A study of the effect of yoga on C-reactive protein, lipid profile and insulin resistance in obese patients

Background: Obesity is defined as a state of excess adipose tissue mass. In the last decade, there has been an alarming prevalence of obesity in the developed and developing countries like India. While modern medicine has so far been unable to control the menace of obesity, yoga offers an alternative holistic approach to tackle the problem of obesity by inculcating an approach towards balanced diet (Satwik aahar), physical activity and behavior modification (through pranayama). In this study, we have included the core anthropometric parameters of obesity, as well as associated abnormalities secondary to obesity like, insulin resistance, glucose intolerance, hypertension, atherogenic dyslipidemia. Methods: The study was conducted in the department of medicine, L.L.R.M. Medical College and associated S.V.B.P. Hospital, Meerut, U.P. during 2020-2021 with the objective to assess the role of yoga therapy in modifying anthropometric and biochemical parameters of obese patients. It was a prospective, controlled trial in which 120 obese patients (BMI?25 kg/m2) were enrolled and followed for a period of six months.Results: Yoga therapy along with dietary restrictions is highly effective in improving the various anthropometric and biochemical parameters in obese patients and also beneficial in controlling complicationslike hypertension, diabetes and dyslipidemias secondary to obesity. It also improved the quality of life of these patients.Conclusions: This study is a modest attempt to ascertain the role of yoga in obesity and it hopes to encourage further research in the field.

Perceived Social Support and Internalized Homophobia among Lesbian, Gay and Bisexual Individuals

Background: The LGBTQIA+ community faces relentless discrimination and negative social attitudes despite the overhaul of IPC Section 377 in India, which are sometimes projected inwards as internalized homophobia. The present study aims to investigate the relationship between perceived social support and internalized homophobia and assess the level of internalized homophobia among lesbian, gay and bisexual individuals. Methodology: A correlational research design was used with a sample of individuals identifying as either gay, lesbian or bisexual (n = 109) recruited using mixed-snowball sampling method for the study and the data was analysed using statistical methods like Spearman’s correlation, Welch’s ANOVA and linear regression. Internalized homophobia was measured using the Internalized Homophobia Scale (IHS) and Lesbian Internalized Homophobia Scale (LIHS), whereas perceived social support was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The results revealed a significant relationship between perceived social support and internalized homophobia among male participants and higher levels of internalized homophobia among non- heterosexual women compared to non-heterosexual men. The findings indicate that lacking perceived social support can contribute to increasing internalized homophobia, which in turn reduces perceived social support within a negative, self-perpetuating cycle. The intersectionality of gender-based violence targeting one's identity as a woman and a non-heterosexual individual, may contribute to heightened levels of internalized homophobia among women. The study provides important findings that may help to formulate instructive queer affirmative mental health policies and practices. Conclusions: Perceived social support can extensively contribute toward the development of internalized homophobia among LGB individuals

A suspected case of COVID-19 vaccine (Covishield) induced Guillain Barre syndrome-a case report

Guillain Barre syndrome (GBS)is a collection of clinical syndromes that manifest as an acute inflammatory poly radiculopathy. It usually presents as an acute, non-febrile, monophonic, post infectious illness manifesting as ascending weakness and areflexia. It is an autoimmune disorder characterized by production of antibodies against the myelin and is often triggered by bacterial and viral infections, vaccines against rabies, flu and COVID-19. Here we present a case of 31 years old male with characteristic signs and symptoms of GBSpossibly triggered by Covishield vaccine.

Efficacy and safety of hydroxychloroquine in osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

Background/Aims@#Conventional disease-modifying anti-rheumatic drugs have been trialed in osteoarthritis (OA). Hydroxychloroquine (HCQ), which has shown its effectiveness in rheumatoid arthritis, has been trialed for the treatment of OA; however, its efficacy and safety remain unclear. This systematic review and meta-analysis evaluate efficacy and safety of HCQ for the treatment of OA. @*Methods@#MEDLINE, EMBASE, and Cochrane Central were searched from inception through June 2020. Two reviewers independently screened for randomized controlled trials (RCTs) comparing HCQ with placebo or other active-comparators for the treatment of knee, hand, or hip OA, extracted data, and performed Cochrane risk of bias assessments. @*Results@#Six RCTs, four in hand OA, two in knee OA, consisting of 842 patients (436 in HCQ arm, 406 in control arm) were included. RCTs were conducted between 2012 and 2020, one each at UK, Netherlands, Germany, Italy, Iran, and Egypt; follow-up period ranged 24 to 52 weeks. High-quality evidence showed no clinically important pain reduction with HCQ compared to placebo/active-control in hand OA (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], –0.20 to 0.48). Effect on pain reduction in knee and hand OA was small and non-significant (SMD, –0.09; 95% CI, –0.44 to 0.25). High-quality evidence showed no improvement in dysfunction with HCQ compared to placebo in hand OA patients (SMD, 0.08; 95% CI, –0.23 to 0.40). Effect on dysfunction improvement in knee and hand OA was modest and statistically non-significant (SMD, –0.20; 95% CI,–0.57 to 0.18). No improvement in quality of life was observed in hand OA. @*Conclusions@#HCQ has no benefit in reducing pain and improving physical function in hand or knee OA patients.

Building the health-economic case for scaling up the WHO-HEARTS hypertension control package in low- and middle-income countries / Argumentos de la economía de la salud para ampliar las medidas de control de la hipertensión de la iniciativa HEARTS de la OMS en los países de ingresos medianos y bajos / Ampliação do pacote de controle da hipertensão OMS-HEARTS em países de baixa e média renda: argumentos a partir da perspectiva da economia em saúde

ABSTRACT Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in low- and middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an average <US$ 5 per patient per year in the public sector. This health economic evidence will make a compelling case for government ownership and financial support for national scale hypertension control programs.

RESUMEN En general, los programas de control de la hipertensión son costo-eficaces, incluso en los países de ingresos bajos y medios. Aun así, es poco probable que los gobiernos nacionales y la sociedad civil apoyen los programas de control de la hipertensión a menos que se demuestre su valor en términos de beneficios para la salud pública, impacto presupuestario y valor de la inversión para el contexto individual del país. La Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) implementaron la iniciativa HEARTS, un enfoque mundial estandarizado y simplificado para el control de la hipertensión, que incluye los medicamentos antihipertensivos y los dispositivos de medición de la presión arterial de preferencia. El objetivo de este estudio es informar sobre los estudios en el ámbito de la economía de la salud relativos al costo de las medidas de control de la hipertensión previstas en HEARTS (especialmente, de los medicamentos), la costo-efectividad y el impacto presupuestario, así como describir los modelos matemáticos diseñados para traducir los datos de este programa en un enfoque óptimo para la prestación y el financiamiento de los servicios de atención de la hipertensión, especialmente en países de ingresos medianos y bajos. Los primeros resultados indican que las intervenciones de HEARTS para el control de la hipertensión son de bajo costo o costo-eficaces, que el conjunto de medidas HEARTS es asequible, a un precio que oscila entre US$ 18 y US$ 44 al año por paciente tratado, y que los medicamentos antihipertensivos podrían tener un precio lo suficientemente bajo como para alcanzar un estándar medio mundial de <US$ 5 por paciente al año en el sector público. Estos datos del ámbito de la economía de la salud serán argumentos convincentes para que los gobiernos se involucren en los programas de control de la hipertensión a escala nacional y les brinden apoyo financiero.

RESUMO Geralmente, os programas de controle de hipertensão são custo-efetivos, inclusive em países de baixa e média renda, mas os governos dos países e a sociedade civil provavelmente não apoiarão tais programas a menos que demonstrem valor em termos de benefícios à saúde pública, impacto orçamentário e retorno sobre o investimento no contexto individual do país. A Organização Mundial da Saúde (OMS) e a Organização Pan-Americana da Saúde (OPAS) criaram a Global HEARTS, uma abordagem padrão e simplificada ao controle da hipertensão arterial, que inclui medicamentos anti-hipertensivos preferidos e dispositivos para aferição da pressão arterial preferidos. O objetivo deste estudo é relatar os estudos de economia em saúde que analisaram o custo (especialmente custos de medicamentos), custo-benefício e impacto orçamentário do pacote HEARTS para controle da hipertensão e descrever modelos matemáticos elaborados para traduzir os dados do programa de controle de hipertensão em uma abordagem ideal para a prestação e financiamento de serviços de atenção às pessoas com hipertensão, especialmente em países de baixa e média renda. Os primeiros resultados sugerem que as intervenções HEARTS para controle da hipertensão são de baixo custo ou custo-efetivas, que o pacote HEARTS é acessível (custando de US$ 18 a 44 por pessoa tratada por ano) e que o preço dos medicamentos anti-hipertensivos poderia ser baixo o suficiente para atingir uma média global de <US$ 18 por paciente por ano no setor público. Estas evidências do campo da economia em saúde serão um argumento convincente para que os governos se responsabilizem por programas de controle de hipertensão em escala nacional e os dotem de recursos financeiros.

Morphological and Morphometric Study of Foramen Ovale and Foramen Spinosum in Human Skull

Introduction: Foramen ovale and spinosum are the importantforamina located in the base of skull on the greater wing ofsphenoid. Foramen ovale transmits the mandibular nerve,accessory meningeal artery, lesser petrosal nerve, emissaryvein and occasionally the anterior trunk of the middlemeningeal vein. Foramen spinosum gives passage to middlemeningeal vessels and nervous spinosus. Study of anatomicalvariations of these foramina provides important informationuseful in skull base injury and helpful for procedures liketransfacial fine needle aspiration technique, percutaneoustrigeminal rhizotomy for trigeminal neuralgia, etc.Materials and Methods: 60 dry human skulls were obtainedfrom the department of anatomy, SMS Medical College, Jaipur.The anteroposterior (APD), transverse diameter (TD) offoramen ovale and spinosum were measured by verniercalipers and shapes were observed. Mean and range werecalculated and tabulated.Observations and Results: The mean length of foramenovale was 7.98 mm and 4.24 mm on right side and 7.14 mmand 3.78 mm on left side. Most common shape observed wasoval (74%). The mean length and width of foramen spinosumwas 3.14 mm and 2.68 mm on the right side and 3.05 mm and2.58 mm on left side. The most common shape observed wasrounded (58.5%).Conclusion: No significant difference was found between theforamen spinosum of both sides whereas significant differencewas observed in the size of foramen ovale. The knowledge offoramina is helpful for the neurosurgeons and radiologists.

Overview and project highlights of an initiative to integrate diabetic retinopathy screening and management in the public health system in India

Purpose: Diabetes is a public health concern in India and diabetic retinopathy (DR) is an emerging cause of visual impairment and blindness. Approximately 3.35–4.55 million people with diabetes mellitus (PwDM) are at risk of vision-threatening DR (VTDR) in India. More than 2/3 of India's population resides in rural areas where penetration of modern medicine is mostly limited to the government public health system. Despite the increasing magnitude, there is no systematic screening for the complications of diabetes, including DR in the public health system. Therefore, a pilot project was initiated with the major objectives of management of DR at all levels of the government health system, initiating a comprehensive program for the detection of eye complications among PwDM at public health noncommunicable disease (NCD) clinics, augmenting the capacity of physicians, ophthalmologists and health support personnel and empowering carers/PwDM to control the risk of DR through increased awareness and self-management. Methods: A national task force (NTF) was constituted to oversee policy formulation and provide strategic direction. 10 districts were identified for implementation across 10 states. Protocols were developed to help implement training and service delivery. Results: Overall, 66,455 PwDM were screened and DR was detected in 16.2% (10,765) while VTDR was detected in 7.5%. 10.1% of those initially screened returned for the next annual assessment. There was a 7-fold increase in the number of PwDM screened and a 7.6-fold increase in the number of PwDM treated between 2016 and 2018. Conclusion: Services for detecting and managing DR can be successfully integrated into the existing public health system.

Comparative Evaluation of Conventional Approach Versus Paraglossal Approach for Routine Anesthesia

Background: Paraglossal technique was described as early as 1930 but is seldom taught now or practiced. AIM: To evaluate the effectiveness of paraglossal technique over conventional approach and to evaluate the ease of insertion and glottic view obtained. Methods: This Randomized Controlled Trial, was done after taking informed consent 140 patients scheduled for elective surgery under general anesthesia were enrolled for the study. They were randomly divided into Group P: Intubation was performed using paraglossal approach with Miller blade and Group C: Intubation was done using conventional larynogoscopy technique with Mcintosh blade. Comparisons were made in improvement in Cormack Lehane grade, intubation difficulty score, time taken for intubation and complications if any. Results: Cormack Lehane Grade I was obtained in 97.1% subjects in paraglossal group as compared to 67.1% in group C (p=0.02). Time taken for intubation was significantly more in group C (p=0.014). The ease of intubation on Likert scale was graded as 1 (1-2) and 1 (1-1) for Group P and C respectively. Conclusion: Paraglossal approach improves the glottic visualization and also leads to successful intubation. We recommend that paraglossal approach be taught to anesthesia residents as an alternative technique so that it can be used with confidence if conventional laryngoscopy fails.

Evaluation of the Role of Pre-Operative Ketamine Gargle to Control URTI in Patients with Endotracheal Intubation

Background: Postoperative sore throat is a common and disturbing complication after endotracheal intubation, leading to patient discomfort and dissatisfaction. Objective: To find out the efficacy of ketamine gargles in reducing the incidence and severity of postoperative sore throat after endotracheal intubation. Methods: We studied the role of preoperative ketamine gargles for reducing postoperative sore throat. Patients undergoing elective abdominal and pelvic surgery under general anaesthesia with endotracheal tube were included in the study. They were randomly allocated in two groups, each group comprising of 30 patients. Group 1 received preservative free ketamine 50mg in 29 ml distilled water. Group 2 gargled with 30 ml distilled water. Patients were asked to gargle for 30 seconds, 5minutes before induction of anaesthesia. Postoperatively sore throat was assessed at 0, 4, 8 and 24 hours after extubation. The severity of sore throat was assessed from mild to severe. Results: Immediately after extubation, 90% patients in group 2 had sore throat compared to 66.7% in group 1. 24 hours after extubation, the incidence decreased to 50% in group 2 and 13.3% in group 1. Similar decrease incidence was noted at 4 and 8 hours post extubation in group 1. No patient in group 1 complained of change in voice or hoarseness of voice. Conclusion: We found that preoperative gargling with ketamine is a simple and cost effective way to reduce the incidence and severity of postoperative sore throat.

Evaluation and comparison of surface characteristics of commercially available TMA wires using scanning electron microscopy and optical profilometer

Aim: The aim of this study was to evaluate and compare the surface characteristics of colored titanium molybdenum alloy archwires (purple-coated TMA and honey dew-coated TMA) and the regular titanium molybdenum alloy archwires. Materials and Methods: The experiment comprised three groups, Group I – regular TMA archwires, Group II – purple-coated TMA archwires, Group III – honey dew-coated TMA wires involving 21 samples each. The surface characteristics were assessed using scanning electron microscopy and optical profilometer. Results: The results were statistically analyzed using analysis of variance wherein Group I regular TMA wires exhibited a root mean square value of 148.071 nm and a standard deviation of 9.0027 nm followed by group II (purple-coated TMA wires) which showed a root mean square value of 84.095 nm with a standard deviation of 2.6005 nm, while group III (honey dew-coated TMA wires) was found to have a root mean square value of 71.681 nm with a standard deviation of 1.4645 nm on subjecting to optical profilometry. Conclusion: The surface roughness is higher for regular TMA wire exhibiting superior characteristic of color-coated TMA wires, especially honey dew-coated TMA wires over the regular and purple-coated TMA wires. This property of the archwires details regarding its application in both sliding and frictionless mechanics in retraction phase of fixed orthodontic treatment.

Meta-analysis of genomic variants and gene expression data in schizophrenia suggests the potential need for adjunctive therapeutic interventions for neuropsychiatric disorders

Schizophrenia (SZ) is a debilitating mental illness with a multigenic aetiology and significant heritability. Despite extensive genetic studies, the molecular aetiology has remained enigmatic. A recent systems biology study suggested a protein–protein interaction network for SZ with 504 novel interactions. The onset of psychiatric disorders is predominant during adolescence, often accompanied by subtle structural abnormalities in multiple regions of the brain. The availability of BrainSpan Atlas data allowed us to re-examine the genes present in the SZ interactome as a function of space and time. The availability of genomes of healthy centenarians and nonpsychiatric Exome Aggregation Consortium database allowed us to identify the variants of criticality. The expression of the SZ candidate genes responsible for cognition and disease onset was studied in different brain regions during particular developmental stages. A subset of novel interactors detected in the network was further validated using gene expression data of post-mortem brains of patients with psychiatric illness. We have narrowed down the list of drug targets proposed by theprevious interactome study to 10 proteins. These proteins belonging to 81 biological pathways are targeted by 34 known Food and Drug Administration-approved drugs that have distinct potential for the treatment of neuropsychiatric disorders. We also report the possibility of targeting key genes belonging to celecoxib pharmacodynamics, Gα signalling and cGMP-PKG signalling pathwaysthat are not known to be specific to SZ aetiology.

Common operation, uncommon complication. Bleeding from superior haemorrhoidal artery after minimally invasive procedure for hemorrhoids - a case report / Operação comum, complicação incomum. Sangramento de artéria hemorroidária superior após PMIH - um relato de caso

ABSTRACT Minimally invasive procedure for hemorrhoids is one of the commonest new wave operations done for prolapsed hemorrhoids. The diameter of the stapled tissue is critical in this operation, and an increase in the same could include more tissue in the anvil, with disastrous results. This is a case report of a post minimally invasive procedure for hemorrhoids bleed, which was refractory to two local oversewing attempts. When the bleeding was massive, an angiogram was obtained. This revealed a pseudo aneurysm of the left superior haemorrhoidal artery, which was embolized, stopping the bleed. The stapler dimensions were studied and the possible cause of the event was arrived at. The specific stapler used had a diameter of 2 mm more than the regular Medtronic and Ethicon staplers, possibly including more of the rectal wall, and the superior haemorrhoidal artery as well. This case report documents a rare and potentially fatal complication of a simple procedure.

RESUMO O procedimento minimamente invasivo para as hemorroidas (PMIH) é uma das novas operações mais comuns para ao tratamento de hemorroidas prolapsadas. O diâmetro do tecido grampeado é crítico nessa operação; um aumento nesse diâmetro poderia colocar mais tecido na bigorna do grampeador, com resultados desastrosos. Este relato de caso descreve o desfecho de uma hemorragia após PMIH, refratária a duas tentativas locais de sobressutura. Um angiograma foi realizado quando a hemorragia foi considerada intensa. O exame revelou um pseudoaneurisma da artéria hemorroidária superior esquerda, que foi embolizada, interrompendo o sangramento. As dimensões do grampeador foram estudadas e descobriu-se a possível causa do evento. O grampeador específico usado tinha um diâmetro 2 mm maior do que os grampeadores regulares da Medtronic e da Ethicon e possivelmente captou uma área maior da parede retal e a artéria hemorroidária superior. Este relato de caso documenta uma complicação rara e potencialmente fatal de um procedimento simples.

Test Tube or Computed Tomography Gantry - The Better Diagnostic Indicator of Severe Pancreatitis: A Retrospective Cohort Study

Background: Various studies have been done to assess the use of serum amylase, serum lipase, and amylase/lipase (A/L) ratio to differentiate between the causes of pancreatitis. Scoring systems (Ranson’s, Glasgow, and APACHE II) have been developed to assess the severity of pancreatitis. Computed tomography (CT), a gold standard for prognosticating pancreatitis, is expensive and affordability is a concern in developing country like ours. Methodology: We did a retrospective study in a tertiary care hospital to assess the use of A/L ratio to predict the severity of acute pancreatitis and to correlate with the presence on necrosis in comparison to that given by CT. Results: The median A/L ratio was higher among those with severe and necrotizing pancreatitis, 0.19 (interquartile range [IQR] 0.124–0.304) and 0.183 (IQR 0.117–0.300), respectively. Cutoff of 0.14 was taken, based on the receiver operating characteristic curves, which could predict severity with 75% sensitivity and 53% specificity and necrosis with 73% sensitivity and 55% specificity. Higher A/L ratio correlated with a decrease in hematocrit (P = 0.08), blood glucose (P = 0.042), and aminotransferase (P = 0.03), which are indicators of clinical severity. Increase in A/L ratio had an increased trend to a longer duration of stay and a higher chance of detecting multiorgan dysfunction syndrome. Conclusions: A/L ratio of >0.14 can be used as a predictor of severity as it indicates the presence or absence of necrosis, which further aids in referral and the need for a CT scan in low-resource settings

Cardiac arrest in the prone position caused by central venous cannulation-induced cardiac tamponade / 대한마취과학회지

No abstract available.

Subcutaneous Glomus Tumor Of Chest Wall

Glomus tumors are known to occur in the subungual region of fingers. Extradigital occurrences have been reported in the past but are rare. Occurrence in the anterior chest wall has not been reported. We report a case of subcutaneous glomus tumor occurring in the anterior chest wall in a 47-year-old gentleman, suffering from pain for 2 years without diagnosis, who was successfully treated by excision biopsy

A study of Brain Natriuretic Peptide levels in acute cardiac failure

Background: The clinical diagnosis of heart failure may be difficult and may pose a particular challenge in patients presenting with acute shortness of breath (SOB) in the emergency department (ED). The present study was done to identify easily the heart failure patients and their prognostication by doing BNP level. Materials and methods: The study group consisted of patients 50 patients presenting to the hospital with acute cardiac failure diagnosed on the basis of Framingham Criteria and excluded the patients with creatinine level >2mg/dl. Results: We found high BNP levels in patients with high NYHA class of failure, high CPKMB value, more LVEDD, low ejection fraction, diastolic dysfunction and mortality is also high in those patients. Conclusion: This study showed higher value of BNP level in patients with low ejaction fraction, with diastolic dysfunction, with higher NYHA class and with higher mortality. We can recognize the importance of BNP level as a marker of both diagnostic and prognostic significance. The value of such an investigation in the overall treatment of acute Dyspnea on Exertion in the emergency department cannot be understated. BNP levels can help doctors in the ED to both effectively and conclusively diagnose and prognosticate heart failure.

Portosystemic collateral pathways and interventions in portal hypertension

Pathologic increase in portal pressure can be caused by increased resistance to blood flow at the level of the portal vein (pre-hepatic), hepatic sinusoids (hepatic) or hepatovenous outflow (post-hepatic). This results in recruitment and dilatation of tiny portosystemic collateral pathways, diverting portal venous blood flow to low pressure systemic veins. Based on the location of the causative factor of portal venous resistance, different collateral pathways and shunts may develop, resulting in unique syndromes of portal hypertension and in-turn requiring unique treatment options. Knowledge of the common and less-common portosystemic collateral pathways have important implication for clinicians and interventionalists. The objective of this pictorial review is to illustrate the various collateral pathways using diagrammatic and conventional non-invasive and invasive radiologic examples. Additionally, we will briefly address minimally invasive interventional techniques used to treat the sequelae of portal hypertension.

The Importance of the Sagittal Diameters of the Cervical Spinal Canal in Relation to Spondylosis and Myelopathy.

Background: The pre existing sagittal diameter is the distance from the middle of the posterior part of the vertebral body of each vertebra to the midpoint of corresponding lamina. The absolute diameter is the distance from the posterior aspect of spondylotic spur to the closest point in spinolaminar line at the particular inters space. They found in their study that pre existing sagittal diameter of 16.4 mm to 12.4 mm at C5 and the absolute diameter of 14.8 mm to 12.6 mm at C5-6 interspace. To study the importance of the sagittal diameters of the cervical spinal canal in relation to spondylosis and myelopathy. Methods: This study consisting of evaluation of initial and decreased sagittal diameters of cervical spines and its correlation with cervical spondylosis with and without myelopathy. The material of this analysis consisted of 150 patients who attended the outpatient department of the hospital. A detailed clinical examination was done in all the patients who included clinical history, general and systemic examination. Major groups under this study were the patients referred by a clinician with a provisional diagnosis of cervical spondylosis. A random survey of patients visited the Department of Radiology without any complaints were done, they were evaluated radiologically. While undertaking the radiological examination, we observed a specific proforma. Results: When multiple discs were involved, C5 – C6 disc involvement along with C4 – C5 was more common. When single disc involvement was there, then C5 – C6 disc involvement was maximum. Conclusion: The initial size of the canal may be an etiological factor in the development of cervical myelopathy.

Radiological Profile of Patients with Benign Prostate Hypertrophy.

Background: As TRUS-guided prostate biopsy is associated with significant complications, preventing unnecessary biopsies becomes very important. TRUS-guided prostate biopsies also raise the diagnostic rate of clinically insignificant prostate cancer. Objective: To study the radiological profile of patients with benign prostatic hyperplasia. Methods: A hospital based cross sectional study was carried out among 40 patients. Their informed consent was obtained. The patients were referred from Urology department. Digital rectal examination and trans rectal ultrasonography was performed for all patients. The results were expressed as percentages. Results: 24 patients were in the age group of 51 to 71 years. The least age group subjected to in the study was the patients below the age of 40 years. 35% of the patients studied in the present study had diffuse enlargement of the prostate. In addition, it can be observed that 65% of the patients studied in the present study had focal nodular benign prostatic hyperplasia. Conclusion: Benign prostatic hyperplasia was found common in the elderly patients.

Single-incision multi-port appendectomy for a patient with situs inversus totalis: first case report

Situs inversus totalis [SIT] is a rare autosomal recessive condition involving the complete lateral transposition of the organs. When individuals with this condition suffer from appendicitis, associated pain and symptoms are usually present on the left side, resulting in diagnostic difficulties. Moreover, the laparoscopic removal of the left-sided appendix may pose practical problems during surgery. Removal of an inflamed appendix is generally performed using a multiple-port laparoscopy. We report a 22-year-old male who presented to the Lifeline Institute of Minimal Access Surgery in Chennai, India, in April 2015 with pain in the left iliac fossa. Chest X-rays and ultrasonography confirmed SIT with an acutely inflamed appendix on the left side. The patient underwent a single-incision multi-port laparoscopic appendectomy with a successful outcome. To the best of the authors' knowledge, this is the first report in the literature of a single-incision multi-port appendectomy in a patient with SIT