Patient satisfaction and experience with various modes of Xylocaine administration for cervical dilatation and endometrial curettage: a randomized interventional study

Background: Patient satisfaction after a surgical procedure is an important outcome of hospital care. Many of the gynaecological menstrual problems such as abnormal uterine bleeding, postmenopausal bleeding requires endometrial evaluation which is done traditionally by dilatation and curettage. But this procedure is painful and requires appropriate pain management protocol. The aim is to evaluate the post-operative patient satisfaction following dilatation and curettage procedure.Methods: This study was conducted in a tertiary care hospital belonging to a medical college. A total of 236 patients were recruited for the study who subsequently underwent dilatation and curettage with different mode of Xylocaine anesthesia for pain relief. Of them 16 patients were excluded due to valid reasons and the remaining 220 were interviewed face to face following the procedure. The level of anxiety was assessed using Beck’s Anxiety inventory and also perception of satisfaction was documented along with complication related to the anesthesia.Results: The overall level of satisfaction was higher in the group receiving both paracervical block and intrauterine instillation of lidocaine during the procedure of dilatation and curettage. A further analysis showed that increase in level of satisfaction was due to improvement in pain scores due to combined mode of paracervical and endometrial anesthesia.Conclusions: A multimodal pain management protocol which involves pre-procedural sedation, combined cervical and endometrial anesthesia improves overall outcome with respect to reduction in anxiety scores and postoperative satisfaction levels

Quantitative Estimation of Biochemical and Inorganic Constituents Present in the GallStones

Carcinoma of gallbladder has an unusual geographic distribution. Gallbladder cancer is the most common type of biliary tract cancer which is the fifth most common gastrointestinal tract cancer and sixth most common digestive tract malignancy. Thus, the study was carried out based on quantitative analysis of biochemical constituents (cholesterol, bilirubin, bile acids, fatty acids, phospholipids and soluble protein) and inorganic constituents (sodium, potassium, calcium, magnesium, inorganic phosphate, oxalate and chloride) in all the three types of gallstones and also compare the present findings with other researchers findings. The results indicated that out of 179 gallstones, 41 were of cholesterol type, 77 mixed and 61 of pigment type. Cholesterol content was found to be the major component in all the three types of stones. Also, cholesterol stones had higher content of total cholesterol, fatty acids, phospholipids and inorganic phosphates as compared to mixed stones and pigment stones. While in case of pigment stones bilirubin, bile acids, soluble protein, sodium, potassium, calcium were found to be higher as compared to cholesterol and mixed stones. The overall findings with respect to biochemical constituents resulted that the cholesterol saturation is mostly responsible for crystallization sequences in human gallbladder

A pure and bizarre ovarian malignancy - choriocarcinoma: case report

Germ cell malignancies represent 15% of ovarian cancers in Asians. Choriocarcinoma is a malignant tumor of the ovary with trophoblastic differentiation can be gestational or non-gestational in origin the study is aimed to increase awareness of rare malignant cancer in children that can present in uncommon symptoms and is diagnosed only if the doctor is vigilant. It is a prospective observational case report. Though uncommon a cancer, choriocarcinoma cases have been reported several times in the literature with no definitive treatment plan. The neoadjuvant chemotherapy followed by surgery has proven too successful in the above case. A multidisciplinary approach to juvenile cancer can have a fruitful outcome with high cure rates. The rarity of this cancer makes it difficult to have clear cut diagnosis fixed treatment plan. A good history taking and easy availability of ultrasound with fast-track referral can save many lives from the deadly disease like cancer. Due to paucity of data in regard to pure choriocarcinoma this case report may help in gathering more attention to the research towards this cancer

FORMULATION AND EVALUATION OF RACECADOTRIL MUCOADHESIVE MICROSPHERES

Objective: To develop and evaluate the mucoadhesive microsphere using combinations of natural polymers chitosan and xanthan gum for sustained release. Methods: In the present work mucoadhesive microspheres were prepared by using natural polymers like chitosan and xanthan gum by using the emulsion chemical cross-linking method. Chemical cross-linking was done by using glutaraldehyde. The 22 factorial design was employed to show the effect of cross-linking agent and processing factor-like stirring and speed. Prepared microspheres were evaluated for their particle size, surface morphology, drug entrapment efficiency, in vitro drug release, swelling index, and mucoadhesive strength. Results: The size of microspheres of factorial batches were in the range of 26-46 µm. The swelling index was showed in the range of 1.51-1.66 percentage. The equation of multiple regression revealed that there was significant interaction among factors. The glutaraldehyde concentration had a positive effect on % entrapment efficiency, % cumulative drug release and % mucoadhesion. Stirring speed showed a negative impact on % entrapment efficiency, % cumulative drug release and % mucoadhesion. The interactive effect of glutaraldehyde concentration and the stirring speed was found to be positive for % entrapment efficiency and % cumulative drug release. In vitro drug release study of optimized formulation F2 show 96 % of drug release with 6 h indicating sustained release behavior with diffusion mechanism. The SEM image of the optimized batch was spherical with a porous surface. Conclusion: The results obtained in this research work indicated that a promising potential of chitosan and xanthan gum combination for the preparation of the mucoadhesive microsphere of Racecadotril

The Applicability of Oxidative Stress Biomarkers in Assessing Chromium Induced Toxicity in the Fish Labeo rohita

The evaluation of metal’s toxicity in freshwater is one of the imperative areas of research and there is an emergent concern on the development of techniques for detecting toxic effects in aquatic animals. Oxidative stress biomarkers are very useful in assessing the health of aquatic life and more in depth studies are necessary to establish an exact cause effect relationship.Therefore, to study the effectiveness of this approach, a laboratory study was conducted in the fish Labeo rohita as a function of hexavalent chromium and the toxicity indices using a battery of oxidative stress biomarkers such as catalase (CAT), superoxide dismutase (SOD), and glutathione reductase (GR) in the liver, muscle, gills, and brain have been studied along with biometric parameters, behavioral changes, and Cr bioaccumulation. A significant increased HSI was observed in contrast to CF which reduced significantly. SOD,CAT, and GR activity increased significantly in all the tissues of treated fishes. The bioaccumulation of Cr was highest in liver followed by gills, muscle, and brain. This study highlights the significance of using a set of integrated biomarker and advocate to include these parameters in National Water Quality Monitoring Program in areas potentially polluted with metals to assess the health of the ecosystem

EXERCISE ON PRESCRIPTION AUDIT : A TOOL FOR PHARMACOLOGY PRACTICAL LESSON

To improve the understanding and perception about rational prescribing among the Undergraduate (UG) students, a record based study 'exercise on prescription audit' was undertaken as self-directed learning strategy. Study was conducted on Objectively Structured Evaluation of pharmacotherapy taking one year record of prescriptions in Bed Head Tickets (BHTs) of discharged Ophthalmic in-patients. Standard format for prescription writing, WHO guide to Good prescribing and Essential Medicines were followed to assess the in-patient prescriptions. Students improved markedly (p< 0.001) in audit of real prescriptions. Results revealed that 37 types of drugs were prescribed over 948 BHTs. Completeness of the prescription showed 100% perfection in maximum indicators with exception in judicious investigations (99.89%), medication information (89.32%) and relevant advices for patient (97.12%). Subsidiary or symptomatic drugs (56.76%) were prescribed more than the core drugs (43.24% of total drugs prescribed). Generic prescription was 54.05%. Study in turn improved the understanding and perception about rational prescribing among the students. The students gained knowledge about the utilization of different types of dosage forms of drugs. Prescription audit as self-directed learning must be a tool for practical lesson of Pharmacology for UG-course as well as for PG-curriculum

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Background: This study was conducted to evaluate the incidence of shivering and likely associated risk factors following spinal anaesthesia in patients undergoing lower abdominal and lower limb surgeries.Methods: The present study was conducted in MMIMSR, Department of anaesthesia from December 2016 to September 2018. It was an observational study which was conducted over a period of 2 years. Patients who were scheduled to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia were included in study.Results: The present study depicts a high incidence of post spinal shivering, which was 42.8%. Majority of the patients belonged to the young age group between 20-30 years. The mean time of onset of shivering, was around 25 mins. Duration of shivering was observed between 15-75 minutess with a mean of 43.75 and SD±19.39.Conclusions: Shivering is one of the distressing complications of spinal block, which may be deleterious to the patients with poor cardio-respiratory reserve

Smart Ration Card System using RFID and Embedded System

In the present days many immoral activities are taking place in ration shop, which are meant to distribute the commodities to the people who are in below the poverty line, as the distribution process is manually operated and due to which it consumes a lots of time. To overcome this problem we one can use RFID technology. In this report RFID tags are introduced, the RFID card are used instead of ration cards, which consists of all the details about the card holder like family details, type of card and its validity etc. In this report we are going to discuss different types of automatic ration distribution system implemented for the automatic ration distribution

Virilising ovarian tumors: a single-center experience

Literature on virilising ovarian tumors (VOTs) is limited to case reports and series reporting single pathological type. We have analyzed the clinical, hormonal, radiological, histological, management and outcome data of VOT. This retrospective study was conducted at a tertiary health care center from Western India. Consecutive patients with VOT presenting to our endocrine center between 2002 and 2017 were included. Our study included 13 patients of VOT. Out of 13 patients, two were postmenopausal. All patients in the reproductive age group had secondary amenorrhea except one who presented with primary amenorrhea. Modified F and G score (mFG) at presentation was 24 ± 4.3 and all patients had severe hirsutism (mFG ≥15). Change in voice (n = 11) and clitoromegaly (n = 7) were the other most common virilising symptoms. Duration of symptoms varied from 4 to 48 months. Median serum total testosterone level at presentation was 5.6 ng/mL with severe hyperandrogenemia (serum testosterone ≥2 ng/mL) but unsuppressed gonadotropins in all patients. Transabdominal ultrasonography (TAS) detected VOT in all except one. Ten patients underwent unilateral salpingo-oophorectomy whereas three patients (peri- or postmenopausal) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Seven patients had Sertoli Leydig cell tumor, three had steroid cell tumor and two had Leydig cell tumor and one had miscellaneous sex cord stromal tumor. All patients had normalization of serum testosterone after tumor excision. In conclusion, VOTs present with severe hyperandrogenism and hyperandrogenemia. Sertoli Leydig cell tumor is the most common histological subtype. Surgery is the treatment of choice with good surgical outcome

A study of morphological variations of the human ear for its applications in personal identification

Abstract Background External human ear is considered to be a highly variable structure showing different morphological and individualistic features in different individuals and population groups. The uniqueness of the ear may be useful in establishing the identity of individuals by direct examination, during the examination of CCTV footage or analysis of the ear prints. Considering the forensic significance of the human ear and ear prints encountered at the scene of the crime, the present study is an attempt to evaluate various morphological characteristics of the ear in a north Indian population. Methodology The sample for the present study comprises of 90 males and 87 females aged between 18 and 30 years. All the study participants were from upper reaches of Himachal Pradesh in North India. The morphological characteristics such as overall shape of the ear, size and shape of the tragus, earlobe, shape of the helix, and forms of Darwin’s tubercle were studied in the participants. Results The oval-shaped ear was present among 40% of the males and 44.8% of the females in the study sample. The other types of the ear such as oblique, rectangular, round, and triangular were also found in both sexes. Bilateral asymmetry was observed in the shape of the ear. The shape of the tragus also varied with respect to the left and right sides as well as sexes. The earlobe showed different characteristics in different individuals. In nearly half of the cases in both males and females, the earlobe was found to be attached to the face; in many cases, it was free and in some partially attached. The size and shape of the earlobe also showed variations with respect to sides as well as sexes. The Darwin’s tubercle showed a variety of structures in both the left and right sides in both sexes. Conclusion The present study shows that the individualistic characteristics of the ear can provide very useful information for personal identification in forensic examinations. The shape of the ear and the important structures such as the tragus, helix, earlobe, and Darwin’s tubercle show a variety of structures and individuality. The importance and variability of the human ear may encourage the researchers in conducting further studies and solving the forensic cases pertaining to the investigation of CCTV footage and in examination of dead in airplane crashes, intentional mutilation and dismemberment, explosions, or other mass disasters