Study on Outcome of Karydakis Procedure in the Management of Intergluteal Pilonidal Sinus Disease

Introduction: Pilonidal sinus is a cavity in the subcutaneous tissue lined by granulation tissue that contains hair and communicates with the surface by a track which is lined usually by squamous epithelium and continuous with the epidermis. It mainly affects the intergluteal furrow. Materials and Methods: It is a hospital-based descriptive study conducted in the Department of General Surgery, Sree Gokulam Medical College and Research Foundation from February 2017 to November 2018. Patients with clinically diagnosed pilonidal sinus disease admitted in the Surgery Department, Sree Gokulam Medical College and Research Foundation. Results: A total of 140 patients were evaluated postoperatively and for a mean period of 12 months (range 6–18 months), every 3 months during their review visit or over phone. Mean operative time was 54.3 min with a median hospital stay of 5 days. Postoperative pain lasted for a median duration of 2 days. Drains were removed at a median of 3 days and sutures at a median of 7 days. Three patients presented with serous wound collection and 12 patients presented with wound dehiscence. Conclusion: Karydakis flap procedure is a safe surgical treatment for sacrococcygeal pilonidal sinus disease due to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

Knowledge, attitude and practice of hypertension among hypertensive patients in a tertiary care teaching hospital

Background: Hypertension is a chronic disease and an important risk factor for cardiovascular complications. The increase in prevalence of hypertension is attributed to age of population, urbanization, sedentary habits, lack of physical activity, obesity, alcohol consumption and exposure to continuous stress. Regular anti-hypertensive medications can reduce the long-term risk of cardiovascular morbidity and mortality. This study was done to assess the knowledge, attitude and practice regarding hypertension and to assess the drug compliance in hypertensive patients.Methods: This study was a cross sectional questionnaire based, conducted among 200 hypertensive patients attending hypertension clinic (Department of Medicine) of Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India from October to December 2018. A close-ended questionnaire was given to the patients, which comprised of 16 questions on knowledge (5), attitude (5) and practice (6). Data was analyzed and expressed in descriptive statistics.Results: The commonly prescribed anti-hypertensive medications were calcium channel blockers (79%) and ? blockers (26.5%). Knowledge regarding hypertension, normal BP, symptoms and complications was 74%, 54.5%, 41.5% and 37.5% respectively. Positive attitude regarding regular medications, role of drugs, diet control, salt restriction and physical activity was found in 94%, 40.5%, 74%, 76% and 67% respectively. Regular BP measurement, follow up, salt restriction and exercise were practiced by 77%, 77%, 72% and 9% of patients respectively.Conclusions: Present study reflected a lack of knowledge among hypertensive patients regarding normal BP, symptoms and complications. A positive attitude and practice were observed among the patients except for practice of regular exercise. Hence, emphasize on awareness about symptoms, complications and importance of physical activity should be improved particularly among male patients.

Structural studies on Mycobacterium tuberculosis RecA: Molecular plasticity and interspecies variability.

Structures of crystals of Mycobacterium tuberculosis RecA, grown and analysed under different conditions, provide insights into hitherto underappreciated details of molecular structure and plasticity. In particular, they yield information on the invariant and variable features of the geometry of the P-loop, whose binding to ATP is central for all the biochemical activities of RecA. The strengths of interaction of the ligands with the P-loop reveal significant differences. This in turn affects the magnitude of the motion of the ‘switch’ residue, Gln195 in M. tuberculosis RecA, which triggers the transmission of ATP-mediated allosteric information to the DNA binding region. M. tuberculosis RecA is substantially rigid compared with its counterparts from M. smegmatis and E. coli, which exhibit concerted internal molecular mobility. The interspecies variability in the plasticity of the two mycobacterial proteins is particularly surprising as they have similar sequence and 3D structure. Details of the interactions of ligands with the protein, characterized in the structures reported here, could be useful for design of inhibitors against M. tuberculosis RecA.