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Background: Head and neck squamous cell carcinomas are the sixth most common cancer, with 830,000 new cases and 430,000 deaths annually. India accounts for 30% of global cases, with 119,992 new cases and 72,616 deaths in 2018. Locally advanced cancers (stage III or higher) have a high recurrence rate despite treatment advances. Hypofractionated radiotherapy, offering larger doses in shorter durations, shows promise for better tumor control and patient compliance, prompting a randomized study on its efficacy and tolerance. Methods: A total of 70 patients (15 months study) who were willing to give informed consent and fulfilling the specified inclusion and exclusion criteria were enrolled for the study. This 15-month study at the State Cancer Institute, Jabalpur, enrolled 70 head and neck squamous cell carcinoma patients. Eligible participants were aged 18-70, treatment-naive, and had an ECOG score of 0-2. Patients were randomized into two treatment arms, both receiving weekly cisplatin. Treatment response and adverse reactions were monitored weekly, with evaluations based on WHO and RTOG criteria. Results: Both arms had similar male dominance (~87-89%) and rural representation (~80-82.5%). Tobacco use was high in both groups (~77-80%), with Arm B showing higher alcohol and dual addiction rates (65.71% vs. 41.67%). Arm A had a higher complete response rate (77.1% vs. 62.8%), and fewer cases of progressive disease (0% vs. 20%). Toxicities were manageable, with similar dysphagia rates, but Arm B showed more severe mucositis. Conclusion: The study concluded that hypofractionated radiation therapy can be preferred over conventional chemoradiation therapy because it offers a comparable clinical response with manageable toxicities.
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Background: Type 2 diabetes mellitus (T2DM) poses a significant health-care challenge and is a primary contributor to both mortality and morbidity. Diabetic autonomic neuropathy (DAN) is a frequently occurring complication associated with diabetes mellitus. Autonomic nerve damage leading to cardiac autonomic dysfunction and peripheral sympathetic neuropathy can lead to changes in heart rate variability (HRV) and galvanic skin response (GSR), respectively. Aims and Objectives: The study was designed and done to evaluate the impact of T2DM on HRV and GSR for assessing DAN. Materials and Methods: A total of 100 individuals diagnosed with T2DM (cases) and 100 healthy individuals (controls) participated in this study. Physio Pac (PC-2004) was used to record the necessary data. Statistical analysis was performed using the non-parametric Mann– Whitney test to see the comparison of the cases and controls. In addition, to measure the statistical relationship between the duration of the disease and the HRV and GSR parameters, Spearman’s rank correlation coefficient was utilized. The study received approval from the Ethical and Research Committee at the Government Medical College, Patiala. Results: Significant statistical differences were observed between the cases and controls in all time domain measures, as well as GSR and the majority of frequency domain measures of HRV. The correlation analysis revealed a strong association between the duration of T2DM and a decrease in HRV as well as an increase in GSR. Conclusion: The findings from the present study provide evidence that T2DM has an impact on HRV, which suggests the presence of cardiac autonomic neuropathy among diabetic patients, leading to an increased risk of cardiovascular morbidity. In addition, the study indicates that reduced sudomotor function, as assessed by galvanic skin response (GSR), serves as a predictive measure for autonomic neuropathy. Therefore, these tests can serve as valuable tools in facilitating the assessment of DAN.
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Background: Obesity is defined as an excessive accumulation of fat in the body, resulting in adverse effects on the health of the individual. Obesity alters the relationship between the lungs, chest wall, and diaphragm. So, it has been expected to alter respiratory function. Aims and Objectives: The aim of the present study was to conduct a study of pulmonary function in obese (study group) and non-obese (control group) healthy college students. Materials and Methods: The present study involved 100 subjects in the age group of 18–25 years, both obese and non-obese, recruited from various colleges. Out of a total of 100 subjects, 50 were obese (study group) and 50 were non-obese (control group) subjects. Data were statistically analyzed using an unpaired Student “t” test; P < 0.05 was considered statistically significant. Results: In this study, pulmonary functions such as peak expiratory flow rate and maximum voluntary ventilation decreased significantly (<0.05) in obese people when compared with non-obese people. forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) decreased in obese people when compared with non-obese people, but the results were not significant (>0.05). There was no change in FEV1/FVC%. Conclusion: Obesity can cause various deleterious effects on respiratory function. These changes in lung function are caused by extra adipose tissue in the chest wall and abdominal cavity compressing the thoracic cage, diaphragm, and lungs.
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Background: Inguinal Hernia mesh repair surgery is one of the most commonly conducted surgical procedures. Between two approaches: open and laparoscopic, which is better for the patient in terms of cost and outcome in terms of quality of life and return to economic activity. To facilitate comparability across studies, cost effectiveness analysis requires measurement of both costs and quality adjusted life years (QALY). Methods: Descriptive, observational study which entails classifying costs, identifying cost centres, tracing all costs related to the elective procedures for inguinal mesh hernioplasty by both open and laparoscopic methods followed by checking the Quality of life pre and post-surgery of these patients through the EQ-5D-3L by telephonic interview. A Cost Effective analysis was conducted by the end of the study. Based on available data, we took 35 cases of laparoscopic procedure and 45 cases of open surgery as a universal sample size. Results: Traditional costing showed a difference of approximately INR 3245.93/- in the 2 procedures with laparoscopic surgery being costlier. Significant improvements were noted in patients post laparoscopic surgeries with less people complaining of post operative pain/discomfort and early resumption of daily activities and mobility within a month after the surgery. ICER is tilted in favour of laparoscopic surgeries by a value of Rs 1,08,197.66 per QALY. Conclusions: The difference in cost is minimal but the difference in the QALY scores and ultimately the ICER determines that laparoscopic surgery has an edge over open surgery in terms of outcome and patient comfort.
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The Gram-positive Enterococci found in the normal flora of the gastrointestinal tract (GIT) and urinary tract infection (UTI) were characterized by high resistance to antibiotics and large virulence. The aim of our study was to evaluate the diversity of antibiotic-resistant and quorum-sensing assays of Enterococcus faecalis isolated from urine samples of children aged between 11 and 15 with UTI. A total of 155 samples were collected from hospitals and diagnostic centers of Kalaburagi region. The E. faecalis isolates were screened on bile esculin azide agar media. Antibiotic susceptibility test was performed using different antibiotics as per Clinical and Laboratory Standards Institute guidelines. Minimum inhibitory concentrations (MICs) for gentamycin and vancomycin were determined by the method of broth dilution. Quorum sensing assay of E. faecalis was determined by a bioluminescence-based method. The species-level identification of E. faecalis isolates was determined by 16S rRNA polymerase chain reaction amplification. The incidence of E. faecalis in urine samples was found to be 47.74% (74/155). Antimicrobial susceptibility test (AST) indicates that 27% of isolates were multi-drug resistant, showing increased resistance to gentamycin and vancomycin (54.05%). MIC results show that 23 isolates were resistant to gentamycin with concentration of 128 ?g/ml and 17 isolates were resistant to vancomycin with concentration of 1024 ?g/ml. The quorum sensing assay has shown that the normalized relative light units range from 0.4 to 1.2. According to the 16srRNA gene amplification, out of 10 isolates, seven were identified as Enterococcus faecalis and three isolates were Streptococcus gallolyticus. This study emphasizes the development of increased vancomycin resistance of E. faecalis and indicates the presence of the virulence factors through the autoinducer assay. It is been suggested that major precaution measures should be implemented in the eradication of VRE in UTI infection.
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Background: Sleep disturbances are common among medical students worldwide and affects their health and academic performance. The objective of this study was to assess the quality of sleep in undergraduate medical students of Delhi. Methods: A cross-sectional study was conducted among 234 undergraduate students from medical college in New Delhi. A pre-designed, pre-tested questionnaire was used to collect socio-demographic and life style details and Pittsburgh Sleep Quality Index (PSQI) was used to study the quality of sleep. Data was analyzed by SPSS software version 25.0 and for qualitative data analysis chi-square test was used. Results: Mean age of study subjects was 21.99±1.74 years and males (67.5%) were more as compared to (32.5%) females. Most of the participants 47.4% were in first and second year, 35.5% were from third and final year and 17.1% were interns. Out of 234 participants, only 44% of study participants has good quality of sleep. Most of study participants (56%) were suffering from poor sleep quality. Batch of MBBS, relationship status, BMI and dietary habits of participants were found to be significant predictors of quality of sleep. Conclusions: This study shows that 56% of study participants were suffering from poor quality of sleep. Professionals and medical students who suffer from poor sleep quality have a higher risk of misjudgements, substance abuse, accidents, burnout, anxiety, and depression. So, there is a need to improve knowledge regarding importance of good sleep quality among medical students.
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Background: Tropical pulmonary eosinophilia (TPE) is a prominent feature of lymphatic filariasis caused predominantly by lymphatic-dwelling filarial infections (e.g., Wuchereria bancrofti, Brugia malayi, Brugia timori). While some filarial species are endemic in tropical and subtropical regions, worldwide travel and immigration have resulted in incidences in non-endemic areas. Case description: A 26-year-old laboratory worker with a 3-month history of nonproductive cough, dyspnea, and intermittent fever. Initially diagnosed with asthma, but symptoms continued despite medication. Eosinophilia, increased immunoglobulin E (IgE) levels, and reticulonodular lung opacities were discovered in laboratory tests. Spirometry revealed restrictive as well as obstructive behaviors. Clinical criteria validated the diagnosis of TPE, and therapy with diethylcarbamazine (DEC) led to significant symptom alleviation and laboratory improvements. Discussion: Tropical pulmonary eosinophilia is difficult to diagnose due to its diverse appearance, miming illnesses such as asthma and allergic bronchopulmonary aspergillosis. Clinical factors such as residence/travel history, paroxysmal cough, eosinophilia, increased IgE, lung infiltrations, and response to DEC are used to make an accurate diagnosis. Furthermore, differential diagnoses include a variety of eosinophilic lung disorders. Clinicians should be cautious in non-endemic areas and rule out other illnesses caused by helminth infections, such as Loeffler syndrome. Conclusion: This case emphasizes the necessity of including TPE in the differential diagnosis of respiratory symptoms, particularly in nonendemic locations, and indicates the efficacy of DEC in treating this illness.
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Background: Nerve conduction studies (NCS) are known to be influenced by various physiological and environmental factors. Region and population-specific normative reference values of NCS required for comparison and evaluation of results have been published in many research studies but the age-group-specific significant pattern of reference values is not available for the same. Researchers have agreed that results are variable by chronological age, the present study was carried out to determine the effect of aging on nerve conduction velocity (NCV) of two commonly tested median and ulnar nerves of upper limb in individuals of different age groups. Furthermore, the motive was to collect reference data that can be used during clinically significant diagnostic testing of nerves. Aims and Objectives: The study aimed to study the effect of aging on nerve conduction velocities of the median and ulnar nerve, as well as to observe the correlation of age and changes in NCS of the median and ulnar nerve. Materials and Methods: A cross-sectional (observational) study was conducted on 110 healthy individuals (count of males-60, females-50). The subjects for the study were taken up amongst the volunteers (medical students, teaching and non- teaching staff members in the Government Medical College and Rajindra Hospital, Patiala, and healthy volunteers who were willing to participate in the study). The subjects were grouped according to their age: Group I (18–30 years) (n = 38), Group II (31–45 years) (n = 38), and Group III (46–60 years) (n = 34). The motor and sensory distal latencies, amplitudes, and NCVs of median and ulnar nerves were recorded, and data were evaluated. Results: The mean and standard deviation of the median and ulnar nerve was studied for latencies, amplitude, and velocities for both sensory and motor components. Patients with older age had longer latencies (median: Motor and sensory P < 0.001, ulnar: Motor = 0.013 and sensory = 0.006), smaller amplitudes (median: Motor P = 0.013 and sensory <0.001, ulnar: Motor P = 0.014, and sensory = 0.008), and slower conduction velocities (median: Motor P < 0.001 and sensory = 0.006, ulnar: Motor P = 0.003 and sensory = 0.069) compared with the younger age group, and the change was well observed in the age group of ?46 years. The change with age was greater in sensory nerve conduction of the median and ulnar nerves. Conclusion: Our study results demonstrate that age is significantly correlated with all three nerve conduction parameters recorded from both nerves. An age-matched comparison of the results obtained during routine testing should be made to increase the diagnostic sensitivity of NCS.
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Background: Estimating the age of death is a crucial step since it narrows the field of probable identities that must be compared to remains after mass tragedies. Morphological changes in the mandible are mostly driven by an individual抯 age and occlusal status. The aim of this study was to determine the association of the dimensions of these parameters with the age and gender of an individual with a larger sample size using orthopantograms in the north Indian population. Methods: A retrospective radio morphometric analysis was performed for panoramic radiographs of 300 (150 males and 150 females). The digital panoramic images were saved in Dicom format and exported to MicroDicom software for linear measurements. The co-relation of study parameters with age was analyzed by one-way ANOVA and assessment of co-relation with sex by applying student抯 t-test. Results: The mean values of the right and left gonial angles were higher in females, while the ramus height and bigonial width dimensions were greater in males. However, only the left gonial angle and ramus height showed statistically significant differences with gender (p<0.05). Conclusions: The present study found substantial changes in gonial angle, ramus height, and bigonial breadth based on gender and age in a larger sample size. As a result, these dimensions can be an accurate predictor of an individual抯 age and sex. Thus, morphometric examination of the mandible can be a useful tool in both identifying individuals and studying growth patterns.
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Introduction: Oral lesions are common occurrences in day-to-day clinical scenarios. The accurate diagnosis and appropriate therapeutic intervention are crucial aspects of delivering effective oral health care. It is well-established that the appearance of a lesion itself serves as key diagnostic data, particularly in cases of clinical dermatology. The primary objective of this study is to assess the concordance between clinical evaluations and histopathological diagnoses of pathologies in the oral cavity. Materials and Methods: The questionnaire comprised 10 questions based on clinical photographs, ensuring patient anonymity by avoiding the sharing of identifiable information. The questions aimed to elicit a comprehensive diagnosis for various categories such as odontogenic lesions, salivary gland origins, infectious lesions, and precancerous lesions. Additionally, questions regarding appropriate investigations for each type of lesion were included. The questionnaire was distributed to a diverse group of participants, including undergraduate students (third and final year), interns, postgraduate students, and faculty members from various departments. Results: The present cross-sectional study involved 160 participants, consisting of 71 (44%) undergraduates (UGs), 32 (20%) postgraduates (PGs), 30 (19%) interns, and 27 (17%) faculty members. A total of 10 clinical cases were evaluated. Conclusion: Clinicians should remain focused on the varied causative features and potential diagnostic possibilities, which may necessitate the collection of additional detailed information and a thorough clinical assessment of the patient. In instances where the clinical diagnosis does not align with the etiological factors or the results of laboratory or radiological investigations, the pathology (biopsy report) serves as the ultimate diagnostic tool.
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In agricultural fields, excessive application of pesticides often leads to the contamination of aquatic ecosystems. The present study aimed to evaluate the effects of Mancozeb (MZB) exposure in gills, liver, kidney, and muscles of Channa punctatus (Bloch, 1793). Acute exposure of the test fish to MZB for 96-h resulted in oxidative stress due to elevated levels of reactive oxygen species. In the exposed group markers of oxidative stress such as lipid peroxidation and glutathione showed significant increment and decrement in their activity, respectively. Furthermore, histopathological anomalies were observed in the vital organs of the fish of the treated group. DNA damage was also observed in the erythrocytes, in the form of micronuclei (MN) in the fish, under toxicant exposure. The study clearly reveals that fish, C. punctatus is highly affected when exposed to MZB-contaminated aquatic medium.
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Background: Peripheral arterial disease represents a major caseload in emergency department and also is major cause of distress and socio-economic burden to patient and his/her family due to risk of complications. It has a multifactorial etilogy and requires prompt treatment to salvage the limb and prevent complications. This study is a clinic-pathological correlation between various factors and surgical outcome. Methods: It is a prospective study involving 75 patients who had presented with peripheral vascular disease with different mode of presentations. All patients underwent surgical procedure and were given inj. heparin and tab. Aspirin in post operative period. Their surgical outcome was studied and co-related with etiological factors and clinical presentation. Result: Time from onset till presentation was one of the most important factors in deciding outcome. COVID-19 also emerged as one of the important risk factors in 12 cases. Patients who had been given prior anticoagulation therapy had better outcomes. Conclusions: Outcome in peripheral vascular disease patient depends on variable factors, however starting patients prior on anticoagulants has shown more possibility of salvaging the limb.
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Background: Proton pump inhibitors are the most frequently prescribed class of medications for prescription and over-the-counter, and the data suggest that comorbidities, polypharmacy, self-medication, no clear indications and duration beyond the recommended guidelines PPIs use are associated with renal dysfunction. Aim was to study the proportion of renal dysfunction among patients using oral PPIs and determine the association between the duration of oral PPIs use and the severity of renal dysfunction. Methods: The data collection of 250 patients was done at the time of contact, which included demographic profiles, complete medical history, physical examination, and laboratory investigation in this study. For analysis, name of oral PPIs used, duration and dosage of oral PPIs therapy, laboratory values of serum blood urea, serum creatinine, eGFR, and serum electrolytes parameters have been considered. Results: Amongst 250 patients with PPIs used for a week, 23 patients showed mildly reduced kidney function (p=0.000), PPIs used for >1 to 2 weeks, 29 patients showed grade 2 kidney function (p=0.001), while PPIs used for >2-3 weeks only two patients showed grade 3 kidney function (p=0.44). Patients aged >50 years in all groups showed grade 2 renal function, regardless of the duration of PPIs use. Increasing age, males, rural, smoking, and alcoholics were the risk factors for renal dysfunction. PPIs use significantly impacts eGFR. Conclusions: Collectively, this study found a significant association between PPIs use and renal dysfunction. PPIs used for >2 weeks in elderly patients have shown a 4?fold increased risk of developing renal dysfunction.
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Background: Thalassemia and hemoglobinopathies are a group of inherited conditions characterized by abnormalities in the synthesis or structure of hemoglobin (Hb). According to estimates, approximately 7% of the world population is a carrier of Hb disorders, leading to high morbidity and mortality. To reduce the burden of these highly prevalent monogenic disorders, detecting them in the carrier stage is crucial to prevent disease progression. Aim: We aimed to estimate the prevalence and spectrum of hemoglobinopathies in females in the reproductive (20–40 years) age group. Settings and Design: It was a retrospective observational study carried out for 2.5 years (from January 2018 till June 2020). Materials and Methods: All the females in the age group of 20–40 years age whose blood samples were received in the department for High-Performance Liquid Chromatography (HPLC) were included. The cases with abnormal HPLC findings were analyzed for hematological parameters including hemoglobin, RBC count, and RBC indices [mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), & red cell distribution width - coefficient of variation (RDW-CV)]. Statistical Analysis: Statistical package for social science (SPSS) statistics 21 version for Microsoft Windows (Chicago, USA) was used for statistical analysis of data. The data were described in terms of range, mean ± standard deviation (SD), frequencies (number of cases), and relative frequencies (percentage) as appropriate. Results: During the study period, 72.2% of the females were affected with ?-thalassemia trait, followed by HbD Punjab trait (17.8%), HbQ India trait (2.9%), ?-thalassemia major (1.8%), and two cases (1.2%) each of HbS trait, HbD Iran trait, and compound heterozygous of HbD Punjab and ?-thalassaemia, whereas HbE trait, compound heterozygous of HbQ and ?-thalassemia, compound heterozygous of HbJ-variant and ?-thalassemia had one case each (0.6%). Conclusion: Preventive strategies are cost-effective and include population screening, premarital screening, screening of spouses, genetic counseling, and prenatal diagnosis. Educating the carrier females about the potential risk and various screening methods may help in controlling the disease.
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Laparascopic cholecystectomy is a minimally invasive surgical procedure for the removal of a diseased gall bladder which has largely replaced open cholecystectomy since early 1990s. However some exhibit a certain ‘post cholecystectomy syndrome’ where there is a recurrence of symptoms similar to those before cholecystectomy. We reported a previously asymptomatic thirty eight year old woman with right hypochondrium pain and a history of laparascopic cholecystectomy seven years ago. Various causes for the same were evaluated and the patient was found to have gall bladder stump cholelithiasis on magnetic resonance cholangio pancreatography. A complete cholecystectomy was then performed and the patient achieved symptomatic resolution. It is important to be aware of this complication in post cholecystectomy patients who may present several years later.
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Background: Hepatitis C virus (HCV) is a global prevalent pathogen causes both acute and chronic hepatitis and leading to serious liver damage. Correct and rapid diagnosis is pivotal for the management of HCV disease. Rapid card tests are superior alternatives for the large-scale screening of HCV infection. Methods: The present observational study evaluates analytical performance of four different anti-HCV rapid tests. A total of 200 ELISA confirmed, HCV positive (n=100) and HCV negative (n=100) clinical specimens were selected and re-tested for anti-HCV antibodies by using commercially available four different immunochromatography cards (Meriscreen, Accurate, Oscar and Biolab). Results: Among all, Biolab rapid card test shown highest (98%) sensitivity. On the other hand, all rapid card test kits showed identical 100% specificity. Conclusions: Overall BioLab anti-HCV rapid card tests found to be superior in the present study and strongly suggest in house validation of rapid card tests before their diagnostics use on clinical specimens.
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Background: Hepatitis B virus (HBV) infection is a significant public health problem in third-world countries, including India. The risk of infection among close family members of patients infected with chronic HBV infection is four to six times higher than in the general population. However, literature is scarce regarding the Knowledge, attitude, and practice toward HBV infection among the first-degree relatives of patients suffering from chronic hepatitis B. Hence, this study aimed to assess the knowledge, attitude, and practice regarding hepatitis B virus infection among first-degree relatives of hepatitis B patients. Methods: A cross-sectional, observational study was conducted amongst the 354 first-degree relatives of HBsAg-positive patients. A validated questionnaire consisted of twenty questions of knowledge, seven questions of attitude, and ten practice questions were employed to gather information. Results: The mean knowledge, attitude, and practice (KAP) were significantly better amongst participants aged 55-65 years and those who were educated. There was a positive correlation between knowledge and attitude (r=0.58, p value<0.05) and knowledge and practice (r=0.64, p value<0.05). Conclusions: There is insufficient knowledge regarding hepatitis B, its common symptoms, modes of transmission, and preventive tools among close relatives of patients suffering from chronic hepatitis B.
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Background: Epilepsy is an abnormal excessive electric neuronal activity and always represents by recurrent seizures. There is positive feedback cycle between epileptogenesis and brain inflammation. It has been proved that an inflammatory enzyme, cyclooxygenase (COX) (especially isoform-2, a constitutive enzyme), expressed in some important parts of the central nervous system and is responsible to induced inflammation locally and having seizurogenic property. Aim and Objective: The goal of this study was to see if celecoxib (a selective COX-2 inhibitor) could reduce the maximal electroshock seizure (MES)-induced seizures in mice. Materials and Methods: Celecoxib injected intraperitoneally in two different doses 5 mg/kgb/w and 10 mg/kg b/w, in albino Swiss mice and in two different phases. MES was elicited and length of different phases was noted. Length of tonic hindlimb extension was considered as indicator of anti-epileptic activity. Results: Celecoxib, when given intraperitoneally, exert significant reduction in the duration of THLE. This action of celecoxib strongly suggests the involvement of inflammation in the pathophysiology of epilepsy. Conclusion: The findings are suggestive of the therapeutic significance of celecoxib, as a future antiepileptic agent for seizure management.
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Gastric hyperplastic polyps (GHP) account for a majority of benign gastric polyps. Most of the GHPs are <2 cm, asymptomatic, and incidentally detected on endoscopy or radiologically. With increasing size, these polyps manifest as upper gastrointestinal bleeding, iron deficiency anemia, and gastric outlet obstruction (GOO). We report an unusual case of giant GHP simulating gastric carcinoma and posing as a diagnostic challenge for the surgeons emphasizing the diagnostic role of histopathology. A 46-year-old female presented with clinical features of progressive GOO for 1 year. Endoscopy revealed an eccentric proliferative lesion in the antrum. Computed tomography showed a polypoidal, enhancing mural thickening involving distal body and antro-pyloric region measuring 8.4 cm × 6.6 cm × 1.8 cm. Subtotal gastrectomy was done in view of clinical features of GOO and having a clinical suspicion of malignancy. Gross examination showed a giant sessile hyperplastic polyp with lobulated surface. Microscopy revealed features of a large, sessile hyperplastic polyp without any evidence of dysplasia. The patient was symptomatically relieved and is on follow-up. To conclude, giant GHPs can mimic gastric carcinoma on endoscopy and radiology. The possibility of giant GHP should be kept in mind in the presence of an intensely contrast-enhancing polypoidal lesion in the gastric antrum. Long-term endoscopic follow-up is recommended.
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Regional analgesia features a prime role within the multimodal analgesia approach for surgical pain management. currently each day it's common apply of using transverses abdominis plane block (TAP Block) with numerous sorts of native anaesthetics and adjuvants, as a multimodal pain relieving remedy used worldwide for intra and postoperative pain management in several surgeries. However, only a few studies are done wherever hemodyanamics effects when bupivacaine versus levobupivacaine have compared. Aim of this study to examine the consequences of bupivacaine vs levobupivacaine in patients undergoing lower abdominal surgeries and their effects on hemodynamics ( the blood pressure, HR, and SpO2). Method: A randomised double-blind management study conducted when approval from IEC Ref. code-92nd IIB Thesis / P4 . The study has fifty patients, with ASA I – II physical status, as well as each sex and 2-10 years cluster age and who set up for abdominal surgery notably lower abdominal . 25 patients set in every group and every which way allotted: cluster Bupiva and Levobupiva . All patients were well well-read regarding the procedure, drugs, and effects of drugs, and untoward complications. well-read written consent was taken from each patient before involving them within the study. primary objective is to examine the impact of those medicine on Blood pressure, HR, and SPO2 & Secondary objective was to check rescue physiological condition reduction within the surgical period. After the comparison between these 2 clusters, The mean SBP of group Bupiva was found below that of group Levobupiva . and located to be important at fifteen min, one hour, a pair of hr, and four hr and insignificant at baseline zero min, thirty min, half dozen hr (p=0.092), twelve hr, eighteen hr, and twenty four h.differences is insignificant in comparison the DBP at any purpose of your time from baseline to 24 hr. On comparing the center rate, variations were found insignificant from baseline (p = 0.897), 0 min (p = 0.651), 30 min (p = 0.096), 1hr (p = 0.192), 2 hr (p=0.390), four hour (p=0.525), half dozen hr (p=0.469), twelve hr (p=0.443), eighteen hr (p=0.288) to twenty four hr (p=0. 390) except at fifteen min (p=0.010) that was the mean pulse rate of cluster Bupiva is over that of group Levobupiva at one,5 min. On comparison the SPO2differences were insignificant at baseline (p = 0.620), 15 min (p = 0.108), thirty min (p=0.353), 1 hr (p = 0.789), 2 hr (p = 0.364), 4 hr (p = 0.292) and 6 hr (p = 0. 198) however important at 0 min (p = 0.002), 12hr (p = 0.012), 18hr (p = 0.002) and24 hr (p = 0.028) wherever the mean SPO2 of cluster Bupiva was abundant below the group Levobupiva. Stable hemodynamics for a extended period were provided by Levobupivacaine as compared to Bupivacaine.