Factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

Laparoscopic cholecystectomy is the ‘gold standard’ treatment for symptomatic cholelithiasis. Advantages over open cholecystectomy being less pain, early ambulation, shorter hospital stay and lower incidence of incisional hernia. The condition of the patient, the level of experience of the surgeon, and technical factors all play a role in the decision for conversion. This study was conducted in an effort to determine the conversion rate and also identify the factors responsible for conversion to open cholecystectomy. These findings will allow us to preoperatively discuss the higher risk of conversion and allow for an earlier judgement and decision on conversion if intra-operative difficulty is encountered. A total of 50 patients presenting with symptomatic gallstone disease without choledocholithiasis between April 2014 and September 2014 admitted in Govt. Royapettah Hospital and Kilpauk Medical College Hospital were included in the study. Every patient were subjected to the following assessments regarded as risk factors for laparoscopic cholecystectomy: patients’ chracteristics, complaints, history, clinical examination, radiological investigations, laboratory data and operative findings. The results were that gallstones were more common in females and usually seen in the 3rd-4th decades of life. The most common chief complaint is pain in the right-hypochondrium. The mean operation time was 80.7minutes and the average length of post-operative hospital stay was 5.7days. Out of 50 patients studied, 6 cases were converted to open cholecystectomy (12 %). Conversion was more common in diabetic patients and in acute cholecystitis.Ultrasound finding suggestive of thickened gall bladder wall was a good indicator of conversion. In conclusion we encountered a conversion rate of 12% which is comparable with other studies. Therefore laparoscopic cholecystectomy is a safe and minimally invasive technique, with only low conversion rate and the commonest cause of conversion in this study was the presence of dense adhesions at Calot's triangle

Depression, its correlates and quality of life of undergraduate medical students in the Kumaon region of Uttarakhand state, India

Background: Medical students are future health care providers and experience a lot of stress during their training years. They are more likely to suffer depressive disorders than the general population and have a poorer quality of life. Objectives: To determine the prevalence of depressive disorder, its correlates and quality of life of medical students studying at a medical college in North India. Methods and material: It was a cross sectional study which included all the students enrolled at the study medical college. Data was collected using pre-validated questionnaires namely - 20 item ‘Center for Epidemiologic Studies Depression Scale (CES-D)’, WHO Quality of life (QoL) – BREF questionnaire and ‘Smartphone Addition Scale - Short version’ (SAS-SV) questionnaire to assess for depression, quality of life and smartphone addiction respectively which was distributed in the classroom to be filled. Multivariate logistic regression was employed to ascertain association between depression and the other variables. Results: The study had an effective response rate of 79%. Using a score of 16 or above as cut-off on CES-D scale145 study participants (36.7%) were found to be depressed. Participants who negatively compared themselves with their peers/friends and also those who were addicted to smartphone were significantly more likely to be depressed [1.85(1.12-3.05) and 1.96 (1.29-2.97) respectively]. We report a statistically significant negative relationship between physical domain score [0.97(0.95-0.99)], psychological domain score [0.95(0.93-0.97)] and social relationship domain score [0.97(0.95-0.99)] on BREF Quality of life questionnaire and the presence of depression among the study participants. Conclusion: The prevalence of depression among medical students was high and those with depression have significantly poor quality of life

Drug adherence to anti-tubercular treatment during COVID-19 lockdown in Haldwani block of Nainital district

Background: India saw one of the stringent lockdowns during the COVID-19 pandemic. In the wake of this period, the normal functioning of medical services was affected. People were reluctant to seek medical attention and notification of Tuberculosis dipped. The aim of the study was to estimate the proportion of non-adherence to anti-tubercular treatment and to identify the factors affecting the non-adherence to treatment. Methods: A retrospective community-based study was conducted among 284 tuberculosis patients. They were interviewed using a pre-designed questionnaire consisting of WHO dimensions of non-adherence and lockdown related questions. Results: The proportion of non-adherence to treatment was found to be 5.3%. Factors like chronic diseases, depression, without knowledge on how the disease is transmitted and that medication can be discontinued once the symptoms subsided, alcohol consumption, and trouble accessing medicine were found to be the determining factors in non-adherence to the treatment. Conclusions: Non-adherence to anti-tuberculosis treatment in our study was low but the various dimensions of adherence along with lockdown related factors had significant impact on it. To further minimize non-adherence during emergency like the lockdown due to COVID-19 pandemic, corrective measures must be explored and implemented

Gairan Pamei's Quick Files

The Quick Files feature was discontinued and it’s files were migrated into this Project on March 11, 2022. The file URL’s will still resolve properly, and the Quick Files logs are available in the Project’s Recent Activity

Early initiation of breast feeding and its associated factors among 0-23 months children in Haldwani, District Nainital

Introduction: Breastfeeding benefits both the mother and infant. It contains all the essential nutrients in an adequate amount that fulfils the infant first six month’s needs. Early initiation of breastfeeding is necessary to ensure consumption of colostrum having multiple protective factors. Aim and Objectives: To estimate the prevalence of early initiation of breast feeding and to determine its associated factors among 0- 23 months children. Methodology: A community-based cross- sectional study was carried out among 339 children aged 0-23 months in field practice areas of Rural & Urban Health Training Centres (RHTC & UHTC), Department of Community Medicine, Govt. Medical College, Haldwani, District Nainital for a period of 6 months using simple random sampling. Questions related to Early initiation of breast feeding and its associated factors were asked through Epicollect software. Wald’s statistics, Chi- square test, Fisher’s exact test were applied. P value of less than 0.05 was considered as significant. Results: The prevalence of Early Initiation of Breastfeeding was 45.1% (95% CI= 39.9%-50.5%) which was significantly associated with place of delivery, mode of delivery, mother’s education & ANC care. Conclusion: Early Initiation of Breastfeeding practice was found in almost half of children which were significantly associated with various factors highlighting the importance of addressing these factors to improve Early Initiation of Breastfeeding practices

Influence of dietary supplementation of chromium on the carcass traits of crossbred pigs

This study was conducted to assess the influence of chromium on the carcass traits in crossbred (Large White Yorkshire X Landrace) pigs fed with swill feeding for a period of 5 months. Early-weaned crossbred piglets (n=24) were selected for this study, and the piglets were randomly divided into three equal groups; Group I, II, and III. The piglets were reared by following standard health coverage protocols. The feeds of Group I and II were supplemented with chromium in the form of chromium tripicolinate at 0.1 and 0.2 mg/kg of swill feed respectively, and Group III was kept as control. Carcass weight, carcass length, and bone percentage showed no significant difference among the three groups. However, better dressing percentage was observed in Group I (p<0.05). Liver and kidney weights were reduced in chromium supplemented groups (p<0.05). Chromium supplemented groups showed lower backfat thickness and fat percentage (p<0.01); whereas, loin eye areas and muscle percentage were increased as compared to the control group. Thus, it was concluded that chromium supplementation in feed of crossbred piglets influenced positively in their carcass traits

Assessment of economically important tree-based NTFPs in Indo-Burma region, <i>Manipur, India</i>

The present study was undertaken to identify economically important NTFPs yielding tree species. Surveys were conducted in 15 local markets in 7 districts of the state and assessment of value-added forest products were also conducted in Van Dhan Vikas Kendra (VDVK), a nationalized minor forest products market. During the survey, a total of 33 NTFPs yielding tree species with varied uses were recorded. Among those, edible fruit species were found to be the most important category with the most profitable items. Some species like, Baccaurea sapida, Docynia indica, Elaeocarpus floribundus, Phyllanthus emblica, Ficus semicordata, Prunus napaulensis, Rhus semialata, Spondias pinnata and Ziziphus mauritiana were utilised in value addition for making different items like candies, pickles, jams, beverages, etc, which have price range of 400–1200 INR per kg having a far higher market value than the raw form, and eventually improve the income of the locals. Poor transportation and unestablished market channels were some of the constraints faced by the people in the trade of NTFPs. Establishing proper market channels would help in improving livelihood of the locals.</p