Long-term follow-up of anorectal malformation – how long is long term?

Introduction: The ultimate goal of treatment in patients with anorectal malformation (ARM) has moved from mere survival to alleviating symptoms and improving quality of life (QoL), which has become established as an important endpoint in medical care. Adolescents and adults with ARM face several major functional and psychological problems requiring continuity of care.Materials and methods: All patients more than 15 years of age presenting with ARM between June 2010 and 2015 were evaluated. Clinical features, investigations, type of surgery done at birth, present treatment given and outcome were analysed. Anal continence was assessed by Kelly’s scoring system. Psychological assessment was done using QoL score.Results: Six male and seven female patients, aged 16–32 years, presented to our institute with problems related to ARM. Two presented with anal stenosis, two with mucosal ectropion, four had constipation and soiling despite adequate opening, two had megarectosigmoid and three had undergone ileostomy elsewhere for distension/obstruction owing to impacted faecoliths during adolescence. Surgical treatment was offered to 10 patients, out of whom two patients on ileostomy refused to undergo any surgery. Patients underwent Malone’s antegrade enemaprocedure (two), ectropion excision (two), revision anoplasty (two), excision of pouch and anoplasty (two). Psychological assessment showed that patients felt embarrassed and depressed and used lifestyle-coping behaviour. After bowel management and surgery, mean continence and QoL scores improved from 2.7 to 5.1 and 1.26 to 3.04, respectively, which was statistically highly significant (P=0.001).Conclusion: Long-term follow-up of patients with ARM is essential to maintain overall QoL. Improvement in continence by bowel management programme and appropriate surgical intervention leads to improvement in QoL.Keywords: adults, anorectal malformation, complications, quality of lif

Evaluation of the efficacy of Latakaranja as Antispasmodic Drug in Kastaartava - A Randomised Clinical Control Trial

Kastaartava (Dysmenorrohea) is a greek word, describes about painful menstruation which the Pratyatmaka Lakhshans of various Yonivyapad that are Vatala Yonivyapad, Udavartini Yonivyapad, Paripluta Yonivyapad, Mahayoni and Vataja Artava Dusti that affects 75% of adolscents, 25-50% of adult women and 5-20% having dysmenorrhea. It is a common reason for losing time at school or work or visiting family doctor. Morbid Vatadosha especially Apanavata is a causative factor of Kastaartava. Vatahara properties are beneficial considering the morbidity and complications that are caused by Kastaaratava, mentioned above herbal preparation has been tried here. This research work is randomized control clinical study with Pre-test and Post-test design. 40 patients suffering from Kastaaratava (Dysmenorrohoea) were selected randomly for study. The selected patients were divided into 2 groups, 20 patients each. The selected 20 patients in Group A (Trial group) were administered Latakaranja Beeja Churna orally. The selected 20 patients in Group B (Controlled group) were administered Rajapravartini Vati. The duration of treatment was for 03 days of menstruation for 2 menstrual cycles and followup for the next menstrual cycle. After the completion of the clinical trial, it was found that in Rajapravartini Vati, there was highly significant result in Cramping pain in abdomen, Irritability, Tenderness in Breast, Back pain and Headache, where as Latakaranja Beeja Choorna there is also significant result in Cramping pain in Abdomen, Irritability, Tenderness in Breast, Back Pain, Headache and Vomiting but statistically considering average mean Latakaranja Choorna shows comparatively lesser effective than Rajapravartini Vati. By the statistical results it can be concluded that Rajapravartini Vati has better result when compared to Latakaranja Choorna in the present study

Variation of ICF strength function with projectile energy for 12C + 165Ho system at Elab ≤ 7MeV/A

376-379During the last few decades, research in heavy-ion induced nuclear reactions has opened numerous fields, in its theoretical and experimental domains. At energies, from near the Coulomb barrier to well above it, the complete fusion (CF) and incomplete fusion (ICF) reactions compete with each other. The relative contribution of these processes depends on various entrance channel parameters. In order to study the dependence of CF and ICF reaction dynamics on various entrance channel parameters, comparative studies with different parameters of the statistical model codes have been done. In this paper, an attempt has been made to study the dependence of incomplete fusion strength function on incident energy for 12C + 165Ho system at energies ≤ 7 MeV/A. The analysis of data has been done within the frame work of statistical model code PACE4, which do not take ICF into account; and thus predicts cross-section values only due to complete fusion process. For the present reaction system, the excitation functions (EFs) of xn/pxn channels, predicted by PACE4 code, well reproduces the experimentally measured values, indicating their production via CF process only. However, for α and 2α-emitting channels, calculated EFs through PACE4 code underpredict the experimentally measured cross-sections by »25-30%, in general. The enhancement of experimental cross-sections for α and 2α-emitting channels as compared to the PACE4 predictions, indicates that the major contribution of their production comes from the ICF of 12C, if it breaks up into 8Be and α-fragments, and one of the fragments fuses with the target nucleus. The incomplete fusion strength function (FICF), which gives relative importance of ICF processes over CF process has also been deduced and is found to depend sensitively on beam energy

Variation of ICF strength function with projectile energy for 12C + 165Ho system at Elab ≤ 7MeV/A

During the last few decades, research in heavy-ion induced nuclear reactions has opened numerous fields, in its theoretical and experimental domains. At energies, from near the Coulomb barrier to well above it, the complete fusion (CF) and incomplete fusion (ICF) reactions compete with each other. The relative contribution of these processes depends on various entrance channel parameters. In order to study the dependence of CF and ICF reaction dynamics on various entrance channel parameters, comparative studies with different parameters of the statistical model codes have been done. In this paper, an attempt has been made to study the dependence of incomplete fusion strength function on incident energy for 12C + 165Ho system at energies ≤ 7 MeV/A. The analysis of data has been done within the frame work of statistical model code PACE4, which do not take ICF into account; and thus predicts cross-section values only due to complete fusion process. For the present reaction system, the excitation functions (EFs) of xn/pxn channels, predicted by PACE4 code, well reproduces the experimentally measured values, indicating their production via CF process only. However, for α and 2α-emitting channels, calculated EFs through PACE4 code underpredict the experimentally measured cross-sections by »25-30%, in general. The enhancement of experimental cross-sections for α and 2α-emitting channels as compared to the PACE4 predictions, indicates that the major contribution of their production comes from the ICF of 12C, if it breaks up into 8Be and α-fragments, and one of the fragments fuses with the target nucleus. The incomplete fusion strength function (FICF), which gives relative importance of ICF processes over CF process has also been deduced and is found to depend sensitively on beam energy

Daily Bread: Women’s Self-Help Microfinance and the Social Meanings of Money

In this article we explore the impacts and implications of ‘Rojiroti’, a women’s self-help group (SHG) microfinance scheme operating in poor communities in Bihar, India. We focus particularly on how improvements found in women’s circumstances and in children’s health might result from Rojiroti SHG membership. Through data from five focus groups and 19 individual interviews with women in communities where Rojiroti operates, we discover how the scheme is regarded and how it affects women’s management of household budgets. Moreover, we explore the relational aspects of SHG microfinance and the ways that it can alter family and social dynamics. Drawing on notions of ‘earmarked’ money (Zelizer, 1997) and ‘safeguarded’ money (Wilkis, 2017), we argue that the money itself has meaning and non-pecuniary value in the form of other currencies including power and agency, which can lead to improved wellbeing and health of families

Unraveling Prostaglandin and NLRP3 Inflammasomemediated Pathways of Primary Dysmenorrhea and the Role of Mefenamic Acid and Its Combinations

Painful menstrual cramps during or around the time of the monthly cycle are known as dysmenorrhea. The estimated global prevalence in women of reproductive age ranges from 45% to 95%. It has a significant negative impact on regular activities and productivity at work. However, despite the severe consequences on quality of life, primary dysmenorrhea (PD) is underdiagnosed. Dysmenorrhea has complex pathogenesis. It involves the release of prostaglandins and activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and also includes the involvement of other mediators such as bradykinin, histamine and acetylcholine. Even though nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most common type of pain medication, the question of which one should be the most preferred is still open to debate. The current review examines the existing evidence for the pathogenesis of PD and makes evidence based and clinical experience based recommendations for the use of mefenamic acid and its combination in the treatment of dysmenorrhea. Mefenamic acid alleviates PD by inhibiting endometrial prostaglandin formation, restoring normal uterine activity, and reducing the inflammatory response by inhibiting the NLRP3 inflammasome and reducing the release of cytokines such as interleukin (IL)-1β. It is also known to have bradykinin antagonist activity. Dicyclomine has a dual action of blocking the muscarinic action of acetylcholine in postganglionic parasympathetic effect or regions and acting directly on uterine smooth muscle by blocking bradykinin and histamine receptors to relieve spasms. According to the experts, mefenamic acid and dicyclomine act synergistically by acting on the different pathways of dysmenorrhea by blocking multifactorial agents attributed to the cause of dysmenorrhea. Hence, the combination of mefenamic acid and dicyclomine should be the preferred treatment option for dysmenorrhea

Case Report- Congenital midureteral obstructions

Congenital midureteral obstruction caused by a ureteral stricture, valve, or an adynamic segment, is an exceedingly rare entity. When encountered, it is generally misdiagnosed as megaureter or ureteropelvic junction obstruction. Two children with midureteral obstructions were seen over the last two years. One of these had an anatomical defect- a midureteral stricture; the other had a physiological abnormality- midureteral adynamic segment. In one of the cases, the midureteral obstruction was missed initially; the patient underwent ipsilateral ureteroneocystostomy for vesicoureteral reflux. Later, midureteral stricture was diagnosed; excision of the lesion with primary anastomosis was done, with successful salvage of the renal unit. The other patient was pre-operatively diagnosed to have midureteral stricture; intra-operatively an adynamic midureteral segment of 4 cms was found, which was resected, and ureteral anastomosis was done. Pathological examination revealed probe-patent ureter with muscular disarray, suggesting functional obstruction. Neither of the patients had contralateral renal abnormality. A high index of suspicion is required to make a correct pre-operative diagnosis. Antegrade or retrograde urography would clinch the diagnosis. Over-reliance on radionucleotide scans to diagnosis the level of ureteral obstructions could be misleading occasionally, as happened in one of our cases

Case Report - Anterior urethral valves associated with hypospadias

An association of coronal hypospadias with meatal stenosis and anterior urethral valves is described in this report. A combination of double obstruction in anterior urethra may overshadow the expression of proximal one

AGRIS Database: An experience with CAZRI Scientists

65-76Evaluates the AGRIS database through a study and training conducted at Dr. Raheja Library. CAZRI, Jodhpur for the agricultural scientists. The paper provides an extensive manual prepared for the users which is user-friendly and self-explanatory. Study reveals that the present coverage of abstracted references is very less (15- 20%) in the AGRIS and hence does not fulfill the complete requirements of agricultural scientists. Scientists feel that AGRIS should provide more abstracts. Suggestions have also been made to procure CAB CDs instead of AGRIS-CDs