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Background: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality., Materials and Methods: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by-pass graft (CABG) were included in the study. Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90-120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death., Results: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75-80% of participants had severe anxiety in the preoperative period while 10-20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups., Conclusion: The preoperative anxiety levels were high among cardiac surgery patients. Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32-53 is not associated with MACE and 30-day mortality among cardiac surgery patients.

Background: Hypogalactia is the common condition, especially in preterm deliveries. Some herbs in Indian medicines such as Lepidium sativum L. ( L. sativum ) have galactogogeus effects. The galactogogeus effect of L. sativum (Chandrashoora) has not been quantified in randomized control trials in humans till date. We intend to study the galactogogeus effects of L. sativum in hypogalactic mothers through an open-label noncross-over trial., Materials and Methods: The target population were women who had delivered infants <32 weeks gestation with no lower limit to gestational age and their babies admitted in neonatal intensive care unit for prematurity. Participants who were taking specific drugs as a result of their primary illnesses, such as chemotherapy, sedatives, or antiseziure medications, were excluded. The randomization was achieved with computer-generated random number table. The experimental group ( n = 23) received 2.5 g of L. sativum (Chandrashoora ) seeds each day, soaked in luke warm water for half an hour in the morning, along with instructions about how to take the seeds. The control group did not receive any medication ( n = 23). According to the institutional procedure, participants were trained to express breast milk six times using a breast pump. The amount of milk extracted was measured every day for 28 days. The difference in milk production between the two groups at 28 days was the primary endpoint. The secondary endpoint was to asses if any of the trial medicines had any adverse drug effects., Results: A total of 46 participants completed the study till 28 days. In both groups, demographic factors were comparable. The study group surpassed the control group in terms of breast milk volume slowly and reached statistical significance ( P = 0.00002) after 28 days of therapy. No adverse drug effects were reported by the participants., Conclusion: There was statistically significant improvement in breast milk production at 28 days in hypogalactic mothers in the experimental group. L. sativum can be used as cheap alternatives to costly medicines to improve lactation with minimal costs and no adverse drug reactions., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 AYU (An International Quarterly Journal of Research in Ayurveda).)

Introduction: Diabetes is prevalent in India. This study was conducted to assess the impact of ingestion of fenugreek seed on fasting blood glucose levels and glycosylated hemoglobin (HbA 1 C) levels in patients of Type 2 diabetes mellitus controlled with diet, exercise and oral hypoglycemic agents (OHAs) or insulin., Aims: Assessment of impact of ingestion of Trigonella foenum-graecum or fenugreek seed in patients with Type 2 diabetes controlled with OHAs and insulin on fasting blood sugar levels and HbA 1 C levels., Settings and Design: Prospective, randomized control trial in a single center., Materials and Methods: Total sixty patients of Type 2 diabetes mellitus diagnosed at least 6 months prior and on OHAs and insulin were included in the study. Patients were randomized to receive 10 gm of fenugreek seeds soaked in hot water and another group was not. Strict dietary and exercise controls were followed as per the guidelines of American Diabetic Association protocols. The parameters assessed were demographic profile on the first visits and fasting blood sugar levels and HbA 1 C every month till 6 months., Results: A total of sixty patients were enrolled in the study divided into two groups each containing thirty patients. One group of patients received 10 gm of fenugreek seeds soaked in hot water every day, while the second group did not received. Statistical analysis shows that there is significant reduction in fasting blood glucose levels in the 5 th month in the study group ( P = 0.0421) while significant reduction in HbA 1 C in the 6 th month ( P = 0.0201)., Conclusion: A simple complementary addition of fenugreek seeds can have a synergistic effect along with diet control and exercise on fasting blood glucose and HbA 1 c but is of delayed occurrence., Competing Interests: There are no conflicts of interest.

Background: Visual analog scales (VAS) and numeric analog scales (NAS) are used to assess post-operative pain, but few studies indicate their usefulness in rural illiterate population in India., Aims: This study was designed to 1) Compare the impact of literacy on the ability to indicate pain rating on VAS and NAS in post-operative rural patients. 2) Assess the level of agreement between the pain scales., Setting and Design: Cross sectional, hospital based study., Methods: Informed consent was obtained from patients prior to undergoing surgical procedures in a teaching hospital. Post surgery, patients who were conscious and coherent, were asked to rate pain on both VAS and NAS. The pain ratings were obtained within 24 hours of surgery and within 5 minutes of each other., Statistical Methods: Percentages, chi square test, regression analysis., Results: A total of 105 patients participated in the study. 43 (41%) of the sample was illiterate. 82 (78.1%) were able to rate pain on VAS while 81 (77.1%) were able to rate pain on NAS. There was no significant association between pain ratings and type of surgery, duration of surgery and nature of anaesthesia. In multivariate analysis, age, sex and literacy had no significant association with the ability to rate pain on VAS (P value 0.652, 0.967, 0.328 respectively). Similarly, no significant association was obtained between age, sex and literacy and ability to rate pain on NAS (P value 0.713, 0.405, 0.875 respectively). Correlation coefficient between the scales was 0.693., Conclusion: VAS and NAS can be used interchangeably in Indian rural population as post-operative pain assessment tools irrespective of literacy status.

Background: Health-Related Quality Of Life (HRQOL) among patients with End-Stage Renal Disease (ESRD) is significantly impacted by virtue of varied disease or treatment-related factors, and its evaluation along with existential concerns is required for providing comprehensive care to the patient., Aim: The aim of this study was to describe the various dimensions of HRQOL and existential concerns and to examine the relationship between the two among patients with ESRD., Materials and Methods: A cross-sectional descriptive study was conducted among 54 patients with ESRD undergoing maintenance hemodialysis in a teaching hospital. A semi-structured questionnaire was used to assess socio-demographic characteristics and existential concerns of the respondents. The HRQOL was evaluated using a standardized scale of Kidney Disease Quality of Life-Short Form (KDQOL-SF™) questionnaire. Data were presented as frequencies, mean ± Standard Deviation (SD) for baseline characteristics and scores. Pearson correlation was used to study the association between various domains of quality of life and existential concerns., Results: Among HRQOL, the worst results obtained were in the domain of burden of kidney disease (33.45 ± 13.53), work status (49.07 ± 24.75), quality of social interaction (62.22 ±11.80), general health (43.06 ± 13.01), and physical functioning (47.50 ± 18.88). Disrupted personal integrity (12.80 ± 2.81) and loss of continuity (5.37 ± 1.17) were most bothersome existential concerns. A co-relational model behaves distinctly eliciting weak to strong association among various domains of HRQOL and existential concerns., Conclusion: Patients with ESRD reported impaired HRQOL in most of the domains. Existential concerns are distinguished as important dimensions of HRQOL. Association between HRQOL and existential concerns showed that these dimensions are distinct, and there is a need for assessing and attending these entities through a multidisciplinary approach to alleviate the suffering and achieving a sense of overall wellbeing among patients.