Surgery for complicated pulmonary tuberculosis

Abstract not availabl

Studies of the silkworm enzyme activity and their correlations with economic variables

The experiment was conducted to analyse the larval performance and economic traits of bivoltine silkworm breeds of silkworm (SK-1, SK-6, SK-22, SK-28, SK-33, CSR4, CSR2, NB4D2, DUN6 and APS4) during spring season. The haemolymph total protein, succinate and gultamate dehydrogenase activities were estimated and their correlation with economic traits were also worked out. The results of the study confirmed that among ten bivoltine silkworm breeds, highest haemolymph SDH activity of 3.47 µmoles/ml/mgprotein/min was recorded in the silkworm breed SK1 and least SDH activity of 1.58 µmoles/ml/mg protein/min was recorded in the breed APS4. The highest peak of succinate dehydrogenase activity of 2.65 µmoles/ml/mg protein/min was observed on 7th day of the 5th instar and lowest peak of succinate dehydrogenase activity of 2.39 µmoles/ml/mg protein/min was observed on 4th day of the 5th instar. GDH activity of 0.46 µmoles/ml/mg protein/min was recorded highest in the silkworm breed SK1 and lowest of 0.15 µmoles/ml/mg protein/min was recorded in silkworm breed APS4. The highest peak of haemolymph GDH of 0.36 µmoles/ml/mg protein/min was recorded on 7th day of 5th instar and lowest peak of 0.26 µmoles/ml/mg protein/min was recorded on 4th day of 5th instar. The correlational studies revealed that haemolymph total protein, SDH and GDH were found to be positively corelated with yield by weight and number (cocoon), weight of mature larvae, shell weight ,cocoon weight, shell ratio percent, silk productivity, rate of pupation, fecundity, raw silk percentage  and length of filament. Thus, the study revealed that silkworm breeds like SK1, SK6, SK22 and SK28 as productive breeds and hence may be used for future breeding programmes for evolution of new robust silkworm breed

Development of novel functional foods using Himalayan honey having enhanced nutraceutical and nutritional potential

This study was carried out to conduct the geographical discrimination of various types of honey, and their utilization in development of novel functional foods where in honey could be substituted in place of white sugar. Honey based apple spread and marmalade products were developed and evaluated for quality analysis. The results showed higher water activity (aw) and moisture content in Plectranthus rugosus (PR) honey based apple spread and marmalade while, TSS was highest (p < 0.05) in Multifloral (MF) honey based apple spread and marmalade. Hydroxymethylfurfural was found to be in the ranged of 6.77–7.05 (mg/kg) for honey based apple spread products and 3.09–3.46 (mg/kg) for honey based apple marmalade products. The lightness (L*) value was significantly highest in MF honey based apple spread and marmalades (p < 0.05). Redness (a*) and yellowness (b*) values were significantly highest in PR honey based apple spreads and marmalades and lowest in Robinia pseudo acacia (RSA) honey based apple spread and marmalades. In general, all MF honey based apple spreads and marmalades has the highest score for overall acceptability in comparison to RSA and PR honey based apple spreads. The values of gel strength (Fe), rupture force (FR), energy of penetration (E) and adhesiveness (A) in the given spread products were in the range of 1.50–1.54 N, 1.70–1.73 N, 17.00–17.05 Ns and −1.11–−1.08 Ns, respectively. The values of gel strength (Fe), rupture force (FR), energy of penetration (E) and adhesiveness (A) in the investigated marmalade products were in the range of 1.65–1.69 N, 2.08–2.13 N, 16.05–16.10 Ns and −1.14–−1.10 Ns, respectively

Surgery for complicated pulmonary tuberculosis

Abstract not availabl

Early results after transatrial repair of RVOT obstruction including teratology of fallot

Background: Right ventricular (RV) dysfunction is a significant cause of morbidity and mortality after surgical correction of RVOT obstruction including tetralogy of Fallot (TOF). Transatrial repair avoids a ventriculotomy (in contrast to the transventricular approach) emphasizing maximal preservation of RV structure and function. We have adopted this technique as less traumatic for the right ventricle. This study evaluates the early surgical results of our approach.Methods: Between January 2005 to January 2014, 77 consecutive patients with RVOT obstruction were referred to our unit for surgical therapy. Of these, 14 were unsuitable for repair and underwent aortopulmonary shunting. In the remaining 63 patients (mean age of 2.67±0.38 years), complete transatrial/transpulmonary repair was performed. Previously placed shunts (four patients) were taken down. In all cases, subpulmonary resection and ventricular septal defect (VSD) closure were accomplished transatrially. In 51 patients, the main pulmonary artery was augmented with an autologous pericardial patch.Results: There were 7 (9%) deaths in this series. No patient required permanent pacemaker. Median ICU and hospital stay were 91 hours and 14 days, respectively. At median follow up of 54 (mean 51±12) months, all patients are asymptomatic, with no significant residual lesion.Conclusions: Transatrial/transpulmonary repair of TOF is associated with remarkably low morbidity and mortality in our early experience

The Diagnostic Efficacy of Adenosine Deaminase in Tubercular Effusion

Objective: This study aims to evaluate the diagnostic efficacy of adenosine deaminase in tubercular effusions.Methods: This study was conducted at the Department of General Medicine and Cardiovascular and Thoracic Surgery, SKIMS, for a period of two years between November 2008 and November 2010. A total of 57 patients presenting with pleural effusions during the two-year study period, who presented with clinical manifestations suggestive of tuberculosis (i.e., the presence of productive cough, low-grade fever, night sweats, weight loss, and chest pain, especially if these symptoms last ≥4 weeks) were included in the study. If the patients presented with less than two of these symptoms, and especially if the clinical manifestations were of <4 weeks duration, they were excluded from the study.Results: The mean adenosine deaminase activity level in all the 57 patients was 109 U/L while the mean adenosine deaminase activity levels in pleural TB patients was 80 U/, and 64 U/L in the controls (p=0.381). Considering 40 U/L as the cut off, the results were positive in 35 out of 39 tuberculosis patients and 9 out of 18 controls. The sensitivity of adenosine deaminase for tubercular effusions worked out to be 90%, with only 50% specificity.Conclusion: This study suggests that the estimation of adenosine deaminase activity in pleural fluid is a rapid diagnostic tool for differentiation of tubercular and non tubercular-effusions. The sensitivity and specificity of adenosine deaminase for tubercular effusions in this study was 90% and 50% respectively

The Characteristics and Surgical Approach in Post-Traumatic Diaphragmatic Hernia: A Single Center Experience

Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS), Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported. Results: The mean age of the patients was 32±1 years and there were 16 (76.1%) men and 5 (23.8%) women among the patients. Thoracotomy was performed in 14 patients (66.7%), laparotomy in 6 patients (28.6%) and combined procedure was used in 1 patient (4.7%). The reduction of hernia contents with repair of diaphragmatic rent was done in 11 (52.2%) of the patients and splenectomy with repair of rent in 6 (28.6%). Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate.Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries

Carcinoma lung: Clinical presentation, diagnosis, and its surgical management

The aim of this article is to review the surgical management of lung carcinoma. Lung cancer is the most common cancer in the world, and a leading cause of death in men and women. By any conventional measure, the enormity of this global problem is immense. In some countries incidence and mortality rates have peaked and are beginning to decline. In many developing nations, the burden of disease is rising and will continue to rise because of aggressive tobacco industry marketing which is leading to a growing prevalence of cigarette smoking. This is also one of the major causes of cancer deaths in our Kashmir valley. The method of literature search was from articles published in PubMed and Google Scholar

Favorable subset of acute myeloid leukemia with translocation 8;21: An elusive experience

Background: Risk stratification is critical in the management of acute myeloid leukemia (AML) and among the favorable subset translocations known, 8;21 seems elusive in our clinical practice as regards the response remission status. This led us to review our patients retrospectively to highlight this ambiguity. Patients and Methods: A retrospective study was carried out on a total of 20 patients positive for translocation (8;21) and negative for FLT3 and NPM gene mutation. These patients were treated with standard AML treatment protocols. Post induction day 14 and day 28 assessments were done. Four patients died during induction chemotherapy and all the remaining patients were in remission. Subsequently, these patients were subjected to consolidation chemotherapy. Results: Out of total of 16 (80%) survivors, 10 (50%) could not maintain the remission status on a mean follow-up of 6 months and were treated with a different induction protocol. After the second induction, all patients were in remission at day 28, but this remission again was short lasting (<3 months). Conclusion: One needs to be careful in treatment of AML with translocation (8;21) and this should not be taken as a single criterion for treatment of these patients. These patients should be subjected to additional somatic mutation analysis before final risk stratification

Right anterolateral thoracotomy a minimally invasive approach to mitral valve replacement

Background: The objectives of this study were to analyze the results of the right anterolateral thoracotomy approach for primary mitral valve replacement with reference to length of incision, surgical exposure, mean cross-clamp time, mean bypass time, intensive care unit (ICU) stay, hospital stay, overall comorbidity sepsis, dehiscence, healing cosmesis and cost-effectiveness. Materials and Methods: Thirty-three patients were operated for mitral valve disease in the Department of Cardiovascular and Thoracic Surgery at the Sher-i-Kashmir Institute of Medical Sciences from September 2009 to August 2011 and all patients underwent mitral valve replacement. Results: Of the 33 patients, 13 were male (40.6%) and 19 were female (59.4%). The length of incision was 14.8 ± 2.3 cm and, in thoracotomy, there was a significantly lesser duration of ICU stay the entire hospital stay. Scar visibility was around 25% in case of thoracotomy. Conclusion: Approach through a right anterolateral thoracotomy proved to be easy to perform while maintaining maximum security for the patients. Besides its better cosmetic result, especially in female patients, this approach proved to have several advantages. It offered a better exposure to the mitral apparatus even in patients with small left atrium, allowing mitral valve replacement to be performed easily. The shorter hospital stay and cost-effectiveness of thoracotomy approach is an additional relief to the family