Asthma and diabetes have strong relationship; both are cause and effect of each other. Oxidative stress due to bronchial asthma may cause insulin resistance whereas lack of proper insulin can cause defective smooth muscle relaxant. There is no single medicine available that can manage both diseases, rather the mainstay treatment of bronchial asthma causes hyperglycemia. Keeping this problem in focus, in this study the hypoglycemic effect of an indigenous antiasthmatic Ayurvedic drug Shirishadi was evaluated. Pancreatic alpha amylase and glucosidase inhibitors offer an effective strategy to lower the level of post prandial hyperglycemia via control of starch breakdown. For evaluation of hypoglycemic activity of drug, in-vitro alpha amylase and alpha glucosidase enzyme inhibition was calculated. Ethanolic extract of compound showed 76.40% + 0.88% reduction in alpha amylase activity and 63.85% + 0.36% in alpha glucosidase activity with IC50 0.68 mg/ml and 2.89 mg/ml, respectively. This study suggests that the ethanolic extract of Shirishadi polyherbal compound effectively acts as alpha amylase and glucosidase inhibitor leading to a reduction in starch hydrolysis and hence acts as antiasthmatic as well as hypoglycemic drug.

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Background: Obstructed labour is one of the most common preventable cause of maternal and neonatal morbidity and mortality in developing countries. This study was undertaken to assess the incidence, causes and feto-maternal outcomes of obstructed labour. Methods: This prospective study was carried out in the Department of Obstetrics and Gynaecology at Patna Medical College and Hospital, Patna, Bihar, India over a period of one year from February 2012 to February 2013. The 228 patients diagnosed to have obstructed labour were studied. Results: Out of 2556 deliveries conducted during this period, 228 cases of obstructed labour were found constituting an incidence of 8.9%. Majority of the patients were unbooked (89.47%), between 21-30 years of age (90.35%) and with parity 3 or more. The most common cause of obstructed labour was malposition (45.61%) followed by cephalopelvic disproportion (43.85%) and malpresentation (8.7%). caesarean section was the most common mode of delivery. In 21.92% of cases ruptured uterus was diagnosed pre-operatively among which, 2.63% has scar rupture and in remaining cases rupture was in unscarred uterus due to obstructed labour diagnosed intra-operatively. PPH was seen intra-operatively in 17.54% of cases and bladder trauma in 3.5% of cases. Most common post-operative complications were paralytic ileus (52.6%) followed by severe anaemia (48.2%) and infections (23.68%). Only 0.8% patients developed vesico-vaginal fistula as a late sequela of obstructed labour. The maternal mortality was 3.5% and perinatal mortality was 39%. Conclusions: In present study, the incidence of obstructed labour is very high. Good antenatal care, education of primary health care providers and traditional birth attendants on dangers of obstructed labour and the need for early referral is suggested to reduce the incidence of this condition.

Aims of Study:To evaluate the efficacy, hemodynamic changes, and patient comfort during awake fiberoptic intubation done under combined regional blocks.Materials and Methods:In the present observational study, 50 patients of American Society of Anesthesiologists ( ASA) Grade I–II, Mallampati Grade I–IV were given nerve blocks - bilateral glossopharyngeal nerve block, bilateral superior laryngeal nerve block, and recurrent laryngeal nerve block before awake fiberoptic intubation using 2% lidocaine.Results:Procedure was associated with minimal increases in hemodynamic parameters during the procedure and until 3 min after it. Most of the intubations were being carried out within 3 min. Patient comfort was satisfactory with 90% of patients having favorable grades.Discussion:The most common cause of mortality and serious morbidity due to anesthesia is from airway problems. One-third of all anesthetic deaths are due to failure to intubate and ventilate. Awake flexible fiberoptic intubation under local anesthesia is now an accepted technique for managing such situations. In awake patient's anatomy, muscle tone, airway protection, and ventilation are preserved, but it is essential to sufficiently anesthetize the upper airway before the performance of awake fiberoptic bronchoscope-guided intubation to ensure patient comfort and cooperation for which in our study we used the nerve block technique.Conclusion:A properly performed technique of awake fiberoptic intubation done under combined regional nerve blocks provides good intubating conditions, patient comfort and safety and results in minimal hemodynamic changes.