Comparison of the Clinical Effects of Unilateral Biportal Endoscopic and Microscopic Lumbar Discectomy

Introduction : Micro discectomy is the surgical procedure of choice for treating lumbar disc herniations. A laminectomy can cause instability, significant epidural fibrosis, continued radiated pain, and surgical site infection, although there is still concern about the dangers of muscle damage, such as to the multifidus, and excessive articular facet resection. Unilateral biportal endoscopic discectomy has been suggested as a less invasive therapeutic approach.Objective: To compare the clinical effects in terms of pain, impairment, and complications associated with percutaneous endoscopic lumbar discectomy with standard micro discectomy for the treatment of disc herniations. Materials and methods: A study of 60 people with disc herniations who were treated with either microdiscectomy or unilateral biportal endoscopic lumbar discectomy. The Oswestry Disability Index and visual analogue score for back and leg pain was evaluated after three, six, and twelve months. Results: In comparison to Group E, Group M's mean operating time was substantially lower (p<0.05). In addition, it took group M more time on average to get back to work. (p<0.05), and the VAS score at 3 showed a statistically significant change (p<0.05). At three months, group M's Oswestry Low Back Pain Disability score was considerably greater than group E's. (p<0.001). Conclusion: In terms of a three-month return to work and wound infections, endoscopic surgery has a little advantage over microscopic surgery. Both techniques are efficient and safe for lumbar discectomy. However, after 6 months of follow-up, the results seem to be comparable. Keywords: Intervertebral Disc Prolapse, Discectomy, Endoscopy, Intervertebral Disc, Micro Discectomy, Visual Analog Scale, Oswestry Low Back Pain Disability Scor

Mapping private pharmacies and their characteristics in Ujjain district, Central India

<p>Abstract</p> <p>Background</p> <p>In India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines. These are often the first points of treatment seeking in parts of India and other low income settings around the world. The characteristics of these pharmacies including their location, drug availability, human resources and infrastructure have not been studied before. Given the ubiquity and popularity of private pharmacies in India, such information would be useful to harness the potential of these pharmacies to deliver desirable public health outcomes, to facilitate regulation and to involve in initiatives pertaining to rational drug use. This study was a cross sectional survey that mapped private pharmacies in one district on a geographic information system and described relevant characteristics of these units.</p> <p>Methods</p> <p>This study of pharmacies was a part of larger cross sectional survey carried out to map all the health care providers in Ujjain district (population 1.9 million), Central India, on a geographic information system. Their location vis-à-vis formal providers of health services were studied. Other characteristics like human resources, infrastructure, clients and availability of tracer drugs were also surveyed.</p> <p>Results</p> <p>A total 475 private pharmacies were identified in the district. Three-quarter were in urban areas, where they were concentrated around physician practices. In rural areas, pharmacies were located along the main roads. A majority of pharmacies simultaneously retailed medicines from multiple systems of medicine. Tracer parenteral antibiotics and injectable steroids were available in 83.7% and 88.7% pharmacies respectively. The proportion of clients without prescription was 39.04%. Only 11.58% of staff had formal pharmacist qualifications. Power outages were a significant challenge.</p> <p>Conclusion</p> <p>This is the first mapping of pharmacies & their characteristics in India. It provides evidence of the urban dominance and close relationship between healthcare provider location and pharmacy location. The implications of this relationship are discussed. The study reports a lack of qualified staff in the presence of a high proportion of clients attending without a prescription. The study highlights the need for the better implementation of regulation. Besides facilitating regulation & partnerships, the data also provides a sampling frame for future interventional studies on these pharmacies.</p

Eigenvalues of the Laplacian for certain Riemannian metrics on S2 and S3

In this dissertation, we begin by characterizing the left-invariant Riemannian metrics on S3 possessing a positive definite Ricci tensor. Of these metrics, for the ones that further satisfy Ric g ≥ 2g, we compare the eigenvalues of the associated Laplace operator, Δg, with the eigenvalues of the Laplace operator for the standard Euclidean metric on S3 with constant sectional curvature 1. We then introduce certain conformal, rotationally symmetric, real-analytic perturbations of the standard Euclidean metric on S 2, and study the perturbed eigen-values of the Laplace operators for the metrics sufficiently close to the Euclidean metric. The motivation for this study has been to answer a problem regarding the vector space of harmonic functions with growth conditions on Riemannian manifolds of dimensions three and four having non-negative Ricci curvature

On the eigenvalues of the Laplacian on ellipsoids obtained as perturbation of unit sphere

We study the eigenvalues of the Laplacian on ellipsoids that are obtained as perturbations of the standard Euclidean unit sphere in dimension two. A comparison of these eigenvalues with those of the standard Euclidean unit sphere is obtained under a Gaussian curvature condition, in line with the Lichnerowicz theorem on the first positive eigenvalue on a compact Riemannian manifold

Assessment of Postmenopausal Symptoms among women Residing in Urban Slums

Background: Menopause is a normal physiological change and an important transition in women’s life. Onset of menopause has important implications on women’s fertility and health. Menopausal symptoms vary in severity and may decrease quality of life Thise is, because the majority of women still do not take treatment for these symptoms as most Indian women have a history of self-denial and neglect. This study is conducted to find the prevalence of postmenopausal symptoms among women resisting in urban slums Methods: This was a community based, cross-sectional study conducted among 334 postmenopausal women (45-60) residing in urban slums by systematic random sampling. Menopause Rating Scale (MRS) was used to assess postmenopausal symptoms Pre-designed, pre-tested proforma was used for collecting data to identify the factors affecting it. General physical examination was carried out and anthropometric measurements were recorded. Data were   analysed using SPSS software version 20. Results were expressed as descriptive statistics (Mean (SD), Frequency (%)) and Chi-square test was used to find the association between two attributes. Results: 69.76% of participants had mild symptoms, 23.95% moderate symptoms and only 2.1% suffered from severe symptoms.   Prevalence of somatic symptoms was 93.11%, psychological symptoms 85.33% and urogenital symptoms was 33.53%. 44.31% of women from class 4 of SES suffered from mild to severe symptoms, followed by class 3 with 20.06% (p= 0.00005). 73.86% from nuclear families and 66.67% for three generations in their families suffered from mild symptoms (p=0.0001) Conclusion: The prevalence of somatic postmenopausal symptoms was high compared to psychological and urogenital using MRS. Factors like age, poor socio-economic status, marital and educational status played a role in postmenopausal symptoms. Measures should be taken for early recognition of symptoms and treatment. To achieve this, the government, private, and voluntary organizations can establish postmenopausal clinics as soon as possible at the earliest at all levels of healthcare

EFFECT OF FUEL INJECTION TIMING, INJECTION PRESSURE AND COMBUSTION CHAMBER SHAPES ON THE PERFORMANCE OF DIESEL ENGINE RUN ON BIODIESEL

The compression ignition (CI) engine is knownfor robustnessand itsbetter performance when powered with diesel orbiodiesel. In this work Rubber seed oil biodiesel (BRO) was used as CI engine fuel. Experimental tests were conducted on diesel engine to study the effect of fuel injection timing (IT),fuel injector opening pressure (IOP)and combustion chamber shapes (CCS) on the performance, emission and combustion characteristicswhen run on BRO. In the first phase the IT and IOP were optimized. In the second phase, the effect of combustion chamber shapes was studied. The test fuel yielded better resultswith 27° bTDC (before top dead center)IT,240 bar injector opening pressure (IOP)and reentrant toroidal combustion chamber (RCC). At the best operating conditions BTE 28.8%, smoke 47 HSU, HC38ppm, CO0.135vol.%, NOx 1182ppm at 80% load. Lower ignition delay (ID) and combustion duration (CD) with higher peak pressure (PP) and heat release rate (HRR). Overall,the diesel engine yieldedhigher BTE and lower emissions except NOx withIT of 27obTDC,240 bar IOPand RC