ABSTRACT
Introduction: Recurrent tonsillitis is a major cause of morbidity and may require surgical intervention when medical treatment has failed. Reasons suggested for treatment failure include the use of inappropriate antibiotics aimed at pathogens present on the tonsil surface rather than those present in the tonsil core. Material and Methods: A total of 60 cases of chronic and recurrent tonsillitis which were not responding to medical treatment and are fit and willing for surgery were included in the study. Results: The culture results of tonsillar surface and core tissue revealed that the majority of samples showed pathogens. Out of 120 cultures of tonsillar tissue,14 results showed the growth of commensal flora. Single pathogen was isolated from 86 samples from surface and core of the tonsil. However, 14 cultures of core tissue revealed growth of two pathogens as compared to 6 cultures from the tonsillar surface. Conclusion: Staphylococcus is the most common pathogen isolated from the tosillar surface as well as core followed by GABHS
ABSTRACT
Aim: The study aimed to identify the optimum tillage and source of nitrogen for refining yields, yield sustainability and rainwater-use efficiency, and to develop predictive models explaining the relationship between crop yield and monthly rainfall with main goal of reduced cost of cultivation and increased profitability for long-term sustainability of maize-wheat system. Methodology: A long-term field experiment on maize-wheat system was conducted from 2000 to 2012 at Regional Research Station, Ballowal Saunkhri, Punjab Agricultural University, Ludhiana in split plot design with three replications. The treatment included three tillage practices, viz., conventional tillage (CT), reduced tillage (RT1) and RT1 + herbicide (RT2) in the main plots and three nitrogen (N) management practices, viz., 100% N from organic source (F1), 50% N from organic + 50% N from inorganic source (F2) and 100% N from inorganic source (F3) in the sub-plots. The parameters included maize and wheat yield, rainwater use efficiency, economics, sustainability yield index to develop predictive models. Results: Prediction models expressing relation between yield and monthly rainfall showed beneficial effect of rainfall in June, July and September months on maize and January and February in wheat on crop productivity. RT2 gave highest mean maize grain yield (2264 kg ha−1) with 13.8 and 1.8% yield superiority over RT1 and CT, respectively. However, in wheat, CT recorded highest grain yield (2110 kg ha−1) with 7.9 and 1.7% higher yield than RT1 and RT2, respectively. The RT2F3 gave highest net returns of US$ 222.60 ha−1 with benefit-cost ratio (B:C) of 1.88, rain water use efficiency (RWUE) of 4.78 kg ha−1 mm−1 and a sustainable yield index (SYI) of 60.7% in maize, whereas in wheat it provided net returns of US$315.45 ha−1 with B:C of 2.28, RWUE of 23.0 kg ha−1 mm−1 and SYI of 47.4%. Interpretation: The efficient rainwater use and optimum yields of rainfed maize-wheat system can be realised with reduced tillage + herbicide based weed management along with application of recommended nitrogen. The study suggests the shift from conventional tillage practices to reduced/conservation tillage practices.
ABSTRACT
Background: Cholecystectomy is the commonest operation of the biliary tract. Laparoscopic cholecystectomy (LC) is the standard treatment of symptomatic gallbladder disease. It has numerous advantages over open cholecystectomy (OC). However, current literature suggests that rate of conversion from LC to OC is 1%–15%.Methods: This retrospective study aims to evaluate the risk factors of conversion of LC to open between the elderly (> 50 years old) and the young (≤ 50 years old) and its relation with preoperative data and intraoperative findings. A total of 120 patients, 60 in each group, over a period of January 2016 to June 2017 were studied.Results: A total of 36 cases out of 120 were converted. Of these 36, 14 were in the young age group and 22 in the elderly. In each group, majority cases who were converted, were men (P value <0.05) and duration of symptoms of more than 1 year (P value<0.001). There was highly significant difference seen in the cases converted in the young age group and comorbidities (P value<0.001). Of all the converted cases, a highly significant difference was seen in both age groups with adhesions, intrahepatic and gangrenous gall bladder Conclusion: We believe this is the first study in a developing country like ours suggesting laparoscopic cholecystectomy is a safe procedure irrespective of the age of the patient. While in fact, it is the chronicity of the symptoms, the gender and the intraoperative findings which predict and mandate the conversion of LC to OC.
ABSTRACT
Multiple Myeloma (MM) is a disease of the elderly. The occurrence of MM in patients younger than thirty years is rare. Over the last ten years five patients with MM of less than thirty years of age were evaluated at our centre and which constituted 3.3% of all the MM cases. Three patients had initial extramedullary involvement. All patients responded to the initial planned therapy and were clinically disease free at the time of last follow-up. In the background of clinical and laboratory features, a brief review of literature was carried out and the prognosis of this subgroup has been discussed.