ROLE OF KSHARSUTRA IN THE TREATMENT OF RECURRENT PILONIDAL SINUSES

Pilonidal sinus is a disease that most commonly arises in the hair follicles of the natal cleft of the sacrococcygeal area. Incidence is reportedly 26 per 1000 population, affecting males twice as often as females and predominantly young adults of working age. Pilonidal sinus usually presents as an abscess or a chronically discharging, painful sinus tract. Irrespective of the mode of presentation the painful nature of the condition causes significant morbidity, often with a protracted loss of normal activity. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, with minimal morbidity and a low risk of complications. As recurrence rate after surgery is very high almost 50 % and 30 % after surgery, this needs to see another treatment modalities. Ksharasutra has proved its efficacy in the treatment of fistula-in-ano since many decades. So here we have considered Ksharsutra for the treatment of recurrent pilonidal sinus especially in the recurrence after surgery. In this study very good results were found with post treatment follow up. In this study of 34 patients, all had achieved complete healing within 4 weeks to 8 weeks, mean is 6 weeks of operation. Follow-up of 30 patients was available for 12–24 months in which no patients had recurrence

Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

PURPOSE :We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization.METHODS:CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated.RESULTS:Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs.CONCLUSION:CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites

Reproducibility of Retinal Nerve Fiber Layer and Macular Thickness Measurements Using Spectral Domain Optical Coherence Tomography

The objective of the research was to assess the reproducibility of retinal nerve fiber layer (RNFL) and macular thickness using spectral domain optical coherence tomography and to establish whether the same investigator can get the same or similar results when performing the scan thrice in an hour, without reference to the previous scan and the repeat function. Materials and Methods. In this prospective observational study, 200 subjects who fulfilled the inclusion and exclusion criteria were scanned 3 times according to predefined guidelines at 0, 30 and 60 minutes on the same day, by the same investigator, using spectral domain optical coherence tomography for measurements of RNFL and macular thickness; observations were statistically analyzed and correlated. Results. In RNFL thickness, the temporal sector showed the worst reproducibility as compared to other sectors. RNFL was the greatest in the superior quadrant and the thinnest in the temporal quadrant. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility, while in the outer zone, the inferior sector showed the worst reproducibility; macular thickness was the thinnest at the central zone (innermost 1-mm ring), the thickest within the inner 3-mm ring and diminished peripherally. Conclusions. RNFL and macular thickness measurements using spectral domain optical coherence tomography by the same observer at 0, 30 and 60 minutes were very reproducible, except for the sectors specifically mentioned. The greater the thickness of the RNFL in any sector the better was the reproducibility in that sector. For macular thickness, the temporal sector (mid zone) showed the worst reproducibility

JIT Implementation: Concepts, Benefit and Obstructions in Indian Industries

Abstract: Just-in Time system has been defined and identified worldwide by many researchers and practitioners for world class manufacturing. In today"s competitive world shorten product life cycles, customer"s rapid demands and quickly changing business environment is putting lot of pressures on original equipment manufacturers (OEM). This system has been accepted as a systematic approach to achieve competitiveness and excellence in manufacturing by many researchers and practioners in many countries in last three decades. This system has potential to compete in the present scenario of rapid development and growth of industrialization. This paper presents the spread of JIT movement, concepts, benefits, implementation and obstructions of JIT system

Full Mouth Rehabilitation of a Patient with Amelogenesis Imperfecta using Twin Stage Procedure

A 26-year-old male patient came to the Department of Prosthodontics with the chief complaint of compromised appearance for 10-12 years with generalised sensitivity to hot and cold and difficulty in chewing for two years. There was no significant medical history. Extraoral examination revealed no facial asymmetry and muscle tenderness. The mandibular movements were also within normal limits. On intraoral examination, enamel was thin and all the teeth were smaller than normal. There was generalised spacing between anterior teeth, generalised attrition, yellow to brownish discoloration and dental caries in 47 and 85 [Table/Fig-1,2]. Radiographic examination revealed thin radiopaque layer of enamel with normal radiodensity [Table/Fig-2]. The younger sister of the patient also exhibited similar characteristics that indicate a family history. Based on family history and clinical and radiographic findings, the patient was diagnosed as a case of Amelogenesis Imperfecta (AI) hypoplastic type [1]. A free-way space of 6 mm was evaluated. Based on all the clinical findings and freeway space evaluation, it was decided to reconstruct the dentition at 3 mm raised vertical dimension of occlusion. The possible treatment options were full mouth restorations using Hobo Twin Stage Technique or Pankey-Mann Schuyler Technique [2]. Finally, it was chosen to rehabilitate the patient with full mouth Porcelain Fused Metal (PFM) crown restorations using Hobo twin stage procedure due to single-step tooth preparation, pre-set values, no condylar and lateral records, and multiple visits [3]. After clinical crown lengthening [Table/Fig-1], diagnostic impressions were made in the irreversible hydrocolloid impression material (Zelgan 2002 Alginate; Dentsply) to obtain diagnostic casts. The portrait view and photographs were recorded [Table/Fig-3], face bow record was made and transferred to the semi-adjustable articulator (Hanau™ Wide-Vue, Whip Mix) [Table/Fig-4]. A Centric record was obtained [Table/Fig-5] and mandibular cast along with centric record was mounted to the articulator. An occlusal splint (NMD Splint Plus; NMD Nexus Medodent) was fabricated at the 3 mm raised vertical dimension and the patient was kept in an observation period of six weeks to evaluate the adaptation to the altered Vertical Dimension of Occlusion (VDO) [Table/Fig-6]. A diagnostic wax-up was done thereafter and the putty index (Photosil; DPI) was made [Table/Fig-7,8]. All teeth were prepared in a single appointment with minimal occlusal reduction [Table/Fig-9]. Full arch impressions of prepared teeth were made using addition silicon elastomeric impression material (Photosil; DPI) [Table/Fig-10]. Chairside provisional crowns were fabricated using the putty index of the diagnostic wax-up. A maximum intercuspation in centric relation, as well as posterior disclusion in protrusive guidance, was established [Table/Fig-11-13]. The working casts were mounted on semi-adjustable articulator using facebow. To transfer the VDO and centric relation, provisional crowns were removed from left posterior regions, while the provisional crowns from right and anterior regions served as a stop. An interocclusal record material (Aluwax; Aluwax Dental Products Co.) was placed between the left maxillary and mandibular prepared teeth. Similarly, the provisional crowns were removed from right maxillary and mandibular region while they were seated in left and anterior regions. Interocclusal record was placed between the right maxillary and mandibular prepared teeth. A similar procedure was carried out in the anterior region as well. Using these three segmental interocclusal records, the mandibular cast was mounted [Table/Fig-14,15]. The provisional crowns were then luted with non eugenol temporary cement (NETC; Meta Biomed). The anterior porcelain build-up was completed and anterior guidance was provided to generate a standard amount of disclusion in posterior teeth [Table/Fig-18-20]. The average values for posterior disclusion are 1.1 mm, 0.5 mm and 1.0 mm on protrusive movement, working side, and non working side during lateral movement respectively [3]. PFM crowns were cemented with polycarboxylate cement [Table/Fig-21-26]. Oral hygiene instructions were given and follow-up was carried out at an interval of six weeks. The follow-up examination of the patient revealed a healthy and comfortable stomatognathic system. A clear change was noticed by comparative evaluation of preoperative, provisional restoration and final restoration profile photographs of the patient [Table/Fig-27]. The patient was satisfied with the aesthetics and became more confident to engage in social activities. patient [Table/Fig-27]. The patient was satisfied with the aesthetics and became more confident to engage in social activities. Full mouth rehabilitation aims to restore the stomatognathic system’s function, aesthetics and biological harmony. A unique feature of Hobo twin stage technique is that it reproduces disocclusion with accuracy and does not require condylar path measurement. Disocclusion can be reproduced precisely as programmed. It ensures optimised occlusion with a predictable posterior disclusion. A relatively simple technique that does not require any special equipment and gives predictable results in minimum appointments

Development of novel g-SSR markers in guava (Psidium guajava L.) cv. Allahabad Safeda and their application in genetic diversity, population structure and cross species transferability studies.

Dearth of genomic resources particularly, microsatellite markers in nutritionally and commercially important fruit crop, guava necessitate the development of the novel genomic SSR markers through the library enrichment techniques. Three types of 3' -biotinylated oligonucleotide probes [(CT)14, (GT)12, and (AAC)8] were used to develop microsatellite enriched libraries. A total of 153 transformed colonies were screened of which 111 positive colonies were subjected for Sanger sequencing. The clones having more than five motif repeats were selected for primer designing and a total of 38 novel genomic simple sequence repeats could be identified. The g-SSRs had the motif groups ranging from monomer to pentamer out of which dimer group occurred the most (89.47%). Out of 38 g-SSRs markers developed, 26 were found polymorphic, which showed substantial genetic diversity among the guava genotypes including wild species. The average number of alleles per locus, major allele frequency, gene diversity, expected heterozygosity and polymorphic information content of 26 SSRs were 3.46, 0.56, 0.53, 0.29 and 0.46, respectively. The rate of cross-species transferability of the developed g-SSR loci varied from 38.46 to 80.77% among the studied wild Psidium species. Generation of N-J tree based on 26 SSRs grouped the 40 guava genotypes into six clades with two out-groups, the wild guava species showed genetic distinctness from cultivated genotypes. Furthermore, population structure analysis grouped the guava genotypes into three genetic groups, which were partly supported by PCoA and N-J tree. Further, AMOVA and PCoA deciphered high genetic diversity among the present set of guava genotypes including wild species. Thus, the developed novel g-SSRs were found efficient and informative for diversity and population structure analyses of the guava genotypes. These developed novel g-SSR loci would add to the new genomic resource in guava, which may be utilized in genomic-assisted guava breeding