Rajarajeswari Medical College and Hospital

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by aggregates of α-synuclein and the degeneration of dopaminergic neurons in the substantia nigra. Current pharmaceutical therapies mainly alleviate symptoms without halting disease progression. Evidence suggests that traditional plant-based interventions may serve as supplementary therapies by targeting oxidative stress, mitochondrial dysfunction, neuroinflammation, and apoptosis. This review explores the neuroprotective properties of ten medicinal plants commonly used in traditional medicine: Bacopa monnieri, Curcuma longa, Mimosa pudica, Zingiber officinale, Ocimum sanctum, Emblica officinalis, Camellia sinensis, Cannabis sativa, Panax ginseng, and Withania somnifera. A systematic and comprehensive search of PubMed, Scopus, and Web of Science identified relevant in vitro, in vivo, and clinical studies. This study highlights the mechanisms by which plant-derived chemicals influence cellular pathways associated with PD, emphasising their therapeutic potential despite limited clinical validation. Studies have shown that bioactive compounds such as curcumin, bacoside, Epigallocatechin-3-gallate (EGCG), cannabidiol, ginsenosides, and withanolides exhibit antioxidant, anti-inflammatory, anti-apoptotic, and neuroprotective effects in PD models. Nanotechnology offers promising strategy to enhance the efficacy of herbal compounds, addressing challenges of poor solubility, rapid metabolism, low bioavailability, and restricted blood-brain barrier penetration. Nano-delivery systems including liposomes, polymeric nanoparticles, nanoemulsions, and metal nanoparticles can improve stability, brain targeting, controlled release, and cellular uptake of these bioactives, thereby enhancing therapeutic efficiency while reducing systemic toxicity. Green-synthesized plant-based nanoparticles further provide synergistic neuroprotective benefits, positioning phyto-nanomedicine as a multi-target approach for PD therapy. However, extensive clinical studies are required to confirm safety and effectiveness. Parkinson’s disease leads to the loss of dopaminergic neurons and the buildup of α-synuclein. Plant-based compounds provide neuroprotective, antioxidant, and anti-inflammatory benefits. Key protective pathways include PI3K/Akt, Nrf2/ARE, MAPK, and NF-κB. Traditional medicinal plants show neuroprotective effects in Parkinson’s disease. Phytochemicals target oxidative stress, inflammation, and mitochondrial dysfunction. Nanoformulations improve bioavailability and brain delivery of herbal compounds.

BACKGROUND:Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in reproductive-aged women, affecting 5%-10% worldwide. It is a multisystem condition characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries, with potential long-term complications including type 2 diabetes, cardiovascular disease, and metabolic syndrome. OBJECTIVE:This study compares serum anti-Müllerian hormone (AMH) levels between women with and without PCOS and evaluate the prevalence of glucose intolerance and metabolic syndrome in these groups. MATERIALS AND METHODS:This prospective comparative study was conducted on 150 women of reproductive age attending the gynecology outpatient department at Rajarajeshwari Medical College and Hospital, Bengaluru. Group A (n = 75) included women without PCOS, and Group B (n = 75) included women diagnosed with PCOS based on the Rotterdam criteria (2003). Clinical examinations, serum AMH levels, 75 g oral glucose tolerance test, lipid profile, blood pressure, body mass index, waist circumference, and waist-hip ratio were assessed. Data were analyzed to determine associations between AMH, glucose intolerance, and metabolic syndrome. RESULTS:Serum AMH levels were significantly higher in the PCOS group (mean 7.98 ng/mL), with 63% showing elevated AMH (P < 0.005). Metabolic syndrome was also significantly more common in women with PCOS (P < 0.005). Glucose intolerance was observed in 25% of women with PCOS, but no significant association was observed between serum AMH levels and glucose intolerance in women with PCOS. CONCLUSION:Serum AMH is significantly elevated in women with PCOS and is as a potential marker for predicting metabolic risk but has no association with glucose intolerance in PCOS patients.

Antimicrobial resistance (AMR) is a growing global concern driven by inappropriate antimicrobial use, leading to increased multidrug-resistant (MDR) organisms. Antimicrobial Stewardship Programs (AMSPs) are essential to optimize antibiotic use and reduce resistance. Objectives: To assess the trend of MDR bacteria and evaluate the impact of a policydriven AMSP in a tertiary care hospital. Methods: A retrospective cross-sectional study was conducted from June 2022 to May 2025 in two phases: Phase 1 (policy preparation and restricted use) and Phase 2 (implementation of structured AMSP with audit, feedback, and surveillance). MDR trends were analyzed year-wise and organism-wise. Antibiotic susceptibility testing followed CLSI guidelines. Results: MDR cases increased from 342 (2022) to 389 (2023), followed by a decline to 220 (2024) and 105 (2025), showing a 69.3% reduction (p < 0.001). Klebsiella spp., Pseudomonas spp., and Escherichia coli showed significant reductions, while Acinetobacter spp. showed a slight increase. Conclusion: Structured AMSP implementation significantly reduced MDR burden, highlighting the importance of sustained stewardship and infection control strategies.

Background and objective Medical thoracoscopy (MT) is associated with significant postoperative pain of varying intensity and duration, leading to significant morbidity. Our study compared the efficacy of thoracic spinal anesthesia (TSA) combined with erector spinae plane block (ESPB) with conscious sedation for MT using a patient-centered outcome measure. Methods This is a non-randomized prospective comparative pilot study wherein 36 patients undergoing MT were assigned alternately to receive TSA with ESPB or conscious sedation. Conscious sedation was administered with fentanyl and midazolam in graded doses with local instillation of lignocaine 2%. TSA was administered at the T6-T7 level with 25 mcg of fentanyl and 0.5% levobupivacaine (1.5 ml), followed by ESPB with 0.25% levobupivacaine (10 ml). The primary outcome was to compare the efficacy of ESPB with conscious sedation in terms of quality of recovery. The secondary outcome was to compare the time to administration of the first analgesic post procedure, total postoperative opioid consumption (mg) at 24 hours, and duration of the procedure. Intraoperative hemodynamic stability and block-related and post-procedure complications were also assessed. Results The total Quality of Recovery-15 (QoR-15) score was 112.83 ± 27.16 vs. 65.78 ± 22.13 (p = 0.0001), time to first analgesic was 11.69 ± 6.93 hours vs. 2.39 ± 1.69 hours (p = 0.0001), opioid consumption was 50 ± 10 vs. 75 ± 15 (p = 0.001), and the mean duration of the procedure was 64.72 vs. 93.89 minutes (p = 0.0001) in the ESPB group and the conscious sedation group, respectively. No block/anesthesia-related complications were reported in either group. Conclusion The combination of TSA with ESPB can be a novel, effective, and safe anesthetic technique for MT, offering better quality of recovery, improved postoperative analgesia, shorter procedure duration, and reduced perioperative morbidity.

Learning the intricate three-dimensional anatomy of the middle ear, nasal cavity, and larynx presents a challenge for undergraduate medical students, as conventional teaching methods may not effectively connect anatomical knowledge with applied clinical skills. To address this gap, an innovative teaching approach was introduced, wherein final year MBBS students constructed low cost 3 dimensional models of key ENT structures and correlated them with endoscopic simulation. Thirty students participated in creating cardboard based middle ear models, clay nasal cavity models, and house like laryngeal models. These were subsequently used for endoscopic orientation and skill practice. Knowledge acquisition was evaluated using pre- and post-tests, and feedback on learning experience was obtained. A marked improvement in mean test scores from 60 to 95