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Abstract: Progressive supranuclear palsy (PSP) has emerged as a key area of interest among researchers worldwide, including those in India, who have actively studied the disorder over the past several decades. This review meticulously explores the extensive range of Indian research on PSP up to the present and offers insights into both current initiatives and potential future directions for managing PSP within the region. Historical research contributions have spanned 80 publications from 1974 to 2023, encompassing diverse themes from clinical phenotyping and historical analysis to isolated investigative studies and therapeutic trials. Traditionally, these studies have been conducted in single centers or specific departments, involving a broad range of recruitment numbers. The most frequently encountered phenotype among these studies is PSP-Richardson's syndrome, with patients typically presenting at an average age of 64 years, alongside various other subtypes. Recently, there has been a significant shift toward more collaborative research models, moving from isolated, center-based studies to expansive, multicentric, and pan India projects. A prime example of this new approach is the PAn India Registry for PSP (PAIR-PSP) project, which represents a comprehensive effort to uniformly examine the demographic, clinical, and genetic facets of PSP across India. Looking ahead, there is a critical need for focused research on unraveling genetic insights, identifying risk factors, and developing effective treatment interventions and preventive models. Given its vast population, India's role in advancing our understanding of PSP and other tauopathies could be pivotal, and this work reflects the work on PSP in India till now., (Copyright © 2024 Annals of Indian Academy of Neurology.)

Stress is an enormous concern in our culture because it is the root cause of many health issues. Yoga asanas and mindfulness-based practices are becoming increasingly popular for stress management; nevertheless, the biological effect of these practices on stress reactivity is still a research domain. The purpose of this review is to emphasize various biosignals that reflect stress reduction through various yoga-based practices. A comprehensive synthesis of numerous prior investigations in the existing literature was conducted. These investigations undertook a thorough examination of numerous biosignals. Various features are extracted from these signals, which are further explored to reflect the effectiveness of yoga practice in stress reduction. The multifaceted character of stress and the extensive research undertaken in this field indicate that the proposed approach would rely on multiple modalities. The notable growth of the body of literature pertaining to prospective yoga processes is deserving of attention; nonetheless, there exists a scarcity of research undertaken on these mechanisms. Hence, it is recommended that future studies adopt more stringent yoga methods and ensure the incorporation of suitable participant cohorts., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 International Journal of Yoga.)

Objectives: Benign paroxysmal positional vertigo (BPPV) is a condition in which a patient gets severe vertigo on moving his head from one position to another. This study aims at comparing the traditional maneuver-Epley repositioning maneuver (ERM) and the newly emerged maneuver-Gans Repositioning maneuver (GRM)., Design: A randomized controlled trial., Settings: Tertiary care teaching University Hospital., Participants: Posterior canal BPPV., Intervention: Two hundred and thirty-four patients with BPPV (PC-BPPV) of the posterior canal, diagnosed using the Dix-hallpike test (DH test), were recruited for the study as per random allocation. Two groups were divided by the random allocation method. One group was treated with the Epley maneuver and the other with Gans maneuver by two separate physiotherapists., Main Outcome Measures: DH test negativity (absence of vertigo and nystagmus), Vertigo Analogue Scale (VAS), and Dizziness Handicap Inventory (DHI). Twenty-four hours post-treatment assessments and data analysis were conducted by another (third) therapist. A one month follow-up subjective assessment was performed., Results: Results of one-variable Chi-square tests revealed significant improvement ( P < .0001) in maximum (95%) patients of both groups whether subjects were given GRM or ERM. Also, objective improvement (DH test) was found in the Epley group (n = 118, 82.20%) and the Gans group (n = 116, 78.44%). Patients in both groups improved significantly with no dizziness on the VVAS scale (n = 118, 82.20%) in the Epley group and (n = 116, 78.44%) in the Gans group., Conclusion: GRM is as easy, effective, and safe maneuver as the ERM with the absence of recurrence for the treatment of posterior canal BPPV., Trial Registration: Clinical Trials Registry (CTRI/2019/10/021681)., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Annals of Indian Academy of Neurology.)

Context: Previous research has shown the vast benefits associated with BhP. However, the dynamics of cortical activity in connection with Bhramari sound have not been investigated yet., Aim: To investigate the cortical activity in connection with Bhramari sound., Settings and Design: Humming sound was analyzed with a custom-made nasal device consisting of MAX4466 sensor time synchronized with the EEG setup. We anticipated that the modulation of cortical activity with the humming sound (either of long or short durations) leaves its effects after the Pranayama, which helps to understand the positive impacts of BhP., Methods and Material: 30 participants were instructed to perform the BhP for a period of 90 seconds. We proposed to investigate the cortical correlates before, during, and after the BhP through EEG. A custom-made nasal device consisting of MAX4466 sensor time synchronized with the EEG setup was used for analyzing the humming sound., Statistical Analysis Used: A paired t -test ( P < 0.05) with a Bonferroni correction is carried out to explore the statistically significant difference in power spectral density (PSD) values., Results: Results show that the relative spectral power in theta band for short humming durations (less than or equal to 9 seconds) was similar on the frontal cortex during and after the Pranayama practice ( P > 0.05) in most of the subjects., Conclusions: In conclusion, for the immediate positive effects of BhP, the humming duration should be kept less than or equal to 9 seconds. A wearable sound recording system can be developed in the future as a feedback system that provides biofeedback to the user so that a constant humming duration can be maintained., Competing Interests: Rishabh Bajpai and Deepak Joshi are named inventors on a pending patent application that describes the wearable sound measurement device utilized in the study. Rishabh Bajpai and Deepak Joshi are seeking to commercialize the device for breathing monitoring applications., (Copyright: © 2023 Annals of Indian Academy of Neurology.)

Competing Interests: There are no conflicts of interest.

Background: A principal caregiver (CG) is directly affected by the patient's health problems leading to CG strain. In the present study, we evaluated the different factors related to increased CG burden in stroke survivors and assessed the relationship between patient's personal and clinical characteristics and CG's stress., Material and Methods: In this prospective, follow-up study, a total of 141 principle CGs of 164 First-ever stroke (FES) survivors were subjected to the Caregivers Strain Index (CSI) and Oberst Caregiving Burden Scale (OCBS) at 30 days (n = 141), 90 days (n = 129), and 6 months (n = 119) after informed consent. Patients were subjected to modified Rankin Scale (mRS) and Barthel index score assessment at the end of 30 days., Results: The mean age of CG was 49.8 ± 21.0 years, approximately 20 years lesser than that of the patients. 102 (72.34%) CGs were females. Urinary incontinence (p < 0.006) morbidity at 30 days, mRS (p = 0.004), and moderate to the severe neurological deficit on admission (p = 0.003) were the patient factors in FES cases leading to significant CGs stress. CG factors responsible for major stress were long caregiving hours (P < 0.001), anxiety (P < 0.001), disturbed night sleep (P < 0.001), financial stress (P < 0.001), younger age (P = 0.002), and CGs being daughters-in-law (P = 0.039)., Conclusion: CG burden increases with increased severity of stroke. Integrated stroke rehabilitation services should also address CGs issues along with patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Indian Academy of Neurology.)

Competing Interests: There are no conflicts of interest.

Background & Objectives: There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India., Methods: This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria., Results: Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e. 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired., Interpretation & Conclusions: Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.

Competing Interests: There are no conflicts of interest.

Background: During the past decade the view of Parkinson's disease (PD) as a motor disorder has changed significantly and currently it is recognized as a multisystem disorder with diverse non-motor symptoms (NMS)., Aims: The present study aimed to evaluate and characterize the NMS and study their impact on quality of life (QoL) in a PD patient cohort., Material and Methods: This was a cross-sectional study where 92 PD patients fulfilling the UK Parkinson's disease society brain bank criteria were enrolled from a movement disorder clinic. All patients were evaluated using unified Parkinson's disease rating scale, non-motor symptoms scale (NMSS) for the non-motor symptoms, and Parkinson's disease questionnaire-39 (PDQ-39) for the QoL. The impact of NMS on QoL was assessed statistically., Results: A total of 92 patients were enrolled with a mean age of 55.40 ± 7.37 years, mean age of onset of disease 51.62 ± 6.38 years, and mean disease duration of 3.78 ± 1.54 years. Type of disease was akinetic rigid variant in 29.3% (n = 27), tremor predominant type in 36.9%(n = 34), and mixed type in 33.6% (n = 31). Mean Hoehn and Yahr stage was 2.12 ± 0.54. In the NMSS, most common symptom was sleep and fatigue (83%), followed by urinary tract symptoms (63%), mood and cognition (51%), cardiovascular symptoms and falls (43%), gastrointestinal tract symptoms (38%), and sexual function (33%). Univariate analyses showed that all NMS domains had a significant correlation with PDQ-39 with P < 001., Conclusion: Our study shows that NMS in PDare fairly common and significantly impact the QoL., Competing Interests: Both Dr. Anand Kumar and Dr. Sooraj Patil will have the first authorship. Rest there are no conflicts of interest between the authors to declare., (Copyright: © 2022 Annals of Indian Academy of Neurology.)

Background & Objectives: Zinc is a crucial micronutrient in adolescence, required for promoting growth and sexual maturation. Adolescents of some tribes may be at high risk of zinc deficiency due to dietary inadequacy and poor bioavailability of zinc from plant-based diets. This study aimed to evaluate the risk of zinc deficiency by estimating prevalence of inadequate zinc intake, prevalence of low serum zinc and stunting among tribal adolescents., Methods: A cross-sectional community-based survey was conducted among adolescents (10-19 yr) in three purposively selected districts where Bhil, Korku and Gond tribes were in majority. Structured data collection instrument comprising information about sociodemographic characteristics and dietary recall data was used. Anthropometric assessment was conducted by standardized weighing scales and anthropometry tapes, and blood sample was collected from antecubital vein into trace element-free vacutainers. Serum zinc was estimated using an atomic absorption spectrophotometer., Results: A total of 2310 households were approached for participation in the study, of which 2224 households having 5151 adolescents participated. Out of these enlisted adolescents, 4673 responded to dietary recall (90.7% response rate). Anthropometry of 2437 participants was carried out, and serum zinc was analyzed in 844 adolescents. The overall prevalence of dietary zinc inadequacy was 42.6 per cent [95% confidence interval (CI) 41.2 to 44.1] with reference to the estimated average requirement suggested by International Zinc Nutrition Consultative Group (IZiNCG) and 64.8 per cent (95% CI 63.4 to 66.2) with Indian Council of Medical Research-recommended requirements. Stunting was observed in 29 per cent (95% CI 27.2 to 30.8) participants. According to IZiNCG cut-offs, low serum zinc was detected in 57.5 per cent (95% CI 54.1 to 60.8) of adolescents, whereas it was 34.4 per cent (95% CI: 31.2-37.5) according to the national level cut-off., Interpretation & Conclusions: Risk of dietary zinc inadequacy and low serum zinc concentration amongst adolescents of the Gond, Bhil and Korku tribes is a public health concern.

We describe three postmortem open lung-biopsy findings among patients with COVID-19 pneumonia who were on anticoagulant therapy. The spectrum of histopathological findings included lung inflammation in the form of diffuse alveolar damage (DAD) in exudative and organizing phases, with or without pulmonary artery thrombosis in different stages of evolution. This spectrum of inflammation and thrombosis may be indicative of a natural history of severe COVID-19 pneumonia or demonstrative of variation in therapeutics., Competing Interests: None

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Mast cells are naturally distributed in the dermis, respiratory, gastrointestinal/genitourinary mucosa, adjacent to blood vessels, lymphatics, and peripheral nerves. The most common site for the abnormal accumulation of mast cells is the skin, which is known as cutaneous mastocytosis. We report four cases of cutaneous mastocytosis with erythematous maculopapular to bullous lesion along with a positive Darier sign. Skin biopsy, with special stains like Toluidine blue, Giemsa stain, immunohistochemistry (IHC) for CD117, and serum tryptase level correlations were done. Mastocytosis can affect only the cutaneous sites or involve multiple organs. It is most common in infancy with varied clinical presentations, thus requiring a high index of suspicion with histopathological correlation. Although the prognosis is good, there remains a risk of sudden mast cell degranulation due to triggering agents and subsequent collapse.

Background: The COVID-19 pandemic lockdown has forced university hospitals to forego traditional classes and embrace online teaching platforms as the sole modality of medical education. Herein, we describe our experience of shifting from the arena of a real to a virtual classroom during the lockdown phase. Materials and., Methods: The institutional subscription of G-suite was used for creating a virtual Google classroom. Google Calendar, Google Meet, and Google Forms were used for notification of schedules, conducting theory and practical classes, and conducting assessments, respectively. The learner-centric SNAPPS model was adapted for an interactive case-based learning (CBL) program using multimedia tools. Students' perspective on online education was assessed based on their responses to a validated questionnaire., Results: The conduction of online classes, particularly the live practical classes and the CBL program got the maximum affirmative (up to 85%) responses. Students of the same batch also performed better in a test following the online CBL (77.03% vs 73.3%, P = 0.03, paired t-test statistically significant) compared to a test before it. However, access to laptops and poor Internet connectivity were significant causes of concern for nearly 40% of students., Conclusion: The use of virtual classroom has proved to be an efficient method for continuing teaching of Pathology to MBBS students in times of lockdown when face-to-face conventional teaching was not possible. The experience indicated that in the future a judicious mixture of traditional and online classes may be a more effective educational design for teaching Pathology to MBBS students.

Background & Objectives: Parkinson's disease (PD) is a motor disorder that affects movement. More than 24 loci and 28 associated genes have been identified to be associated with this disease. The present study accounts for the contribution of two candidates, leucine-rich repeat kinase 2 ( LRRK2) and parkin RBR E3 ubiquitin protein ligase ( PRKN) in the PD patients, and their characterization in silico and in vitro., Methods: A total of 145 sporadic PD cases and 120 ethnically matched healthy controls were enrolled with their informed consent. Mutation screening was performed by direct DNA sequencing of the targeted exons of LRRK2 and all exons flanking introns of PRKN. The effect of the pathogenic PRKN variants on a drug (MG-132) induced loss of mitochondrial membrane potential (△ΨM) was measured by a fluorescent dye tetramethylrhodamine methyl ester (TMRM)., Results: Twelve and 20 genetic variants were identified in LRRK2 and PRKN, respectively. Interestingly, five out of seven exonic LRRK2 variants were synonymous. Further assessment in controls confirmed the rarity of two such p.Y1527 and p.V1615. Among the pathogenic missense variations (as predicted in silico) in PRKN, two were selected (p.R42H and p.A82E) for their functional study in vitro, which revealed the reduced fluorescence intensity of TMRM as compared to wild type, in case of p.R42H but not the other., Interpretation & Conclusions: About 6.2 per cent of the cases (9/145) in the studied patient cohort were found to carry pathogenic (as predicted in silico) missense variations in PRKN in heterozygous condition but not in case of LRRK2 which was rare. The presence of two rare synonymous variants of LRRK2 (p.Y1527 and p.V1615) may support the phenomenon of codon bias. Functional characterization of selected PRKN variations revealed p.R42H to cause disruption of mitochondrial membrane potential (△ΨM) rendering cells more susceptible to cellular stress., Competing Interests: None

Background & Objectives: The National AIDS Control Organisation (NACO) and the ICMR-National Institute of Medical Statistics, the nodal agency for conducting HIV estimations in India, have been generating HIV estimates regularly since 2003. The objective of this study was to describe India's biennial HIV estimation 2017 process, data inputs, tool, methodology and epidemiological assumptions used to generate the HIV estimates and trends of key indicators for 2010-2017 at national and State/Union Territory levels., Methods: Demographic Projection (DemProj) and AIDS Impact Modules (AIM) of Spectrum 5.63 software recommended by the United Nations Programme on HIV and AIDS Global Reference Group on HIV Estimates, Modelling and Projections, were used for generating HIV estimations on key indicators. HIV sentinel surveillance, epidemiological and programme data were entered into Estimation Projection Package (EPP), and curve fitting was done using EPP classic model. Finally, calibration was done using the State HIV prevalence of two rounds of National Family Health Survey (NFHS) -3 and -4 and Integrated Biological and Behavioural Surveillance (IBBS), 2014-2015., Results: The national adult prevalence of HIV was estimated to be 0.22 per cent in 2017. Mizoram, Manipur and Nagaland had the highest prevalence over one per cent. An estimated 2.1 million people were living with HIV in 2017, with Maharashtra estimated to have the highest number. Of the 88 thousand annual new HIV infections estimated nationally in 2017, Telangana accounted for the largest share. HIV incidence was found to be higher among key population groups, especially people who inject drugs. The annual AIDS-related deaths were estimated to be 69 thousand nationally. For all indicators, geographic variation in levels and trends between States existed., Interpretation & Conclusions: With a slow decline in annual new HIV infections by only 27 per cent from 2010 to 2017 against the national target of 75 per cent by 2020, the national target to end AIDS by 2030 may be missed; although at the sub-national level some States have made better progress to reduce new HIV infection. It calls for reinforcement of HIV prevention, diagnosis and treatment efforts by geographical regions and population groups., Competing Interests: None

Purpose: Association of peripheral neuropathy with diabetic retinopathy is known but the relationship of preclinical neuropathy with various grades of retinopathy is not well documented. This study evaluated the association of preclinical peripheral neuropathy using nerve conduction studies with various grades of retinopathy., Methods: Cases of diabetic retinopathy of various grades but asymptomatic for peripheral neuropathy underwent nerve conduction studies of the lower limbs using Caldwell machine and Sierra wave software. The risk factors for retinopathy and association of neuropathy with various grades of retinopathy were analyzed by bivariate and multivariate regression analysis., Results: The overall prevalence of neuropathy was 75.6% (sensory 58.54% and combined motor and sensory 17.1%) with increase in prevalence with increase in severity of retinopathy. Duration was positively associated with neuropathy (OR = 1.13, 95% CI = 1.02-1.24; P = 0.012); moderate nonproliferative diabetic retinopathy (NPDR) (OR = 5.60, P = 0.002), severe and very severe NPDR (OR = 5.8, P = 0.041), and PDR (OR = 16.05, P = 0.000) were significantly at higher risk for having neuropathy as compared to mild NPDR., Conclusion: Duration and severity of retinopathy are important risk factors for peripheral neuropathy. There is a high prevalence of peripheral neuropathy among diabetics with retinopathy especially with severe grades, when neuropathy is diagnosed using nerve conduction studies., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)

Background: Cognitive impairment is increasingly being recognized as a major cause of morbidity and increased dependence over the caregivers in Parkinson's disease (PD) patients., Objective: The present study aimed to compare the cognition testing in young- and late-onset PD patient., Methods: Sixty PD patients (20 young onset and 40 late onset) fulfilling UKPDS Brain Bank diagnostic criteria were enrolled in the study. Patients were assessed clinically and using scales for cognition testing such as Scales for Outcomes in PDCognition (SCOPA-COG), Unified Parkinson's Disease Rating scale (motor part), and Hoehn and Yahr staging., Results: Young-onset group comprised 20 (33.3%) and late-onset group comprised 40 (66.7%) patients. Most of the young- and late-onset patients, 15 (75%) and 21 (52.5%), had SCOPA-COG score in the range of 30-39, respectively. On comparison between young- and late-onset groups, SCOPA-COG score's mean ± standard deviation (SD) for young and late onset was 32.60 ± 2.52 and 30.30 ± 3.65, respectively, with statistical significance ( P = 0.01). SCOPA-COG score's mean ± SD for mild, moderate, and severely impaired PD patients was 31.48 ± 3.19, 30.60 ± 3.24, and 23.50 ± 3.53, respectively, which on group comparisons (ANOVA) were statistically significant ( P = 0.004). However, the SCOPA-COG score was statistically insignificant with respect to disease duration., Conclusion: There was statistically significant difference in SCOPA-COG score between young- and late-onset PD patients and in patients with more severe motor impairment., Competing Interests: There are no conflicts of interest.

Objective: The aim is to compare the retinal nerve fiber layer (RNFL) thickness of longitudinally extensive transverse myelitis (LETM) eyes without previous optic neuritis with that of healthy control subjects., Methods: Over 20 LETM eyes and 20 normal control eyes were included in the study and subjected to optical coherence tomography to evaluate and compare the RNFL thickness., Result: Significant RNFL thinning was observed at 8 o'clock position in LETM eyes as compared to the control eyes ( P = 0.038). No significant differences were seen in other RNFL measurements., Conclusion: Even in the absence of previous optic neuritis LETM can lead to subclinical axonal damage leading to focal RNFL thinning., Competing Interests: There are no conflicts of interest.

Background: Paliperidone is an active metabolite of risperidone and actss through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism., Aim: The present randomized, double-blind, multicentric trial was designed to determine the safety and efficacy of paliperidone extended release (ER) compared to olanzapine in the treatment of acute schizophrenia., Materials and Methods: A total of 214 patients with diagnosis of schizophrenia were randomized to paliperidone ER (n=109) and olanzapine (n=106) treatment groups. Totally 206 patients were evaluated for efficacy parameters using Positive and negative syndrome scale (PANSS) score and Clinical Global Impression-severity of illness (CGI-S) and Clinical Global Impression-improvement of illness (CGI-I) scales. Safety was assessed by treatment-emergent adverse events and movement disorders., Results: All patients showed significant reduction in PANSS scores at the end of treatment. However, the results were comparable and there was no significant difference at the end of the trial between paliperidone ER group and olanzapine group. Both the treatment groups showed decrease in the severity of illness and improvement in symptomatology. The most common adverse events reported in paliperidone ER versus olanzapine group were Extra Pyramidal Syndrome (EPS) (13.7% vs. 15.6%), headache (12.7% vs. 8.9%), increased appetite (8.8% vs. 10.0%) and drowsiness (4.9% vs. 303%). There was no clinically relevant difference in change from baseline to the end of the trial in abnormal involuntary movement scale (AIMS) and barnes akathisia rating scale (BARS) total scores between both the groups., Conclusion: Paliperidone ER is effective in controlling schizophrenic symptoms as well as exhibits comparable tolerability profile. Thus, paliperidone ER has the potential to be a useful new treatment option for patients with schizophrenia.

Rhabdomyolysis and myoglobinuria are a rare complication of dermatomyositis. Such patient can land up in acute renal failure. Recognition of this fact has important therapeutic implications as patients require immunotherapy in addition to the symptomatic treatment for renal failure. We report a case of dermatomyositis with evidence of rhabdomyolysis and myoglobinuria presenting with acute renal failure. The patient responded dramatically to corticosteroid therapy.

Haemoglobin-S has been reported in several studies on remote populations from various parts of India eg Maharashtra, Madhya Pradesh, Andhra Pradesh, Orissa, West Bengal, Rajasthan and Malaysian Indians. Uttaranchal also has got scattered areas with people living in remote-pockets due to its geophysical nature. There has been no previous report from this state about prevalence of Hb-S. In the present study on 38 individual eight were found to have Hb-S positivity by sickling test. In one of these electrophoretic confirmation was positive with demonstration of associated Beta thalassaemia. The group was a family of muslims in village Baghori near Haldwani. Due to technical, geographical and social restrictions further study could not be done. However, this study does establish the presence of Hb-S-Beta thalassaemia in Uttaranchal State for the first time. Follow up study in the affected area and elsewhere in the state might discover more of Hb-S positivity, other haemoglobinopathies and thalassaemias.

The authors report in this article an evaluation of the Rasayana effect of makradhwaja through biochemical parameters like - S.G.O.T., S.G.P.T and Blood urea along with E.C.G.

Rasa sindura, is a famous and prestigious Ayurvedic Preparation, prepared by Kupipakwa method through Baluka Yantra system of healing. It is supposed as a toxic drug due to presence of Mercury. Therefore, it needs experimental proves and such type of experimental study shows that there are no toxic effects in therapeutic doses. Gamdhaka Jarana process reduces the unwanted effects, along with potentiating its diseases curing capacity.

In ancient days, Physicians having the comprehensive knowledge of Bhaishajya Kalpana, used to prepare the drugs themselves to treat their patients. So there was no doubt in obtaining genuine drug with desired therapeutic effect. But in recent years, the growing population and their life style, industrialization etc have forced physicians to depend on market preparations. As such we find the necessity of standardization of these preparations. The quality assessments of a drug, which is a chemical irrespective of the system is possible by 'Thin Layer Chromatographic technique' using known Chemical constituents as reference standards. A herbal preparation 'Kutajarishta', has been standardized by using this technique and the significance of the findings is discussed.

The role of different types of containers and methods of preparation was studied in the case of Kutajarista. Stainless steel containers were found to be superior of vessels made of earth and wood. Addition of yeast generated more alcohol facilitating better extraction of chemicals. The significance of the findings is discussed.

This study deals with Asavarishta preparations of the Ayurvedic System of medicine and scans various classical texts to find out the different types of constituents required for their preparation along with their proportions, the method of preparation, the time required to complete the process, the fermentations pots, the fermenting materials, the place and time (season) of fermentation etc. with a view to develop certain common norms for their preparation.

n this study on "Madhumeha" (Prameha) the authors discuss of minerlometallic preparations and its effect either as curative or as palliative measures in Prameha.

To Substantiate the claims of Ayurvedic classics, animal experimentation with modern technology has been carried out in this paper. Various methods have been described for induction diabetes Mellitus or any other disease. Now it is the duty of an Ayurvedist to select the suitable method on the guidelines of Ayurvedic aetiology to produce a condition stimulating to Prameha (Madhumeha) and the best suitable method (Folin-Wu) for estimating the sugar content of blood is adopted. Besides this one must do experiment in all species and should confirm the finding by clinical evaluation. Side by side toxicity studies are also necessary.

The authors attempts to present in this paper different treatments employed for Sodhana with different and its toxicity reduction level.

Vanga bhasma, a popular Ayurvedic Medicine is prepared from Tin metal. This drug is claimed to have 'Sukrala' (Semenaugmentator), 'vrsya' (good for testis) properties in the literature and is widely in vogue for genito - urinary disorders in Ayurvedic practice. An experimental evaluation of the claim has been undertaken and the results have been presented in this paper. The drug in reference is found to have testicular regenerative potential on cadmium induced testicular degeneration in albino tats, when administered orally. This effect on 'Sukravaha Srotomula' (testis) appears to corroborate "Sukrala" and "Vrsya" properties attributed to the drug in Ayuredic literature.

A study on Kutajarista' was carried out and it was tested for anti-amoebic action which is presented in this paper.

Svarna Vanga, an important Ayurvedic tin preparation having mercury as one of its ingredients, is mainly indicated in the treatment of Pramehas (genitourinary disorders). What role does mercury play in its preparation is not known. Hence present study has been planned with a view to prepare SvarnaVanga using mercury in different amounts. It was observed that the amount of mercury atleast in half proportion to in tin Kajjali, is considered necessary in making the standard Svarna-Vanga preparation.

Vangabhasma is a popular and effective dosage form prepared from tin metal in Ayurvedic practice. Since modern literature attributes certain toxicity to tin salts, an attempt is made to screen the acute and sub-acute toxicity of Vangabhasma in the form, dose and route as is in the practice or Ayurveda. In this paper, dose-effect relation of Vangabhasma on Digestive system (G.I. T., Liver and Pancreas) has been presented. But for local irritation, no significant toxicity attributable to Vangabhasma has been observed even in eight times higher dose than therapeutic dose, on exposure to the drug for ten days.

SODHANA, which literally means purification, is a procedure necessary for every drug before taking it for adding in any compound or subjecting it for further processes like Bhasmikarana (incineration) etc. Purified drug in the lines of modern science is different from, that of Ayurveda as the former is cent percent the main drug only and latter may contain other particles also. Present paper gives the details of Sodhana along with such methods practically done on Sulphur.

Swarna - Vanga, an Ayurvedic preparation, is used in the treatment mainly of Pramehas (genitor urinary and metabolic disorders), Sveta Pradara (Leucorrhoea), Kasa - Swasa (Respiratory disorders), etc. The drug contains tin and sulphur as major components along with traces of mercury, iron and aluminum. According to modern point of view certain metals have been claimed toxic to both human and animal. Since Svarna - Vanga contains these metals, it is essential to screen out its toxic effect, if any, although it is claimed in Ayurveda that when a metal is processed as prescribed, it become non - toxic or the least toxic. Considering the above facts, an animal experiment was carried out for short duration (14 days) to screen the toxic effects of Svarna - Vanga (SV) in increasing doses of the drug starting from the maximum therapeutic dose (12.5 mg / 100 gm b.wt / day). The drug was found to have no toxic effects in tissues of the animal at doses of 12.5 mg and 25 mg / 100 gm b.wt. / day. Fine fatty vacuolization in liver and focal superficial mucosal degeneration and necrosis of small intestine confined to one animal each at dose of 50 mg / 100gm b.wt. and 100 mg/ 100 gm. b.wt. / day were observed. Our study indicates that the drug has no toxic effect on tissues at therapeutic dose.