Role of Deep Tension Sutures in Closing the Defect Following Excision of Sacrococcygeal Pilonidal Sinus – A Case Series

Background: The midline sacrococcygeal pilonidal sinus is the common surgical condition among younger population. They present to surgical outpatient department with pain and history of pus discharge from natal cleft. These patients approach for permanent cure following repeated attacks of pain and abscess drainage. We present a new surgical technique of primary closure by applying deep tension sutures (DTS) to close the defect following excision of midline sacrococcygeal pilonidal sinus. The rationale behind this technique is to avoid prolonged hospital stay and early return to work.Materials and Methods: In this study, a group of five patients (one female and four male patients) with the age group between 18 and 35 years was studied for the effectiveness, duration of hospital stay post-operative complications, and recurrence following the new surgical technique of DTS. Following excision of midline sacral pilonidal sinus, the resulting elliptical wound varying from 6 cm to 10 cm was approximated using two or three DTS with No-1 Prolene. In this suturing technique, the sutures were held in place using small pieces of plastic tubing from intravenous drip set to avoid suture cutting through the skin. This technique was similar to abdominal wound closure in cases of complete wound dehiscence. The superficial part of the wound was approximated using No-3 zero Ethilon. In this procedure, author has not used any type of drain in the wound. No suture materials were used inside the wound to approximate the raw area (e.g., Vicryl suture). Patients were covered with IV antibiotics and analgesics for a period of 5 days. All sutures were removed on the 10th day.Results: There were no post-operative complications noted during the hospital stay and during follow-up period ranging from 2 months to 6 months. The scar was healthy with functionally, cosmetically acceptable results. There was no recurrence noted in our study group during the follow-up

An epidemiological study to evaluate morbidity patterns among wood workers belonging to unorganized sector

Background: Wood workers are predisposed to many occupational diseases. Studying work place environment and its association with the morbidities would provide practical insights to promote the health and prevent disease in wood workers. Present study intends to study the epidemiological determinants of health and morbidity in wood workers. Methods: Quantitative method of research is used. All One hundred and five wood workers in the study area were recruited after taking informed consent. A semi-structured, pre-validated, questionnaire consisting of questions on sociodemographic profile, working pattern, morbidities experienced and working environment was prepared. Data was collected using one to one interview at their workplace. Environmental factors like iIllumination (In LUX) and noise level (in db) at the work place was measured using a Lux meter and sound level meter respectively. Association between different variables were analysed using Chi-square test or t-test wherever applicable. Results: Participants were all male belonging to economically productive age group. They were predominantly Muslims, belonging to lower socioeconomic status. Morbidities experienced by the wood workers were musculoskeletal pain (52%), skin problems (57%), eye problems (57.14%) and ear problems (32.38%). Inadequate illumination (<100 LUX) and noise levels more than 90 db were significantly associated with increased accidents and ear morbidities respectively. Conclusions: Poor working environment and non-compliance with the working standards prescribed by ILO (Indian Labour Organisation) are associated with morbidities among the workers. Environmental modification, use of protective devices, availability of basic minimum facilities for working and continuous monitoring of the workplaces by competent authority would help in decreasing the prevalence of morbidities among woodworkers.

Potential of Vigna radiata (L.) sprouts in the management of inflammation and arthritis in rats: Possible biochemical alterations.

Vigna radiata (Fabaceae) is an important pulse crop widespread throughout the tropics and warm temperature regions. In this study, we evaluated the in vitro anti-inflammatory and in vivo antiarthritic activity of Vigna radiata sprouts in rats. The in vitro anti-inflammatory activity was determined by membrane stabilization and protein denaturation method. Whereas, the antiarthritic activity of the ethanolic extract of the sprouts was evaluated by complete Freund’s adjuvant model with diclofenac sodium as the standard drug. Body weights, paw volume, biochemical parameters such as lipid peroxidation, total reduced glutathione, myeloperoxidase and lysosomal enzymes like cathepsin-D, N-acetyl β-D-glucosamindase and β-D-glucuronidase were estimated. Treatment with ethanolic extract of V. radiata exhibited significant membrane stabilization activity and protein denaturation activity, and significantly attenuated the biochemical changes induced by administration of complete Freund’s adjuvant. The findings of the present study suggest the possible role of Vigna radiata in the therapeutics of arthritis.

Study of treatment outcomes in tuberculosis patients on DOTS therapy at five centres in Goa.

Background: The objective was to study the treatment outcomes in tuberculosis patients on DOTS therapy in five centres in Goa in terms of cure rates, treatment completion rates, unfavourable outcomes and factors responsible for unfavorable outcomes. Methods: Study setting: It was a facility based study at five DOTS centres from the Panaji Tuberculosis Unit (TU). Study design: prospective follow up design was used for the study. Study subjects: All patients registered at the selected five DOTS centres for DOTS therapy under RNTCP in the period from 1st April 2011 to 31st December 2011 were selected as study subjects and followed prospectively for a period of nine months till 30th September 2012. Study instruments: data was collected from patients by personal interview and a pretested structured questionnaire. Data was also obtained from patient treatment cards and by interviewing the DOTS provider. Statistical analysis: Data was analysed using SPSS software. The statistical tests used were frequencies, descriptive, Chi square test, odds ratio and logistic regression analysis. Results: Overall 42.9% of the patients were declared cured, 42.3% had treatment completed as the outcome, 4.9% were defaulters, 2.7% patients died, 1.6% were classified as treatment failure, 2.2% were transferred out and 0.5% of the patients were shifted to Non-DOTS treatment regimen while in 2.7% of the patients treatment outcome was not available. Presence of diabetes mellitus, hypertension and alcohol use were found to be significantly associated with unfavourable outcomes in Tuberculosis patients on DOTS. Conclusions: Patients with alcohol addiction and concomitant hypertension were found to have higher levels of un-favourable outcomes; therefore such patients require continuous monitoring and support to ensure treatment success.

cross-sectional study of the sociodemographic profile of juveniles under institutional care in the city of Mumbai

To study the sociodemographic profiles of children under institutional care, identify the characteristic features of the families prone to have destitute children, and suggest measures for prevention of destitution of children in the community. A questionnaire-based cross-sectional study was conducted in a population of 507 boys and girls from 6 to 18 years admitted to four different institutes for care and support. A sample of 170 children was selected using systematic random sampling technique. A survey was done to study the health status of the children. Data was analyzed using SPSS software. Frequency and proportion were calculated and chi square test was used. P value of >0.05 was considered significant. 65.9% of children were in the 6 to 12 age group. 63.5% were Hindu by religion. The majority i.e., 80.9% of the boys and 80% of the girls were urban in origin, 82.4% of the juveniles were from nuclear families, 40.0% of boys and 62.3% of the girl juveniles were from lower socioeconomic status. 75% of boys and 25% of the girls had been child laborers just before institutionalization. Only 12.7% of juveniles were from large families, the rest, the majority [87.3%] were from medium to small sized families. Nuclear families of medium to small size which belong to the lower socioeconomic status and of urban origin were found to be unable to provide care and support to their children putting them at the risk of becoming destitute

Handling of ferric iron by branchial and intestinal epithelia of climbing perch (Anabas testudineus Bloch).

With a view to test how the branchial and intestinal tissues of fish, the two sites of metal acquisition, utilize the water-borne ferric [Fe(III)] iron and whether the accumulation of this form of iron influences cellular Na/K gradient in these tissues, the gills and intestines of climbing perch adapted to freshwater (FW) and acclimated to dilute seawater (20 ppt; SW) were analyzed for ouabain-sensitive Na+, K+-ATPase activity, Fe and electrolyte contents after loading a low (8.95 microM) or high dose (89.5 microM) of Fe(III) iron in the water. The SW gills showed higher levels of total Fe after treating with 8.95 microM of Fe(III) iron which was not seen in the FW gills. Na+, K+-ATPase activity, reflecting Na/K pump activity, showed an increase in the FW gills and not in the SW gills. Substantial increase in the branchial Na and K content was observed in the SW gills, but the FW gills failed to show such effects after Fe(III) loading. The total Fe content was declined in the FW intestine but not in the SW intestine. Water-borne Fe(III) iron decreased the activity of Na+, K+-ATPase in the SW intestine while not changing its activity in the FW intestine. The Na and K content in the FW intestine did not respond to Fe(III) iron exposure but showed a reduction in its Na levels in the SW intestine. The moisture content in the gills and intestines of both the FW and SW perch remained unaffected after Fe(III) loading. In FW fish, the plasma Na levels were decreased by a low dose of Fe(III) iron, though a high dose of Fe(III) iron was required in the SW fish for such an effect. Overall, the results for the first time provide evidence that gills act as a major site for Fe(III) iron absorption and accumulation during salinity acclimation which depends on a high cellular Na/K gradient.

Niveles de hemoglobina y cirugia coronaria: II. Relacion entre concentracion de hemoglobina y angina recurrente despues de cirugia coronaria / Hemoglobin levels and coronary surgery: II. Relationship between hemoglobin concentration and reccurrent angina after coronary surgery

Con el objeto de probar la relacion existente entre bajas concentraciones de hemoglobina y menor riesgo de trombosis despues de cirugia coronaria, y en esta forma menor incidencia de angina recurrente, hemos tomado en cuenta los niveles de hemoglobina en 212 pacientes sometidos a cirugia de injerto aorto-coronario (bypass). La incidencia de angina recurrente encontrada en enfermos con niveles altos de hemoglobina (alrededor de 13-14 g%) fue significativamente mayor en comparacion con aquellos que tuvieron concentraciones relativamente bajas (alrededor de 11 g%), con una significancia estadistica de p<0,001.