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Purpose: To identify the facial anthropometric parameters that predict the difficulty during femtosecond (FS) laser. Methods: This was a single?center observational study was conducted on participants between the ages 18 and 30 years who were planned for FS?LASIK (femtosecond laser?assisted laser in situ keratomileusis) or SMILE (small incision lenticule extraction) at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. The front and side?facing images of the participants were analyzed using Image J software to measure different anthropometric parameters. The nasal bridge index, facial convexity, and other parameters were measured. The difficulty faced by the surgeon during docking was recorded for each subject. The data were analyzed on Stata 14. Results: A total of 97 subjects were included. The mean age was 24 (±7) years. Twenty?three (23.71%) subjects were females while the rest were males. Difficulty in docking was seen in 1 (4.34%) female and 14 (19%) males. The mean nasal bridge index was 92.58 (±4.01) in subjects with deep?set eyes and 89.72 (±4.30) in normal subjects. The mean total facial convexity was 129.28 (±4.24) in deep?set eyes, and 140.23 (±4.74) in normal subjects. Conclusion: Total facial convexity appeared as the most important feature, with the value being less than 133° in most subjects with unfavorable facial anthropometry
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Introduction: Surgical correction is the fundamental strategyfor severe rheumatic mitral regurgitation as (MR) as medicalmanagement for MR can not prevent the hemodynamicconsequences of severe MR in the asymptomatic andminimally symptomatic subjects. The purpose of this study isto assess the impact of duration of progressive rheumatic MRon LVEF, PH, LV and right ventricular dysfunction and decideabout the selection of optimal timing for surgical interventionin our patient population.Material and methods: This study involves the data of 30patients of MVR divided over 2 groups, from 1st January 2015to 31st December, 2018 and follow up of the survivors. Therewere (a) 12 cases of isolated severe MR described as MR and(b) 18 cases of severe MR associated with mild MS describedas MS +MR. Changes in echocardiographic parameters inboth the groups after MVR, LVEF, LVESD, LV end diastolicdiameter (LVEDD), PASP and NYHA functional class wereassessed, analyzed and compared at 30 and 180 days.Results: In the postoperative period after 30 days,improvement of NYHA status were observed to be higher in13 survivors with MS +MR from III to I while it was 6 in MRgroup. This improvement noted more in younger group below40 years. NYHA changes from III to II was observed in 4 ineach in both groups more in older group above 40 years. At180 days, 1 each from NYHA II improved to I in youngergroup. Out of the 2 post operative mortality, there was 1 in MRgroup who had post operative RV dysfunction and died afterdischarge on 29th day and 1 in MS+MR group and who diedof respiratory failure after 7 days though the cardiac indicesimproved and both were in older group.Conclusion: MVR can reversely remodel hearts and restoreLV function with relatively preserved LV.
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Introduction: Renal injuries account for up to 1–5% of alltrauma related injuries. Over the years there has been a shifttowards non-operative treatment for blunt renal trauma. Theaim of our study was to assess outcomes of patients managedconservatively (non-operatively) for high grade blunt renalinjury at our centre.Material and methods: The study was conducted in aretrospective manner using hospital records of last 5 years. Allpatients with blunt renal injuries were included. These patientswere categorized based on AAST(1989) injury gradingand further subdivided into operative and non-operativemanagement groups. These management strategies wereanalyzed in terms of ‘failure of non- operative management’,complications and need for adjunctive procedures. Descriptiveanalysis was done using Microsoft Excel(2010, ver14)software.Results: Forty three patients were included in the study witha mean age of 44.6 years. Out of the total, 28 had grade I– III injuries, 11 had grade IV and 4 had grade V injuries.All the grade I-III patients were managed conservatively andrequired no adjunctive procedures. One (9%) of grade IV and2(50%) of grade V injuries underwent immediate exploration.Out of 10 cases of grade IV injuries which underwent nonoperative management, 3(30%) required delayed explorationand none of the grade V injuries required delayed exploration.Complications included urinary tract infection (UTI) (6 cases),persistent hematuria (3 cases), hypertension(2 cases), urinoma(2 cases) and ileus(2 cases) .All complications were Claviengrade 1-2 with no mortalities overall.Conclusion: If the patient is hemodynamically stable,even grade IV and V blunt renal injuries can be managedconservatively, as is seen in our study where failure of nonoperative management occured in only 30% of grade IV andnone of the Grade V injuries.
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To analyse the effect of sexed semen on different breeds used in artificial insemination following study was conducted using sexed semen from seven different breeds for artificial insemination in females. All bulls used for sexing by ABS India were genomically tested for Holstein and Jersey breeds. A total of 3034 inseminations with Sexcel were performed with 2589 inseminations in dairy cows and 445 in buffaloes. The conception rate of sexed semen using confirmative pregnancy diagnosis (using peri rectal examination) at 90 days post insemination both in cows and buffaloes was recorded. Sex of the calf was recorded after the birth in each case. The results of conception rate (CR) and pregnancy rate evaluation in different breeds were recorded. The results revealed the average conception rate of Sexcel semen is 49.1% (ranging from 45.1 to 55.3%) in cows and 42.7 % in buffaloes. These figures show a cumulative picture wherein sexed semen was used in animals of different parities (Both primiparous and pluriparous). The current study provides ample insights into the conception rate using sexed semen under various agro climatic conditions in different breeds. The study showed that sexed semen gives good conception in animals of one to three parities provided they are reproductively clean and possess good fertility
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Background: Pleural space infection is common and causessignificant morbidity and mortality up to 10%. The propermanagement of empyema remains controversial, and patientsare often seen by a physician after their purulent process hasalready reached the fibrinopurulent or chronic stage. Thesepatients are often subjected to multiple procedures and longhospitalization before the empyema is successfully treated.Most cases are treated initially using antibiotics with or withoutrepeated thoracentesis or chest tube insertion. Surgicalapproaches, such as video-assisted thoracic surgery (VATS) oropen thoracotomy and decortications, are usually reserved forpatients with deteriorated clinical condition following failedconservative treatment, which in turn increase the mortalityrate.Aims and Objective: The aim of our retrospective study is toevaluate our experience with thoracic empyema over a 36-month period with special attention to procedures used,success rate of each procedure and outcome.Materials & Methods: A retrospective chart analysis onpatients in whom thoracic empyema was diagnosed fromMarch 2016 to March 2018 at Civil hospital, BJ Medicalcollege, Ahmedabad, India. was performed. The definition ofempyema was selected as any pleural fluid that was grosslypurulent, and/or had a positive Gram stain or culture andempyema were classified by etiology and culture results.Charts were reviewed for patients age, symptoms, underlyingdisease, etiology of empyema, culture results, diagnosticmodalities, duration of hospitalization, therapeutic intervention,date of procedures, complications, mortality and long-termoutcome.Results and Conclusion: Empyema thoracis is a cause ofhigh mortality in man and its occurrence is increasing in bothchildren and adults. Two guidelines documents on themanagement of empyema in adults have been published bythe ACCP and the BTS. Although they differ in their approachto management, they agree on that the pleural space shouldbe drained in all patients with exudative PPE with pleural fluidpH < 7.2 and in those who have frank pus in the pleural space.Patients who do not improve should be referred to the surgeonfor further management. A large randomized multi-centre trialhas shown no survival advantage with the use of intrapleuralstreptokinase in patients with pleural infection and the use ofstreptokinase has not prevented surgery in the group ofpatients studied. However, streptokinase enhances infectedpleural fluid drainage and may still be used in patients whohave large collection of infected pleural collection causingventilatory impairment.