ABSTRACT
Background: Surgery is the mainstay of the treatment for perforated duodenal ulcer by closing the perforation with or without omental patch. There are no controversies in the surgical treatment of perforated duodenal ulcer but the best approach to surgery is still debatable. Advances in minimal access surgery has made it possible to close the perforated duodenal ulcer laparoscopically. The present study was conducted to compare the results of open and laparoscopic repair of perforated duodenal ulcer in terms of operative time, postoperative pain, hospital stay, and post-operative complications etc.Methods: The study was conducted in Dr. V. M. Government Medical College and Hospital located in Solapur (Maharashtra) from December 2008 to December 2010. It was a prospective comparative study. Patients were randomly divided into 2 groups alternately where group A and B were operated by conventional and laparoscopic techniques respectively and their outcomes were compared.Results: Most commonly affected age in this study was 51 to 60 years with male preponderance. Post-operative pain, analgesic requirement, wound infection, hospital stay, was significantly less in laparoscopic group as compared to open group (p<0.05).Conclusions: Laparoscopic repair of perforated duodenal ulcer is safe and feasible in properly selected patients and has superior results as compared to open surgery.
ABSTRACT
Background: Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. Hydrocephalus can occur at any age, but it is more common in infants. Long-term complications of hydrocephalus can vary widely and are often difficult to predict and may result in significant intellectual, developmental and physical disabilities. Ventriculoperitoneal shunt remains mainstay of treatment even today as it is easily available and inexpensive.Methods: The study was conducted in Dr. V. M. Government Medical College and Hospital located in Solapur (Maharashtra) from September 2016 to 2018. It was a prospective descriptive study. 30 cases up to the age 14 years with diagnosis of hydrocephalus undergoing VP (ventriculo-peritoneal) shunt surgery were included in the study.Results: Aqueductal stenosis and tuberculous meningitis were the commonest causes of congenital and acquired hydrocephalus in children respectively. Shunt infection and shunt obstruction were the commonest post-operative complications required shunt revision. Low birth weight and other associated congenital anomalies increased the mortality rate.Conclusions: VP shunt placement has been the main treatment modality for hydrocephalus. VP shunts procedures are associated with complications and morbidity. Number of revision shunt procedures, low birth weight, associated congenital anomalies adversely affected the final surgical outcome.
ABSTRACT
Background: Open appendectomy has been the gold standard for the treatment of acute appendicitis since its introduction by Charles Mc Burney in 1889.The introduction of laparoscopic surgery has dramatically changed the field of surgery. Various studies showed conflicting results about the superiority of laparoscopic approach over open for treatment of acute appendicitis. Present study is conducted to determine any possible benefits of the laparoscopic approach over open surgery.Methods: The study was conducted in Dr. V. M. Government Medical College and hospital located in Solapur (Maharashtra) from September 2017 to September 2019. It is a prospective comparative study. Patients were randomly divided into 2 groups alternately where group A and B were operated by conventional and laparoscopic techniques respectively and their outcomes were compared.Results: Mean age of patients in open and laparoscopic appendicectomy group was 29.67 years and 31 years respectively. Post-operative pain, wound infection and hospital stay was significantly more in open group as compared to laparoscopic group (p<0.05).Conclusions: From the results of our study we conclude that laparoscopic appendicectomy has superior results as compared to open appendicectomy.
ABSTRACT
@#Coronavirus Disease 2019 (COVID-19) is an emerging disease and since its first identification in Wuhan, China, in December 2019, there has been a rapid increase in cases and deaths across the world. COVID-19 has been shown to have an immense impact in infected persons with diabetes, worsening their outcome, especially in elderly, smokers, obese, those having CVD, CKD, poor glycemic control and long duration of diabetes. In this review we summarize the current understanding of `the impact of COVID-19 on diabetes and discusses the pathophysiological mechanisms and management of diabetes and its complication in this scenario.
Subject(s)
COVID-19 , Diabetes MellitusABSTRACT
Avascular necrosis (AVN), also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis, is a condition that occurs when there is loss of blood supply to the bone, an interruption to the blood supply causes bone to die. If not stopped this process eventually cause the bone to collapse. It is the most challenging condition of the present era in orthopedics. In Ayurveda it can be co-related with the Asthi Majja Gata Vata due to similar sign and symptoms of Avascular necrosis of neck of femur. Aim and objectives: To assess the efficacy of Manjisthadi Kshara Basti, Rooksha Choorna Pinda Swedana, Pizhichil and Shastikashali Pinda Swedana in the management of AVN. Objective was to stop the further deterioration of the hip joint and to reduce the chances of surgical intervention in managing AVN. Materials and methods: A diagnosed and non operated case of Avascular necrosis of stage 3 with complaints of pain of bilateral hip joint, restricted movements and limping gait approached the out-patient division of the hospital and was managed by Rooksha Choorna Pinda Swedana, Manjisthadi Kshara Basti, Pizhichil and Shastikashali Pinda Swedana. Observation and Result: Significant improvement was noticed after the treatment. Pain was reduced significantly with improvement in range of movement. Patient was able to walk and climb stairs after the treatment without pain and stiffness. There was reduction in VAS scale, marked improvement was noticed in Harris Hip Score.
ABSTRACT
Background: Seizures are the most common indicator of significant neurologic dysfunction in neonatal period with incidence of 11.7/1000 live births. Phenobarbitone is used as first line of treatment since 1900s. Newer anti-epileptic drugs (AED) available are Levetiracetam, Topiramate etc. Present study focused on utilization pattern of AED, treatment outcomes and to study economic burden of disease.Methods: An observational study was done on 100 neonates admitted to Neonatal Intensive Care Unit in Basaveshwara hospital, Kalaburagi (June 2016-May 2017). Prescription data was entered into specially designed proforma, WHO core indicators were determined. The data was analyzed using descriptive statistics and presented as means and percentages.Results: Majority of neonates were male (58%) and 63% were diagnosed with subtle seizure. Out of 458 drugs prescribed, 201 were antiepileptics. 41% cases were successfully managed by monotherapy. Most commonly used drug was phenobarbitone (82%) and phenytoin (31%). Leviteracetam, newer AED was used in 3 refractory cases. The major combination of drugs used was Phenobarbitone-Phenytoin (24%). AED were rationally prescribed, but antibiotic was over-utilized(68%). 31% cases had adverse drug reaction. On average per prescription, number of drugs used were 4.6 and drug cost was Rs.3803/-. The total cost of illness per patient was Rs.16363/-.Conclusions: AED utilization in neonatal seizures was in accordance to guidelines, with phenobarbitone being extensively used despite its potential neurotoxicity. The utilization of newer AED would increase if clinicians are supported with the safety and efficacy data. Although monotherapy was preferred with respect to AED, antibiotics were highly prescribed; hence awareness is needed to curb this practice.
ABSTRACT
Background: Dengue fever (DF) is a serious public health problem, gaining global attention because of its morbidity and mortality. Less studies on Drug utilization pattern of DF in India. The present study was undertaken to analyze Drug utilization pattern of dengue infection in a tertiary care hospital.Methods: A prospective cross-sectional study was conducted for a period of 2 months in a tertiary care hospital and the data was analyzed by using various drug use indicators.Results: A total of 52 prescriptions were analyzed. Male and female were (46.16%, 53.84%), A total of 330 drugs were prescribed. 86 (26.06%) antibiotics, 70 (21.21%) antipyretics, 51 (15.46%) antacids, 19 (5.76%) multivitamins, 52 (15.76%) anti-emetics and 52 (15.76%) papaya leaf extract was prescribed. 84 (25.46%) oral and 246 (74.54%) injectable drugs. IV-fluids given to all patients. 10 (19.24%) were given blood transfusion. 6.17 drugs per prescription. 96% drugs were prescribed by brand names. High DDD for drugs like diclofenac (184), doxycycline (115), metronidazole (2.5), pantoprazole (161.5), rabeprazole (34.6), ondansetron (200) was observed.Conclusions: Most commonly used drugs are antipyretics, antibiotics, antacids, antiemetic, papaya leaf extract. As the incidence of DF is increasing with epidemics, demand for specific treatment guidelines is in great need. Early recognition of the disease, with a rational approach in case management leads good clinical outcome.
ABSTRACT
Bone-specific alkaline phosphatase (B-ALP), a product of osteoblasts, is a bone formation marker whose serum levels fluctuate with puberty and adolescence. Aims: This study aims to assess B-ALP levels in saliva and correlate it with different skeletal maturity stages of hand-wrist radiographs using Hagg and Taranger method. Settings and Design: Observational study and cross-sectional design. Subjects and Methods: Total sample comprised of 90 individuals, right hand-wrist radiographs, and 2 ml unstimulated whole saliva samples taken from each patient on the same day. The hand-wrist radiographs were traced and staged into 5 subgroups (18 individuals each) according to Hagg and Taranger method. Statistical Analysis Used: One-way analysis of variance (ANOVA) and Tukey's multiple post hoc test. Results: The comparison of salivary B-ALP values between the different skeletal subgroups using one-way ANOVA depicted statistically significant results (P = 0.0003). Pairwise comparison using Tukey's multiple post hoc procedures showed that salivary B-ALP levels were comparatively higher in subgroup 3 and that the difference between subgroups 1 and 3 (P = 0.0109) and subgroups 3 and 5 (P = 0.0014) was statistically significant. Conclusion: B-ALP could be successfully identified and quantitatively estimated in saliva and showed significant correlation with different skeletal age subgroups as determined by Hagg and Taranger method.
ABSTRACT
Background & objectives: The reports from the countries where mumps vaccine is given as routine immunization suggest differences in mumps virus neutralizing antibody titres when tested with vaccine and wild type viruses. Such reports are unavailable from countries like India where mumps vaccine is not included in routine immunization. We, therefore, undertook this study to understand the cross-neutralization activity of Indian mumps viruses. Methods: By using commercial mumps IgG enzyme immunoassay (EIA) and a rapid focus reduction neutralization test (FRNT), a panel of serum samples was tested. The panel consisted of 14 acute and 14 convalescent serum samples collected during a mumps outbreak and 18 archived serum samples. Two wild types (genotypes C and G) and Leningrad-Zagreb vaccine strain (genotype N) were used for the challenge experiments and FRNT titres were determined and further compared. The HN protein sequence of three mumps viruses was analyzed for the presence of key epitopes. Results: All serum samples effectively neutralized mumps virus wild types and a vaccine strain. However, significantly lower FRNT titres were noted to wild types than to vaccine strain (P<0.05). The comparison between EIA and FRNT results revealed 95.6 per cent agreement. No amino acid changes were seen in the epitopes in the Indian wild type strains. All potential N-linked glycosylation sites were observed in Indian strains. Interpretation & conclusions: Good cross-neutralization activity was observed for three mumps virus strains, however, higher level of FRNT titres was detected for mumps virus vaccine strain compared to Indian wild type isolates.
ABSTRACT
PURPOSE: Controversy exists over the pain during prostate biopsy. Periprostatic nerve block is a commonly used anaesthetic technique during transrectal ultrasound (TRUS)-guided prostate biopsy. The recent trend toward increasing the number of cores has become popular. This practice further increases the need for a proper anaesthetic application. We compared the efficacy of periprostatic nerve block with or without intraprostatic nerve block. MATERIALS AND METHODS: We conducted a prospective double-blinded placebo-controlled study at our institute with 142 consecutive patients. Patients were randomly assigned into 3 groups. Group 1 received periprostatic nerve block with intraprostatic nerve block with 1% lignocaine. Group 2 patients were administered periprostatic nerve block only with 1% lignocaine. Group 3 received no anaesthesia. Patients were asked to grade their level of pain by using an 11-point linear analogue scale at the time of ultrasound probe insertion, at the time of anaesthesia, during biopsy, and 30 minutes after biopsy. RESULTS: The study groups were comparable in demographic profile, prostate-specific antigen (PSA) level, and prostate size. The mean pain scores at the time of biopsy in groups 1, 2, and 3 were 2.70, 3.39, and 4.16, respectively. Group 1 recorded the minimum mean pain score of 2.70 during prostate biopsy, which was significantly lower than the scores of groups 2 and 3 (p0.05). CONCLUSIONS: Periprostatic nerve block with intraprostatic nerve block provides better pain control than does periprostatic nerve block alone in TRUS-guided prostate biopsy.
Subject(s)
Humans , Analgesia , Biopsy , Biopsy, Needle , Lidocaine , Needles , Nerve Block , Prospective Studies , Prostate , Prostate-Specific AntigenABSTRACT
Intrathoracic teratomas are usually seen in the mediastinum; they rarely occur in the lung as intrapulmonary teratomas. The criteria for pulmonary origin are the exclusion of a gonadal site or other extragonadal primary sites and the exclusive origin of the tumour from the lung. Lung teratomas, for reasons unknown, commonly involve the upper lobe. Here, we report the case of a mature cystic teratoma (dermoid cyst) in the right middle lobe of the lung in a 22-year-old man. We present the clinical and radiological features, as well as histopathological findings, and discuss the relevant literature.
Subject(s)
Humans , Male , Young Adult , Bronchoscopy , Dermoid Cyst , Diagnosis , General Surgery , Lung Neoplasms , Diagnosis , General Surgery , Teratoma , Diagnosis , General Surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The one-stripe spiny eel, Macrognathus aral (Bloch and Schneider), has been gaining importance not only as a food fish but also as an aquarium fish for its body shape and behaviour. The overall M:F ratio recorded 1:0.27, both the males and females were mostly mature in May-August. The peak values of gonado somatic ratio (GSR) attained during May for males (1.3) and August for females (12.4) indicating that the fish have only one breeding season during summer. The range of ova diameter was found to vary from 0.3 to 1.4 mm, the absolute fecundity ranged from 250 (21.6 cm / 27.4 g) to 5220.1 (27.2 cm / 66.3 g) while relative fecundity ranged from 9.1 to 128.9. The 50% maturity is attained in length group of 10.1-14 cm for males and 14.1-18 cm for females. The species is a moderately fecund, isochronal spawner and having a restricted breeding season. The relationship between fecundity and body weight and length has also been discussed.
ABSTRACT
Objectives: To evaluate the drug utilization of antihypertensive in obstetric practice two tertiary care hospitals in Gulbarga city. Material & Methods: A prospective cross-sectional study was conducted for 2 years in obstetric departments of Government General Hospital and Sangameshwar Teaching Hospital, Gulbarga. W.H.O. basic drug indicators were used for studying the prescribing trends and interviewing the patients. Results: A total of 200 prescriptions were studied and the average number of drugs per prescription was 2.47. 1.89% of generics and 49.59% of essential drugs were prescribed. 98.15% were non generic names used. The average consulting time given per patient was 9 mins 8 secs. 69.5% of the patients knew their dosage schedule and this was related to their education status. 13% were irrational prescription. The frequency of use of Nifedipine was highest followed by Benzathiazide + Triamterene, Amlodipine, Furosemide, Methyldopa and Spiranolactone etc. The use of the safest drug, Methyldopa was among only 4% of patients. 66.28% of prescribes drugs were available in hospital pharmacy. Conclusion : The incidence of poly pharmacy was high. Patient compliance is good only among educated patients. Irrational prescriptions were few. The availability of drugs in the hospitals was not satisfactory. The present healthcare can be improved by advocating rational drug prescribing patient education and improving the facilities in the hospitals.
ABSTRACT
Outer membrane proteins of Pasteurella (P.) multocida have been known to be protective immunogens. Pasteurella lipoprotein E (PlpE) has been reported to be an important cross reactive outer membrane protein in P. multocida. The gene encoding the PlpE of P. multocida serotypes A: 3, B: 2 and D: 1 was amplified from the genomic DNA. The amplified products were cloned and the nucleotide sequence was determined. Sequence analysis of the recombinant clones revealed a single open reading frame of 1,011 bp, 1,008 bp and 1,017 bp encoding a protein with a calculated molecular mass of 37.829 kDa, 37.389 kDa and 37.965 kDa for serotypes A: 3, B: 2 and D: 1 respectively. The comparison of the plpE sequence in different capsular types revealed a high degree (>90%) of homology. Furthermore, the plpE gene of Haemorhhagic septicaemia causing serotype (B: 2) was expressed in E. coli and recombinant PlpE was strongly immunostained by antiserum against whole cell antigen, indicating that the protein is expressed in vivo.
Subject(s)
Animals , Cattle , Bacterial Outer Membrane Proteins/genetics , Base Sequence , Blotting, Western , Cattle Diseases/microbiology , Cloning, Molecular , Electrophoresis, Polyacrylamide Gel , Escherichia coli , Genetic Variation , Hemorrhagic Septicemia/microbiology , India , Lipoproteins/genetics , Molecular Sequence Data , Open Reading Frames/genetics , Pasteurella multocida/genetics , Sequence Analysis, DNA , Sequence Homology , Serotyping , Species SpecificityABSTRACT
A 39 year old male, chronic alcoholic for 12 years, presented with recurrent abdominal pain for last 3 years. He was admitted in our hospital with history of breathlessness, chest pain and abdominal pain for last 20 days. On investigation he had raised total leukocyte count with elevated serum amylase and lipase. Chest radiograph showed mediastinal widening and ultrasound of abdomen revealed chronic pancreatitis with peripancreatic pseudocysts. CT scan revealed extensive phlegmonous collections with cyst formation in the mediastinum which extended from the level of thoracic inlet to below the level of the diaphragm. There were in addition multiple pancreatic and lesser sac pseudocysts. Patient was stable and was hence closely observed on conservative treatment with complete abstinence from alcohol. We performed no surgical, endoscopic or radiological interventions. A repeat CT performed after 14 weeks showed almost complete resolution of the mediastinal pseudocyst. Overall adequate conservative management and timely imaging follow-up before planning any intervention helped us to see that there can be spontaneous resolution of mediastinal pseudocysts.
Subject(s)
Adult , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Fluid Therapy/methods , Follow-Up Studies , Humans , Male , Mediastinal Cyst/complications , Ofloxacin/therapeutic use , Pancreatic Pseudocyst/complications , Pancreatitis, Chronic/complications , Tomography, X-Ray ComputedABSTRACT
The neuropathological features of temporal lobe epilepsy were studied utilising 100 consecutive surgical specimens from patients with medically refractory complex partial seizures. A wide spectrum of neuropathological changes was recorded in 98 specimens. Fifty-eight specimens showed features of Ammon's horn sclerosis. Diffuse accumulation of corpora amylacea were demonstrated in the resected temporal lobes from 54 patients. Six patients had neoplastic lesions of temporal lobe. One unique case of dysembryoplastic neuroepithelial tumour showed a melanotic component within the tumour. The neuropathological features were regarded as nonspecific in 31% of cases. Our results indicate that a majority of patients with medically intractable epilepsy of temporal lobe origin reveal significant neuropathological features. Careful documentation of the neuropathological features and its correlation with radiological, electrophysiological and pre- and post-surgical clinical features will help in predicting the seizure outcome after temporal lobectomy for medically refractory epilepsy.