Evaluation of mesh fixation versus non-fixation in laparoscopic mesh hernioplasty in inguinal hernias

 Background: Laparoscopic inguinal hernia repair (LIHR) is usually done by two methods, which vary in approach to the preperitoneal space; transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP). This study aimed at comparing the effect of mesh fixation and non-fixation in terms of operative time, hospital stay, analgesic requirement, complications and cost analysis with respect to fixation device in LIHR.Methods: This prospective randomized comparative study included 60 patients of inguinal hernias admitted to the Department of Surgery at Rajendra Hospital, G.M.C, Patiala from July 2016 to September 2017 (duration of study was 15 months). Cases were divided into two groups by draw of lots with group A as mesh fixation (n=30) and group B as non-fixation (n=30).Results: The results were calculated with chi square test (p value). Results were found to be not significant in two groups in the terms of postoperative analgesia, complications i.e. (intraoperative, postoperative and long term) postoperative hospital stay and time to return for work. The cost of procedure was found to be very high in Group A and results were highly significant (p<0.001).Conclusion: LIHR repair without mesh fixation shows advantages over mesh fixation, which includes significant less cost of surgery, with comparable intraoperative, postoperative and long-term complications (with no increase in hernia recurrence), hospital stay and mean operative time. Hence, our study favours LIHR without mesh fixation a valuable alterative option.

Role of Raktapradoshaja Nidana in the manifestation of Kushtharoga in Ayurveda: a cross sectional survey study

Background: In Ayurveda all the skin diseases are described under the term Kushtha which is mentioned as a Raktapradoshaja vikara. Due to Rakta dusti several disease pathogenesis accurse in population which leads to Raktapradoshaja vikara.Methods: Present study aimed to conduct a cross-sectional survey based study for investigating the role of Raktapradoshaja nidana in the pathogenesis Kushtha (skin diseases). A duly prepared proforma was prepared based on various etiology of Raktapradoshaja vikara mentioned in classical texts of Ayurveda. Total 500 patients diagnosed as skin disease were screened on the basis of prepared questionnaires prior obtaining the ethical clearance form IEC, NIA, Jaipur (IEC/ACA/2017/60 dated 26/04/2017).Results: Based on over all observation the present survey study explains an easy diagnostic criterion for the different types of Raktapradoshaja vikara mentioned in Ayurveda. Here a unique attempt was taken for quantitative analysis of various classical nidana in relation to the pathogenesis of the disease Raktapradoshaja vikara.Conclusions: Analyzed data of all these extreme exposure of nidana may provide a significant role for diagnosis, prognosis, as well as prevention of the disease of Raktapradoshaja vikara.

Elucidation of Immunomodulating Potential of Morus alba against Sub Acute Exposure of Fipronil in Rats

Immunotoxicity is defined as adverse effects on the functioning of the immune system that results from exposure to chemical substances. The present investigation was carried out to evaluate immunomodulating effect of Morus alba (500mg/kg B.w.) against immunotoxicity induced by sub-acute exposure of Fipronil (10mg/kg B.w.) in rats. Sub-acute immunotoxicity was conducted in adult male wistar rats. Rats were randomly divided into four groups (6 rats/group). Group I served as control in which corn oil (acting as a vehicle of Fipronil) was administered @10 ml/kg B.w. Group II served as Fipronil treated group @10 mg/kg B.w. In Group III Fipronil along with Morus alba fruits extract @ 300 mg/kg B.w. was administered and in Group IV Morus alba fruits extract @ 300 mg/kg B.w. was administered. Vehicle, Fipronil and Morus alba were administered daily to the rats by oral gavage for 28 days. The dose of fipronil was selected on the basis of LD50 in rats. TLC, DLC, serum total protein, albumin, globulin, A:G ratio, serum antibody titer/haemagglutination (HA) titer and delayed type hypersensitivity (DTH) response were estimated. Fipronil produced immunotoxicity in the form of alteration from normal values in these parameters. Morus alba was significantly effective in restoration of these parameters towards normal. The study suggested that Morus alba has immunomodulating potential against toxicity induced by fipronil in rats.

Pharmacognostic investigation on roots & leaves extract of Abutilon indicum linn.

Herbal medicines are natural products and their phytoconstitutents vary depending on time and region, processing and storage. Variations in the collection, processing or storage of an herb could impact its efficacy profile. Since prior knowledge regarding appropriate collection and usage of most medicinal plants exists in tradition, it can be used as a guide to quality standardization. The present study is aimed to carry out research work to evaluate Pharmacognostic investigation on Root & Leaf extract of Abutilon indicum. From the literature study it is found that a very little work is done on root & leaf part of plant for setting standardization limits. So, our aim is to find out again various standardization limits according WHO guideline like macroscopic & microscopic study, to find out LOD, ash values, extractive values etc. for root & leaf part of drug with a view to control the quality of crude drug.

Formulation and Characterization of Transdermal Patches of Losartan.

Administration of drugs through skin has received great attention through the last decade. Hence this study aims to formulate an anti-hypertensive drug losartan as transdermal patch using different bioadhesive polymers such as ethyl cellulose, cellulose acetate, and polyvinyl pyrrolidon,hydroxyl propylemethylcellulose with plasticizers propylene glycol (PG). Patches were prepared though solvent evaporation method, The backing membrane was a non permeable aluminium foil laminated with polyethylene and evaluated for thickness uniformity, Uniformity of weight, Scanning Electron Microscopy, Surface pH, Swelling studies, Drug content uniformity Effect on agingn, skin irritation potential, and In vitro release study.Patches exhibited controlled release over more than 2 hr.It was concluded that patches containing 30 mg of losartane with HPMC (formulation F2) ,showed moderate swelling, surface pH and controlled drug release, thus can be selected for the development of transdermal patches for effective uses.

Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation.

Intestinal myiasis is usually an accidental phenomenon which is transient and asymptomatic. It occurs due to intake of contaminated food or water containing fly larvae or eggs. We report a case of invasive intestinal myiasis presenting with complaint of pain, blood-mixed mucous discharge per rectum along with passage of maggots in stool. On proctoscopy an irregular fungating rectal growth with maggots was detected in rectum and anal canal. Excision of growth with diversion colostomy was done. On histopathology numerous variable-sized larvae in different stages of development were detected throughout the inflamed and necrosed bowel wall. No tumor was seen. With maintenance of proper hygiene, vermicide anti inflammatory and purgatives were given. Patient became alright after colostomy closure. The symptomatic presentation as a mass lesion and necessity for surgical intervention prompted us to report this rare case.

Niosomal drug delivery system: The magic bullet.

The concept of drug targeting or site specific drug delivery was introduced first time by Paul Elrich in 1909, when he reported ‘magic bullet’ to deliver a drug to the desired site of action without affecting the non target organs or tissues (Juliano, 1980) by associating the drug with a pharmacologically “inactive carrier” capable of conveying the drug selectively towards its target cells. The methods of preparation of niosomes such as hand shaking, ether injection and sonication (developed on the basis of liposome production technique) have been reviewed by Khandare et al., 1994. The hand shaking method form vesicles with greater diameter [0.35 – 13􀀀m] as compared to those prepared by ether injection method [50-1000nm]. The film formation method was used for the preparation of the niosomes due to simplicity, reproducibility and high drug entrapment efficiency.

Recurrent posterior fossa anaplastic ependymoma with prominent chondroid metaplasia: A case report and review of literature.

We report an unusual case of a recurrent fourth ventricular anaplastic ependymoma with prominent chondroid metaplasia in a 16-year-old male. On initial presentation, the patient had a WHO Grade II tumor. However, at recurrence 1 year later, the tumor progressed to WHO Grade III tumor with more cellularity, necrosis and brisk mitotic activity. Chondroid metaplasia was present in both the initial and recurrent tumors.