Surgical management of chronic fourth degree perineal tear: a single center experience

Background: The aim of this article is to present the ridge about the recognition, preoperative management, surgical technique and long term follow up of patients with chronic fourth degree perineal tear.Methods: Authors conducted a prospective study in the department of obstetrics and gynecology in SDM hospital of medical sciences from 2008 January to 2016 December. Data on age, parity, incontinence to flatus, solid or liquids stools, duration of symptoms, history of previous repair, duration of repair, post-operative stay, complications and recovery were collected and analyzed. A total of thirty cases of chronic perineal tear were studied.Results: A total of 30 patients underwent CPT repair. Average duration of surgery was 90 minutes. 27 out of 30 patients were discharged on post-operative day 10. Three patients were non-compliant to treatment. Of the total 30 patients, two patients were lost for follow up. Overall success rate was 93% including patients who underwent re-surgery for failed repair.Conclusions: The significant finding of the present study was that a secondary repair of an anal sphincter injury was not associated with an unfavorable subjective outcome in relation to symptoms of anal incontinence. A good insight of perineal and anal sphincter anatomy and adherence to the sound principles is essential. The success rate in this study is 93.3% highlighting that a diligently performed operation by a surgeon of adequate expertise likely results in satisfactory outcome

HEPATOPROTECTIVE ACTIVITY OF AQUEOUS EXTRACT OF CAESALPENIA BONDUC AGAINST CCL4 INDUCED CHRONIC HEPATOTOXICITY

Objective: The leaves of Caesalpinia bonduc (CB) have been used against various disorders in folk medicine including the liver disorders. Earlier, we have shown the hepatoprotective effect of CB in acute hepatotoxicity model. The present study was designed to evaluate the anti-hepatotoxic and anti-fibrotic effect of the aqueous leaf extract of CB on CCl4 (carbon tetrachloride) induced chronic hepatotoxicity/fibrosis in Wistar rats.Methods: Animals were divided into three groups namely; preventive, curative and prophylactic, which was further subdivided into four groups each: Group I–untreated control, group II-CCl4 control, group III-CB+CCl4 and group IV–silymarin+CCl4. The aqueous extract of CB/silymarin was administered orally once, daily for eight weeks in the curative group and for four weeks in preventive and prophylactic groups respectively. The chronic liver damage/fibrosis was induced by intraperitoneal injection of CCl4 twice a week, for four weeks in preventive and prophylactic groups and for eight weeks in the curative group. Blood samples were collected for assaying serum biochemical parameters, and the livers were excised and processed for histology.Results: The data showed that supplementation of aqueous leaf extract of CB along with CCl4 significantly reduced the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase(ALP), total bilirubin(TB) and prothrombin time(PT) thus further restoring the total protein(TP) and albumin(ALB) in preventive, curative and prophylactic groups when compared to CCl4 control. Significant improvement in the microscopic structure of the liver further confirmed the hepatoprotective effect of aqueous extract of CB over the liver injury and fibrosis induced by CCl4 in rats.Conclusion: The study, therefore, suggests that aqueous extract of CB might provide a novel and alternative approach for treating the chronic hepatotoxicity/liver fibrosis.Keywords: Caesalpenia bonduc, Liver, Chronic, CCl4, Fibrosis, Silymarin, Hepato-protectio

HERBAL DRUG SWIETENIA MAHAGONI JACQ. -A REVIEW

ABSTRACT The dire need for such a review arises as the plant is included in the list of endangered species due to its high exploitation for timber utilization

Leadership Qualities Among Women Leaders in Educational Institutions at Bangalore City

Purpose: First, it seeks to investigate the factors that influence women's leadership traits within academic institutions located in Bangalore. Second, it aims to gain a deeper understanding of the evolving role of women in leadership positions within modern society.   Design/Methodology/Approach: To achieve its objectives, this study employs a qualitative research approach. Researchers conduct interviews and surveys within academic institutions in Bangalore. By gathering and analyzing this data, they intend to uncover key themes and patterns that shed light on the factors impacting women's leadership traits.   Findings: The findings of this research reveal several noteworthy insights. It becomes evident that women's leadership traits are significantly influenced by societal perceptions and economic circumstances. Furthermore, the progression of women in their professional lives has played a crucial role in altering societal views. The study also acknowledges the importance of India's long-standing policy efforts to promote women's development. Additionally, it highlights the remarkable achievements of women in various fields, including academia and athletics.   Research, Practical & Social implications: In terms of implications, this study carries significance on multiple fronts. From a research standpoint, it offers valuable insights into the factors that shape women's leadership roles within academic institutions. Practically, the findings can inform strategies and initiatives aimed at promoting and enhancing women's leadership within the educational sector. On a broader social level, the study underscores the evolving role of women in Indian society, emphasizing the importance of gender equality as a key societal value.   Originality/Value: In terms of originality, this research distinguishes itself by focusing on the specific context of academic institutions in Bangalore. Its value lies in its contribution to a deeper understanding of women's leadership within a culturally diverse context, shedding light on the unique factors at play in this region

A STUDY TO ASSESS KNOWLEDGE, ATTITUDE AND PRACTICE ON BREAST CANCER AMONG WOMEN IN GOVERNMENT GENERAL HOSPITAL

Objectives: Breast cancer is the most frequent cancer in women worldwide and it accounts for 27% of all cancer cases among women in India. This study aims to assess the awareness of the patients regarding the breast cancer and also to check their knowledge toward the symptoms of breast cancer as well as the breast self-examination process. This study also determines the attitude of patients regarding the breast cancer and breast self-examination. Methods: A prospective educational study was done using a pre-designed questionnaire on 523 patients in a tertiary care teaching hospital for a period of 6 months. All women greater than 20 years admitted in the Department of General Medicine and General Surgery in-patient female ward of SVRRGGH were included in the study. Results: Out of 523 women, a greater proportion respondents 515 (98%) had poor knowledge of breast cancer. Two hundred and eighty-one (53%) show positive attitude while 225 (43%) show neutral attitude and 17 (4%) show negative attitude toward breast cancer. Only 18 (0.3%) know how to perform breast self-examination while the remaining patients have never performed the breast self-examination. Two hundred and one (38%) have agreed to consult a doctor if they found any lumps in the breast whereas the remaining did not respond. After the counseling session with patients, their knowledge regarding the above problems related to breast cancer has significantly increased. Conclusion: Majority of the participants had poor knowledge of breast cancer as well as low level of practice of breast cancer screening procedures. However, patients do have a positive attitude toward the breast cancer which can help to detect the cancer in early stages. Hence, a greater focus on providing breast cancer education programs can create awareness among women in respect to screening programs which, in turn, can decrease the risk of death due to its late discovery

Equation of state and high-pressure phase transitions in Mg2GeO4 olivine

Germanates are often used as structural analogs of planetary silicates. We have explored the high-pressure phase relations in Mg2GeO4 using diamond anvil cell experiments combined with synchrotron x-ray diffraction and computations based on density functional theory. Upon room temperature compression, forsterite remains stable up to 30 GPa. At higher pressures, a phase transition to a CmC21 structure was observed, which remained stable to the peak pressure of 105 GPa. Using a 3rd order Birch Murnaghan fit to the experimental data, we obtained V0 = 305.1 (3) A3, K0 = 124.6 (14) GPa and K' = 3.86 (fixed) for forsterite and V0 = 263.5 (15) A3, K0 = 175 (7) GPa and K' = 4.2 (fixed) for the CmC21 phase. In three separate runs, the forsterite sample was compressed to 26 GPa, 54 GPa and 105 GPa respectively and then laser-heated to ~2500 K. On laser heating, a mixture of perovskite MgGeO3 + MgO was found to be stable at the lower pressure conditions, whereas post-perovskite + MgO was observed at the highest pressure

Association of Intronic Single Nucleotide Polymorphism (SNP) of CALM 1 gene with Osteoarthritis of the Knee in Indian Population: A Case-control Study

Osteoarthritis knee is one of the most prevalent disorders in the Indian subcontinent. The wide prevalence and varying features makes it a disease of disguise. Multiple etiological factors have been described. The most recent is genetic contribution in the causation of the disease. This case control study was conducted in the Department of Orthopaedic Surgery, CSM Medical University, Lucknow in collaboration with IIT, Kanpur. 120 cases and 120 controls were enrolled. Clinico-radiological features were noted and symptomatic clinical scoring was done. Genetic polymorphism in relation to intronic region of CALM 1 gene was studied by DNA extraction, Polymerase chain reaction (PCR) and Restriction fragment length polymorphism (RFLP) method. Statistical analysis was done using Stata software. There was no significant difference between age, sex and BMI among cases and controls (p value > .05). ESR (p value =0.0000), fasting blood sugar (p value= 0.0004) and serum uric acid (p value=0.0001) were significantly different among cases and controls. SNP was found in significantly higher number in cases than controls (p value = .0022). Heterozygosity was found only in 5 cases. Logistic regression has also proved significant association of occurrence of Single Nucleotide Polymorphism (SNP) with disease. CALM-1 gene intronic SNP (rs3213718) is present in Indian population. Occurrence of this SNP is significantly affecting the disease

A molecular approach to reveal the genetic identity of parrot mussel and other sympatric mussel species distributed along the Kerala coast

Two commercially important mussel species are recorded from the Indian coast: green mussel Perna viridis (Linnaeus, 1758) and brown mussel P. indica (Kuriakose and Nair, 1976). Apart from this, a third type referred to as parrot mussel, which has shell shape of brown mussel, but with green shell colouration and suspected to be the hybrid of the above two species has also been reported from Kollam coast of Kerala, where both the species co-occur. In the present work, genetic identity of parrot and sympatric mussel species was determined using protein and genomic DNA markers. Protein markers viz. Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) and allozymes and the genomic DNA marker Random Amplified Polymorphic DNA (RAPD) were used for determining genetic identity of the three mussel groups. The green and brown mussels could be clearly differentiated using SDS PAGE. The parrot mussel protein pattern was similar to that of brown mussel, except for an additional band of molecular weight 48.7 Kda which is unique to brown mussel. Genus specific protein bands for Perna viz. 66 Kda, 43 Kda and 14.3 Kda, were detected in this study. Allozyme electrophoresis also followed a similar pattern. Of the 10 allozyme loci studied, seven revealed speciesspecific diagnostic differences between P.viridis and P.indica. They were AAT-1* (Aspartate Amino Transferase-1*), AAT-2*, ME (Malic Enzyme)*, PGM-2*(Phospo Gluco Mutase-2*), EST-1* (Esterase- 1*), EST-2*, IcDH* (Isocitrate Dehydrogenase)*. Parrot mussel shared all the alleles of brown mussel, and no hybrid pattern was observed. Species-specific alleles clearly differentiated green mussel from both brown and parrot mussel. The genetic distance of green mussel from brown mussel, estimated from allozyme data was 1.1145 and with parrot mussel it was 1.105. The genetic distance between parrot mussel and brown mussel was negligibly low (0.0005). Using allozyme and RAPD data, the Nei’s Unbiased Measures of genetic distance were calculated and the dendograms prepared based on these values clearly depicted the separation of parrot mussel from green mussel as well as the close resemblance of parrot mussel with brown mussel. The higher gene flow (1.1539) determined using RAPD marker also hints that brown and parrot mussel may be acting as single interbreeding population. Hence this study using molecular tools to test the genetic identity of parrot mussel has helped to conclude that parrot mussel is only a morphotype of brown mussel and not a true hybrid of the two

Key distinguishing characters (KDCs) of official (Boerhaavia diffusa L.) and commonly mistaken (Trianthema portulacastrum L.) sources of Mukkirattai of Siddha

Boerhaavia diffusa L. has been used extensively in Siddha system of medicine and is often confused with Trianthema portulacastrum L. due to morphological similarities. This particular study compares, analyses and identifies the key distinguishing features of the two whole plant drugs based on pharmacognostical and phytochemical aspects. The samples were studied for macroscopy, microscopy, physicochemical analysis, preliminary phytochemical analysis and HPTLC following standard procedures. Macroscopic studies showed few notable differences in macro-microscopy of root, stem, leaves and flowers of both the plants. Microscopically root, stem, leaf and petiole of both the plants showed differences in layers of cork, presence of crystals and medullary rays (in root), the thickness of cuticle, cortex and arrangement of vascular bundles (stem), presence of characteristic type of trichomes (leaf) and shape of the petiole. Powder microscopy showed differences in epidermis, crystal types and shape of pollen. Preliminary phytochemical analysis showed the presence of phenol, saponins and coumarins in B. diffusa and was not detected in T. portulacastrum. There were significant differences in the values of quantitative microscopy, physicochemical parameters and HPTLC of both the whole plant samples. The finding of this study will be helpful for the correct identification of the plant