A Prospective Study of Common Surgical Problems in Geriatric Patient with Special Reference to Gastrointestinal Tract Diseases in Vindhya Region

Background: Aging is a continuous process which begins with conception and ends with death. It is said that nobody grows oldmerely by living a certain number of years, while aging merely stands for growing. The health problems to be considered shouldinclude – physical, mental, emotional, and socioeconomical. Old age is not a disease but the aged people are often vulnerableto long-term diseases such as cardiovascular, cerebrovascular, respiratory, gastrointestinal, cancers, mental derangement,hearing and visual loss, and conditions affecting the locomotor system. Aim of this study is to analyze the common surgicalproblems in geriatric patient with special reference to gastrointestinal tract (GIT) diseases in Vindhya region.Materials and Methods: A total of 1585 cases were studied with common surgical geriatrics problems admitted in the surgicalwards in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa (MP), India, in the periodfrom 1 June 2018 to 31 May 2019. The proposed study includes patients with age 60 years and above who will be admittedthrough surgical outpatient department, casualty and/or will be transferred from other departments. After admission of patients,particular will be recorded and they will be also inquired for chief complaints with duration, history, drug history, personal history,and family history. Their findings will be recorded in a pro forma.Results: Of 10,887 patients admitted in Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa(MP), India, during the period of 1 June 2018–31 May 2019, in which common surgical problems were diagnosed in 1585 patients(14.55%), among which most of the patients were males (1137) and rest were females (448). Most of the patients belonged to 60–64years of age group. From this study, intestinal obstruction among GIT diseases was found to be the most common surgical problem.Conclusion: Majority of elderly patients admitted with GIT disorders were having intestinal obstruction (22.17%), followedby PUD (21.47%), peritonitis (17.09%), malignant lesions and hemorrhoids (9.23%), and colitis (6.92%). Of sex-wise totaladmission. The incidence of intestinal obstruction (26.11% vs. 20.40%) and colitis (14.92% vs. 3.34%) was more common infemale than male. Whereas PUD (23.41% vs. 17.16%) and perforation peritonitis (19.06% vs.12.68%), hemorrhoids were morecommon in male than female.

Endoscopic Third Ventriculostomy in Hydrocephalus: An Institutional Experience in Tertiary Care Centre

Introduction: Hydrocephalus is a clinical condition in which anexcess of CSF fluid accumulates within the ventricular systemof the brain. The treatment of hydrocephalus depends onpatient’s clinical condition and etiology. Neuroendoscopy isbecoming more widely used for diagnostic and therapeuticpurposes of many different conditions including treatment ofhydrocephalus.Materials and Methods: This prospective study of 52 patientswas carried to analyze the safety and efficacy of EndoscopicThird Ventriculostomy (ETV). 24 cases of obstructive and 28cases of communicating hydrocephalus underwent ETV.Results: Most (43%) of the patients were less than 10 years ofage. 59% of patients having obstructive hydrocephalus andonly 28% of patients having communicating hydrocephalus hadgood outcome.Conclusion: ETV should be considered as first line oftreatment in patients of obstructive hydrocephalus.

Comparison of the Cardiomyogenic Potency of Human Amniotic Fluid and Bone Marrow Mesenchymal Stem Cells

BACKGROUND AND OBJECTIVES: Most studies in cardiac regeneration have explored bone marrow mesenchymal stem cells (BM-MSC) with variable therapeutic effects. Amniotic fluid MSC (AF-MSC) having extended self-renewal and multi-potent properties may be superior to bone marrow MSC (BM-MSC). However, a comparison of their cardiomyogenic potency has not been studied yet.METHODS: The 5-azacytidine (5-aza) treated AF-MSC and BM-MSC were evaluated for the expression of GATA-4, Nkx2.5 and ISL-1 transcripts and proteins by quantitative RT-PCR and Western blotting, respectively as well as for the expression of cardiomyogenic differentiation markers cardiac troponin-T (cTNT), beta myosin heavy chain (βMHC) and alpha sarcomeric actinin (ASA) by immunocytochemistry.RESULTS: The AF-MSC as compared to BM-MSC had significantly higher expression of GATA-4 (183.06±29.85 vs. 9.80±0.05; p<0.01), Nkx2.5 (8.3±1.4 vs. 1.82±0.32; p<0.05), and ISL-1 (39.59±4.05 vs. 4.36±0.39; p<0.01) genes as well as GATA-4 (2.01±0.5 vs. 0.6±0.1; p<0.05), NKx2.5 (1.9±0.14 vs. 0.8±0.2; p<0.01) and ISL-1 (1.7±0.3 vs. 0.9±0.1; p<0.05) proteins. The AF-MSC also had significantly elevated expression of cTNT (5.0×10⁴±0.6×10⁴ vs. 3.5 ×10⁴±0.8×10⁴; p<0.01), β-MHC (15.7×10⁴±0.9×10⁴ vs. 8.2×10⁴±0.6×10⁴; p<0.01) and ASA (18.6×10⁴±4.9×10⁴ vs. 13.1×10⁴±3.0×10⁴; p<0.05) than BM-MSC.CONCLUSIONS: Our data suggest that AF-MSC have greater cardiomyogenic potency than BM-MSC, and thus may be a better source of MSC for therapeutic applications in cardiac regenerative medicine.

A comparative study of 075% ropivacaine and 05% bupivacaine for epidural anesthesia in patients undergoing lower abdominal and lower extremity surgeries

Background: Regional anaesthesia has come to occupy an important part in clinical anaesthesiology today. As with other fields, regional anaesthesia too has undergone major developments both in techniques and drug availability. Aim: To study and compare the effect of 0.75% Ropivacaine with 0.5% Bupivacaine for epidural anaesthesia in patients undergoing lower abdominal and lower extremity surgeries with respect to the following factors, Onset and Duration of Sensory Block and Onset and Duration of Motor Block. Materials and Methods: To conduct this study, it was decided to consider a random sample of at least sixty (60) patients of either sex between the age of 20-65 years belonging to the American Society of Anaesthesiologists (ASA) physical status I or II scheduled to undergo elective surgery. The study was conducted to compare 0.75% Ropivacaine and 0.5% Bupivacaine for epidural anaesthesia in lower abdominal and lower extremity surgeries across the following parameters; Time taken for the onset of sensory block T12, Time taken for maximum height of sensory block T6, Time C. Geetha, L. Umapradeepa, K. Chandra Prakash, R. Pandu Naik. A comparative study of 0.75% ropivacaine and 0.5% bupivacaine for epidural anesthesia in patients undergoing lower abdominal and lower extremity surgeries. IAIM, 2017; 4(11): 250-258. Page 251 taken for two dermatome segment regression, Time taken for regression up to T12, Time taken for the onset of maximum motor block and Duration of motor block. Results: The onset time for sensory block up to T12 and up to the maximum height of T6 were found to be statistically insignificant; there was no difference in the effect of both the drugs. The two dermatome segment regression and regression up to T12 were statistically significant; it was prolonged in the case of Ropivacaine compared to Bupivacaine. The onset of motor block was statistically significant and was found to be faster in the case of Bupivacaine. The duration of the motor block was also statistically insignificant and it was the same for both the drugs. Conclusion: From these results, this study provides a reasonable ground to conclude that Ropivacaine and Bupivacaine differ in terms of their onset and duration of both sensory and motor block in epidural anaesthesia. Thus Ropivacaine with its higher efficacy, prolonged sensory blockade, lower propensity for motor blockade, proven reduced potential for CNS toxicity and cardiotoxicity, appears to be an important option for regional anaesthesia, management of post-operative pain, labour pain making it the current local anaesthetic drug of choice

Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated. Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing. Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures. Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.</p><p><b>METHODS</b>This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion. There were 26 males and 6 females and the average age was 40 years. Patients were randomly divided into two groups (n=16 for each): one underwent Ilizarov fixation and the other received LRS fixation. Cases were followed up for 3-24 months, 6 months on average from September 2012 to October 2014. Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.</p><p><b>RESULTS</b>Union was achieved in all cases. Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators. Functional result was satis- factory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs. 31.25%.</p><p><b>CONCLUSION</b>In our short-term assessment, LRS fixators show a better result than Ilizarov fixators in terms of fracture union and functional outcome with soft tissue care and limb length.</p>

Problematic eating and its association with early childhood caries among 46-71-month-old children using Children's Eating Behavior Questionnaire (CEBQ): A cross sectional study .

Context: Problematic eating behavior in children presents a wide spectrum from anorexia, selective eating, and fussy eating to neophobia. Pouching of food and slow eating represents eating behavioral problems that may be relevant to pediatric dentist as far as early childhood caries (ECC) is concerned. Aim: The aim of this study was to determine the prevalence of problematic eating and its association with ECC among 46-71-month-old children in Bengaluru city, India. Settings and Design: A cross-sectional study was carried out in 250 children aged 46-71 months old in various schools of Bengaluru city. Subjects and Methods: All the selected children were clinically examined for dental caries using decayed, missing, filled surfaces index. Children's eating behavior was assessed using Children's Eating Behavior Questionnaire (CEBQ) which was filled by the parents. Statistical Analysis Used: Both descriptive statistics as well as Chi-square test was used with SPSS 16.00. Results: The prevalence of dental caries was found to be 34%. It was observed that 81.6% of the children did not have a tendency to keep food in their mouth all the time and ECC was found to be significantly less. Furthermore, approximately 90% of the children did not have a tendency to eat too much and in those, 68% of them were caries free which was statistically significant. Prevalence of ECC was highest (52.6%) in children who ate more when they had nothing else to do. Conclusion: Problematic eating behavior is prevalent in the preschooler group and needs to be considered by the pediatric dentist.

Study of septic abortion cases at a tertiary centre of Uttarakhand.

Aim of this study was to evaluate the incidence, maternal morbidity & mortality, clinical features, management in cases of septic abortion in a tertiary centre. This study included 37 cases of septic abortion admitted during 5 years from January 2007 to January 2012 in the Department of obstetrics & Gynaecology in Government Medical College, Haldwani. All patients were evaluated with special reference to incidence, etiological factors, clinical features, surgery & maternal morbidity & mortality. The incidence of septic abortion was 1.08%. Common age group was between 26-30 years. Most of the cases were from lower socioeconomic status. Septic abortion following spontaneous abortion was present in 5 cases. Unwanted pregnancy was the indication for termination of pregnancy in 32 cases. 4 women were admitted in state of septic shock. 12 cases required lapratomy for drainage of pus, 3 had hysterectomy, 3 had resection anastomosis & uterus repair was done in 4 cases. Overall maternal mortality was 5 (13.5%).The incidence of illegal and septic abortion can be reduced by increasing awareness about family planning services and making legal abortion services easily available to the women and that too at a cheaper cost.

Pulmonary functions in plastic factory workers: A preliminary study.

Exposure to long term air pollution in the work environment may result in decreased lung functions and various other health problems. A significant occupational hazard to lung functions is experienced by plastic factory workers. The present study is planned to assess the pulmonary functions of workers in the plastic factory where recycling of pastic material was done. These workers were constantly exposed to fumes of various chemicals throughout the day. Thirty one workers of plastic factory were assessed for their pulmonary functions. Parameters were compared with 31 age and sex matched controls not exposed to the same environment. The pulmonary function tests were done using Sibelmed Datospir 120 B portable spirometer. A significant decrease in most of the flow rates (MEF 25%, MEF 50%, MEF 75% and FEF 25-75%) and most of the lung volumes and capacities (FVC, FEV1, VC, TV, ERV, MVV) were observed in the workers. Smoking and duration of exposure were not affecting the lung functions as the non smokers also showed a similar decrement in pulmonary functions. Similarly the workers working for less than 5 years also had decrement in pulmonary functions indicating that their lungs are being affected even if they have worked for one year. Exposure to the organic dust in the work environment should be controlled by adequate engineering measures, complemented by effective personal respiratory protection.

Culture conditions for the production of a-galactosidase by Aspergillus parasiticus MTCC-2796: a novel source / Condiciones del cultivo para la producción de a-galactosidasa por Aspergillus parasiticus MTCC-2796: una nueva fuente

Aspergillus parasiticus microbial type culture collection (MTCC)-2796, a new source of a-galactosidase is an efficient producer of enzyme in basic medium under submerged fermentation conditions. Maximum a-galactosidase production (156.25 Uml-1) was obtained when the basic medium is supplemented with galactose (0.5 percent w/v) and raffinose (0.5 percent w/v) as carbon source and yeast extract as nitrogen source. Enzyme production was also enhanced considerably in the presence of wheat bran (1.0 percent w/v). Enzyme secretion was strongly inhibited by the presence of Hg2+, Cu2+, and Co2+ in the medium and to some extent by Zn2+ and Ni2+, while marginal increase in the enzyme production was observed when Mg2+ and Mn2+ were added in the medium. Among amino acids checked (aparagine, cysteine, glutamine, leucine and proline), glutamine (1 mM) was found to be an enhancer for the enzyme production. The temperature and pH range for the production of enzyme were 25ºC to 35ºC and 6.5 to 7.5, respectively with maximum activity (50 Uml-1) at 30ºC and pH 6.5 under static fermentation condition.

Comparison of terbutaline and salbutamol inhalation in children with mild or moderate acute exacerbation of asthma.

OBJECTIVE: To compare the clinical efficacy and side effects of terbutaline and salbutamol administered by metered dose inhaler and holding chamber in the mild to moderate acute exacerbations of asthma in children. METHODS: The study subjects were children in the age group of 5- 15 years who presented with a mild or moderate acute exacerbation of asthma. Baseline assessment included clinical parameters and spirometry. The children were then randomized to receive salbutamol or terbutaline. Three puffs each of either 100 mcg salbutamol or 250 mcg of terbutaline were administered using 750 ml holding chamber with valve. Thirty minutes after drug administration, the children were reevaluated for clinical parameters and spirometry. RESULTS: Of the total 60 subjects studied, 31 were administered terbutaline and 29 salbutamol. The baseline spirometric parameters were comparable. After drug administration, all the studied variables showed significant improvement within each group. However, there were no statistically significant differences when the two groups were compared with each other. There was no significant difference in the side effects between two groups. CONCLUSION: Terbutaline and salbutamol, when administered by MDI with holding chamber, are equally efficacious in children with mild or moderate acute exacerbation of asthma.