Role of oral antibiotic preparation in bowel preparation for colorectal surgery in reducing surgical site infection

Background: Mechanical bowel preparation for colorectal surgeries is thought to clear the bowel lumen of stool, thus decreasing intraluminal pressure of hard, potentially impacting stool and reduce ischemia at the new anastomosis. This reduces the dreaded complication of organ space surgical site infection (SSI) that leads to anastomotic leak which is most commonly seen in colorectal surgeries. Oral antibiotic preparation is thought to reduce the bacterial concentration of colonic mucosa which is thought to further bring down the incidence of organ space SSI in colorectal surgery. Aim of this study was to evaluate the role of oral antibiotics given preoperatively as an adjunct to mechanical bowel preparation and intravenous antibiotics, in reducing SSI in colorectal surgeries. Methods: Comparative study of 60 cases of colorectal surgery divided into two equal groups (group A-patients who received oral antibiotic preparations (OABP) with mechanical bowel preparations (MBPs) and ivAb preoperatively (oral antibiotic preparation and mechanical bowel preparation +intravenous antibiotic) versus group B-patients who only received MBP and ivAb preoperatively. Outcomes of SSI results were compared. Results: Incidence of SSI in group A was 16% whereas it was 40% in group B. Incidence of anastomotic leak in group A was 3.3% and in group B was 13.3%. E. coli was found in the pus culture of 60% cases of SSI in study groups whereas S. aureus was found to be the causative organism in rest of the cases that developed SSI. Conclusions: The study supports the use of OABP as an adjunct to MBP and ivAb preoperatively in colorectal surgery for the prevention of SSI and its related complications

Gall bladder specimen histopathological findings after cholecystectomy

Background: Cholecystitis is a generally widespread problem in adult population. Multiple finding has been found in gross and microscopic examination of gallbladder. Existence of stones is one of the known causative factors that lead to histopathological changes in gallbladder. It is also responsible for the development of gallbladder carcinoma. The purpose of this study was to find out the histopathology of gall bladder specimens following surgical intervention. Methods: This observational study included 116 patients admitted in the department of general surgery, PMCH, Patna with acute or chronic cholecystitis from August 2018 to July 2019. Written and informed consent was taken from all the participants. Data was analyzed using SPSS version 20. Results: A total of 116 gallbladder specimens that presented for histopathological examination during the study period were included into the study, with male to female ratio of 1:3. The highest prevalence was found in the age group of 31-50 years. The results of histopathological examination of these gallbladder specimens showed that chronic cholecystitis was found in 93 (80.1%), acute cholecystitis in 17 (14.6%), and dysplasia was found in 5 (4.3%) patients, and gall bladder carcinoma was detected in 1 (0.8%) patients. On morphological analysis, the commonest gall stones were made up of cholesterol and the most common lesion was chronic cholecystitis by histopathology. Conclusions: This study concludes that the chronic calculus cholecystitis was dominant in our population. It is assumed that routine histopathological examination following cholecystectomies essential for all gallbladder specimens even in the non-existence of macroscopic signs of carcinoma, which was the case in our patients

Public Private Partnership for Primary Education in ASEAN

ABSTRAC

Analysis of presentation, etiology, management and outcome of perforation peritonitis in a tertiary care centre

Background: The most common surgical emergency in general surgery is perforation peritonitis. It is a serious condition with a mortality rate of up to 20%, and it is the third most common cause of surgical abdomen after appendicitis and intestinal obstruction. The aim of this study to discuss presentation, etiology, management and outcome of perforation peritonitis in our hospital. Methods: The 60 patients with features of perforation peritonitis admitted from September 2021 to August 2022 in the department of general surgery, PMCH, Patna were chosen. Descriptive statistics was used for analysis. Detailed history was taken, physical examination and X-ray was done. Signs and symptoms, duration of illness, age of presentation, intra-op findings regarding size and location, its management, post-op complications were documented. Results: Total 60 cases of perforation peritonitis were included in this study, among that 80% (48) were males and 20% (12) were females, with male to female ratio of 4:1. Pain abdomen was a universal symptom. Generalized pain abdomen was seen in 54 (90%) cases, followed by lower quadrant in 3 cases (5%) and epigastrium pain seen in 3 cases (5%). Radiation of pain to right iliac fossa was seen in 6 cases (10%). Blunt injury was seen in 9 (15%) case. 14 patients were treated with anti-ulcer medications. Three patients with duodenal ulcer perforation were treated with nonsteroidal anti-inflammatory drugs. Liver dullness was obliterated in 28 patients (47%). Bowel sounds were either sluggish or absent in most cases. Conclusions: Perforation peritonitis is a frequently encountered surgical emergency. Various factors like age, sex, duration, site of perforation, extent of peritonitis and delay in surgical intervention are associated with morbidity and mortality. A successful management depends upon early surgical intervention, source control and exclusive intraoperative peritoneal lavage

Plastic Waste Management in Sri Lanka - Effective policy approaches

Waste management is one of the key environmental issues identified in Sri Lanka. Waste generation is linked with the increase of population and urbanization. Polyethylene and other plastics have become a significant consumable material in lifestyles of the public as well as all types of industries in the country. The plastic consumption is high with the sophistication of living standards of the lifestyle. Managing plastic waste is significant issue in Sri Lanka due to unavailability of valided technology along with the infrastructure for material recycling and recovery. Littering is the main issue of plastic and haphazard disposal, open dumping and burning of plastic cause negative externalities to the environment and human health. The main environmental impacts are air pollution, impact on human health, degradation of land and water, impact on biodiversity and aesthetic value. The government of Sri Lanka has taken many initiatives to improve waste management systems in the country where some of them are development of policies, strategies, guidelines, legislation and provision of infrastructure facilities for waste management. However, poor results have been achieved due to many reasons. This research aims to explore important policy approaches that could be applied in Sri Lanka as a long-term solution to manage plastic waste. The overarching goal of this research is to make recommendations based on policy tools that have been successfully applied in other countries and which can be adopted in Sri Lanka

Thiazolidinones: Potential Human Novel Coronavirus (SARS-CoV-2) Protease Inhibitors Against COVID-19

COVID-19 is a rapidly spreading infectious disease caused by a novel beta coronavirus SARS-CoV-2. During the 1980\u27s coronavirus, genomic RNA was transcribed into a set of subgenomic mRNAs that encode viral proteins containing a leader sequence derived from the 5\u27 end of the genome. The subgenomic mRNAs are transcribed from negative-strand RNAs, synthesized for the full-length genomic RNA - a unique mechanism, presumed to occur by a process involving viral polymerase jumping from one part of the genome template to another, leading to high rate of recombination for coronaviruses, playing role in viral interspecies infections. The sequence of SARS-CoV-2 confined that spike protein has furin cleavage site in the S1/S2 junction different from SARS-CoV and other closely related viruses. This has proved the possibility of Protease inhibitors as antivirals has led to the speculation about virulence and pathogenesis, and it is also possible that this new furin site may serve as a marker to identify a possible precursor virus. This novel human coronavirus (SARS-CoV-2) has resulted in a large number of fatalities and incapacitated human health system. No treatment is available, and a vaccine will not be available for several months. Hence, the protease of coronavirus is a promising target for antiviral drug discovery. We herein report a new generation of thiazolidinone derivatives, inhibitors of SARS-CoV-2 coronavirus protease that incorporated thiazolidinone heterocycles as N-terminal capping groups of the peptide moiety. The compounds were extensively characterized with respect to inhibition of various proteases, inhibition mechanism, membrane permeability, antiviral activity. Our research group has recently designed a one-pot three-component reaction and its mechanism was studied through DFT. Further, a library of the molecules based on the products is designed. These novel molecules were screened through ADMET and molecular docking to find out the potential inhibitor of SARS-CoV-2 protease, as they may have competitive inhibition mechanisms, in correlation with their membrane permeability, a more pronounced antiviral activity

JU_KS_Group@FIRE 2016: Consumer Health Information Search

ABSTRACT In this paper, we describe the methodology used and the results obtained by us for completing the tasks given under the shared task on Consumer Health Information Search (CHIS) collocated with the Forum for Information Retrieval Evaluation (FIRE) 2016, ISI Kolkata. The shared task consists of two sub-tasks -(1) task1: given a query and a document/set of documents associated with that query, the task is to classify the sentences in the document as relevant to the query or not and (2) task 2: the relevant sentences need to be further classified as supporting the claim made in the query, or opposing the claim made in the query. We have participated in both the sub-tasks. The percentage accuracy obtained by our developed system for task1 was 73.39 which is third highest among the 9 teams participated in the shared task

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Not AvailableTillage enhances soil physical condition which favors root growth and crop productivity. Though, continuous rotary tillage at same depth leads to the formation of plough pan which slowdown crop productivity. Some serious speculations have been made about rotary tillage that in long run it induces subsoil compaction. This study was conducted at farmers’ field in Malhendi , Shamli (UP) to investigate the effect of prolonged use of rototilling with special attention to subsoil compaction. The experimental sites were under rotary tillage (RT) under wheat for last 15 years under rice-wheat cropping system which compared with conventional tillage (CT-cultivator harrow). The crop growth and yield was reduced under RT due high mechanical impedance and BD in deeper layer as compared to CT. In upper soil strata (5-15 cm) the cone index of RT (505kPa-2057kPa) soils are lesser than that of CT (625-2257kPa) while in subsoil layer (45cm) it becomes severe under RT(4578 kPa) compared to CT (2468 kPa). Similar trend found in bulk density under both tillage treatments. The bulk densities observed before tillage at 0-15cm, 15-30 and 30-45cm depth were 1.50 Mg/m3and 1.56 Mg/m3,1.37 Mg/m3for CT 1.42 Mg/m3 1.67 Mg/m3and 1.81 Mg/m3 for RT respectively. The grain yields were (5909 kg/ha) and (4594 kg/ha) under CT and RT tillage system respectively. The CT system well performed in plant height, no of tillers and root growth characteristics, viz. root length density, root volume than that of RT. Performing studies shows that long-term RT induced subsoil compaction which needs some amelioration tillage management.Not Availabl

Degree of exposure to interventions influences maternal and child dietary practices: Evidence from a large-scale multisectoral nutrition program.

The prevalence of maternal and child malnutrition in Nepal is among the highest in the world, despite substantial reductions in the last few decades. One effort to combat this problem is Suaahara II (SII), a multi-sectoral program implemented in 42 of Nepal's 77 districts to improve dietary diversity (DD) and reduce maternal and child undernutrition. Using cross-sectional data from SII's 2017 annual monitoring survey, this study explores associations between exposure to SII and maternal and child DD. The study sample included 3635 mothers with at least one child under the age of five. We focused on three primary SII intervention platforms: interpersonal communication (IPC) by frontline workers, community mobilization (CM) via events, and mass media through a weekly radio program (Bhanchhin Aama); and also created an exposure scale to assess the dose-response relationship. DD was measured both as a continuous score and as a binary measure of meeting the recommended minimum dietary diversity of consuming foods from at least 5 of 10 food groups for mothers and at least 4 of 7 food groups for children. We used linear and logistic regression models, controlling for potentially confounding factors at the individual and household level. We found a positive association between any exposure to SII platforms and maternal DD scores (b = 0.09; p = 0.05), child (aged 2-5 years) DD scores (b = 0.11; p = 0.03), and mothers meeting minimum dietary diversity (OR = 1.16; p = 0.05). There were significant, positive associations between both IPC and CM events and meeting minimum DD (IPC: OR = 1.31, p = 0.05; CM: OR = 1.37; p<0.001) and also between CM events and DD scores (b = 0.14; p = 0.03) among mothers. We found significant, positive associations between mass media and meeting minimum DD (OR: 1.38; p = 0.04) among children aged 6-24 months and between mass media and DD scores (b = 0.15; p = 0.01) among children aged 2-5 years. We also found that exposure to all three platforms, versus fewer platforms, had the strongest association with maternal DD scores (b = 0.45; p = 0.01), child (aged 2-5 years) DD scores (b = 0.41; p<0.001) and mothers meeting MDD (OR = 2.33; p<0.001). These findings suggest that a multi-pronged intervention package is necessary to address poor maternal and child dietary practices and that the barriers to behavior change for maternal diets may differ from those for child diets. They also highlight the importance of IPC and CM for behavior change and as a pre-requisite to mass media programs being effective, particularly for maternal diets