Derangement of liver function tests in dengue patients

Background: Changes in the liver function test may serve as an early marker for timely diagnosis and identification of patients who may develop severe dengue. The purpose of this study was to examine the link between dengue fever severity and liver function test. Methods: This prospective observational study was conducted in the Department of General Medicine, Madhesh Institute of health sciences, provincial hospital, Janakpurdham in which we included dengue positive patients (aged 18 years or more) based on NS1 antigen or high titer on IgM/IgG testing from July 2023 till August 2023. We excluded patients with diseases like malaria, cirrhosis of liver, enteric fever, viral hepatitis or any other disease or taking any medication which can derange LFT. Results: We included 96 patients fulfilling the study criteria. Of these, 71% had DF, 22% had DHF and 7% had DSS. Among liver enzymes, mean AST of the patients was significantly higher in DSS group of patients (775.19�.65 U/l), as compared to those in the DF and DHF group of patients, p value <0.01. Similarly, mean ALT of the patients was significantly higher in DSS group of patients (387.8�.6 U/l), as compared to those in the DF and DHF group of patients, p value<0.01. On the contrary, mean alkaline phosphatase levels were similar between the three patient groups. Conclusions: Based on the results our study, we conclude that raised AST and ALT levels were significantly associated with severity of DSS and DHF. Patients with dengue infection should have a baseline liver function test and subsequent LFT monitoring to detect early hepatic impairment.

Impact of Technological Interventions on Pigeon Pea for Enhancing Income through Cluster Front Line Demonstrations

Aims: The area and production of pigeon pea in Bhadohi are still significantly lower than in other districts of other states. There is a significant yield gap between the potential output and the yield under current farming conditions. To study the impact of technological interventions on the pigeon pea crop for increasing income through Cluster Front Line Demonstrations was the goal of the current study.Place and Duration of Study: Cluster front line demonstrations on improved pigeon pea technologies were carried out by ICAR-IIVR-Krishi Vigyan Kendra, Bhadohi, at farmers' fields from 2015–16 to 2019–20.Methodology: A total of 155 pigeon pea cluster front line demonstrations on improved pigeon pea technologies covering a 45.70 hectare area were held in one hundred eighteen localities. Field days, training and group meetings were also organized to provide opportunities for other farmers to witness the benefits of demonstrated technologies. The output data were collected from CFLD plots as well as control plots (farmers practice) by random crop cutting method and analyzed using simple statistical tools such as per cent change in yield, cost of cultivation, net income, and benefit cost ratio etc. Results: In the experimental plots, the mean yield over five years was 15.44 q/ha, while it was only 11.21 q/ha in the control plots. Over the course of the five years of the study, the yield development varied, though on average, it was measured at 42.49 percent. When compared to the farmer's practice (28,463/ha), the average net return for the demonstration plots at the farmer's field over the investigation period was greater at 56,611/ha. Additionally, the demonstration plots' benefit-cost ratio was larger (2.32) than the farmer's practice's (1.69).Conclusion: From the aforementioned findings, it can be concluded that using modern technologies for pigeon pea cultivation may significantly close the extension and technology gap, increasing pigeon pea yield in the area. It requires collaborative extension efforts to enhance the adoption of location and crop specific technologies among the farmers to bridge these gaps.

Impact Analysis of Front Line Demonstration on Tomato under Mid Plain Agro-Climatic Zone of Uttar Pradesh, India

Aims: Tomatoes benefit local farmers because of their excellent storage and truck-gardening capabilities. Because of local demand, tomatoes are a prominent commercial vegetable production in the Bhadohi area. A Frontline demonstration was held to cover the aforementioned possibility and impact of increase farmer earnings.Place and Duration of Study: The current study was conducted by ICAR-IIVR - Krishi Vigyan Kendra, Bhadohi for five years in a row from 2018–19 to 2022–23 in the farmers' fields in various areas of the district using front-line demonstration.Methodology: Over the investigation's five years, a total of 112 demonstrations were held at farmer fields on 5.0 ha of land. Each frontline demonstration was set up on 0.1 ha of land, with the nearby 0.3 ha serving as the comparison control (farmer's practice). KVK scientists gathered information on yield, production costs, and returns from farmers' practice plots (control plots) and front-line demonstration plots. Finally, the formulas proposed by Samui et al. [1] was used to calculate the extension gap, technology gap, and technology index.Results: Under the five-year FLD program, the average extension gap was 140.9 q/ha, the technology gap was 184.74 q/ha, and the technology indexwas 30.79 percent. The benefit cost ratio of tomato ranged from 5.02 to 7.44 in demonstration plots and from 3.99 to 5.74 in farmer’s practice plots during five years of demonstration with an average of 2.60 in demonstration and 2.09 under farmer’s practices. Conclusion: Front-line example shows how new technology may boost output and profit .The Bhadohi districts of Uttar Pradesh's mid plain have improved vegetable production, consumption, nutritional security, and overall livelihood security as a result of the productivity gain under FLD over existing tomato cultivation practices. This has increased awareness and inspired other farmers in the district to adopt the demonstrated technologies for tomato production.

Clinical Analysis, Management and Outcome of Intussusception in Children.

Introduction: Intussusception is the commonest cause of bowel obstruction in infancy and childhood. Early diagnosis and management is essential to reduce morbidity and mortality. The objective was to To review the diagnostic criteria of intussusception in infants and children to increase awareness of attending personnel for effective management decrease the rate of operative treatment and complications. Materials and Methods: The data collected of all 38 patients admitted in Kanti Childrens Hospital between 2008 September to 2009 September were studied prospectively. Each patient was evaluated in regard to age at presentation, sex, signs and symptoms, diagnostic method, treatment (operative, non-operative). Results: During study period of one year there were a total of 20 (52%) males and 18 (48%) females of age 3 months to 6 years. Pain abdomen was seen in 25(66%), vomiting 16(42%), diarrhea 15(40%), blood mixed with stool 10(26%). These symptoms were seen in different combination. X-ray erect abdomen was done in 15 and ultrasound in all 38 cases. Ten out of 15 (66.6%) patients with early presentation and diagnosis had successful barium enema reduction.10 (66.6%) had successful reduction and admitted to our hospital. 28(74%) patients were undergone laparatomy. Among 28 (74%) patents that had lapartotomy, manual reduction was successful in 18 and 10 required bowel resection and anastomosis. Conclusion: The awareness of early features of intussusception is important for early referral to tertiary centers for successful non-operative barium reduction and reduce the need of laparotomies in children.

Single stage Anterior Sagittal Anorectoplasty (ASARP) for Anorectal Malformations with Vestibular Fistula and Perineal Ectopic Anus in Females: A New Approach.

Introduction: Despite a better understanding of the embryology, anatomy of anorectal malformations and of the physiology of continence, the management of children born with imperforate anus continues to be a surgical challenge and is still fraught with numerous complications and often leads to less than perfect qualitative results. Pediatric patients with recto-vestibular fistula have good prognoses in terms of bowel function when properly treated. Aim & Objective: The study was designed to assess the surgical morbidity of single stage Anterior Sagittal Anorectoplasty (ASARP). Methodology: This prospective study was carried for a period of 26 months. It included a total of 48 female patients (aged 0 – 14 years) with diagnosis of Anorectal Malformations (ARM) with vestibular fistula or perineal ectopic anus. In ASARP, Patient in lithotomy position, the anterior portion of sphincter muscles were cut through a midline perineal skin incision, rectum was separated from the vagina & then rectum was pulled through the center of these muscles. The perineal body was reconstructed and the normal appearance of perineum was achieved. Results: Short-term surgical outcome was satisfactory in all cases. No one needed colostomy. Conclusion: Single-stage ASARP is a good approach in experience hands for ARM with vestibular fistula and perineal ectopic anus in females and thereby complications and time involved in staged procedures including colostomy can be avoided.