Role of Deep Tension Sutures in Closing the Defect Following Excision of Sacrococcygeal Pilonidal Sinus – A Case Series

Background: The midline sacrococcygeal pilonidal sinus is the common surgical condition among younger population. They present to surgical outpatient department with pain and history of pus discharge from natal cleft. These patients approach for permanent cure following repeated attacks of pain and abscess drainage. We present a new surgical technique of primary closure by applying deep tension sutures (DTS) to close the defect following excision of midline sacrococcygeal pilonidal sinus. The rationale behind this technique is to avoid prolonged hospital stay and early return to work.Materials and Methods: In this study, a group of five patients (one female and four male patients) with the age group between 18 and 35 years was studied for the effectiveness, duration of hospital stay post-operative complications, and recurrence following the new surgical technique of DTS. Following excision of midline sacral pilonidal sinus, the resulting elliptical wound varying from 6 cm to 10 cm was approximated using two or three DTS with No-1 Prolene. In this suturing technique, the sutures were held in place using small pieces of plastic tubing from intravenous drip set to avoid suture cutting through the skin. This technique was similar to abdominal wound closure in cases of complete wound dehiscence. The superficial part of the wound was approximated using No-3 zero Ethilon. In this procedure, author has not used any type of drain in the wound. No suture materials were used inside the wound to approximate the raw area (e.g., Vicryl suture). Patients were covered with IV antibiotics and analgesics for a period of 5 days. All sutures were removed on the 10th day.Results: There were no post-operative complications noted during the hospital stay and during follow-up period ranging from 2 months to 6 months. The scar was healthy with functionally, cosmetically acceptable results. There was no recurrence noted in our study group during the follow-up

Pharmacy education in India and its neighbouring countries.

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. The Pharmacist is a key component of healthcare and manages the human resource to support the growth. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in India, Pakistan and Bangladesh. The paper draws on the literature related to the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in India, Bangladesh and Pakistan. It concludes that although the pharmacy profession in developing countries is continuously evolving, the health care system which yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in developing countries are concerned about their present professional role in the health care system. The information presented in this paper may stimulate discussion and critical analysis and planning, and will be of value in further adaptation of the pharmacy education to desired educational outcomes. These are times of enormous change in healthcare and the pharmacy profession and pharmaceutical education must prepare students to enter into the practice of pharmacy.

Pharmacy education in India and its neighbouring countries.

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. The Pharmacist is a key component of healthcare and manages the human resource to support the growth. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in India, Pakistan and Bangladesh. The paper draws on the literature related to the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in India, Bangladesh and Pakistan. It concludes that although the pharmacy profession in developing countries is continuously evolving, the health care system which yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in developing countries are concerned about their present professional role in the health care system. The information presented in this paper may stimulate discussion and critical analysis and planning, and will be of value in further adaptation of the pharmacy education to desired educational outcomes. These are times of enormous change in healthcare and the pharmacy profession and pharmaceutical education must prepare students to enter into the practice of pharmacy.

Histopathologic changes in soft tissue associated with radiographically normal impacted third molars.

Background: The incidence of impacted or embedded third molars accounts for approximately 98%. Since 1948, there are studies reporting pathological changes in an asymptomatic dental follicle. Controversy still exists for removal of asmptomatic impacted teeth. Hence, this study was performed to histologically evaluate soft tissue pathosis in the pericoronal tissues of impacted third molars with pericoronal radiolucency measuring up to 2.5 mm on orthopantomographs. Materials and Methods: Forty-one asymptomatic impacted third molars with follicular space of up to 2.5 mm on radiographs were included. The disimpacted teeth and the follicular tissues were obtained for histological examination. Results: Age of the patients ranged from 14 to 25 years. Of 41 tissues evaluated, histopathological reports of 18 follicles were suggestive of dentigerous cyst, two follicles showed odontogenic keratocyst, one follicle each of calcifying epithelial odontogenic cyst, ameloblastoma-like proliferation, odontogenic myxoma and odontogenic fibroma. Conclusion: This study showed 58.5% of asymptomatic cases with definite pathological changes. Hence, thorough clinical and radiographic examination should be carried out for all impacted third molars and the dental follicular tissue should be submitted for histopathological evaluation.

Comparison of the protective effect of Withaferin-'A' and hydrocortisone against CCL4 induced hepatotoxicity in rats.

Protective effect of Withaferin-'A' against CCl4 induced hepatotoxicity has been assessed and the compound at 10 mg/kg dose was found to possess significant protective effect. A comparison of this protective effect with that of hydrocortisone showed it to be as effective as hydrocortisone dose per dose.

Acute effect of ethanol administration on platelet function.

The acute effect of single dose of ethanol (1.5 g kg) and aspirin (10 mg/kg) alone and in combination, on platelet aggregation time and platelet adhesiveness were studied in rabbits. There was a significant and comparable increase in aggregation time both by aspirin and ethanol. Similarly platelet adhesiveness was decreased by both the agents.

Status of platelet functions in volunteers of various blood groups: effect of aspirin.

Platelet functions (platelet aggregation and adhesiveness) were studied in volunteers of different blood groups. The platelet aggregation time was found to be significantly (P less than 0.01) more in blood group O as compared A, B and AB blood groups. Similarly, platelet adhesive index was higher in A, B and AB blood groups when compared to that of blood group O. The administration of a single dose of aspirin (4 mg/kg, po) increased the platelet aggregation time and reduced the platelet adhesive index in all the blood groups.

Cardiovascular effects of a withanolide from Withania coagulans, dunal fruits.

A new withanolide, with a unique chemical structure similar to the aglycones of the cardiac glycosides, with mol. wt. 488 6, m. p. 260-261 degrees, isolated from the fruits of Withania coagulans, was screened for cardiovascular effects. At doses of 5 mg/kg body weight, the withanolide produced a moderate fall of blood pressure in dogs (34 +/- 2.1, mm Hg) which was blocked by atropine and not by mepyramine or propranolol. In rabbit Langendorff preparation and ECG studies, it produced myocardial depressant effects but in perfused frog heart it produced mild positive inotropic and chronotropic effects.

Enhanced platelet aggregation by oral contraceptives: effect of PG synthetase inhibitors.

Platelet aggregation time was significantly (P less than 0.01) decreased in female rabbits treated with oral contraceptive (a preparation containing low dose of estrogen) as also by injection of diethylstilbestrol (10 mg/kg), while in animals that received indomethacin (10 mg/kg) or aspirin (30 mg/kg) (PG synthetase inhibitors) along with oral contraceptives or diethylstilbestrol there was no significant alteration in platelet aggregation time. The increased synthesis of prostaglandins or some of the intermediary product like TXA2 might be responsible for this effect.