were identified in methanol root extract of RC. Biochemical analysis in CP-induced rat model administered with RC extract revealed significantly enhanced levels of antioxidant markers such as superoxide dismutase, catalase, and glutathione S-transferase. Histopathological study showed that the rat model treated with the root extract had reduced the cardiac injury.CONCLUSION:Our results have shown that the RC extract contains various antioxidant compounds with cardioprotective effect. Treatment with RC root extract could significantly protect CP-induced rats from cardiac tissue injury by restoring the antioxidant markers.

Walker-Warburg syndrome (WWS) is a rare lethal autosomal recessive disorder manifested by characteristic central nervous system and eye malformations. We have not come across reports of general anaesthesia in a child with WWS in the English literature. We report a case of general anaesthesia in a 12-month-old male child with WWS. The child also had bilateral cleft lip, cleft palate, urogenital malformation and hydronephrosis. Despite many potential anaesthesia concerns, anaesthesia was uneventful in this child.

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Background  Drug utilization studies are important and considered as a potential tool for the evaluation of health care systems. The goal of drug utilization research studies should be to assess whether drug therapy is rational or not. Objective  The main aim of this article is to analyze the different types of epilepsy and their drug utilization pattern in children with epilepsy at the Department of Pediatrics and evaluate the extent of older and newer antiepileptic drugs (AEDs), either as monotherapy or polytherapy in pediatric age groups. Materials and Methods  To look into the sociodemographic profile of children with epilepsy, the type of epilepsy was diagnosed along with drug utilization pattern in children attending both outpatient and inpatient department of pediatrics. Demographic details were collected according to modified Kuppuswamy scale. Disease characteristics such as type of epilepsy, onset, duration, time since last attack, family history, comorbid conditions, monotherapy/polytherapy, dose, and duration of treatment were noted. Investigations such as electroencephalography, magnetic resonance imaging, and computed tomographic scan if any were recorded. Results  In this pilot study, we have 100 patients, younger than 18 years, with confirmed cases of epilepsy, receiving AEDs either monotherapy or polytherapy. Male predominance was 56%, and 60% were from rural areas and 40% were from urban areas. As per the modified Kuppuswamy scale, we analyzed socioeconomic class of these 100 patients and found that 40% belong to lower-middle-class family. Nearly 51% were diagnosed with generalized tonic clonic seizures, 30% were with febrile seizures, while focal, partial, absence, and myoclonic seizures, and hot water epilepsy were less in percentage. Almost 83% received monotherapy, while only 17% received polytherapy. Among monotherapy, 51.80% received older AEDs and 48.20% received newer drugs. Conclusion  Although epilepsy can be controlled and managed effectively with older AEDs, an experience in management with newer AEDs is required to offer an additional advantage to patients to have better safety profile.

Ghee is also known as clarified butter, utilized for thousands of years in Ayurveda as a therapeutic agent. Ghee which is known as "Gritha" in Ayurveda, described as the best among lipid media due to its quality of inheriting and enhancing the drug potency. Even though ghee is an animal fat, earlier studies have shown that larger doses given for cleansing purpose did not increase the level of Low Density Lipoprotein (LDL). Instead increased High Density Lipoprotein (HDL) or some time did not alter lipid profile at all. Earlier studies in rats, which were fed up to 10% dietary ghee showed dose dependent decrease in cholesterol and other lipid profiles. There are two methods in preparation of butter. One is from milk cream, clarified butter and the other from curds, cultured butter. Butter will be further processed to convert it into ghee. None of the earlier studies have shown, which type of ghee is better and compared their effects on lipid profiles. So, our objective of the study was to know the effects of 5% and 10% milk cream ghee (Ghee from clarified Butter) and curd ghee (Ghee made out of Cultured Butter) supplementation on lipid profile in Wistar rats. So we supplied 5% and 10% dietary ghee in a nutritionally balanced diet to 8 weeks old male rats for 12 weeks and estimated Total cholesterol, HDL, LDL, Very Low Density Lipoprotein (VLDL) and Triglycerides (TGL) levels after 12 weeks. These results indicate that 5% and 10% of cream ghee and 10% curds ghee did increase body weight after 12 weeks of consumption and 5% curds ghee was found not to increase the body weight; 5% Curd Ghee has shown to lower total cholesterol, LDL, VLDL, triglycerides levels and cholesterol ratio more than other groups in our experimental model. HDL levels were increased in all the groups, which was not statistically significant in 5% cream and 5% curd ghee groups.

Introduction: Thyroid gland is unique among the endocrine glands in that it can be affected by a wide spectrum of diseases ranging from functional and immunologically mediated enlargements to neoplastic lesions. Thyroid neoplasms represent the most common malignancies of the endocrine system. Aims and objectives:To study the frequency of various thyroid lesions in thyroidectomy specimens and categorize neoplasms based on current World Health Organization (WHO) classification. Materials and methods:All thyroidectomy specimens received in the Department of Pathology, RajaRajeswari Medical College, Bengaluru, India, for histopathological examination over a period of 5 years, from July 2010 to June 2015, were included in the study.Results: A total of 211 thyroidectomies were examined in the study. The highest incidence of thyroid lesions was seen in the fourth decade (n = 68, 36%) and showed a female predominance (90%). Non-neoplastic lesions accounted for 148 cases (70.1%) and neoplasms accounted for 63 cases (29.9%). The common non-neoplastic lesions were multinodular goiter (37.2%) followed by Hashimoto thyroiditis (35.8%), colloid goiter (16.9%), and adenomatous hyperplasia (5.3%). Benign neoplasms (22.2%) were lower with all cases being follicular adenoma, and malignancies were higher (77.8%) with papillary carcinoma (58.7%) as the most common malignancy in our study. Colloid goiter and multinodular goiter were the common features in peritumoral thyroid tissue, followed by Hashimoto thyroiditis. Conclusion:Thyroid disorders are commonly encountered endocrine diseases. Histopathological examination is the mainstay for definitive diagnosis and management of thyroid neoplasms. Appropriate categorization of neoplasms according to international guidelines is to be followed for diagnostic accuracy.