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Introduction: Rickshaw pulling is among the major activities in the informal sector. Cycle rickshaw pulling involves the task of prolonged sitting, fixed posture, and vibrations which could increase the risk of developing many health problems including one of the major problems of musculoskeletal disorder (MSD). Rickshaw pulling remains important for urban transport system, and such activities contribute in terms of employment and transportation services. The injury and illness resulting from work leads to lower productivity and quality employment which force them to increase their daily hours of working. The work environment and various other environmental determinants for MSD were assessed. The spatial variability of these environmental determinants and MSDs of cycle rickshaw pullers was studied in Delhi. Material and Methods: A cross-sectional study was conducted among cycle rickshaw pullers of Delhi. Five districts were randomly selected, and out of 448 study subjects, a total of 425 were included in the study. Consent was obtained before the study. The Nordic Musculoskeletal Questionnaire instrument for MSDs was used. The spatial distribution of MSD and risk factors was studied using QGIS software. Results: MSD was observed in 51.5% of the cycle rickshaw pullers and the prevalence increased with age from 9.6% to 34.7%. A statistically significant association of MSD with duration of work, sleeping hour, and sleeping place was observed. Poor road condition and posture were also having an association with MSD. Conclusion: Every second cycle rickshaw puller was having MSD. Lifestyle, road conditions, harsh environmental condition, strenuous physical exertion, and ergonomics of the cycle rickshaw were important factors contributing for MSD.
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The exponential increase in world population and average human lifespan is expected to result in geriatric population globally. The problem of preventable blindness due to cataract will increase manifold. Simultaneous Bilateral cataract surgery (SBCS) is a viable option in such subset of patients. Despite faster visual recovery, economic benefits to patients and health care providers, decreased risk of complications associated with General anaesthesia, there is significant resistance in accepting SBCS as a routine procedure. Bilateral endophthalmitis is the main deterrent in performing ISBCS. This case highlights successful ISBCS in 36 years old female patient with Down抯 syndrome.
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Congenital inguinal hernia repair is one of the most commonly encountered paediatric surgical procedures. With advancements in minimal access surgery, there is an increasing inclination towards the repair of paediatric inguinal hernia (PIH) laparoscopically over an open procedure. Currently, a single port laparoscopic percutaneous extraperitoneal closure, a simple and reliable method, is being used widely. METHODS100 patients with PIH were treated using a single port LPEC technique from August 2014 to July 2018. The study was conducted with a modified LPEC technique using a Tuohy needle. The deep ring was encircled with the help of Tuohy needle under laparoscopic visualization and a suture was passed through it. The needle was then used to encircle the ring from the opposite side and the initial suture was retrieved with the help of a loop, and a purse string was created to obliterate the deep ring with extracorporeal knotting. RESULTS100 congenital hernias were repaired by LPEC method. Mean age was 5.85 ± 2 years. Male to female ratio was 7.3 : 1. 96% of cases were unilateral and 4 % were bilateral preoperatively. PPV was found in 8% of cases intraoperatively. Mean operating time was 22.08 ± 10.2 and 27.6 ± 11.47 minutes for unilateral and bilateral cases respectively. There were no intraoperative complications and no recurrences. Only one patient developed wound infection. CONCLUSIONSLPEC of hernial sac using a Tuohy needle is a safe and effective method for the repair of PIH. It is easy to perform, faster, and offers good cosmesis with cure for imminent contralateral hernias.
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Introduction: The management of varicose veins haschanged rapidly in recent years. Conservative therapy istypically the first-line treatment for many patients withsymptomatic varicose veins. The present study was conductedfor retrospectively analyzing the profile of varicose vein andits management.Material and methods: A total of 100 patients within the agegroup of 15 to 65 years with varicose vein complications wereincluded. Complete demographic details of all the patientswere obtained from the data record files. Clinical details werealso obtained. A Performa was made and results of routineinvestigations were recorded. Details regarding the treatmentprotocol used (conservative, sclerotherapy, surgical) andfollow-up data was also recorded separately. Patients were notwilling and unfit for surgery and patients with complicationsaccording to data record files, were treated by conservativemanagement.Results: Dilated veins only were found to be present in 18percent of the patients while dilated veins with pain waspresent in 64 percent of the patients. Dilated veins withulcerations and dilated veins with bleeding were present in40 percent and 8 percent of the patients respectively. In 33patients undergoing Sclerotherapy, complete response wasseen in 17 patients, recurrence was seen in 6 patients whilethe remaining 10 patients did not come back on follow-up. In31 patients undergoing surgical therapy, complete resolutionat time of discharge was seen in 28 patients while residualvaricosities were seen in 3 patients.Conclusion: Varicose veins are a frequently encounteredpathology affecting the middle aged group with commonestpresentation being unilateral limb involvement. Hence agood clinical assessment with investigations is necessary forreducing the morbidity associated with it.
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Introduction: Chronic abdominal pain which is difficult to diagnose initially not only encumbers the patient but it also affectstheir daily routine, leading to physical and psychological disability, here comes the role of diagnostic laparoscopy which provesto be beneficial aiding in diagnosing most of these cases. Hence, the aim was to evaluate the diagnostic value of laparoscopyin cases with chronic abdominal pain.Materials and Methods: This study was done in the Department of General Surgery at Indira Gandhi Institute of Medicalsciences, Patna, Bihar, from July 2019 to March 2020 in 40 patients. Prior Institutional Ethical Committee approval was alsoobtained for this study.Results: Out of 40 patients included in this study, maximum number of patients were females. Male-to-female ratio was 1:1.4.The maximum number of patients were in the age group of 21–40 years (60%). Maximum patients 45% (n = 18) had complaintof pain in the right lower quadrant of abdomen. The most common finding during diagnostic laparoscopy was found to bepathology in the appendix accounting for 27.5% of cases (11/40).Conclusion: Diagnostic laparoscopy is a safe and effective tool to establish the etiology of chronic abdominal pain and allowsfor appropriate interventions. It can serve as a time saving and cost-effective implement for these patients.
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Background: Caesalpinia bonduc (CB) is said to ownvarious pharmacological and therapeutic applicationagainst a number of diseases. It is used widely in folkmedicine to treat liver diseases. In the present study,we have made a sincere effort to evaluate thehepatoprotective activity of CB leaf extracts againstParacetamol (PCM) induced toxicity and theirmechanism of hepatoprotection in the humanHepatocarcinoma cells (HepG2 cells) therebyproviding scientific evidence for the same. Materialand Methods:The hepatoprotective activity of CB wasassessed in-vitro by the estimation of glutathione(GSH) and Malondialdehyde (MDA), anti-apoptoticassay/Annexin V and the expressions of genes such asGlutathione Reductase (GS-R) and GlutamateCysteine Ligase, Catalytic (GCLC). Results: Theobtained results suggest that the aqueous extract of CBpossess significant hepatoprotective activity. Thisactivity may be due to the possible antioxidantproperty and the free radical scavenging ability of theextracts, which might clear the toxic metabolites ofPCM. Conclusion: The present study suggests that theaqueous extract of CB have potential hepatoprotectiveactivity, which may prevent the lipid peroxidation ofthe cell membrane by its antioxidant properties.
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Chronic administration of glucocorticoids produces cachexia like symptoms such as muscular dystrophy, weight loss and skeletal muscle dysfunction. However, only limited options are available for treatment of this disease. One of the tea catechins, epigallocatechin-3-gallate attenuated skeletal muscle atrophy in cancer cachexia. In this context, we explored here (+)-catechin hydrate (catechin) for of its anticachectic activity in dexamethasone induced muscle dystrophy. Dosing of catechin at 100 mg/kg p.o. was continued for 5 days along with a daily dosing of dexamethasone at 0.6 mg/kg i.p. On the 6th day, animals were assessed for cachectic condition using changes in body weight, functional aspect of skeletal muscle such as muscle integrity, locomotor activity, handgrip strength, glucose uptake, responsiveness of skeletal muscle to acetylcholine, by estimating inflammatory parameters such as nitrite, myeloperoxidase in the gastrocnemius muscle and by evaluating plasma biochemical parameters such as triglycerides, total protein, albumin, creatinine, urea and IL-6 levels. Except for a few parameters, such as body weight, glucose uptake by hemi-diaphragm and triglyceride level, remaining parameters were significantly reversed by catechin treatment. The underlying mechanism of the myoprotective action of catechin has been postulated by the increased sensitivity of muscle to acetylcholine as demonstrated in this study, which might be responsible for prevention of muscle inflammation.
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Cancer is a complex disease characterized by a loss in the normal cell regulatory mechanisms that govern cell survival, proliferation, and differentiation. Current chemotherapeutics, as anticancer agents, are developing resistance to single drug and also to treatment therapies involving multiple drugs. Cross resistance associated with the specificity and selectivity of existing drugs has restricted the application of chemotherapy. Alternatively, these limitations have given better insight in understanding the underlying molecular mechanisms responsible for the development of various stages in cancer. In the light of this, continuous efforts are being made in order to identify and validate newer anticancer targets. This review presents some of the important targets that have been already reported, such as aromatase, farnesyl transferase, histone deacetylase, tyrosine kinase and cyclin-dependent kinase. A few molecules designed against these targets have successfully reached clinical trials. However, only limited marketed drugs are available from these classes. Besides, the review also highlights some of the other important targets and strategies that have also drawn considerable attention in the area of anticancer drug development such as, cancer stem cells and monoclonal antibodies. Further, the integration of the tools in molecular biology with the results from preclinical and clinical trials would strengthen the effectiveness of treatment regimens in cancer patients. There lies a much scope for designing promising lead compounds and treatment therapies against these established targets.