Modified three port laparoscopic cholecystectomy versus conventional four port technique

Background: The current  study was undertaken to compare the results of modified three-port laparoscopic cholecystectomy and conventional three or four-port surgery in terms of technical feasibility, safety of the technique, postoperative pain and need of post-operative analgesia, cosmetic satisfaction of the patient and cost effectiveness and were found to be better with the modified technique.Methods: In modified three port laparoscopic cholecystectomy technique, first 10 mm umbilical, second 5 mm epigastric and third 5 mm subcostal ports are made, i.e., "10-5-5" instead of "10-10-5" or "10-10-5-5" of conventional three or four port techniques and finally, gallbladder is extracted through the umbilical port.Results: The pain in the postoperative period and the requirement of postoperative analgesia were significantly less and there was better cosmetic satisfaction of the patients operated by the modified three port laparoscopic cholecystectomy technique as compared to conventional three or four port surgery.Conclusions: The modified three-port laparoscopic cholecystectomy technique is safe and has the same comfort and feasibility to the surgeon along with added advantage of less pain and better cosmetic appearance to the patient in comparison to the conventional three or four-port surgery, with no obvious increase in complications and is definitely a viable alternative procedure for the management of cholelithiasis

Cooperative Integrated Reading Composition (Circ): Improving Achievement in English Writing Composition Among Seventh Graders

Cooperative learning strategies have occupied a prominent place among language learning methodologies. t his study quantitatively validates the effect of the Cooperative Learning approach-Cooperative Integrated Reading Composition (CIRC) on the Writing Composition achievement in English among seventh graders. Cooperative Learning was compared with conventional teaching-learning classroom structure using an experimental design. 140 students of seventh class were randomly selected out of which 70 students formed Experimental Group (E) and 70 students formed Control Group (C). Writing Composition achievement test in English and Instructional Material were developed by the investigators themselves. Whole teaching-learning process was carried out for eight weeks only. at the end of the experiment, Writing Composition achievement test in English was given to the subjects. Data were analyzed by using the t-test. the findings revealed that Experimental Group outscored significantly Control Group on post-test showing the obvious supremacy of Co-operative Learning technique (CIRC) over Conventional Method of teaching. It was concluded that co-operative learning is an effective approach which needs to be incorporated in teaching Writing Composition to improve writing skill

A Study of the Correlates of Organizational Commitment Among Secondary School Teachers

The study was planned to determine the effect of job satisfaction, work motivation and type of schools on organizational commitment of secondary school teachers. Descriptive survey method was employed for the investigation. The organizational commitment has been treated as the dependent variable, whereas job satisfaction, work motivation and type of schools comprised the independent variables for the study. Multi-stage random sampling technique was used to select the sample of 480 secondary school teachers working in Rohtak, Jhajjar and Sonepat cities of Rohtak Division of Haryana. The investigators used Organizational Commitment Scale (OCS) by Hyde and Roy (2006), Job Satisfaction Scale (JSS) by Dixit (1993) and Employees Motivation Schedule (EMS) by Srivastava (1988) to measure organizational commitment, job satisfaction and work motivation of teachers respectively. Means, SD’s and t-test were used for analyzing the collected data. Findings of the study reported significant effect of type of schools and job satisfaction on the organizational commitment of the teachers. No significant difference was found in organizational commitment of private school teachers with high and low level of work motivation and the government school teachers with high level of work motivation were reported to be better than their counterparts with respect to their organizational commitment. The study also revealed certain educational implications for the teachers, principals and the administrators for enhancing the organizational commitment among the teachers

Transient Analysis of Photonic Networks

The behavior of slotted aloha protocol for a star-coupled Wavelength Division Multiple Access (WDMA) photonic network is studied. Semi-markov process is used for developing the steady state and transient models for the protocol. The performance of the network is evaluated in terms of various measures viz. average number of packets in the network, throughput of the network and average packet delay etc. The analytical models are validated by evaluating the numerical values of the performance indices, which are further compared by using Adaptive Neuro Fuzzy Inference System (ANFIS) approach. Keywords:Photonic networks, Slotted aloha, Semi-markov process, Neuro-fuzzy systems, Throughput.

Problem Solving Ability & Locality as The Influential Factors of Academic Achievement Among High School Students

Academic achievement of the pupil is the prime concern of educational process. The problem solving ability has been playing a significant role in determining student’s academic achievement. Keeping this in view, the present study was designed to examine empirically the effect of problem solving ability on the academic achievement of rural and urban school students. The research was conducted on 250 school students (118 rural & 132 urban) studying in 10th class CBSE affiliated private schools that were randomly selected from Rohtak district of Haryana State. Descriptive survey method was used to elicit opinion of rural & urban school students about their problem solving ability and their academic achievement at school. The problem solving ability of sample was assessed by using Dubey’s Problem Solving Ability Test (2006) & for academic achievement of students, the school records i.e. marks obtained by the students in previous (IXth) class was considered. The data was analyzed statistically by using ANOVA supplemented by t-test. The findings of the study revealed that problem solving ability had significant effect on the academic achievement of the students whereas significant difference was observed in the academic achievement of students studied in urban and rural schools. However, the significant interaction effects of locality and problem solving ability on the academic achievement of the students had been found

A prospective comparative study to evaluate the efficacy of ultrasonography and hysteroscopy and their correlation with the histopathology of endometrium in a case of abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is one of the most common complaints that brings a woman to the gynecologist. Key to successful clinical management of AUB is to identify the cause behind it for which proper evaluation of the case is required. In current scenario of increasing cost awareness and taking risk related to invasive procedure hysteroscopy, a balance has to be achieved between the practices of randomly doing all investigation versus a condition appropriate approach. This study was done to compare efficacy of pelvic ultrasonography & hysteroscopy in cases of AUB and their correlation with the histopathology of endometrium.Methods: In this study 70 women with AUB were selected as they presented in OPD. After evaluation of clinical presentation, general, systemic and local examination, ultrasonography and hysteroscopy were performed on every patient and endometrial curetting were sent for histopathology.Results: We concluded that ultrasonography has a better efficacy to detect uterine cause of AUB and hysteroscopy is better for detecting intracavitary lesions.Conclusions: Ultrasonography has a better efficacy to detect uterine cause of AUB. However a thorough history and detailed clinical examination plays a very important role in narrowing the differential diagnosis of AUB. We have developed an algorithmic approach and guidelines for selective use of hysteroscopy in cases of AUB after evaluating the results

KSHARASUTRA (MEDICATED SETON) TREATMENT IN PILONIDAL SINUS

Pilonidal sinus is a disease which causes great suffering and pain to the patient. Persistence of Pilonidal sinus has given a challenge to most indigenous surgeons. This disease manifest itself as a blind track leading down to the tissues ending blind internally and discharging sero-purulent material associated with severe pain. In modern medicines, the treatment of pilonidal sinus includes excision and primary closure of excision with reconstructed flap. The risk of recurrence or of developing an infection of the wound after the operation is high. Kshara sutra is an age old treatment modality practiced since times of Sushruta. A total of 10 patients were selected with complaints of Pain, Discharge, tenderness and induration. The patients with multiple sinuses, previous treatment and co-morbid conditions were excluded. The study factor was of Kshar sutra threading of Pilonidal Sinus done under local infiltration of anaesthesia around the tract and changed every week during entire treatment period. In this study all patients were males within age of 21-30 years and median presentation duration of 10 months were recruited. The median of initial length of track was 2.4cm and median average unit cutting time revealed 6.3days / cm. There was no post-operative complication and recurrence after three months of follow up. The study revealed highly significant results in terms of Pain, Discharge, tenderness and induration. Apamarga Ksharasutra as a modality could be a minimal invasive procedure done under local anaesthesia as outpatient or day care procedure, cost effectiveness, patient can carry out his day today works, without any side effects and complications with good wound healing potential in selected group of patients. Ksharasutra being laced with antibiotics and anti-inflammatory properties also minimizes the uses of antibiotics and analgesics

INDICATING THE FINEST TREATMENT FOR CHRONIC FISSURE IN ANO

An anal fissure is a common, mostly benign, condition that can be acute or chronic. The diagnosis is usually made on history and physical examination, but further investigations are sometimes necessary. Primary fissures are usually benign and located in the posterior or anterior position. Secondary fissures are lateral or multiple and often indicate a more serious underlying pathology. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. Conservative management, using increased fiber and warm baths, results in healing of approximately half of all anal fissures. New therapies include perineal support devices, Gonyautoxin injection, fissurectomy, fissurotomy, sphincterolysis, and flap procedures. Further research is required comparing these new therapies with existing established therapies. New therapies are not suitable as first line treatments, though they can be considered if conventional treatment fails. In fissures if conservative care fails, various pharmacologic and surgical options offer satisfactory cure rates. Lateral internal sphincterotomy remains the gold standard for definitive management of anal fissure. This review outlines the key points in the presentation, pathophysiology, and management of anal fissure

AGNIKARMA- A TRENCHANT TECHNIQUE FOR CATHOLICON OF KADARA W.S.R TO CORN

Kadara has been described as one of the Kshudra roga in Sushruta samhita. It is characterized by hard Granthi type swelling. It amounts to great pain and discomfort when pressure is applied. Even though it is not fatal but makes patient suffer a lot of pain. Patient makes great effort to get rid from this. Kadar can be co-related to corn in modern science. But its management in modern science is not satisfactory. In modern science its treatment includes corn cap application and Surgical excision. Excision of corn is very painful procedure. In modern surgery the only form of treatment of corn that affords any reliable prospect of cure is excision. But the surgeries of corn have an unenviable reputation for subsequent chronic wound healing, more hospitalization etc. Generally is recommended that salicylic acid not to be used by people with diabetes, or when there is frail skin or poor circulation (because of concern about how the skin can heal). Sometime salicylic acid can harmful and allergic to skin moreover by these procedure reoccurrence is very common. So keeping these drawbacks of modern science management, Agnikarma mentioned in Ayurveda selected to give new parameter to management of Kadara. In this present study total 30 patients were selected randomly. They were treated by Agnikarma procedure with Pancloha shalaka in a Systematic manner for duration of 15 days with interval of 5 days in 3 sittings. An excision of Kadar is done by Red Hot Panchloha shalkha. Internally Triphala guggulu 2 tab for 5 days with lukewarm water after food was given. Patient was followed up to 60 days of the procedures to observe and note any reoccurrence. Dressing with Jatyadi Ghrita was done daily in OPD of Shalya tantra department. After completion of clinical trial highly significant result were found in parameter like pain, infection and healing period and no reoccurrence was observed by Agnikarma procedure. By these result it can concluded that Agnikarma is an effective remedy for Kadara.

Exfoliative cytology of body fluids: a study from provincial hospital of Jammu region, India

Background: Cytological study of body fluids is an inexpensive and simple procedure useful in making diagnosis regarding etiology, understanding course of disease and to monitor the response to therapy. It has helped in staging and prognosis of the malignant tumours. The present study aims to understand cytology of various aspirated body fluids, categorize effusions into non neoplastic and neoplastic type with further classification of aspirated fluid as exudate and transudate.Methods: A total of 185 cases of aspirated fluids coming to Pathology Department of Government Hospital Gandhi Nagar for analysis were studied over a period of one year i.e. from Jan 2015 to Dec 2015.The fluid received was centrifuged and the remaining sediment was transferred with the help of pipette onto two glass slides and spread evenly. One was stained with Giemsa and other was stained with Papanicolaou stain. Leishman stain was done in suspicious cases of CSF. Improved Neubauer counting chamber was used for the cell counts.Results: Peritoneal fluid was most common aspirated fluid (49.7%) with overall male to female ratio was 1:1.6. Maximum cases belonged to age group of 30-40 years. Only (5.4%) 10 cases were neoplastic. Among malignant effusions maximum (60%) were adenocarcinoma, followed by squamous cell carcinoma (20%).Conclusions: Exfoliative fluid cytology is rapid and effective method for diagnosis, evaluation and it further guides us in clinical decision making regarding management of underlying pathology.