Ayurvedic concept of Aahara Vidhi Vidhana in maintaining health and preventing diseases

Ayurveda is an ancient science which not only gives effective Chikitsa for many Rogas but also provides healthy way of living. Aahara, Nidra and Bramhacharya are the three Upastambhas of life in Ayurveda. Ayurveda gives immense importance to Aahara and explains that how healthy and technique eating is important for Swastha Shareera, Mana and Aatma. Acharya Charaka describes ‘Aahara Vidhi’ which explains us about importance of Do’s and Don’ts of diet and drink. It gives importance of eating healthy Aahara and also describes its various ways. In present era, diet and lifestyle is unknowingly responsible for many diseases. Now a day people are fascinated towards frozen and preserved food which satisfy their taste bud but as well invites many diseases. That’s why one should follow Ayurveda principles to prevent various disorders

Tubularized parameatal based dartos-spongiosum flap urethroplasty in distal hypospadias with flat glans, shallow meatal groove, and severe glans tilt

Objective: To report the technique and results of single stage tubularized parameatal based dartos-spongiosum flap urethroplasty for distal hypospadias with flat glans, shallow meatal groove, and severe glans tilt. Materials and Methods: The study was conducted over a period of 2-year from October 2013 to October 2015, and 19 patients with distal hypospadias were included in the study with flat glans, poor urethral groove, and severe glans tilt, who otherwise would have been subjected to transection of urethral plate and a two-stage procedure. In this technique, bilateral flaps were fashioned along the preputial edge beginning from the hypospadiac meatus with intact dartos, keeping the base of the flaps attached to the bifurcated spongiosum. The urethral plate was transected. Glans was split wide open. Bilateral flaps joined at ventral midline creating new urethral plate which was tubularized with the creation of slit like wide meatus at the tip of glans. Neourethral coverage was provided with double dartos flap. Complications and aesthetic appearance on a score of 1-10 were outcome measures. Results: There was no urethral stricture, residual chordee, penile rotation, or asymmetrical penis. The average aesthetic score was 8.5. Meatus was at the tip of glans with adequate caliber in all patients. Two (10.5%) out of 19 patients developed subcoronal fistula that required surgical closure. Conclusion: Tubularized parameatal-based dartos-spongiosum flap urethroplasty is viable and easy to reproduce option for management of a specific group of patients with distal hypospadias (with flat glans, poor urethral plate, and glans tilt) and is associated with very low complication rate

Effect of spacing and fertilizer levels on yield, quality and nutrient uptake of fennel (Foeniculum vulgare Mill.) under northern dry zone of Karnataka

An experiment was carried out on effect of spacing and fertilizer levels on yield, quality and nutrient uptake of fennel (Foeniculum vulgare Mill.) under northern dry zone of Karnataka. Among various spacing levels, 60 x 30 cm spacing recorded highest seed yield. The highest essential oil content and essential oil yield was obtained in 60 x 40 cm spacing. Nutrient uptake was found maximum in 60 x 30 cm spacing. The maximum seed yield, essential oil content, oil yield and total nutrient uptake was obtained by supplying 100:50:40 NPK kg ha-1 and it was at par with 90:40:30 N, P2O5, K2O kg ha-1 respectivel

Comparison of clinical outcomes in patients with congenital anorectal malformation treated with posterior sagittal anorectoplasty and laparoscopically assisted anorectal pull through

Aim: To compare the complications and outcomes of laparoscopic-assisted anorectoplasty (LAARP) for anorectal malformation(ARM) with that of posterior sagittal anorectoplasty (PSARP) using Kelly’s score. Materials and Methods: This was a single-centerstudy conducted over a period of 4-year. A total of 95 male ARM patients were included in the study, of which 25 patients underwentLAARP, whereas 70 patients underwent PSARP. Result: Superficial wound infection was seen in 2 (2.85%) cases of the PSARPgroup while in 1 (4%) case in LAARP group. 12 (17.14%) cases of PSARP group had wound dehiscence at the neo-anal site, of which6 (8.57%) had complete wound dehiscence and the remaining 6 (8.57%) had partial dehiscence, whereas 4 (16%) cases had wounddehiscence in LAARP group of which 3 (12%) had partial and 1 (4%) had complete dehiscence. Retraction of the neo-anus was seenin 6 (8.57%) cases of PSARP group while in 2 (8%) cases of LAARP group. Ectopically placed neo-anus was seen in 3 (4.28%)patients of PSARP group while in none of the cases in LAARP group. None of the patients in LAARP group had anal stenosis,whereas 2 (2.85%) patients underwent redoanoplasty in PSARP group for anal stenosis. Mucosal prolapse was seen in 8 (11.42%)cases of PSARP group, as compared to 3 (12%) patients of LAARP group. The net average Kelly’s score in LAARP group was 4.56,whereas, in PSARP group, it was 4.10. Conclusion: This study emphasizes the emerging laparoscopic technique for the managementof ARMs. Using this approach, it is possible to achieve better continence rates as the extent of perineal dissection is minimal

Evaluation of the outcome of right subumbilical transverse incision approach for the management of complicated appendicitis in paediatric age group – A multi-institutional retrospective study

Aim: The aim is to evaluate the outcome of right subumbilical transverse incision approach for the management of complicated appendicitis in paediatric age group. Materials and Methods: This is a retrospective multi-institutional study which was conducted in the Department of Paediatric Surgery, I Q City Medical College and Hospital, Durgapur, West Bengal, India and the Department of Paediatric Surgery, Rajiv Gandhi Super Speciality Hospital/Raichur Institute of Medical Sciences, Raichur, Karnataka, India. In this study, a review of 77 paediatric patients operated for complicated appendicitis using a right subumbilical transverse incision approach was done for a period of 3 years (from December 2017 to December 2020). All patients had proven complicated appendicular pathology like appendicular perforation, appendicular abscess or complicated appendicular lumps on ultrasonography or computed tomography scan, which mandated exploration. Results: There was no mortality. Average operative time was 1 h 48 min (ranging from 58 min to 3 h 12 min). Average length of hospital stay was 9 days (ranging from 5 days to 13 days). There was no incidence of fecal fistula. Seventeen (22%) patients developed superficial surgical site infection which subsided with regular dressings. There was no incidence of wound dehiscence or burst abdomen. Five (6.5%) patients required the incision to be extended beyond the midline to the left side to deal with the pathology and to access the entire peritoneal cavity. Nine (11.6%) patients required loop ileostomies, which was fashioned on the lateral aspect of the transverse incision. Only one patient had a doubtful caecal injury which was repaired and loop ileostomy was done. Six patients (7.7%) had adhesive intestinal obstruction postoperatively, of which three required re-exploration. There was no incidence of incisional hernia or any stoma-related complications. Conclusion: Complicated appendicitis is a condition which lacks standardisation of approach for management, and is inherently associated with complications. However, with a more logical incision and intra-operative approach we can keep the complications to minimum and improve outcomes to great extent in those patients requiring surgical intervention. We have been using the subumbilical transverse incision in all sizes of patients ranging from small children to adolescents with excellent results, and we believe that the same approach can be applied even in adult patients in similar clinical scenarios

Anesthetic management of Shah–Waardenburg syndrome: Experience of two cases and review of literature

Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah–Waardenburg syndrome and discuss them in the context of review of previously published cases

Posterior urethral valves: Morphological normalization of posterior urethra after fulguration is a significant factor in prognosis

<b>Aim:</b> To assess the changes in urethral morphology 3 months post fulguration of posterior urethral valves (PUVs) on micturating cystourethrogram (MCUG) and correlate these changes with the overall clinical status of the patient. <b>Materials and Methods:</b> A total of 217 children, managed for PUVs during a period of 6 years in a single surgical unit were prospectively studied. The ratio of the diameters of the prostatic and bulbar urethras (PU/BU) was calculated on the pre- and post-fulguration MCUG films. They were categorized into three groups based on the degree of normalization of posterior urethra (post-fulguration PU/BU ratio). <b>Results:</b> Group A: Of the 133 patients, 131 had normal urinary stream and 4 (3&#x0025;) had nocturnal enuresis. Vesicoureteral reflux (VUR), initially seen in 83 units (31&#x0025; units), regressed completely at a mean duration of 6 months in 41 units (49&#x0025;). Of the 152 non-VUR, hydroureteronephrosis (HUN) units, 11 were poorly functioning kidneys. Persistent slow but unobstructed drainage was seen in 23 units (16&#x0025;) over a period of 1.5-5 years (mean 2.5 years). Group B: All the 11 patients had a normal stream. Four (36.4&#x0025;) had daytime frequency for a mean duration of 1 year and one (9&#x0025;) had nocturnal enuresis for 1 year. Grade IV-V VUR was seen in five patients (three bilateral), which regressed completely by 3 months in five units (62.5&#x0025;). In the non-VUR, HUN patients, slow (but unobstructed) drainage was persistent in two units (14&#x0025;) at 3 years. Group C: Of the 16 patients, only 5 (31.3&#x0025;) were asymptomatic. Six patients (nine units) had persistent VUR for 6 months to 3 years. Of the 20 units with HUN, 17 (85&#x0025;) were persistent at 1-4 years (mean 2 years). Eight patients (50&#x0025;) required a second fulguration while 3 (18.7&#x0025;) required urethral dilatation for stricture following which all parameters improved. <b>Conclusions:</b> Adequacy of fulguration should be assessed by a properly performed MCUG. A postop PU/BU ratio &gt;3 SD (1.92) should alert to an incomplete fulguration or stricture. Patients within normal range ratio have faster recovery of slow draining units, reflux and less voiding dysfunction. There is a strong correlation between incomplete fulguration and persistent slow draining units, uremia, voiding dysfunction and urinary tract infections