Introduction Growing evidence indicates that psychological stress contributes to cardiovascular diseases through complex neuroendocrine mechanisms. Psychological stress leads to several physiological responses including increased heart rate (HR) and blood pressure (BP) as well as decreased heart rate variability (HRV) through alterations in the autonomic nervous system (ANS), specifically increased sympathetic nervous system (SNS) activity and decreased parasympathetic nervous system (PNS) activity.  Material and Methods This is prospective and observational study was conducted in the Department of Physiology, Index Medical College from January 2022 to July 2024. The aim of this pre & post-yoga interventional study was to evaluate the efficacy of 6 months yoga practice on cardio-respiratory fitness and mental health including perceived stress and memory status and plasma nitric oxide level in healthy individuals. The effects of 6 months yoga practice on cardio-respiratory fitness and mental health of all the study participants/subjects were evaluated at two times. First, investigations or evaluations were made before the study begins or yoga intervention was given and second, immediately after the completion of yoga intervention period i.e. six months. Results  It was noted that, pre-yogic SBP after HST was higher i.e. 167.65 mmHg than post-yogic SBP after HST i.e. 160.20 mmHg. This reduction in SBP from 167.65 mmHg to 160.20 mmHg with mean difference of 7.45 mmHg after HST was found to be statistically highly significant (p<0.0001). It was noted that, pre-yogic mean DBP after HST was higher i.e. 83.26 mmHg than post-yogic mean DBP after HST i.e. 81.79 mmHg. This reduced DBP from 83.26 mmHg to 81.79 mmHg with mean difference of1.47 mmHg after HST was found to be statistically highly significant (p<0.0001). Pre-yogic ECG at rest, after HST and post-yogic ECG at rest and after HST was found to be within normal limits. Conclusion  The results of the present study demonstrate that practicing meditation reduces heart rate and blood pressure in CAD patients and that change were more marked in yoga group. It can be concluded from the present study that meditation helps in improving health status of an individual including heart rate and blood pressure. Furthermore, the practice should be adopted and continued for a long duration

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical syndrome, commonly seen i elderly patients who present with dorsal pitting edema of the hands and has a dramatic response to steroids, suggesting a benign nature. Sometimes it is associated with other rheumatologic conditions and potential underlying malignancy should be ruled out, especially when there is a poor response to steroids.

Left ventricular free wall rupture is a serious complication of myocardial infarction (MI) with a mortality rate without intervention close to 100%. Its presentation is classically late following an MI but, in some cases, can present within 24 hours. There can be sudden overt clinical symptoms or it can present insidiously and therefore there must be a high index of suspicion. This report highlights the case of a gentleman with no prior history of ischemic heart disease that presented with non-specific symptoms. A diagnosis of left ventricular (LV) free wall rupture near the atrial appendage, post MI was made and he was managed successfully.

The Mirena intrauterine system (IUS) has been licensed as a contraceptive in the UK since May 1995. Recent National Statistics suggest the Mirena IUS is used by only 1% of women aged 16–49 years who are currently using contraception.1 The Mirena IUS now also has a licence for the management of idiopathic menorrhagia2 and may therefore be used by women who do not require contraception. Uterine perforation is a serious, albeit rare, potential complication of intrauterine device or system use. Women may be informed that uterine perforation occurs in fewe than 1 in 1000 of either copper intrauterine device (IUD) or IUS insertions.3,4 R te of perforation reported with the Mirena IUS in a large observational cohort study was 0.9 per 1000 insertions.5 In this case report, an intraperitoneal Mirena IUS was detected nearly 4 years after its insertion and perforation of the uterus was diagnosed, despite vaginal hysterectomy and admissions to hospital. This case report demonstrates clearly that whenever there is suspicion from ultrasound scan report of an empty uterus that the IUS has fallen out, and in the persistence of symptoms, we should consider performing a bdominal X-Ray which is an easy, cheap method, to identify the IUS outside the uterus.

Background: The present study was designed to measure changes in markers of antioxidant capacity (measured individually and total) following acute ischemic stroke. Methods: The study included 135 subjects. 62 were controls and 73 were ischemic stroke patients diagnosed clinically and by CT scan of the brain. The cases were divided into two groups, The ischemic stroke patients with large vessel / cortical, subcortical infarcts (Group. I) and small vessel / lacunar infarcts (Group. II) based on CT scan of the brain. Serum vitamin E, vitamin C, superoxide dismutase, uric acid and total antioxidant capacity were estimated in all the subjects. Results: Group I and Group II ischemic stroke cases had significantly lower levels of vitamin E, vitamin C and superoxide dismutase and significantly higher levels of uric acid compared to controls. The group I ischemic stroke cases had significantly lower levels of vitamin E, vitamin C, and superoxide dismutase and significantly higher levels of uric acid than group II ischemic stroke cases. Total antioxidant capacity strongly correlated with serum uric acid in cases Conclusion: The present study suggests that estimation of vitamin E, vitamin C, SOD, uric acid and total antioxidant capacity may be used as indirect evidence of oxidative stress induced neuronal damage in acute ischemic stroke which may be useful for monitoring and optimizing antioxidant therapy.

The primary objective of this survey was to check the availability and use of cameras in documentation of open fractures in emergency departments in England, Wales and Scotland. We also checked the use of mobile phone cameras in emergency departments without cameras. A telephone questionnaire posed questions to the first on-call orthopaedic doctor about the availability of a functional camera in the emergency department. Altogether, 102 doctors replied in 115 hospitals that were surveyed. Only 63 emergency departments had a camera available for photography of open fractures, in which 53 orthopaedic doctors would always take photographs of an open fracture. In 7 emergency departments a mobile phone camera was used for documentation of open fractures, as a camera was not available. Subsequently, recommendations for wound documentation using a mobile phone camera have been proposed as it is easily accessible and portable with good picture quality that can be transmitted to offsite senior colleagues for advice. This would prevent wound infection and also act as an adjunct to a narrative description of the wound.