Outcome Analysis of Redo Urethroplasty for Large and Multiple Urethrocutaneous Fistula

Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. Due to the poor surrounding tissue quality, surgical treatment of these patients represents a complex problem. Objectives: Present study aimed to determine a better procedure of salvage urethroplasty for failed hypospadias, caused by persistent large (>4mm) or multiple -small (<4mm) fistulae, by a randomized comparison.Methods: This interventional study was performed in a single institute over a period of five years. Comparisons were made among three procedures of salvage urethroplasty using substitution of dorsal skin flap, Flip flap, or buccal mucosal graft in a controlled situation. Outcomes were assessed by means of objective scoring system. Results: Refistula rate, devascularization of flap and grafts and wound dehiscence rate were significantly less in Buccal mucosal graft than flip flap and dorsal transposition flap. This led to a higher success rate and better patient compliance in buccal mucosal graft. Though mean duration of hospital stay was significantly longer in buccal mucosal graft compared to other methods, it did not negatively affect patient satisfaction due to overall higher success rate. The objective scoring evaluation revealed that score gain of BM group was significantly higher than that of dorsal transposition flap and flip flap. Conclusion: Staged redo urethroplasty for large or multiple-small fistulae using substitution of buccal mucosal graft revealed as an better option for urethral reconstruction than dorsal transposition flap and flip flap procedures (group A˃ group B ˃group C).

Effectiveness of clobazam on perception, creativity, intelligence, selective and visual memory

Clobazam belongs to benzodiazepine class and is preferably used against anti-epileptic disorders. However, when used in reduced doses, its ability for improving cognitive functions becomes explicitly evident. This study objectively undertook the task of using the reduced doses of clobazam for proving potentials effects on cognitive functions. The drug, clobazam was administered in "active group? which contained 15 young healthy volunteers. The "placebo group? also entailed 15 subjects and each was administered with placebo drug. The controlled group? also included 15 subjects. All these 45 young healthy subjects were subjected to tests for perceptual learning, creativity, selective memory, visual memory and intelligence. Results clearly demonstrated significant impact of clobazam at the dose of 5mg/day on perceptual learning [P=0.0380], creativity [P=0.0787], memory function [P=0.4920], visual memory [P=0.4816] and intelligence of the subject [P=0.4920]. The outcomes highlighted in the studies reviled the positive effects of clobazam when used at reduced doses

Antibiotic resistance pattern shown by various pathogens, causing infections in neonates

This study was schemed to comprehend the latest kaleidoscopic trends of bacterial resistance in neonatal pathogens against all those antibiotics commonly employed as empirical therapy in neonates. The methodological approach included; isolation and subsequent identification of those pathogens having caused bacterial infections in neonates, application of antibiotic sensitivity testing and finally construing the conclusion depicting patterns of antibiotic resistance by various pathogens, isolated from neonatal biological samples. Antibiotic resistance patterns was evident in gram-positive as well as in gram-negative bacteria in all the eight species identified in this study. Even antibiotic drugs which are being commonly relied upon for treating multi-resistant bacterial infections, found to be in effective against many newly emerged resistant bacteria, when used alone. Resistance Antibiotics drugs against which most prominent resistance pattern emerged include; Amikacin sulphate, Linezolid, Piperacillin / Tazobactam, Amoxicillin / Clavulanic acid, Vencomycin, Cefoperazone / Sulbactam, Ceftriaxone sodium, Ciprofloxacin, Cefixime trihydrate and Imipenem. The inferred upshot suggests that antibiotic resistance is emerging fast and ever-changing phenomenon of antibiotic resistance has significantly reduced the therapeutic space to maneuver, particularly, in treating neonatal infections

Preliminary physicochemical evaluation of Kushta tutia: A Unani Formulation.

Background: Kushta is an important solid dosage form of Unani system of medicine used to treat various ailments. Very small particle size of kushta is responsible for its rapid absorption in body leading to instant therapeutic actions. Kushta tutia (KT) is one such renowned formulation used by hakims for successful management of various disorders. However, there is lack of scientific work on KT. Objectives: The present study was performed to evaluate KT physicochemically by testifying it on classical tests along with modern scientific techniques. Materials and Methods: Tutia was first detoxified as per classical literature. It was triturated with water and dried, afterwards subjected to calcination in furnace rather than cow dung cakes due to isolation of material being heated and better temperature control. Finished product was evaluated for physicochemical characteristics including preliminary tests mentioned in classical literature. Results: Floating and finger test were positive. Curd test showed no discoloration after 48 h. These findings indicate correct preparation of KT according to classical literature. Bulk density (0.96 ± 0.00 g/ml); tapped density (1.53 ± 0.00 g/ml); Hausner ratio (0.62 ± 0.00), compressibility index (37.52 ± 0.19%); loss of weight on drying (0.08 ± 0.00%); pH of 1 and 10% (5.20 ± 0.00) and 5.62 ± 0.00, respectively); total ash, acid insoluble ash, and water soluble ash values 95.75 ± 0.09, 6.57 ± 0.02, and 45.02 ± 0.20%, respectively; and extractive values 0.85 ± 0.02% were reported in KT. Conclusion: Since this work has not been reported earlier, the results obtained could be considered as the standard for KT for future studies.

Therapeutic potential of silver in Unani system of medicine: an overview

Metals play important roles in human body, the deficiency of which may lead to various disorders. Earlier there was a perception that metals are not compatible with human body at all, but now it has been reported that number of metallic compounds are essential for body and some are in the category of essential elements. Metals are present in human body in different concentration and combination at various sites and help the respective body tissues to perform their required activities. Perfect health is attributed to the state of equilibrium of these metals in body tissues. Any imbalance in their concentration or inactive states disturbs the body metabolism. Silver is one of the metals known since antiquity. It was used for medicinal purpose since time immemorial. The first recorded use of silver for medicinal purposes dates back to 8th century A.D. where Ibn Sina used silver filings for palpitation of the heart. In Unani system of medicine it is used in the form of kushta [calcined-oxidized herbo-metallic form] and warq [thin foils]. It is highly recommended in fever, chest affections, impotency, seminal weakness, painful and irritable conditions of the stomach, heart burn, chronic diarrhoea and nervous affections. This review is an effort to summarize the detailed prospects of ancient literature on silver along with recent pharmacological studies

Complications of nose and paranasal sinus disease

Background: Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. Method: All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Results: Infections were the most common cause of complicated sinus disease 11 [75%]. The rest of the 4 [25%] cases were tumours. 12 [80%] of the cases presented with proptosis. In 1 of these 12 cases, there was complete blindness. In 2 [13%] of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these patients had malignant tumour of the paranasal sinuses. One patient presented with early signs of meningitis. In 1 case subperiosteal scalp abscess [Pott's puffy tumour] was the only complication noted. Conclusion: Nose and paranasal sinus diseases can complicate to involve mostly the orbit, but sometimes brain, meninges and skull bones can also get involved