Laparoscopic colorectal cancer surgery - a prospective study of short-term outcomes of consecutive cases over 3 years

This study was carried out with the objectives to study the feasibility of laparoscopic colorectal cancer resection, to observe short term outcome such as recovery parameters, oncologic safety, morbidity and mortality, and to analyze the experience of laparoscopic colorectal surgery in a teaching hospital. Between January 2007 and July 2009, all consecutive adult cases admitted to our department for colorectal cancer were assessed for eligibility. The ethical committee approved the protocol at the Sterling Hospital. Out of 31 patients,17 were males and 14 females. The mean age was 59 years. The most common clinical presentation was weight loss and altered bowel habits. Rectum (51.61%) was the most commonly involved organ followed by cecum (22.58%). - median time to liquid diet was two days (range 1-22), and a solid diet was three days (range 3-30). The median time to first flatus was two days (range 1-5), and the first stool was five days (range 3-7). The postoperative stay was eight days (range 6-30) median time to mobilization was 2.5 days. The postoperative stay is cumulative and includes patients who underwent reoperation for the anastomotic leak. The median operating time was 240 mins (range 116 – 520). The median length of incision was 6 cm (range 4 – 10 cm). The median blood loss was 170 ml. Blood loss was higher in patients with hemorrhage and tumor adhesions, and both of them were converted to open. These patients incidentally had a more extended hospital stay. The laparoscopic technique for colorectal cancer is feasible and safe. Laparoscopic colorectal surgery (LCS) is associated with short term benefits like the earlier return of gastrointestinal function and shorter length of hospital stay. From the oncologic point of view, tumor resections are adequate, taking into context numbers of lymph nodes retrieved and resectional margins in context to oncologic safety. The decreased postoperative wound infections and early recovery facilitate appropriate adjuvant therapy. Advanced laparoscopic surgery requires a team approach with proper case selection. Transvaginal delivery of specimens can give scar-less surgery and the option for assisted natural orifice surgery

Ambiguous genitalia with positive reproductive outcome: a case report

Ambiguous genitalia are an uncommon phenotypic manifestation of the urogenital system that may indicate the presence of a life-threatening underlying disease. The development of normal male or female external genitalia is a consequence of a series of genetic and physiological processes beginning with sex determination and proceeding through internal and external reproductive structure differentiation following the genesis of a zygote. While the failure to progress normally through the stages of sex determination and differentiation is referred to as a disorder of sex development (DSD), not everyone with DSD has ambiguous genitalia. As a result, it is critical to ascertain the etiology as soon as feasible when uncertainty is noticed. The purpose of this case study is to highlight the favorable reproductive result associated with ambiguous genitalia

Birth Preparedness and Complication Readiness among Pregnant and Recently Delivered Women in Gandhinagar District, Gujarat, India: A Community-based Cross-sectional Study

Background: Birth Preparedness and Complication Readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice

Self identity and internal environmental locus of control: Comparing their influences on green purchase intentions in high-context versus low-context cultures

YesThis study empirically examines the combined effect of two crucial internal consumer predispositions, self-identity (SI) and internal environmental locus of control (INELOC), among consumers in a collectivistic culture and an individualistic culture. The study validated the extended theory of planned behaviour to predict consumers' green purchase intentions. Structural equation modelling was used to analyse primary data collected from 365 American and 408 Indian respondents. Analysis revealed differences between the two cultures. Green self-identity influenced attitude more than perceived behavioural control among American consumers, while the reverse was true for Indian consumers. Conversely, INELOC positively and significantly affected only Indian consumers’ perceived behavioural control, not that of American consumers

FORMULATION AND EVALUATION OF ORODISPERSIBLE TABLETS OF PERINDOPRIL ERBUMINE USING NATURAL SUPERDISINTEGRANT

Oral disintegrating tablets are emerging trend in Novel drug delivery system & received increasing demand & popularity due to ease of administration & better patient compliance .In recent years superdisintegrant have been employed to develop  effectual mouth dissolving tablet & to overcome limitation of conventional tablets .In present study attempt was made to compare to disintegrating  efficiency of natural superdisintegrats .Main aim of using oscimum basilicum as natural superdisintegrant was to achieve quick onset of action ,increases water uptake with short wetting time & decreasing disintegration time  by cost effective direct compression method. 3 preliminary batches were prepared & these are evaluated for precompression parameter like angle of repose, carr`s index & post compression parameters like wetting time, water absorption ratio,in vitro disintegration. Hardness, friability of all formulations found within limit. Best formulation F2 batch had shown good hardness, friability, disintegration time, swelling time. Present study revealed that mucilage obtained from oscimum basilicum was effective for their disintegrating property

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Sample treatment for tissue proteomics in cancer, toxicology, and forensics

Since the birth of proteomics science in the 1990, the number of applications and of sample preparation methods has grown exponentially, making a huge contribution to the knowledge in life science disciplines. Continuous improvements in the sample treatment strategies unlock and reveal the fine details of disease mechanisms, drug potency, and toxicity as well as enable new disciplines to be investigated such as forensic science. This chapter will cover the most recent developments in sample preparation strategies for tissue proteomics in three areas, namely, cancer, toxicology, and forensics, thus also demonstrating breath of application within the domain of health and well-being, pharmaceuticals, and secure societies. In particular, in the area of cancer (human tumor biomarkers), the most efficient and multi-informative proteomic strategies will be covered in relation to the subsequent application of matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) and liquid extraction surface analysis (LESA), due to their ability to provide molecular localization of tumor biomarkers albeit with different spatial resolution. With respect to toxicology, methodologies applied in toxicoproteomics will be illustrated with examples from its use in two important areas: the study of drug-induced liver injury (DILI) and studies of effects of chemical and environmental insults on skin, i.e., the effects of irritants, sensitizers, and ionizing radiation. Within this chapter, mainly tissue proteomics sample preparation methods for LC-MS/MS analysis will be discussed as (i) the use of LC-MS/MS is majorly represented in the research efforts of the bioanalytical community in this area and (ii) LC-MS/MS still is the gold standard for quantification studies. Finally, the use of proteomics will also be discussed in forensic science with respect to the information that can be recovered from blood and fingerprint evidence which are commonly encountered at the scene of the crime. The application of proteomic strategies for the analysis of blood and fingerprints is novel and proteomic preparation methods will be reported in relation to the subsequent use of mass spectrometry without any hyphenation. While generally yielding more information, hyphenated methods are often more laborious and time-consuming; since forensic investigations need quick turnaround, without compromising validity of the information, the prospect to develop methods for the application of quick forensic mass spectrometry techniques such as MALDI-MS (in imaging or profiling mode) is of great interest

Clinical and laboratory features of intestinal tuberculosis

Bhumit Patel,1 Vipul D Yagnik2 1Department of Medical Gastroenterology, Akshar Bhoomi Liver and Gastro Care, Ahmedabad, Gujarat, India; 2Department of Surgical Gastroenterology, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India Background/aims: As increasing numbers of Crohn’s disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation.Materials and methods: This was a prospective, unicentric, observational study carried out in the gastroenterology department of a tertiary care hospital between August 2011 and January 2013. Patients who presented to our hospital and were suspected of having GITB were included in our study. Patients were then followed up over a 6-month period.Statistical analysis: Chi-square test was used to analyze the data.Results: Of the 69 patients with GITB, 49 (71.01%) had thickening of the involved part of the colon and 33 (47.83%) had abdominal lymphadenopathy. The ileocecal valve was involved in 58 patients (84.05%) Histological detection of granulomas had 78.95% specificity, 36.23% sensitivity, and 51.40% accuracy. Tuberculosis polymerase chain reaction was found to have 78.95% specificity, 71.01% sensitivity, and 73.83% accuracy. BACTEC-MGIT culture was found to have 100% specificity, 20.29% sensitivity, and 48.60% accuracy.Conclusion: Although histology is helpful in ruling out other conditions, TB-specific findings such as caseating granuloma and acid-fast bacilli are rarely seen. Instead, tuberculosis polymerase chain reaction has the highest diagnostic accuracy followed by BACTEC culture. Keywords: gastrointestinal tuberculosis, colonoscopy, TB polymerase chain reaction, BACTEC culture, antituberculous treatment, biops

A study to compare the effectiveness of inspiratory muscle training versus alternative nostril yoga breathing on blood pressure, resting heart rate and quality of life in essential hypertension: A pilot study

Background: Great wellbeing is a pre-essential of human useful and improvement measure. Raised BP stays the main source of death around the world, representing 10.4 million passings each year. Many research has demonstrated the positive effects of inspiratory muscle exercise (IME) on cardiac autonomic function, indicated by reduced sympathetic modulation and increased vagal modulation in young smokers, as well as hypertensive and heart failure patients. Alternate nostril yoga breathing (ANYB) is one of the effective breathing techniques which involve breathing through one nostril at a time while closing the other nostril manually. The normal nasal cycle consists of alternating phases of congestion and decongestion of nasal tissue based on the predominance of parasympathetic or sympathetic tone in the autonomic nervous system. Method: Ethical approval was obtained from the SAFE SEARCH INDEPENDENT ETHICS COMMITTEE. N=30 Essential Hypertensive patients age between 35 to 55, both male and female included in this pilot study and the further study continues with more sample. After taking consent the patients were divided randomly into two groups. Group A Inspiratory muscle training (15) and Group B (15) Alternative nostril yoga breathing. Both groups received treatment for 4 weeks and 5 days/week.&nbsp