Prospective study of midline abdominal incisional hernia repair by component separation technique augmented with prosthetic mesh

Background: In our tertiary care hospital, we receive a large number of acute abdomen cases. Raised intra-abdominal pressure (IAP) makes laparostomy mandatory initially and abdominal wall approximation cannot be completed due to compromised state in most cases. Large incisional hernias were seen on complete healing and this study was done to see the feasibility of component separation technique (CST) with mesh augmentation.Methods: 30 patients were subjected to CST with mesh augmentation. Preoperative defect size mapping, Pre- and post-operative monitoring of IAP were done. Pain scoring by visual analogue scale (VAS), early and late complications was noted. Patients were followed up for 60 months.Results: CST with mesh augmentation was found to be feasible with 96.77% success rate as no recurrence was noted in follow up. Preoperative average Basal metabolic index was 26.09. Size of defect varied from 17-20×9-16 cm2 (length X width). Seroma seen in 50% of patients was managed without any intervention. Skin necrosis in 6.6% and wound dehiscence in 3.33%, managed with minimal debridement & local wound care respectively. Respiratory compromise and hematoma were not seen and no patient required any active ICU care. Average length of hospital stay was 5.22 days. Close monitoring of IAP in immediate post-operative period was found to be significant.Conclusion: Physical acceptance of stable abdominal wall gives a psychological boost to patients with early recovery in form of ambulation and early return to work.

Body image perception, eating attitude and influence of media among undergraduate students of medical college in Delhi: a cross sectional study

Background: Body image perception is being shaped by unrealistic ideals portrayed in the media. Body dissatisfaction is one of the most consistent and robust risk factors for eating disorders, low self-esteem, depression, and obesity. Therefore, the objective of the current study is to ascertain the body image perception, abnormal eating attitudes and the role of media among undergraduate students of a medical college in Delhi, India.Methods: Cross-sectional study on 370 undergraduate medical students of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India selected using stratified random sampling. India. Students completed a self-administered questionnaire which consist of demographic information, perceived body image, Eating Attitudes test (EAT-26) to assess eating attitudes, Socio Cultural Attitude Towards Appearance Questionnaire 3(SATAQ-3) scale for the role of media on body image perception. Data was analyzed using SPSS v21.Results: A total of 370 students (57.6% males and 42.4% females) aged 17-30 years, mean age of 20.30 years±2.02(SD). Abnormal body image perception was seen in 35.4%, 21.1% had abnormal eating attitude (EAT-26≥20), 36.5%, 40.5% agreed to be influenced by models and athletic figures in media respectively, 42.2% accepted that media was their source of information regarding standards of attractiveness, 27.6% felt pressured to be attractive according to SATAQ-3. Males more than females had disordered eating attitudes and felt media pressure to achieve an ideal body image. Significant association was observed between age and perceived body image (p=0.033), gender and EAT-26 score (p=0.039), EAT 26 and perceived body image (p=0.006), general internalization of media and perceived body image (p=0.003), internalization-general, internalization-athlete, media as source of information and EAT-26 score (<0.001, 0.001, 0.003 respectively).Conclusions: The media should take more responsibility to not represent unrealistic ideals of body image concerning both males and females. Educational and preventive efforts at institutional levels should be made to promote a healthy body image and eating behaviours.

Controlled Under vision TEchnique (CUTE) of Laparoscopic Port Site Closure

BACKGROUND:Various new challenges have emerged since the introduction of laparoscopic surgery. Port site hernia is one of the serious complication. Various methods have been introduced to reduce it. The aim of this article is to introduce a procedure that is easy, safe and quick to perform and will help in decreasing port site complications after laparoscopic procedure.MATERIAL AND METHOD:We have described here a simple technique for the facial closure after laparoscopic surgery over 100 patients who underwent laparoscopic cholecystectomy repair at VMMC & Safdarjung Hospital, New Delhi.RESULT:This method was used in 100 patients with no intro-operative complication, no port site hernia reported in a follow up period of 1 year.CONCLUSION:This procedure of fascial closure is safe, quick, effective and easy to perform method of facial closure.

Stability Indicating Simultaneous Equation Method for Determination of Domperidone and (S)-Esomeprazole Magnesium in Capsule Dosage Form Using UV-Spectrophotometer.

Aims: Stability indicating simultaneous equation method for determination of Domperidone and Esomeprazole Magnesium in capsule dosage form using UVSpectrophotometry. Study Design: A new simultaneous equation method was developed and validated for the determination of esomeprazole magnesium and domperidone in capsule dosage form. Place and Duration of Study: Department of Pharmaceutical Chemistry, Invertis Institute of Pharmacy, Invertis University, Bareilly, Uttar Pradesh during July 2012 to June 2013. Methodology: Simultaneous equation method was performed for estimation of dosage form and degradants. Results: The maximum wavelength (λmax) was found to be 299 nm for esomeprazole magnesium and 287 nm for domperidone. The linearity range was found to be 1-6 μg ml-1 (r2= 0.998) and 5-30 μg ml-1 (r2= 0.999) for esomeprazole magnesium and domperidone, respectively. The value of limit of detection and limit of quantification was 0.116 and 0.386 μgml-1 for esomeprazole magnesium and 0.657 and 2.18 μgml-1 for domperidone, respectively. Forced degradations were carried out under acid, base, thermal, photolytic and oxidative stress conditions. The method was satisfactorily validated as per the ICH guideline. Conclusion: This study shows that the proposed spectrophotometric method is useful for the routine determination of esomeprazole magnesium and domperidone in its combined pharmaceutical dosage form.

Purification and characterization of Mn-peroxidase from Musa paradisiaca (banana) stem juice.

Mn-peroxidase (MnP), a biotechnologically important enzyme was purified for the first time from a plant source Musa paradisiaca (banana) stem, which is an agro-waste easily available after harvest of banana fruits. MnP was earlier purified only from the fungal sources. The enzyme was purified from stem juice by ultrafiltration and anion-exchange column chromatography on diethylamino ethylcellulose with 8-fold purification and purification yield of 65%. The enzyme gave a single protein band in SDS-PAGE corresponding to molecular mass 43 kDa. The Native-PAGE of the enzyme also gave a single protein band, confirming the purity of the enzyme. The UV/VIS spectrum of the purified enzyme differed from the other heme peroxidases, as the Soret band was shifted towards lower wavelength and the enzyme had an intense absorption band around 250 nm. The Km values using MnSO4 and H2O2 as the substrates of the purified enzyme were 21.0 and 9.5 μM, respectively. The calculated kcat value of the purified enzyme using Mn(II) as the substrate in 50 mM lactate buffer (pH 4.5) at 25°C was 6.7s-1, giving a kcat/Km value of 0.32 μM-1s-1. The kcat value for the MnP-catalyzed reaction was found to be dependent of the Mn(III) chelator molecules malonate, lactate and oxalate, indicating that the enzyme oxidized chelated Mn(II) to Mn(III). The pH and temperature optima of the enzyme were 4.5 and 25°C, respectively. The enzyme in combination with H2O2 liberated bromine and iodine in presence of KBr and KI respectively. All these enzymatic characteristics were similar to those of fungal MnP. The enzyme has the potential as a green brominating and iodinating agent in combination with KBr/KI and H2O2.

No-patch 23-gauge vitrectomy under topical anesthesia: A pilot study.

A pilot study was designed to evaluate the safety and efficacy of 23-gauge vitrectomy under topical anesthesia. Five eyes of five patients underwent 23-gauge sutureless vitrectomy under topical anesthesia with a pledget soaked in 0.5% proparacaine hydrochloride anesthetic, for vitreous hemorrhage (four eyes), epiretinal membrane (one eye). Subjective pain and discomfort were graded using a visual analogue chart from 0 (no pain or discomfort) to 4 (severe pain and discomfort). At the end of surgery no patch was applied and patients were given dark glasses. Patients underwent an immediate postoperative assessment, followed by next day and one week postoperative evaluation. Four patients had Grade 0 pain during the surgery. One patient had Grade 1 pain during the placement and withdrawal of the micro cannulas. The surgical outcomes were favorable. 23-gauge vitrectomy under topical anesthesia is safe and effective in selected cases. Further study is recommended to validate the outcome of this study.

Mesentric Panniculitis : A Rare Clinical Entity.

Mesenteric panniculitis is a rare, fibrosing inflammatory disease of the mesentery. Its presents with a variety of symptoms and is diagnosis is mostly by CT scan abdomen. We present a case report of a 48 years old gentleman with symptoms of mainly pain abdomen. He was treated conservatively and subsequently improved.

Diagnostic utility of fine needle non-aspiration cytology versus fine needle aspiration cytology in breast masses.

Fine needle aspiration cytology (FNAC) and fine needle non-aspiration cytology (FNNAC) techniques were studied in 145 cases of breast masses. All the needle-sampling procedures were done by single operator. The samples were assessed cytologically and evaluated using five parameters i.e. background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant. After evaluation of FNNAC and FNAC on the basis of these scores, greater number of diagnostically superior samples were obtained by FNNAC; however by FNAC more number of diagnostically adequate smears were observed. This difference was statistically significant. The number of unsuitable smears were also more by FNNAC technique.