Customized And Cost Effective Specimen Retrieval Bag In Laparoscopic Cholecystectomy: Study In 150 Cases

Minimally invasive surgery has undergone rapid development in last decade and it has many advantages but it has a few drawbacks also like difficulty in removing specimen, spillage of contents intraperitoneally and port site infection. Specimen retrieval through trocar site by using laparoscopic retrieval bag is the solution but cost is a barrier in government setups. So our major concern is to make customized Specimen retrieval bags for easy removal of specimen and reducing the rate of port site infection

Risk factors for delayed extubation after ventricular septal defect closure: a prospective observational study

Objective: The objective of our study was to determine the feasibility of early extubation and to identify the risk factors for delayed extubation in pediatric patients operated for ventricular septal defect closure. Methods: A prospective, observational study was carried out at our Institute. This study involved consecutive 135 patients undergoing ventricular septal defect closure. Patients were extubated if feasible within six hours after surgery. Based on duration of extubation, patients were divided two groups: Group 1= extubation time ≤ 6 hours, Group 2= extubation time >6 hours. Results: A total of 99 patients were in Group 1 and 36 patients in Group 2. Duration of ventilation was 4.4±0.9 hours in Group 1 and 25.9±24.9 hours in Group 2 (P<0.001). Univariate analysis showed that young age, low weight, low partial pressure of oxygen, trisomy 21, multiple ventricular septal defect, high vasoactive inotropic score, transient heart block and low cardiac output syndrome were associated with delayed extubation. However, regression analysis revealed that only trisomy 21 (OR: 0.248; 95%CI: 0.176-0.701; P=0.001), low cardiac output syndrome (OR: 0.291; 95%CI: 0.267-0.979; P=0.001), multiple ventricular septal defect (OR: 0.243; 95%CI: 0.147-0.606; P=0.002) and vasoactive inotropic score (OR: 0.174 95%CI: 0.002-0.062; P=0.039) are strongest predictors for delayed extubation. Conclusion: Trisomy 21, low cardiac output syndrome, multiple ventricular septal defect and high vasoactive inotropic score are significant risk factors for delay in extubation. Age, weight, pulmonary artery hypertension, size of ventricular septal defect, aortic cross-clamp and cardiopulmonary bypass time did not affect early extubation.

Estimation of Stature from Foot Length and Hand Length Measurements In Gujarat Region.

Background & objectives: Stature is considered as the height of a person measured in erect position. It is one of the most important factors in establishing identity of a person. In certain medico-legal cases, where only parts or fragments of human body are found. Such a need arises when there is mass casualty. Aim of current study was to establish anthropometric correlation of stature with hand length and foot length in population of Gujarat and also to derive regression equations for correct estimation of stature of male and female in Gujarati population. Material and Method: 150 asymptomatic, apparently healthy, adolescent and adult medical students with age between 18 to 22 years belonging to various regions of Gujarat were selected. Left foot and left hand was selected for measurement. Result: Regression equation for estimation of height using both foot length and hand length were formulated. By using the derived regression equations, height of subjects was calculated and then compared with actual height of subjects. Conclusion: By the present study we conclude that both foot and hand length can be used in estimation of stature of both males and females with fairly accurate results in Gujarati population.

Morphometric study of interparietal bone in Gujarat region.

Background: The occipital bone develops partly in cartilage and partly in membrane. The squamous part of occipital bone between two parietal bones occasionally presents a separate bones which are termed as inca, pre-interparietal bone or interparietal bone. Aims & Objective: (1) To determine the incidence of interparietal bone in skulls of Gujarat region. (2) To study different anomalies of interparietal bone and compare it with other studies. Material and Methods: Total 289 dried macerated skulls from Gujarat region were studied for incidence and type of interparietal bone anomaly. Results: Out of total 289 skulls interparietal bone was found in 23 bones giving incidence of 7.96%. Eight different varieties of interparietal bone anomalies were found and noted. Conclusion: Different anomalies of interparietal bone can be easily interpreted using the knowledge of ossification of interparietal part of occipital bone. Pre-interparietal bone is a misnomer and should not be reported separately.

A study of origin of sinuatrial nodal artery.

Introduction: The sinuatrial (SA) node is known as natural pacemaker of the heart. SA node is supplied by the sinuatrial (SA) nodal artery is an atrial branch. Ischemia of SA nodal artery due to injury or during surgical intervention leads arrhythmia. Origin of sinuatrial (SA) nodal artery is variable; most commonly arise from right coronary artery. It may arise from the circumflex branch of the Left circumflex artery (LCA). In some cases it may originate from the trunk of left coronary artery, aorta or left bronchial artery. SA node may be supplied by single SA nodal artery or may have dual and triple arterial supply. Methods: This study was conducted on 25 cadavers from the dissection laboratory with an age range of 50 – 70 years. The cadavers were embalmed through carotid arterial perfusion of formaldehyde solution, spirit, water and glycerine and preserved in a weak formalin solution before dissection. Dissection method was employed for this study. Result and Observation: Single SA nodal artery found in 22/25 hearts (88%) and dual supply found in 3/25 hearts (12%). The SA nodal artery originated from proximal segment of right coronary artery (RCA) in 16/25 hearts (64%), from proximal segment of circumflex branch (LCX) of left coronary artery (LCA) in 6/25 hearts (24%). The Mean+SD of diameter of SAN artery from right coronary artery was 1.7+0.42mm. The Mean+SD of diameter of SAN artery from circumflex branch of left coronary artery was 1.29+0.30mm. The termination types were 1) precaval found in 44% (11/25), 2) retrocaval in 52% (13/25) and 3) pericaval found in 4%(1/25) of all SA nodal arteries.Conclusion: To be aware of the origin and course of SAN artery may provide a safe approach to interventional cardiologist and cardiac surgeon during cardiac interventions. Cardiac surgeons especially should be careful because compensation.

A study of morphology of coeliac trunk in 100 cadavers.

Background: The coeliac trunk is an integral part of the circulatory system as it delivers blood from the heart to major organs within the abdominal cavity. The blood that it delivers is oxygenated and carries essential nutrients and immune system particles that can aid in life sustaining processes and can also prevent the development of diseases and complications from illnesses. Aims & Objective: (1) To study the anatomy of coeliac trunk, through its diameter, length related to their branches and distance from superior mesenteric artery. (2) To study the clinical implication of coeliac trunk in case of the variations and anomalous formation of coeliac trunk. Material and Methods: Morphology of coeliac trunk was studied in 100 formalin embalmed cadaver, aged between 50 to 80 years. Dissection method was use for this study. Results: Measurement of the length of the coeliac trunk up to the left gastric, Measurement of the length of coeliac trunk up to common hepatic and/or splenic artery, Measurement of coeliac trunk diameter, Distance between coeliac trunk and the superior mesenteric artery were taken. Conclusion: Knowledge of variations concerning the coeliac trunk is of extreme clinical importance in the areas of the laparoscopic surgery, and radiological procedures in the upper abdomen, and should be kept in mind by clinicians to avoid complications.

Effectiveness of image guided fine needle aspiration cytology in cases of deep seated lesions.

Background: Newer development in radiology has completely revolutionized the approach to percutaneous aspiration of space occupying deep seated lesions making it rapid, inexpensive, versatile and an adjunctive tool for evaluating internal organs. Aims & Objective: The present study was conducted to evaluate the effectiveness of image guided fine needle aspiration cytology in cases of deep seated lesions. Material and Methods: Total 169 aspirations performed from 161 cases in period of two years, 131 (77.51%) were under USG guidance and 38 (22.49%) were under CT guidance. Results: Overall adequacy rate was 76.92% for guided aspirations. Adequacy rate in case of aspirations done by pathologist was much higher than clinicians with P value (with Yates correction) of < 0.05. The most common organ for aspiration was liver (30.18 %), followed by ovary (23.67 %). Guided aspirations were also done from various organs like lung, retroperitoneal lymph nodes, pancreas, stomach, gall bladder, kidney, mediastinum, pleura, suprarenal gland and abdominal wall with high adequacy rate and without complications though with smaller sample size. Cytological diagnosis was possible in 73% cases. Conclusion: Guided aspiration is a simple, safe and cost effective screening test for deep seated lesions with a significant role in the detection of clinically unsuspected malignancy making it an investigation of choice for early confirmation or exclusion of pathology.

Development and validation of dissolution method for carvedilol compression-coated tablets

The present study describes the development and validation of a dissolution method for carvedilol compression-coated tablets. Dissolution test was performed using a TDT-06T dissolution apparatus. Based on the physiological conditions of the body, 0.1N hydrochloric acid was used as dissolution medium and release was monitored for 2 hours to verify the immediate release pattern of the drug in acidic pH, followed by pH 6.8 in citric-phosphate buffer for 22 hours, to simulate a sustained release pattern in the intestine. Influences of rotation speed and surfactant concentration in medium were evaluated. Samples were analysed by validated UV visible spectrophotometric method at 286 nm. 1 percent sodium lauryl sulphate (SLS) was found to be optimum for improving carvedilol solubility in pH 6.8 citric-phosphate buffer. Analysis of variance showed no significant difference between the results obtained at 50 and 100 rpm. The discriminating dissolution method was successfully developed for carvedilol compression-coated tablets. The conditions that allowed dissolution determination were USP type I apparatus at 100 rpm, containing 1000 ml of 0.1N HCl for 2 hours, followed by pH 6.8 citric-phosphate buffer with 1 percent SLS for 22 hours at 37.0 ± 0.5 ºC. Samples were analysed by UV spectrophotometric method and validated as per ICH guidelines.

O presente estudo descreve o desenvolvimento e a validação de método de dissolução para comprimidos revestidos de carvedilol. O teste de dissolução foi efetuado utilizando-se o aparelho para dissolução TDT-06T. Com base nas condições fisiológicas do organismo, utilizou-se ácido clorídrico 0,1 N como meio de dissolução e a liberação foi monitorada por 2 horas para se verificar o padrão de liberação imediata do fármaco em condições de pH baixo, seguidas por pH 6,8 em tampão cítrico-fosfato por 22 horas, para simular o padrão de liberação controlada no intestino. Avaliou-se a influência da velocidade de rotação e a concentração de tensoativo no meio. As amostras foram analisadas por método espectrofotométrico UV-visível validado, em 286 nm. O laurilsulfato sódico a 1 por cento (SLS) mostrou-se ótimo para aumentar a solubilidade do carvedilol em pH 6,8 em tampão cítrico-fosfato. A análise da variância não mostrou diferença significativa entre os resultados obtidos a 50 e a 100 rpm. O método da dissolução discriminante foi desenvolvido com sucesso para os comprimidos revestidos de carvedilol. As condições que permitiram a determinação da dissolução foram: aparelho USP tipo I a 100 rpm, contendo 1000 mL de HCL 0,1 N por 2 horas, seguido de pH 6,8 com tampão cítrico-fosfato, com 1 por cento de SLS por 22 horas a 37,0 ± 0,5 ºC. Amostras foram analisadas por método espectrofotométrico e validadas pelas normas ICH.