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Aims & Objectives:About 10% of pelvic fracture injuries are associated with urethral injury. Most of the urethral injuries are successfully repaired by progressive perineal anastomotic urethroplasty. Bulbar urethral ischemic necrosis is a devastating complication seen in 5-8% of failed PFUI repairs. The objective of this study is to present our experience in management of a bulbar urethral ischemic necrosis developed following PFUI repair. Materials & methods:This is a retrospective study done at our institute, which includes data from feb,2003 to feb,2021. This is a descriptive statical analysis. Total 18 patients were managed using various surgical approaches and followed. Out of 18 patients seven patients underwent staged urethroplasty with Results & Observations: success rate of 85.71%,four underwent pedicled preputial skin tube urethroplasty with success rate of 75%,one underwent non transecting augmented urethroplasty with success rate of 100%,three underwent augmented perineal urethrostomy, two underwent continent diversion procedures, one underwent augmented perineal skin tube perineal urethrostomy. Bulbar urethral ischemic necrosi Conclusions: s following PFUI repair although uncommon, is a devastating complication which can be salvaged by various surgical techniques. Type of procedure chosen depends on individual patient and outcomes vary for each type of procedure
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SUMMARY: Traditional methods of bone retrieval from embalmed cadaver are not able to meet the demand of medical colleges as they are time consuming & tedious, thus there is need of evaluating an alternative approach that includes use of laundry detergent. The purpose of the study was to compare & establish the most effective method between laundry detergent and 10 % antiformin solution methods to procure clean bones. Thirty-two bones of the right side that were included in the inclusion criteria obtained from the four embalmed cadaver were cleaned by laundry detergent and of the left side by 10 % antiformin solution methods. Retrieved clean bones were evaluated for their cleanness using the scale from 0 to 5. The mean cleanness scores of the bones cleaned by laundry detergent method were not significantly different at 95 % confidence interval than the mean cleanness scores of the bones cleaned by 10 % antiformin solution method. The study found that though there is no significant difference in the mean cleanness score of the bones cleaned by two employed methods nevertheless, bones were found to be cleaner by using 10 % antiformin solution method and bones obtained by using laundry detergent method had smooth surface as well as more suitable for flat bones.
Los métodos tradicionales de recuperación de huesos de cadáveres embalsamados no pueden satisfacer la demanda de las facultades de medicina, ya que consumen mucho tiempo y son tediosos de realizar, por tanto es necesario evaluar un enfoque alternativo que incluya el uso de detergente de lavandería. El propósito del estudio fue comparar y establecer el método más eficaz entre el detergente para la ropa y los métodos de solución de antiformina al 10 % para obtener huesos limpios. Fueron utilizados 32 huesos del lado derecho que se incluyeron en los criterios de inclusión obtenidos de los cuatro cadáveres embalsamados. Los huesos se trataron con detergente de lavandería y los del lado izquierdo con métodos de solución de antiformina al 10 %. Los huesos tratados se evaluaron respecto a su limpieza utilizando una escala de 0 a 5. Las puntuaciones media de limpieza de los huesos tratados con el método de detergente no fueron significativamente diferentes en un intervalo de confianza del 95 % de las puntuaciones medias obtenidas respecto a la limpieza de los huesos tratados con antiformina al 10 %. El estudio determinó que, aunque no hay hubo diferencia significativa en la puntuación media de la limpieza de los huesos tratados por los dos métodos, se observó que utilizando el método de solución de antiformina al 10 %, la limpieza de los huesos era mejor, sin embargo, los huesos planos presentaban una superficie más lisa cuando se usó el método de detergente de lavandería.
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Humans , Sodium Hypochlorite/chemistry , Bone and Bones , Detergents/chemistry , Embalming , Cadaver , Cross-Sectional StudiesABSTRACT
Nucleus delivery is still considered as one of the tough steps in SICS among fresh surgeons, leading to various complications at the verge of completion of surgery which further decreases the confidence and elongates the learning curve among the residents,trainees & fellows. Our new technique 揌ydroexpression� utilizes minimal manipulation and minimal instrumentation to express the nucleus with only hydro-cannula without even use of viscoelastics in AC.
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Background: Various conceptual hypotheses have been put forth to link association of COVID?19 with various chronic diseases such as periodontitis. Empirical evidence is still lacking to correlate the severity of COVID?19 with periodontal diseases. Objectives: This study was undertaken with an objective to correlate COVID severity in systemically healthy patients suffering from periodontal diseases. Materials and Methods: 44 systemically healthy patients of both genders with minimum of 20 teeth in their oral cavity in age range of 20 to 50 years suffering from periodontitis were recruited and categorised into four stages as per American Academy of Periodontology (AAP) 2017 classification for periodontitis. Serum C?reactive protein (CRP) levels and periodontal disease parameters of all the patients were measured. Because of COVID?19 and the nationwide lockdown, the dental practice was highly affected. With the help of self?designed online questionnaire information regarding COVID?19 infection and associated symptoms were recorded. Cases were categorized into five groups based on the World Health Organization clinical progression scale of COVID severity. Results: All the patients suffering from COVID disease in moderate and severe forms had increased probing pocket depth, clinical attachment level, and raised serum C?reactive protein levels as compared to patients who were uninfected or suffering from mild COVID disease and the results were statistically significant. Conclusion: Prioritisation and Implementation of periodontal treatment as a preventive measure for COVID?19 should be done. A positive correlation is observed between the severity of periodontitis and COVID?19.
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BACKGROUND The Covid-19 pandemic and subsequent lockdown in India caused disruptions in cancer treatment due to the restriction on movement of patients. We aimed to maintain continuity in cancer treatment during the lockdown through teleconsultations. We tried to reach out to our patients using telephonic consultations by establishing a Teleconsult Centre facility run by a team of doctors and patient navigators. METHODS We telephonically contacted all patients who had outpatient appointments from 23 March to 30 April 2020 at our centre through the Teleconsult Centre to understand their current circumstances, feasibility of follow-up, local resources and offered best possible alternatives to continue cancer treatment, if required. RESULTS Of the 2686 patients scheduled for follow-up during this period, we could contact 1783 patients in 9 working days. Through teleconsultations, we could defer follow-ups of 1034 patients (57.99%, 95% confidence interval [CI] 55.6%–60.3%), thus reducing the need for patients to travel to the hospital. Change in systemic therapy was made in 75 patients (4.2%, 95% CI 3.3%–5.2%) as per the requirements and available resources. Symptoms suggestive of disease progression were picked up in 12 patients (0.67%, 95% CI 0.35%–1.17%), who were advised to meet local physicians. CONCLUSION Our study suggests that the majority of patients on follow-up can be managed with teleconsultation in times of crisis. Teleconsultation has the potential of being one of the standard methods of patient follow-up even during periods of normalcy.
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Xanthomonas axonopodis pv. punicae (Xap) is a bacterial pathogen wreaking havoc in pomegranate cultivation. It causes bacterial blight disease dwindling yield and making fruit unfit for consumption. Physiological and histological investigations during host-pathogen interaction are prerequisite to assess the onset of defense mechanism in plants. Therefore, we tried to compare the pomegranate resistant (IC 318734) and highly susceptible (Ruby) genotypes challenged with Xap. The bacterial suspension containing Xap cells of 0.3 OD600 (~106 to 107CFU mL?1) was used for challenge inoculation. Uniformly grown resistant and highly susceptible plants were selected, the surface of leaves was pricked and spray-inoculated with bacterial suspension using native strain IIHR1 (NCBI Gen Bank ID: KT 222897). Simultaneously, the control plants were also sprayed with only distilled water and observed. A total of three replications with five plants per replication were maintained and evaluated under completely randomized design. Physiological investigations were recorded using Portable photosynthesis system (LCpro+, ADC BioScientific limited, UK) for one cycle of disease progression viz., 0, 1, 5, 10, 15 and 20 days after bacterial spray inoculation (DAI). Significant changes in gas exchange parameters were witnessed on pathogen inoculation. Higher reduction in mean percent change of photosynthetic and transpiration rate, instantaneous water use efficiency, internal CO2 content, stomatal conductance and relative water content were noticed in highly susceptible genotype than resistant one. On contrary, an increased percent mean change of intrinsic water use efficiency, carboxylation capacity and lignin was documented in resistant genotype. Relative injury caused due to bacterial infection was found high in highly susceptible genotype than resistant one. Histological investigations in highly susceptible and resistant genotype were studied on 20th day of Xap inoculation using Scanning Electron Microscopy. Highly susceptible genotype exhibited maximum deformed cells, tissues and other visible abnormalities upon Xap inoculation. Thus, this study forms a basis for effective disease management and breeding programmes in pomegranate.
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The current article is a outcome of review of data. After 2014, the contribution of corporate social responsibility (CSR) has expanded significantly in India, and it is regarded a game-changer in the development process. A growing number of businesses are getting involved in this procedure, which is mandated by the government under Section 135 of the Companies Act 2013. Karnataka is a major state in southern India, and it is home to a number of large-scale industries. Karnataka has also seen a significant increase in corporate social responsibility investment when compared to other states. This paper conducts a thorough investigation into the trends in CSR expenditure in Karnataka from 2014 to 2021, as well as the spending patterns by districts.
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Background: The high yielding varieties and intensive cropping together with the shift towards the use of high NPK fertilizers has caused the decline in the level of micronutrients in soils below normal at which productivity of crops cannot be sustained. Methods: The GPS based 104 soil samples were collected and analyzed for fertility status and nutrient indices in 2017-18. Results: The pH and EC of soils of sugar factory varied from 7.78 to 8.73 and 0.17 to 1.33 dSm-1, respectively. The organic carbon and calcium carbonate content in soils also varied from 0.21 to 0.82% and 5.25 to 15.75%, respectively. The available nitrogen, phosphorus and potassium content in soils were ranged from 137.90 to 310.40, 6.37 to 27.12, and 257.60 to 763.20 kg ha-1 respectively. The soil fertility status recorded from very low to moderate in available nitrogen, from very low to moderately high available phosphorus and high to very high available potassium. The available boron ranged from 0.05 to 0.40 mg kg-1. The iron, manganese, zinc and copper content ranged from 2.00 to 6.08, 1.22 to 3.87, 0.24 to 1.86 and 1.09 to 4.42 mg kg-1, respectively. The soils of the sugar factory are sufficient in available copper. Conclusion: The 69.23%, 2.88% and 65.38%samples were deficient in available iron, manganese and zinc, respectively. The soil fertility status of sugar factory was assessed to be low in available nitrogen, medium in available phosphorus and high in available potassium respectively.
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INTRODUCTION@#Nutritional psychiatry is an emerging field of study that investigates the role of diet and nutrition in mental health. Studies conducted in the general population have linked depressive symptoms with poor dietary patterns. The aim of this study was to characterise the dietary intake and analyse the dietary pattern using the Dietary Approach to Stop Hypertension (DASH) in a sample of psychiatric patients in a multiethnic Asian nation.@*METHODS@#Participants were recruited from an outpatient clinic and an inpatient unit at the Institute of Mental Health in Singapore. Self-reported dietary habits of a sample of psychiatric patients (N=380) were analysed using DASH. To examine the variables associated with DASH scores, a linear regression was conducted with the full sample and sociodemographic variables.@*RESULTS@#Persons with depressive disorders had a mean DASH score of 21.3 (±4.2), while persons with psychotic disorders had a mean DASH score of 21.2 (±4.9). Respondents who were older (B=1.94, 95% confidence interval [CI] 0.91-2.96, @*CONCLUSION@#Dietary patterns of persons with mental disorders were characterised. A host of sociodemographic factors, and not diagnosis of mental disorders, influenced the dietary quality of people with depressive and psychotic disorders. Clinicians treating psychiatric patients need to be aware of the nuanced reasons behind poor dietary choices and provide targeted psychoeducation to specific subgroups within the patient population.
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Background: COVID-19 pandemic has affected the daily living globally. It has added to the stress of day to day life. COVID-19 is associated with severe disease in high-risk population groups with increased mortality risk. COVID-19 and it’s impact on pregnancy needs extensive research. Early research data does not suggest any increased risk in the pregnant population and Vertical transmission is yet to be confirmed. As of now no standard protocol is available for management of COVID-19 .Social distancing is the best possible mechanism available to protect patients and health care personnel from COVID-19. The aim of this study is to know the effectiveness of protocol based Antenatal care during COVID-19 pandemic.Methods: This study was conducted at the Antenatal clinic. A total of 40 antenatal cases who satisfied inclusion and exclusion criteria were selected for the above study. They were assessed at the antenatal clinic following a modified protocol.Results: Majority of the pregnant women in the study group were primigravidas and belonged to the age group of 21-25 years. They were called for Antenatal check-ups as per the protocol specifically modified taking into consideration the COVID-19 pandemic. 80% of the deliveries in present study were normal delivery and only in obstetric emergencies LSCS was performed.Conclusions: Antenatal care in COVID-19 pandemic is challenging yet essential. Following a protocol based approach is the key to management of Antenatal care amidst the pandemic. It is cost-effective and has an easy learning curve.
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Background: Folic acid is commonly used by infertile women worldwide. However, studies on the effect of folic acid in women with unexplained infertility are lacking. This aim of this study was to evaluate the effectiveness of folic acid in women with unexplained infertility.Methods: This prospective multicentric study was performed from June 2019 to July 2020 in women with unexplained infertility attending the fertility clinic. In this study, 50 women with unexplained infertility who satisfied the inclusion and exclusion criteria were started on folic acid therapy. The effectiveness of therapy was evaluated on the basis of successful conception and adverse effects if any.Results: Folic acid therapy showed a marked improvement in infertility status measured in terms of successful conception. After initial 12 weeks therapy successful conception was achieved in 40 (80%) women without any adverse effects.Conclusions: Folic acid supplementation has a positive effect on pregnancy outcome in women with unexplained infertility without any adverse effects. Folic acid is thus a safe and cost-effective option in women with unexplained infertility.
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Neurofibromatosis type 1 (NF1) is the most common autosomal dominant neurocutaneous among humans. Epilepsy is more prevalent in NF1 patients than in the general population. NF1 vasculopathy is also a significant but underrecognized complication of the disease, affecting both arterial and venous blood vessels. Herein, we report a 2 year old female child with seizures and multiple cafe-au-lait spots on the body. The patient was diagnosed with NF1 based on clinical findings and family history. MRI Brain revealed middle cerebral artery dysplasia. Here we discuss diagnostic and treatment challenges and briefly reviews the existing literature.
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Benign and malignant bone tumors arise in small bones of the hands and feet. Nevertheless, secondary deposits at these sites are extremely rare. We report a peculiar case of an adult man who presented with thumb swelling, which was later discovered to be a metastasis from renal cell carcinoma. Such cases have a sinister prognosis with a survival rate of 6–12 months from the time of diagnosis. We intend to discuss the diagnostic dilemma and treatment of acrometastases
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Background: The objective of this study was to compare the thickness of the scar and relative thinning of the uterinewall following conventional LSCS closing technique versus new closing technique (modified mattress Suture) and any additional surgical procedure in each group.Methods: A total of sixty patients undergoing primary caesarean for obstetric indications and who were willing for the study were included. In 30 patients uterus was closed by conventional double layer technique (the first layer is suturing with absorbable suture in a continuous running fashion. After first layer is complete, a second continuous stitch is used to invert the first layer, inverting stitch may be horizontal or vertical using same suturing material) and in 30 patient uterus was closed by new modified mattress technique. In both groups same suture material (vicryl 1-0) was used. Measurement of the thickness of scar site and corresponding posterior wall thickness was done following 6 months of caesarean section.Results: The possible parameters of better technique i.e., the mean scar thickness is more and relative as well as percentage thinning is less with this new technique of uterine closure although statistically not significant. Conclusions: Modified mattress suture technique is a single step procedure and gives the feel of double layer uterine closure. Hence the time taken, material. Used and the cost involved will be less along with excellent hemostasis.
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Background: There has been an alarming rise in number of caesarean sections all over the world. Instrumental delivery plays an important role to reduce this trend globally. Forceps delivery though proper training and expertise can definitely reduce the rising caesarean section rates in the modern-day obstetrics. The aim of this study is to study the effectiveness of forceps delivery in modern obstetrics.Methods: In the present observational study, 20 cases of forceps delivery were studied for maternal and foetal outcomes including postpartum hemorrhage, perineal tears, Apgar score, NICU admissions, birth injury, and mortality.Results: The most common indication for forceps application was maternal exhaustion (80%) followed by foetal distress. All the cases of forceps application in the present study were associated uneventful vaginal delivery. No any adverse maternal outcomes including perineal tears, post-partum hemorrhage was observed in this study. Average birth weight in the present study was 3.2 kgs and Apgar scores at birth and five minutes was within normal limits. No any birth injury was noted in any of the newborns.Conclusions: Forceps delivery is a safe and effective option in modern day obstetrics to reduce the alarming rise in rates of caesarean section globally. Training should be encouraged to develop the expertise of this art of forceps delivery.
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Background: Benign prostatic hyperplasia (BPH) is the most common urological condition. The treatment of BPH depends on the severity of symptoms which aims to improve symptoms, lower the risk of progression and improve quality of life. The aim of this survey was to understand the prescription pattern of alpha blockers in the treatment of BPH among clinicians of India.Methods: A cross-sectional questionnaire-based survey was conducted between September to December 2018. Data regarding the management of BPH using ?-blockers were filled by clinicians and collated for data analysis using appropriate statistical test.Results: Total of 1764 clinicians’ responses was collected and the result was analysed. According to the survey, 47.68% of clinicians felt that severity of the BPH symptoms is most common deciding factor for medical management of BPH. For the pharmacological management of BPH patients, around 58% of clinicians opted for ? blockers monotherapy as a preferred option. Among ? blockers, 65.14% of clinicians preferred tamsulosin as first line therapy for management of BPH patients. In this survey, 81.75% of clinicians believed that tamsulosin offers highest persistence rate among commonly prescribed ? blockers. Looking at the switching to a second ?-blocker, 75.45% of clinicians felt that tamsulosin shows the highest return rate following initiation of a second ?-blocker. More than 90% of clinicians felt that favourable efficacy or tolerability of tamsulosin is due to its highest persistence and highest return rates.Conclusions: Tamsulosin is the most commonly preferred and prescribed ?-blocker by Indian clinicians due to its favourable efficacy or tolerability.
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Schistosomiasis is a parasitic trematode that is lesscommonly seen in India. The clinical manifestationsrange from acute, sub acute and chronic phases. Agranulomatous type of lesion formed by Schistosomahematobium in the lower urinary tract. We present acase of rare neglected tropical infection in this part ofDakshin Kannada. A 66-year-old man presents withhistory of irritative voiding symptoms, urgency,incontinence, and nocturia of 2 months duration. CTUrogram showed bladder wall thickening. Cystoscopyshowed granuloma in the posterolateral wall of thebladder. Urine microscopy picked up Schistosomahematobium eggs. Bladder biopsy showed chronicinflammatory type of lesion. This is a case of confirmedchronic granulomatous urinary schistosomiasis in anon-endemic region, and successfully treated.Clinicians should become aware of the existence of thisparasite in few pockets in India.
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Purpose@#Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management.Material & Methods: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. @*Results@#Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. @*Conclusion@#We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.
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Black pepper (Piper nigrum L.), referred as the ‘King of Spices’, is native to India and has shown declined productivity over the years. It exhibits diverse quantitative and qualitative traits, particularly in spike length, floral composition, floral arrangement, fruit size and number. The novel mutant variety of black pepper (Piper nigrum L.) ‘Thekken’ shows a remarkable branching character in the spikes. In the present study, we analyzed RAMOSA3 (RA3) gene at the molecular level in this variety for yield improvement. Screening using degenerate primers designed for RA3 was carried out in ‘Thekken’ and a non-branching variety ‘Karimunda’ at the genomic level and at different stages of spike development at the transcriptome level. Sequence analysis of the amplicons generated in RT-PCR revealed the presence of an integrase core domain in the mutant type of black pepper, suggesting a possibility of mutation at this locus in the branched variety due to retrotransposon integration. The study suggests a possibility for introgression of the genes responsible for branching trait from the mutant variety of black pepper type ‘Thekken’ to other conventional cultivated varieties of black pepper that show single unbranched spike thereby increasing the productivity of black pepper which has very high economic value and export potential.