Objective:To prepare and evaluate a herbal antioxidant face cream which is made by the ethanol extract of Nardostachys jatamansi (Valerianceae).
Methods: Antioxidant activity of ethanol extract was assessed by previously reported 2, 2-Diphenyl-1-picrylhydrazyl method. By discovering different types of formulations, such as oil in water, we were able to create several face creams respectively classified from F1 to F6, by incorporating different concentrations of stearic acid and acetyl alcohol. The evaluation of all formulations (F1 to F6) has been done by the analysis of different parameters like pH, viscosity, spread ability and stability.
Results: An ethanol fraction analyzed from a sample of Nardostachys jatamansi showed a significant antioxidant activity with an IC50 value of 58.39 μg/mL while for ascorbic acid the IC50 value was 46.68 μg/mL. Among the six formulations (F1-F6) F5 and F6 showed good spread ability, good consistency, homogeneity, appearance, pH;there is no proof of a separation phase and ease of removal. Also the formulations F5 and F6 showed no redness or edema or erythema and irritation during irritancy studies.
Conclusions:These formulations can be safely used on the skin. Hence, the study suggests that the composition of extract and the base of the cream F5 and F6 are more stable and safe, but it may produce synergistic action.

Cervicogenic headache (CeH) is caused by the disorder of the cervical spine and its anatomical structures. Patients who fail to respond to conservative therapies can undergo interventional treatment. The purpose of this review is to describe the various interventions and compare their relative efficacies. Although a few reviews have been published focusing on individual interventions, reviewing studies on other available treatments and establishing the most efficacious approach is still necessary. We performed a systematic review of studies available on the various interventions for CeH. The PubMed, Embase, and Cochrane databases were searched for literature published between January 2001 and March 2021. Based on the inclusion criteria, 23 articles were included. Two reviewers independently extracted the data from the studies and summarized them in a table. Eleven of twenty-three studies evaluated the effect of radiofrequency ablation (RFA), 5 evaluated occipital nerve blocks, 2 each for facet joint injections and deep cervical plexus blocks, and 1 study each evaluated atlantoaxial (AA) joint injections, cervical epidural injection, and cryoneurolysis. Most of the studies reported pain reduction except 2 studies on RFA. In conclusion, based on the available literature, occipital nerve blocks, cervical facet joint injection, AA joint injection, deep cervical plexus block, cervical epidural injection may be reasonable options in refractory cases of CeH. RFA was found to have favorable long-term outcomes, while better safety has been reported with pulsed therapy. However, our review revealed only limited evidence, and more randomized controlled trials are needed to provide more conclusive evidence.

Objective: Due to its comprehensive, reliable, and valid format, the objective structured clinical examination (OSCE) is the gold standard for assessing the clinical competency of medical students. In the present study, we evaluated the importance of the OSCE as a learning tool for postgraduate (PG) residents assessing their junior undergraduate students. We further aimed to analyze quality improvement during the pre-coronavirus disease (COVID) and COVID periods. Methods: This quality-improvement interventional study was conducted at the Department of Obstetrics and Gynecology. The PG residents were trained to conduct the OSCE. A formal feedback form was distributed to 22 participants, and their responses were analyzed using a five-point Likert scale. Fishbone analysis was performed, and the ‘plan-do-study-act’ (PDSA) cycle was implemented to improve the OSCE. Results: Most of the residents (95%) believed that this examination system was extremely fair and covered a wide range of clinical skills and knowledge. Further, 4.5% believed it was more labor- and resource intensive and time-consuming. Eighteen (81.8%) residents stated that they had learned all three domains: communication skills, time management skills, and a stepwise approach to clinical scenarios. The PDSA cycle was run eight times, resulting in a dramatic improvement (from 30% to 70%) in the knowledge and clinical skills of PGs and the standard of OSCE. Conclusion The OSCE can be used as a learning tool for young assessors who are receptive to novel tools. The involvement of PGs in the OSCE improved their communication skills and helped overcome human resource limitations while manning various OSCE stations.