Exploring the Bilateral Comparisons of Articular Surfaces of Talus: An Observational Study at Tertiary Health Care Center in Pune City

Background: The existing conclusive data show variations in the subtalar joint regarding its morphological features and articulation of bones. Inadequate studies exist on the morphometry of articular surfaces of the talus which may help in surgical interventions and development of implants and prostheses in diverse populations. Purpose: The current study was undertaken to conduct a bilateral comparison of parameters of articulating surfaces of talus. Material and Methods: An observational study design was carried out at one of the private medical colleges in the Pune district of Maharashtra. A total of 100 (fifty-one from right side and forty-nine left-sided tali) dry human talar bones were collected and various dimensions of articular surfaces of bones were measured by Digital Vernier Caliper and Ruler. The data analysis was performed and results were tabulated and presented graphically. Results: There was a statistically significant difference (p<0.05) in bilateral measurements of lateral articular surface height (LASH) of talar bones. The difference was not significant (p>0.05) for all other parameters. Conclusions: The study inferences can be applied as a guide and baseline information for surgical measures, inflammatory disease management, and forensic anthropologists.

A STUDY OF IMMUNOHISTOCHEMICAL EXPRESSION OF GALECTIN-3 IN NON-NEOPLASTIC AND NEOPLASTIC LESIONS OF THYROID

Introduction: Thyroid lesions are fairly common and have a wide spectrum of diseases ranging from functional, immune mediated to neoplastic lesions. Malignancy of thyroid constitutes approximately 1% of all cancers. These malignant tumors of thyroid gland exhibit a variety of histopathologies and clinical behavior. Immune markers are gaining more and more importance in diagnostic pathology, especially in the differential diagnostics and in the grading of thyroid gland tumors. In the recent times Galectin-3 has received notable recognition for its usefulness as a diagnostic marker for thyroid cancer. To evaluate the diagnostic role of galectin-3 (Gal-3) in Aims and objectives: differentiating malignant from benign thyroid neoplasm. In this observational study, we evaluated Gal-Material and method: 3 expression in a spectrum of all non-neoplastic and neoplastic lesions including benign and malignant lesions of thyroid gland. All types of thyroidectomy specimens were xed in 10% formal saline and subjected to histopathological examination. Sections were stained with H&E stain. Gal-3 immunoperoxidase reaction was carried out in histological sections from all the cases and descriptive analysis was done. In the study of 100 cases of thyroid swelling were included and evaluated by Result: histopathological and by using Gal-3 immunoperoxidase marker. Out of 100 cases, majority of thyroid lesions were seen in females with 76 cases (76%) while only 24 cases (24%) were seen in male. Among 66 non-neoplastic cases, only 6 cases (9.1%) and among 34 neoplastic lesions, 28 cases (82.4%) were positive for galectin-3 marker. Statistical signicance of galectin-3 expression between non-neoplastic and neoplastic thyroid lesions found to be statistically signicant (P value <0000.1). The sensitivity and specicity of galectin-3 detection of malignant lesions were found to be 82.4% and 91% respectively with 82.4% positive predictive value and 90.9% negative predictive value. We suggest that Galectin-3 expression is helpful in Conclusion: enabling better diagnosis and patient care by guiding appropriate therapeutic decisions.

Clinical study of profile of retinal detachment in vasculitis and its management at tertiary eye care hospital

Purpose: The aim of the study was to understand the clinical profile and anatomical and visual outcome in Tractional/Combined (Tractional + Rhegmatogenous) Retinal Detachment due to vasculitis after surgical intervention. Methods: It was an interventional retrospective study of all cases who underwent surgery for RD with vasculitis at a single tertiary eye care center for over a period of 6 years. Patients with retinal detachment due to vasculitis were included in the study. All patients underwent the following surgical procedures: 240 belt buckle with three?port pars plana vitrectomy with membrane dissection and peeling with fluid gas exchange/with endolaser with silicon oil/C3 F8 gas injection. Results: In our study, 83.33% had preoperative vision of less than 6/60, whereas postoperatively 66.66% had vision of less than 6/60. Postoperatively 33.33% patients had vision better than 6/36. Of the six eyes operated for vasculitis with RD, retina was attached in five eyes following surgery. One patient had recurrent retinal detachment due to extensive proliferative vitreoretinopathy changes, and he was advised re?procedure but was lost for follow?up. The anatomical success was 83.33% on the first surgery. Conclusion: The overall anatomic success rate of retina reattachment surgery in vasculitis patient was good, and the visual outcome following the surgery can improve in majority of the cases. Hence, timely intervention is advocated.

Allosteric modulation on specific gene mutated Vitamin D receptor by essential PUFAs and its distinct molecular effects on type 2 diabetes mellitus

A serious health threat affecting the T2DM group is evident more cases T2DM are diagnosed. In this research, we choose to research into all of this possible mechanism of 3T3-L1 Cell lines and Molecular Docking studies Schrodinger software identified Vitamin D, Omega-3, and 6 PUFAs (EPA DHA & AA) Compounds of hydrophilic and hydrophobic pocket throughout molecular modeling besides T2DM. A group of three analog VDRs is being developed for discovery treatment with T2DM. Its use as it was agreed to run a molecular cell culture and docking study. Recognize the binding method involving the compound in T2DM through ADME prediction. The molecular dynamics simulation was enhanced by confirmation of the strength of the possible composite binding. Based on the computational results, the Omega-3 and 6 PUFAs compound encourages energy interaction. The composite contains an in vitro anti-diabetic activity; the compounds have clearly shown that they are active on T2DM. Our studies provide vital information on the findings of the bimolecular T2DM inhibitors.

The Role of Kunjal Kriya in Upper Respiratory Tract Disorders w.s.r. to Bronchial Asthma

Bronchial Asthma is one of the distressing ailments of the present time and is notable for its episodic and chronic course which influences the entire human race & it is a sickness of the human respiratory framework where the aviation routes get restricted. This limiting causes side effects, for example, wheezing, windedness, chest snugness, and hacking, which answer bronchodilators. Kunjal Kriya is the most straightforward technique among all types of Dhouti. The cleaning up of the whole track beginning from the mouth to the stomach related way toward the start of the small digestion tracts, that is mouth, and throat. Asthmatics might notice huge globs of mucus in the ousted water; the solid reflex from the pyloric valve will release bodily fluid discharges from the bronchial cylinders. Kunjal Kriya is suggested as a protected technique during an assault, as the strong activity of the vagus nerve delivers fit in the respiratory framework. Every day Kunjal Kriya is suggested for asthmatics under the arrangement of prepared instructors. In this review study, the author focused to rule out the mode of action of Kunjal Kriya in Upper Respiratory Tract Infections w.s.r. to Bronchial Asthma.

HISTOPATHOLOGY OF GALLBLADDER SPECIMENS AFTER CHOLECYSTECTOMY: A RETROSPECTIVE STUDY

Background Current approach to detect the presence of gallbladder carcinoma involves a routine histopathological examination of all gallbladder specimens, regardless of the clinical characteristics of the patient or macroscopic aspect of the gallbladder. Available pathological reports were interpreted for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic information and clinicopathologic characteristics of the patients with histopathologic findings were assessed in detail, and re-examination of the available specimens was done. Inpatient records of the Methods patients who had been operated for elective and emergency cholecystectomies in the hospital associated with Khaja Bandanawaz University – Faculty of medical Sciences; from January 2018 to November 2022, were retrospectively evaluated. Results A total of 661 gallbladder specimens submitted for histopathological examination during the study period were included in the study. The results of histopathological examination of these gallbladder specimens showed that chronic cholecystitis was found in 535 (81%), acute cholecystitis in 46 (6.99%), cholesterolosis in 44 (6.5%) patients, Dysplasia was found in 34 (5.14%) patients, and gallbladder carcinoma was detected in 2 (0.30%) patients. Conclusion A strategy of selective approach for histopathological examination of gallbladder specimens may be safe in areas with very low incidence of gallbladder carcinoma. Such selective strategy is more cost-effective, reduces the workload of pathologists, and does not appear to compromise patient outcome.

Nasogastric tube insertion using conventional versus bubble technique for its confirmation in anesthetized patients: a prospective randomized study

Abstract Background: Nasogastric tube insertion and confirmation of its position can be difficult in the anesthetized patient. The purpose of the present study was to compare the bubble technique with the conventional method for confirmation of nasogastric tube placement in these patients. Methods: Two hundred sixty adult patients, aged between 20-70 years, posted for surgeries requiring general anesthesia, tracheal intubation, and a nasogastric tube were enrolled in this study. Patients were randomized into 2 groups: Group B (Bubble group) and Group C (Control group). In Group C, a conventional technique using a lubricated nasogastric tube was positioned through the nostril with head remained neutral. In Group B, 2% lidocaine jelly was added to the proximal end to form a single bubble. The correct placement of the nasogastric tube in the stomach was confirmed by fluoroscopy by an independent observer intraoperatively. Results: The duration of nasogastric tube insertion was 57.2 ± 13.3seconds in Group B and 59.8 ± 11.9seconds in Group C (p = 0.111). The confirmation rate of the bubble technique was 76.8% (95% CI: 68.7-83.3), which was significantly better than the conventional method where the confirmation rate was 59.7% (95% CI 50.9-67.9), p< 0.001. When compared to fluoroscopy, bubble technique was found to have a sensitivity of 92.3% (95% CI: 85.6-96.1) with specificity of 81.0% (95% CI: 60.0-92.3), positive predictive value of 96.0% (95% CI: 90.2-98.4), and a moderate negative predictive value of 68.0% (95% CI: 48.4-82.8). Conclusions: The bubble technique of nasogastric tube insertion has a higher confirmation rate in comparison to the conventional technique. Trial Registry Number: Clinical Trial Registry of India (CTRI/2018/09/015864).

Preoperative assessment of inferior vena cava collapsibility index by ultrasound is not a reliable predictor of post-spinal anesthesia hypotension

Abstract Background Post-spinal anesthesia hypotension is of common occurrence, and it hampers tissue perfusion. Several preoperative factors determine patient susceptibility to hypotension. This study aimed to assess the effectiveness of the Inferior Vena Cava Collapsibility Index (IVCCI) for predicting intraoperative hypotension. Methods One hundred twenty-nine adult patients who were scheduled for elective surgical procedures after administration of spinal (intrathecal) anesthesia were included in the study. Ultrasound evaluation of the Inferior Vena Cava (IVC) was done in the preoperative area, and the patients were shifted to the Operating Room (OR) for spinal anesthesia. An independent observer recorded the change in blood pressure after spinal anesthesia inside the OR. Results Twenty-five patients developed hypotension (19.37%). Baseline systolic blood pressure and mean blood pressures were statistically higher in those patients who developed hypotension (p= 0.001). The logistic regression analysis for IVCCI and the incidence of hypotension showed r2 of 0.025. Receiver Operating Characteristic (ROC) curve analysis demonstrated the Area Under the Curve (AUC) of 0.467 (95% Confidence Interval, 0.338 to 0.597; p= 0.615). Conclusions Preoperative evaluation of IVCCI is not a good predictor for the occurrence of hypotension after spinal anesthesia.

Hygiene Predictors among COVID-19 Screened Individuals during the First Wave In Mumbai: A Cross-Sectional Survey

Introduction: taughtThe most important lesson COVID-19 pandemic is basic hygiene practices. It is important to understand hygiene practices among patients during first wave, when meager knowledge about the management of COVID-19 was available. To assess the adopted behavioral practicesObjective: and predictors for COVID-19 infection among screened individuals during the 1st wave. A cross-Method: sectional study included COVID-19 screened individuals attending COVID -19 screening OPD at Mumbai. Total 950 participants were interviewed telephonically using convenient sampling method. Logistic regression nanalysis was performed. A total 950 respondents participated, with median age of36Results: years (range:18yrs to 83 years). Respondents,RTPCR positive or quarantined were 36%. Analysis concludes that practices of having seen or read about hand hygiene, face hygiene, maintaining social distancing, cough etiquettes and enforcement of strict lockdown were significantly associated with lower risk of COVID-19 infection (p value <0.05). Hygiene Practices were followed correctly by more than 50% of thisConclusion: cohort however few individuals were able to answer knowledge related questions correctly. Simple hygiene practices like face hygiene, cough etiquettes, social distancing, strict following of lockdown and having seen or read information on hand washing were predictors of COVID-19 infection. The study highlights the need for quick and rigorous attempts to educate people during a state of a health emergency.

揝how me the way� - Endoilluminator-assisted manual small-incision cataract surgery in a case of corneal scar with a small pupil

Cataracts with coexisting corneal opacities due to various causes present a daunting challenge to surgeons. Adding to the plight could be factors like shallow anterior chamber, small pupil and mono-ocular patient. A manual small-incision cataract surgery (MSICS) could be a saviour in such situations. We demonstrate a case of post perforation corneal scar secondary to Hansen抯 disease with complicated cataract with non-dilating pupil in a bilaterally blind patient. Due to poor visualisation, there could have been difficulties in capsulorrhexsis, cortex aspiration & many other intraoperative manoeuvres, but use of an endo illuminator providing oblique illumination was very useful, resulting in uneventful surgery with good visual outcome. MSCICS, a surgery with minimal instrumentation, short learning curve and comparable results to phacoemulsification is perhaps the preferred procedure, in India, for complicated cataracts with multiple pre-existing pathologies

Manual small-incision cataract surgery under topical anesthesia

Manual small-incision cataract surgery is one of the most common surgical procedures in ophthalmology. Most cataract surgeries are performed under local anaesthesia. Peribulbar or retrobulbar anaesthesia is commonly used to achieve analgesia and akinesia during surgery but it has various complications. Our aim was to study patient comfort and surgeon抯 perspective in terms of patient cooperation in MSICS under topical anaesthesia using only proparacaine 0.5% eye drops without any periocular block or intracameral drug. Also to popularise Topical MSICS similar to Topical Phacoemulsification. A prospective analytical study of 33 patients who underwent MSICS surgery from March 2022 to June 2022 using Topical proparacaine eye drops 0.5% was done and patient抯 comfort and surgeon抯 perspective in terms of patient cooperation was studied on a scale of 1-5. Out of 33 patients who underwent surgery, the average comfort score based on patient feedback was 3.45� 0.96 and average patient cooperation score based on surgeon assessment was 3.42 � 1.07 on a scale of 1-5. We concluded that MSICS using only topical proparacaine 0.5% eye drops, can provide sufficient patient comfort and can avoid complications related to peribulbar anaesthesia. Hence it can be used in large scale cataract surgeries and also provides economical utilisation of resources, lesser complications and early post operative recovery without compromising surgical outcome.

Review on Role of Shukra Dushti (Vitiation of Semen) in Male Infertility and its Management

Infertility is an indeterminate universal issue affecting humanity. It is noticed in approximately 60-80 million couple worldwide among which 40-50% of infertility is estimated to be due to male factors. Male infertility was remarked in Ayurveda as Klaibya and Anapathya. A separate branch as Vajeekarana (Aphrodisiac therapy) was established among eight branches of Ayurveda, emphasizing the awareness of physiology of Shukradhatu (Sperm) and its role in Reproduction along with the measures to procreate children. Shukradushti/Retodushti (vitiation of Semen) occurs due to congenital and acquired factors leading to defective formation or ejaculation of Shukra by vitiation of Tridoshas (three biological humors), resulting in Klaibya (Male Infertility). The clinical diagnosis of Retodushti (vitiation of semen) by clinical signs and symptoms and Retopareeksha (Semen Analysis) is essential for the management of Klaibya, by utilizing drugs possessing Vrushya (Aphrodisiac) Shukrajanana (Spermatogenic), Shukrashodhana (semen purifier) properties and diet-lifestyle modifications. Literature pertaining to Shukradhatu, Shukradushti, Klaibya, Vaieekarana from Ayurvedic classical literatures and reputed journals were referred to gather information. The mention of Retopareeksha in the era of absence of microscope for diagnosis of Shukradushti shows the awareness on the importance of male infertility in the Ancient period.

Analytical Study of Ocular Surface Changes in Patients of Chronic Kidney Disease undergoing Hemodialysis and Peritoneal Dialysis

Objectives?The idiopathic group is a significant cause of chronic kidney disease (CKD) in developing countries. Literature available on ocular surface changes has predominantly been reported in patients undergoing hemodialysis. Little is known about the changes in patients undergoing peritoneal dialysis. The present study aimed to identify ocular surface changes in an idiopathic group of CKD undergoing dialysis. Aim?To compare tear film disorders and the severity of ocular surface changes (goblet cell density, squamous metaplasia, and corneoconjunctival calcification) in patients of idiopathic etiology with CKD undergoing hemodialysis and peritoneal dialysis. This is an analytical study. Materials and Methods?Asymptomatic adult patients of idiopathic CKD, on treatment with dialysis underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp examination, and a dilated fundus examination. Dry eye assessment was done by ocular surface staining score, Schirmer test, and tear breakup time (TBUT). Conjunctival impression cytology was studied to assess changes on ocular surface. Chest X-rays for aortic calcification were reviewed and data analyzed. Results?Both eyes of 76 patients of hemodialysis and 32 patients of peritoneal dialysis were studied. Ocular surface staining (OSS) scores were low. Impression cytology showed a drop in goblet cell density, presence of squamous metaplasia, and conjunctival keratinization significantly more in the hemodialysis group. No correlation was seen between the presence of conjunctival calcification and aortic calcification. Conclusion?The hemodialysis group had mild subclinical dry eye but keratinization of conjunctiva was seen. Similarly, advanced squamous metaplasia was seen in the peritoneal dialysis group. These changes were positively correlated to decrease in goblet cell density.

Systemic review through published clinical trials of artavakshaya

Menstrual irregularity is one of the most frequent gynaecologic disorders among women in reproductive age. In modern science, the treatment is based on mostly hormone therapy. Due to the need of an era for alternative medicine in field of gynecology, present study was tried to overview oral medicine used to treat Artavakshayaaccording Ayurveda classics. This systematic review was designed in order to gather information regarding oral medications for Artavakshayain Ayurveda.This study had several steps assearching only randomised clinical trials in Ayurveda medicine literature, extracting them and finding evidences. To search Ayurveda medicine digital library was used, which includes several ancient traditional medical references. There quire data was gathered using data base such as Google scholar, PubMed, Dhara, Medknow, OMICS, Scopus, J-gate for knowledge. This paper explores different research articles related reviews and overall analysis about oral therapy which can be applied in the treatment of Artavakshaya.

RIGHT ATRIAL MASSES – A SERIES OF THREE CASES

Cardiac masses are rare, and they pose an interesting diagnostic and therapeutic challenge. The differentials vary from tumours – both primary and secondary, thrombus, infective vegetations, artifacts to cysts. They can present with obstructive symptoms, embolisation, constitutional symptoms or pericardial effusions. Multimodality imaging with echocardiogram, computed tomography (CT) and magnetic resonance imaging (MRI) help in diagnosis. Complete surgical resection is often the modality of choice in cases of tumours. Thrombolysis or surgical extraction is suitable in cases of thrombus in the right heart.

MBL PRODUCING P.PENNERI - A MAJOR THREAT TO THE HOSPITAL

Introduction: Proteus spp. has been the signi?cant cause of wound infections as they commonly colonize the wound. Simultaneously multiple drug resistance mechanisms also pose a therapeutic challenge. P.penneri is commonly misidenti?ed as P.mirabilis which is multidrug resistant. The current study was Aim and objectives: conducted to determine the prevalence of MBLs in P.penneri among wound infections at a tertiary care hospital from Western Maharashtra. Specimens collected from wounds of OPD and IPD patients were examined by standard Material and Methods: bacteriological methods. All Proteus isolates were subjected to Antimicrobial susceptibility and MBL production test as per CLSI guidelines. Total 1826 wound samples were screened over the period of May 2017 to July 2018. Overall Results: prevalence of Proteus spp. was 7.12%, P.mirabilis being the commonest. Among all isolates 53.68% and 37.04% of P.mirabilis and P.vulgaris were ESBL producers, respectively. The rate for MBL production was 11.58% and 0% for P.mirabilis and P.vulgaris, respectively. On the contrary 75% of P.penneri isolates were ESBL producers and 12.5% were MBL producers. Discussion and conclusion: Emergence of ESBL and MBL producers is of special concern as Proteus spp. is intrinsically resistant to tigecycline and colistin. Identi?cation of P.penneri from clinical specimens is necessary, due to its multidrug resistance which makes clinical treatment extremely dif?cult. This will limit its control and eradication especially from wound infections as they are common colonizers. Therefore isolation of such beta lactamases producing P.penneri shall be considered as an alarming sign to control the spread of this superbug.

A report on a series of nanophthalmos with histopathology and immunohistochemistry analyses using light microscopy

We aimed to study the histopathological and immunohistochemistry features in clinically diagnosed cases of nanophthalmos using light microscopy. This was an observational comparative study. We enrolled four eyes of four consecutive patients with nanophthalmos and visually significant cataract, who underwent cataract surgery with prophylactic posterior sclerostomy. Histological analysis of the excised scleral tissue was done and compared with age-matched cadaver controls between January 2021 and October 2021. Hematoxylin and Eosin (H&E) stains were used for histological analysis, and was further supplemented with immunohistochemistry (IHC) and immunofluorescence (IF) analyses using a simple light microscope. The immunostained sections were analyzed using confocal microscope for the fibronectin expression level. The main outcome measure was demonstration of histological changes of sclera in nanophthalmic eyes undergoing cataract surgery. Light microscopic features of nanophthalmos revealed thick fibers with fraying and lightly stained cores, irregular serrated edges, and randomly interspersed fibroblasts compared to regular arrangement of collagen fibers seen in cadaver controls. Immunohistochemistry analysis with anti-fibronectin antibody showed strong positivity in clustered fibers in nanophthalmos, and less intense diffuse staining in cadaver tissue. Histoclinical correlation was observed in one nanophthalmic scleral tissue with axial length less than 17 mm showing severe disorganization with diffuse collagenization, loss of fibrillary architecture compared to another specimen with axial length more than 17 mm. Simple, cost-effective light microscopy using basic stains was effective in identifying the characteristic histopathological features in nanophthalmic eyes, and this was further highlighted by immunohistochemistry and immunofluorescence analyses.