PVS Memorial Hospital

The vision of Viksit Bharat emphasizes an education system that harmonizes language diversity, cultural heritage, and knowledge systems to foster holistic development. This qualitative study explores how language and culture serve as foundational pathways for integrating indigenous and global knowledge systems. Using document analysis and thematic interpretation, the study highlights the transformative potential of culturally grounded education. The findings reveal that multilingualism, cultural inclusivity, and epistemological diversity contribute significantly to sustainable educational reform and national development

Background Lupus nephritis (LN) can cause significant morbidity and mortality if not diagnosed and treated in time. This study aimed to assess a non-invasive biomarker (anti-C1q antibody) for predicting LN’s histopathological activity. Materials and Methods This single center observational study included 50 patients with newly diagnosed LN. Serum anti-C1q antibody, anti-dsDNA antibody, C3, and C4 levels were correlated with National Institute of Health (NIH) activity index on kidney biopsy and SELENA SLEDAI instrument score, using Spearman’s correlation coefficient. ROC curves were drawn for these biomarkers’ serum levels for predicting NIH activity index score >10 on kidney biopsy. Results The coefficients of correlation of anti-C1q antibody, anti-dsDNA antibody, C3, and C4 serum levels with LN histological activity were 0.5, 0.43, 0.48, and 0.3, respectively, and with SELENA SLEDAI score were 0.7, 0.45, 0.40, and 0.3, respectively. A 30 U/mL cut-off level for the anti-C1q antibody titer had a 61% sensitivity, 78% specificity, and 72% predictive accuracy in assessing histological LN severity with an activity index > 10 on kidney biopsy. Conclusion Anti-C1q antibody serum levels correlated better with LN activity than anti-ds DNA antibody, C3, and C4 serum levels. Anti-C1q antibody serum levels > 30 U/mL can be used to predict severe proliferative LN with an activity index > 10 on kidney biopsy.

Self medication with over the counter (OTC) drugs is common among medicine and nursing students. Despite all their benefits, improper use of medicines can bring potential health hazards and evidence continue to mount that adverse reaction to medicines are common and yet often preventable1. Over the counter drugs means drugs which are allowed to be sold by pharmacists without need for a prescription. The term does not have a legal definition in India2. Objectives: 1. To assess the level of knowledge of B.Sc Nursing students regarding OTC drugs, 2. To assess the practice of B.Sc Nursing students regarding OTC drugs, 3. To determine the association of knowledge of B.Sc Nursing students with the demographic variables, 4. To determine the association of practice among B.Sc Nursing students with the demographic variables. 5. To determine the correlation between knowledge and practice of B.Sc Nursing students regarding OTC drugs. Methods: Descriptive research design and purposive sampling technique was used for the study. 60 B.Sc Nursing students were selected from NS Memorial College of Nursing, Kollam. Result: Analysis of knowledge of B.Sc(N) students regarding OTC drugs shows that 15% had inadequate knowledge, 48.3% had moderate knowledge and 36.7% had adequate knowledge level. Analysis of the practice of 60 B.Sc(N) students regarding OTC drugs shows that 88.5% had bad practice and 11.5% had good practice level.

Hypnic headache (HH) is a rare primary headache syndrome first described by Raskin in 1988. To describe the occurrence of HH in Indian patients and compare its clinicoepidemiological features to those published in the literature and attempt to trace some of the evolving concepts regarding its etiology and clinical features since it was first described. Patients attending the neurology outpatient department of a tertiary referral teaching hospital from 01-05-2011 to 30-04-2016 who were identified to have HH as per ICHD 3 beta criteria were included in the study. A meticulous history of the headache and comorbidities, clinical examination, Epworth Sleepiness Scale, blood counts, blood biochemistry, magnetic resonance imaging (MRI) scans of the brain and polysomnography (in selected patients) were done and the results were compared to selected international literature. A total of 11 patients with HH were identified during the study period, of which 8 (72.72%) were males and 3 (27.27%) were females. The age of the patients varied from a minimum of 53 years to a maximum of 78 years (Mean: 63.36, SD: 8.09). The frequency of attacks per month ranged from 5 to 46(Mean: 20.36, SD: 11.67). The duration of each headache episode ranged from a minimum of 30 minutes to a maximum of 4 hours (Mean: 1.93, SD: 1.23). The occurrence of the headaches was maximum during the time periods of 0.00-2.00am and 2.00-4.00am (38% and 36%, respectively). The pain was dull in a majority of patients, 7 (63.63%). Trigeminal autonomic features such as lacrimation, ptosis, or rhinorrhea were not recorded from our cohort. Motor activity was noted in 7 (63.63%) cases. Two (18.18%) patients had associated migraine headaches whereas 3 (27.27%) had associated tension-type headaches. None of the patients in our series had chronic obstructive pulmonary disease. Four (36.36%) patients had systemic hypertension and 1 patient (9.09%) had diabetes mellitus. Two (18.18%) patients had symptoms of obstructive sleep apnea syndrome. Three (27.27%) patients had symptoms of excessive daytime sleepiness according to the Epworth Sleepiness Scale. Blood examinations and MRI were normal in all patients, except for the findings of a few lacunar infarcts and nonspecific T2 weighted hyperintensities in 3 patients (27.27%). Our study proves the existence of the newly described primary headache syndrome called HH in the Indian population. On comparing our results with the international literature, the similarities are much greater than the differences. MRI voxel-based morphometry to demonstrate the loss of gray matter in the posterior hypothalamus may prove to be a reliable test to diagnose primary HH in the future.

A 50-year-old woman, diagnosed with systemic lupus erythematosus (SLE) for 4 years and in remission on azathioprine and tacrolimus, without complementary and alternative medication intake, presented with severe lumbosacral radicular pain associated with difficulty in walking for 1 week. On

Ayurveda Bhasma is a metallic-mineral preparation homogenised with herbal juices or decoctions and modified with heat treatment to apparently detoxify the heavy metals. It is widely recommended for the treatment of many disease conditions by practitioners of complementary and alternative medicine in the absence of good quality clinical trial evidence on its safety and efficacy. Heavy metal-induced liver injury is widely reported in the literature, and heavy metal adulteration of non-Bhasma-related Ayurveda and herbal products has been well described. We report a patient who developed severe liver injury requiring listing for liver transplantation for improved survival, after consumption of Bhasma for dyspepsia. This case describes the first documented case and toxicology analysis of Ayurveda Bhasma associated with severe drug-induced liver injury. Physicians must be alert regarding patient’s use of supposedly safe Ayurveda Bhasma that may promote acute severe liver injury in the absence of other known aetiologies.

Hepatic myelopathy (HM) is a devastating but rare complication of cirrhosis and portal hypertension that profoundly affects quality of life and improves only with liver transplantation. We present a case where progressive severe spastic paraparesis due to HM was substantially reversed with partial splenic artery emobilization (PSAE). (Hepatology 2018;67:1169-1171).

Ayurvedic and herbal medicines (AHM) are known to cause varying degrees of drug-induced liver injury (DILI). Clinical, biochemical, histological spectrum and outcomes of AHM linked to severe DILI are not well studied. Out of 1440 liver disease patients, 94 were found to have a severe liver injury and associated AHM intake. Thirty-three patients were suspected to have AHM-DILI on Roussel Uclaf Causality Assessment Scoring Method. Forty-seven and 30 of retrieved AHM samples were analyzed for heavy metals and hepatotoxic volatile organic compounds (hVOCs), respectively. Eleven patients ingested AHM from unregistered traditional healers (UTH). Clinicopathological outcomes were analyzed in 27 patients (who underwent liver biopsy) and outcomes with respect to chemical analyses were studied in 33 patients. Males predominated (70.4%) with mean age 46.9±15.8 years. Mean follow up was 119.2±81.4 days. The median duration of drug intake was 28days (10 - 84). Five patients died (18.5%). Hepatic encephalopathy, hypoalbuminemia, and hepatic necrosis were significantly associated with mortality (p < 0.005). Arsenic and mercury ingestion was significantly associated with death (p < 0.005). hVOCs were detected in more than 70% of samples. AHM intake from UTH was associated with higher mortality. Adequate regulation and scrutiny regarding AHM use among the general population is an unmet need. Early liver biopsy after clinical identification of at-risk patients can expedite definitive treatment with a liver transplant.

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.