Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience

Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken

Application of Lasers in Prosthodontics

In clinical dentistry lasers were introduced with the hope of overcoming some of the drawbacks posed by the conventional methods of dental procedures. Since its first experiment for dental application in the 1960s, the use of laser has increased rapidly in the last couple of decades. The specialty of Prosthodontics takes all concepts of dentistry and integrates effective comprehensive treatment planning. The practice will necessarily include a wide variety of patients seeking a diverse range of care. These include individuals who are highly fearful of dentistry and have long-term neglected care and those who have complex medical histories and require more specialized, advanced procedures. Some also have phobias and/or allergies to anesthetics. Lasers have become an integral part of treatment for these patients. The aim of this review is to describe the current and emerging applications for lasers in prosthetic dentistry. Used in conjunction with or as a replacement for traditional methods, it is observed that specific laser technologies are becoming an essential component of contemporary dental practice over a decade

Antepartum transabdominal amnioinfusion in oligohydramnios - a comparative study

Background: The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion in oligohydramnios with the view to improving pregnancy outcome in oligohydramnios, a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies.Methods: The study comprised of a prospective analysis of 130 pregnant women with oligohydramnios, divided into two groups, the study and control group of 65 patients each and were similar with regard to age, gravidity, parity, gestational age. TAA was performed on all patients in the study group and the results were compared and analyzed.Results: Mean gestational age at first treatment was 29.98 weeks in study group. Mean pre-procedure amniotic fluid index was 4.01 and post-procedure was 12.49. A total of 106 infusions were done on 65 patients (mean1.63). Mean latency period in study group was 49.53 and in controls 26.49. There was significant decrease in fetal distress in patients in study group. 30 % of patients needed caesarean section in study group compared to 60% in controls. Number of preterm deliveries was 18 and 45 respectively in study and control groups. 61% of newborns in the study group weighed more than 2.5 kg compared to only 24% in control group. Neonatal ICU admissions and newborn deaths were lesser in study group.Conclusions: Transabdominal amnioinfusion is an extremely useful procedure to reduce complications arising from oligohyramnios. It significantly increases the latency period, decreases the occurrence of fetal distress preterm deliveries, need for caesarean or instrumental deliveries, improves birth weight of the newborns and significantly reduces the neonatal morbidity and mortality

Dermatophytosis in patients referred for evaluation at a tertiary care teaching hospital in Kashmir, India

Background: Dermatophytoses invade the stratum corneum of the skin and other keratinized tissues derived from the epidermis. They are quite common and can be fairly accurately identified by a simple laboratory test. We conducted this study to identify the common dermatophytic infections in our setting.Methods: Clinically suspected tinea infections were referred to the Department of Microbiology of SKIMS Medical College Hospital, a tertiary-care teaching hospital in Srinagar, Kashmir. The affected area was cleaned with 70% alcohol, and scrapings were obtained. 10% KOH was used for keratinolysis. Samples were thoroughly examined for the presence of filamentous, septate, branched hyphae.Results: A total of 206 samples were analyzed. The overall KOH positivity rate was 44.7%. Of the 206 patients, 119 (57.8%) were males, and 142 (68.9%) resided in rural areas. The mean age of the patients was 32 years (range 4-72). Tinea corporis was the typical clinical manifestation (58.3%).Conclusions: Young and middle-aged males and people living in rural areas are at a higher risk of dermatophyte infections

Virulence gene profile and antimicrobial resistance of Staphylococcus aureus isolated from bovine mastitis in Kashmir, India

The Staphylococcus aureusis often responsible for a number of diseases in humans and animals, and it is considered as a main etiological agent of bovine mastitis. The pathogenicity of S. aureus is due to both its ability to resist antibiotics, and the production of toxins. This study investigated virulence genes, prevalence and antibiogram profile of S. aureus isolated from dairy cows suffering from mastitis in the Kashmir. A total of 70 S. aureus isolates were obtained from 250 mastitic milk samples collected from both organized (47/150) and unorganized (23/100) dairy farms. Five pathogenic factors including clfA, hld, seo, lukM, and coa and one resistance gene mecAgene were checked through PCR. Clumping factor gene (clfA) was found in most of the isolates with a percentage of 81.42 % whereas,hld, seo, lukM, and coa were present in 61.2, 54.28, 70, and 71 percent of isolates, respectively. However, amplification of coagene yielded DNA bands of two different sizes. A high percentage of antimicrobial resistance rates were observed, wherein, Ampicillin showed highest resistance with 85.7 %, followed by Kanamycin, Cefotaxime, Sulphadizine and Streptomicin showing 71.42 %, 54.28 %, 51.48 % and 42 %, respectively. A high frequency of Methicillin resistant S. aureus (MRSA 28.57 %) was observed in these isolates and all methicillin resistant isolates were found to be positive for mecA gene via PCR amplification. These results revealed that mastitis-associated S. aureus among bovines of Kashmir is able to accumulate different virulence factors and resistance to antimicrobials, making the treatment of infections difficult

Isolation, virulence gene profiling with molecular cloning of ibeA gene and antibiogram of Escherichia coli from respiratory tract infections of broiler chicken in Kashmir, India

he present study has determined prevalence, serological diversity, virulence gene profileand in vitro antibiogram of Escherichia coli (E. coli) isolates from respiratory tract of broiler chicken in Kashmir valley along with molecular cloning of ibeA gene, an important zoonotic among invasion-associated genes responsible for neonatal meningitis in humans. A total of 224 broilerchickens with a history of respiratory tract infections, in a flock size of 2692 birds from organised and unorganised poultry farms of Kashmir valley, were screened for E. coli isolation. The prevalence of E. coli in birds with respiratory tract infection was found to be 6.38 per cent. Serogrouping revealed that the E. coli isolates were typeable into 10 serogroups with prevalence rate of 8.8% for serogroup O2, along with few isolates rough or untypeable. The screening of E. coli isolates for virulence gene profile revealed the presence of iss in (89.53%), iucDin (85.46 %), tsh in (51.74 %), cva/cvi in (33.14 %), irp2in (55.23 %), papCin (33.72 %), vat in (31.39 %), astAin (38.95 %), fimCin (93.60 %) and ibeAin (1.16 %) isolates. The antibiogram screening of E. coli isolates revealed majority of isolates to be resistant to tetracycline (94.71%), ampicillin (92.67%) and cephalaxin (79.67%).However, most of the isolates were sensitive to amikacin (74.41%) followed by amoxacillin-sulbactam (68.60%) and gentamicin (67.44%). The study thus, suggests that the E. coli isolates from respiratory tract infection of poultry harbour differential virulence genes along with the genes of zoonotic interest and variable antimicrobial resistance, thus, opening the areas for devising dynamic, emergent and effective treatment line

Spectrum of abdominal organ injury in a primary blast type

Research articl

Palynological Studies in Tribe Aveneae (Poaceae) from Potohar of Pakistan

Pollen morphology of four species belonging to three genera of tribe aveneae (Poaceae) was examined by light microscope (LM) and scanning electron microscope (SEM). The study showed that pollen in all species were circular in polar view, however, there are variations in equatorial view of pollen and other quantitative characters that is, polar and equatorial diameter, pore diameter and exine thickness, that are valuable in the identification and differentiation of species. Average pollen fertility in the tribe is 77.37%. Scabrate type of sculpturing is found in all species except Polypogon monspeliensis which showed the verrucate type of sculpturing and can be differentiated from Polypogon fugaxon the basis of its sculpturing pattern. The study revealed that pollen characters are important in the taxonomy of grasses at the specific and generic level and can be useful in delimiting taxa of different tribes

The Selection of Maxillary Anterior Teeth Width in Kashmiri Population

Introduction: Determining the width of maxillary anterior teeth is a difficult aspect in complete denture fabrication. The width of maxillary anterior teeth is determined by taking various anatomical landmarks on the face as a guide, such as the interpupillary, interalar, intercommissure and interzygomatic distance, etc. The present clinical study was carried out to evaluate the relationships between maxillary anterior teeth measurements (canine to canine and central incisor width) and various horizontal facial parameters. Materials and methods: The facial and dental measurements were obtained directly from 60 Kashmiri  undergraduate dental students by using vernier calliper and dental floss. Result: Correlation analysis was done using Pearson’s correlation analysis and it was determined that the incisor width and canine to canine distance show positive correlation with some of the facial measurements. Conclusion: This study inferred that while most of the measurements showed a positive correlation with the incisor width and canine width in the different face forms none of them were found to be significant.&nbsp

Validation of Setaria (L.) P. Beauv Species based on Palyonological and Anatomical Techniques.

In present study external morphology, leaf epidermal anatomy and pollen structureof three species of genus Setaria(Poaceae)viz., S. glauca, S. verticillata and S. viridiswere studied. The major emphasis was on the importance of palyno-anatomical characters used as an aid in plant systematics. Light microscopy (LM) and scanning electron microscopy (SEM)were used to study leaf epidermal anatomy and pollen structure.Palyno-anatomical analysis of genus Setaria shows variations within the species. It is stated that the study based on classical and modern approaches is very useful for systematic delimitation of problematic taxa like Setaria