Himalayan Institute Hospital Trust

Fetal supraventricular tachycardia may lead to low cardiac output, nonimmune hydrops and fetal demise. We are presenting an antenatal case in whom fetal SVT was picked up during examination and was confirmed by ultrasound and fetal echocardiography. Following administration of flecainide to mother, fetal SVT improved, baby did not develop hydrops, pregnancy continued till term and patient delivered vaginally. Awareness regarding existence of fetal arrhythmias is important for obstetricians as early diagnosis and treatment before development of fetal hydrops will not only help in improving fetal outcome but also in reducing cesarean section rates in these cases.

Lozenges are solid dosage forms that include one or more medications that are supposed to dissolve or disintegrate slowly in the mouth, or medicated candies that dissolve slowly in the mouth to lubricate and soothe sensitive throat tissue. The objective of the present study was formulation and evaluation of Medicated Soft Lozenges of Montelukast sodium by using PEG 1500 as a lozenges base while Dextrose as a sweetener. The drug excipients interaction study was done by FTIR, the compatibility of Montelukast sodium with PEG 1500 and Dextrose the studies of FTIR showed that all above characteristic peaks of Montelukast sodium were observed near about their respective values so it has been concluded that there is no incompatibility between excipients and pure drug. Formulations were prepared by melting and moulding technique. The Medicated Soft lozenges of Montelukast sodium were evaluated for physical appearance, thickness, weight variation, hardness, friability test, drug content, disintegration time, in- vitro drug release and stability study. All prepared batches showed good in- vitro dissolution studies. The best result from lozenges batches was from F2 which gives Thickness of 5.12 mm, Weight variation of 0.24 mg, Hardness of 6.5 kg/cm-1, Friability of 0.695%, Drug content of 98.32%, Disintegration time of 30 min and In- vitro drug release of 80%. The main selection criteria for the best formulation was in-vitro drug release of the formulations equal to the in-vitro drug release of the pure drug which is not less than 70%, which complies with the IP standards and hardness of the formulation batches. Hence it can be concluded that Medicated Soft Lozenges of Montelukast sodium can be successfully formulated by melting and mould technique

Violence, a problematic phenomenon experienced in different forms (physical, verbal, symbolic, sexual, etc.), is increasingly prominent in sociological analysis. Violence is an unwanted aspect of everyday life experience; it is common in traffic incidences, in the family, in the workplace, and in personal interactions almost everywhere. In recent years, women and health professionals (doctors and non-doctors) in particular have been subjected to violence. Violence against women and children has become remarkably commonplace. An increase in violence against physicians and healthcare professionals as part of this more hostile environment could be observed.Violence against doctors is now a global problem.The well-being of health workers has been disrupted not only by the changing dynamics in doctor-patient relationships, but also by the general environment of insecurity. All forms of violence must be condemned; not only healthcare workers but also the decion makers have to deal with the issue of violence collectively and systematically.

Cardiac arrest in a term pregnancy is rare with a survival rate of 15-20% and mortality rate as high as 42%. Eclampsia, amniotic fluid embolism, haemorrhagic shock, sepsis, pulmonary thromboembolic events, and anaesthetic complications are significant causes of cardiac arrest. We report a rarest case of a young 26-year-old unbooked primigravida, 38+4 weeks gestation with eclampsia, HELLP syndrome, thrombocytopenia with sudden cardiac arrest-A Maternal Near Miss. Prompt resuscitation with obstetric, and anaesthetist specialist team, paved the journey to safe motherhood. An emergency Lower Segment Caesarean Section (LSCS) immediately after Cardiopulmonary Resuscitation (CPR) was performed. Ventilator support was continued for 72 hours. Successful CPR and immediate caesarean section paved the way to safe motherhood with discharge of healthy mother and baby on 12th post LSCS day. With increasing trends towards high-risk pregnancy and maternal near miss cases, a thorough knowledge in the management of cardiac arrest in pregnancy with advanced resuscitation skills among obstetricians, anaesthetists, and nursing staff is need of the millennium. Repeated simulation learning and mock drills in CPR in pregnancy should be advocated.

A multi-layer artificial neural network (ANN)-based heart rate variability (HRV) classifier has been proposed, which gives the cardiac health status as the output based on HRV of the patients independently of the cardiologists' view. The electrocardiogram (ECG) data of 46 patients were recorded in the out-patient department (OPD) of a hospital and HRV was evaluated using self-designed autoregressive-model-based technique. These patients suspected to be suffering from cardiac abnormalities were thoroughly examined by experienced cardiologists. On the basis of symptoms and other investigations, the attending cardiologists advised them to be classified into four categories as per the severity of cardiac health. Out of 46, the HRV data of 28 patients were used for training and data of 18 patients were used for testing of the proposed classifier. The cardiac health classification of each tested patient with the proposed classifier matches with the medical opinion of the cardiologists.

Schwannomas are benign neoplasms arising from Schwann cells of the peripheral, cranial and autonomic nerves. We report a case of schwannoma in the sino-nasal tract, a very rare site of tumour origin with unusual pseudoangiomatous histopathological changes, which we came across in a 22 years male with progressive nasal obstruction.

Advanced cancer patients are managed by palliative care and its main aim is to provide best possible quality of life to the patients by symptom management. Pain is the most agonizing symptom experienced by advanced head and neck cancer patients. Control of pain hence requires more attention by the caregiver in order to improve their quality of life. Recently quality of life issues have emerged as a main focus of cancer treatment as compared to conventional increase in survival rate. This study mainly focuses on the effect of palliative drug therapy on quality of life.