Morbidity following Surgical Management of Vulval Cancer.

The objective of this study was to know the complications following vulvectomy and inguinofemoral lymphadenectomy including the time taken to complete wound healing. 42 patients who were subjected to either radical or modified radical vulvectomy for primary and inguinofemoral lymphadenectomy (80 groins) for groin metastases were analysed retrospectively. The complications analysed were wound breakdown, wound cellulitis or infection, lymphocyst, limb edema and the time to wound healing. In a total of 80 inguinofemoral lymphadenectomies 55% had wound breakdown, 17.5% had wound infection/cellulitis, lymphocyst in 31%, limb edema in 36% and time taken for complete wound healing ranged from 10-134 (average 46 days). Overall post operative morbidity was 85%

The Interminable War of Men against Nature: An Ecological View on Sidney Sheldon’s The Best Laid Plans

War is the major threaten of human beings against nature and its resources. In this scientific and technological era, wars are more than a natural calamity which could swipe millions of beings and their chief dependent, nature in seconds. Countries all over the world negotiate and create peace treaties; on the other hand they do research in nuclear weapon which is disastrous. Now-a-days a countries power is determined only by the weapons that they posses. The worse impact of war, its exploitation and total destruction of nature and its resources are described very effectively and empathetically in Sidney Sheldon’s The Best Laid Plans. The novel pictures the traumatic effect of war on human beings and nature as a whole in Sarajevo. In this mode the paper deals with the study of the novel in relation to ecocriticism, the application of ecological concepts to the study of literature

Detection of virulence determinants and its association with drug resistance in clinical isolates of Pseudomonas aeruginosa

Background: Pseudomonas aeruginosa is most commonly noted significant nosocomial pathogen, because of its distribution, of multi drug resistance and expression of various virulence factors. This study was aimed to detect various resistance mechanism and virulence factors of Pseudomonas aeruginosa and to determine the significant association between them.Methods: A total of 203 clinical isolates of Pseudomonas aeruginosa were included in this study. All isolates were detected for various virulence factors like Phospholipase, Hemolysin, Gelatinase and DNAse. Screening of β-lactamase like extended spectrum beta-lactamase (ESBL), AmpC beta-lactamase and Metallo β-lactamase (MBL) of Pseudomonas aeruginosa were also done.Results: Of total 203 isolates of Pseudomonas aeruginosa studied, 103 were from pus, 50 each from urine and respiratory samples. Virulence factors distribution of Pseudomonas aeruginosa showed 80.3% ,70% , 71.4% , 44.8% and 34% were positive for hemolysin, phospholipase, gelatinase, DNAse and biofilm production respectively. Study on prevalence of various β-lactamase in Pseudomonas aeruginosa isolated showed 25.6%, 24.1% and 10.3% were ESBL, MBL and AmpC producers respectively.Conclusions: This study suggests that production of virulence factors may not be significantly associated with antibiotic resistance. However, expression of certain virulence factors, most notably hemolysin and DNAse activity were significantly associated with β-lactamase production. Hence forth, future trends in clinical microbiology laboratories should focus on development of tests for the rapid detection of the most important virulence markers in addition to identification of pathogens and susceptibility pattern

Borderline Ovarian Malignancies : A Single Institute Retrospective Study.

Background: Borderline ovarian tumors are histologically characterized as epithelial tumors with a stratified growth pattern but without destructive stromal invasion. Little is known about the histological subtypes and outcome, role of fertility sparing surgery and role of postoperative therapy in advanced stage in Indian scenario. While there is ample data in the world literature about this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. Objective: To study the demographic profile, clinical features, imaging, treatment and outcome of borderline ovarian tumors. Methods: This is a retrospective study of eighty seven patients with pathologically proven diagnosis of borderline ovarian tumor, diagnosed and treated from January 2006 to October 2011 at our institution. Most patients underwent surgical staging which incuded total abdominal hysterectomy and bilateral salphingo-oophorectomy, infracolic omentectomy, bilateral pelvic and para aortic lymphadenectomy. Young patients who had not completed their family underwent fertility sparing surgery. Patients with invasive metastatic implants received adjuvant chemotherapy. The outcome of these patients was correlated with stage, type of peritoneal implant, type of surgical procedure and with histological subtype. Results: At a median follow-up of 48 months, 100 percent survival was noted. One patient with stage III disease had recurrence. Conclusions: Borderline ovarian tumors occur at a younger age compared to invasive tumors. In patients with early stage disease who wish to preserve fertility, hysterectomy and contralateral oophorectomy are not necessary. Serous tumors occur at a younger age. They can be associated with invasive peritoneal implants and raised CA125 values. Majority of the serous tumors are bilateral and smaller in size compared to mucinous and endometroid tumors. Raised CA125 values did not correlate with the stage of disease. These patients have an excellent prognosis even in Indian scenario where majority of patients present with big ovarian masses

Effect of Auriculopuncture in Patients with Periarthritis Shoulder: A Prospective Control study

BACKGROUND: Frozen shoulder is also referred to as adhesive capsulitis, painful stiff shoulder, and periarthritis.The lifetime prevalence of frozen shoulder is estimated to be 2 to 5 percent of the general population. Patients with diabetes mellitus are at greater risk of developing frozen shoulder, with a prevalence of 10 to 20 percent. Auricular acupuncture (AA) is called the treatment of physical and psychosomatic dysfunctions by stimulating the ear surface exclusively. Previous studies have reported that AA can relieve pain improve Range of motion. This study is designed to assess the effects of AA on PAS patients. METHODS: Sixty subjects aged between 40 to 60 years presents with symptoms of PAS were randomly assigned into (control group n=30) and Auricular acupuncture (Experimental group n=30). Both groups were assessed at the baseline and at the end of 12 sessions in 14 days. Shoulder pain were scored by SPADI (Shoulder pain and disability index) pain and ROM was measured in terms of shoulder abduction, flexion and external rotation. The sterile acupuncture needles were inserted in the ear of the subjects at specific points (such as Jerome point, thalamus point, Shenmen point, shoulder joint point, shoulder point) for 20 minutes of duration. RESULTS: SPADI score and ROM were improved in both the groups. But AA group shows highly significant results clinically as well as statistically in pain index (0.00), disability index (0.002), total SPADI score (0.001), ROM in shoulder flexion (0.002), abduction (0.001) and in external rotation (0.00). CONCLUSION: AA showed greater effect in ROM. Although this study shows that an AA is highly recommended for PAS, future research with a large cohort study with long monitoring is needed to validate these results

A comparative study of the effect of body mass index on pregnancy outcomes in normal and overweight women

Background: Maternal obesity has been reported as a risk factor for various antepartum, intrapartum, postpartum and neonatal complications. Increasing rates of overweight among pregnant women are a significant public health concern with various implications for prenatal care and supervision of delivery. Therefore, the present study is to determine the adverse materno-fetal outcome in primigravid overweight and obese women delivering singleton babies.Methods: A prospective comparative study was conducted for a year at IMCH, Medical College, Calicut. Primigravid women with a singleton uncomplicated pregnancy with cephalic presentation at ≥37 weeks of gestation with accurate information regarding height and weight recorded at the booking visit were included in the study. Comparisons were made between 100 women with BMI >25 and 200 women with BMI 18.5-24.9. Statistical analysis was done using SPSS version 16.0. Data was analysed by Pearson Chi square test and Fisher’s exact test.Results: Overweight mothers are at increased risk quoted as relative risk (RR) and 95% confidence intervals (CI) of adverse materno-fetal outcomes. Gestational hypertension RR 2.39 (CI 1.65-3.47), Gestational diabetes RR 2.67(CI 0.95-7.48), induction of labour RR 2.35 (CI 1.4-3.95), Cesarean section RR 5.73 (CI 3.76-8.73), macrosomia RR 14 (CI 1.75-112.23), NICU admissions RR 4.51(CI 2.61-7.84),perineal lacerations RR 4.72 (CI 1.15-20.4), wound infection RR 2.97 (CI 1.06-8.41), and prolonged hospital stay.Conclusions: It is clearly evident from the study that maternal overweight and obesity is associated with adverse materno-fetal outcome

A study on medication adherence, medication related challenges faced and coping strategies adopted by visually impaired subjects in a tertiary care hospital

Background: Visual impairment poses a significant threat to proper medication practice leading to medication related challenges and some adopted self coping strategies with substantial impact on medication adherence. Visually impaired are potentially more likely to have unsafe medicine related practice which by itself is more rampant in general population. Studies related to them are largely unexplored and can provide data to improve disease management and health related quality of life. Objectives was to study the level of medication adherence, medication related challenges and self adopted coping strategies in visually impaired people.Methods: A cross sectional descriptive study enrolling 204 subjects with VI was done. Medication adherence was assessed using MMAS. Medication related challenges and self-adopted coping strategies was assessed by using pre-validated semi-structured questionnaire.Results: Majority of the subjects showed medium medication adherence with forgetfulness to take medicine as the main reason for non adherence. Difficulty in remembering the instructions, spilling of liquid medicine, taking wrong dose, difficulty in using topical medications were the most common challenges faced by them in daily drug administration. To overcome challenges locating the drugs at different places, finger felt volume for liquid medication, textural feeling of the drug or container, time tracking were the major self adopted coping strategies by the visually impaired subjects.Conclusions: Creating awareness of the medication related problem faced by visually impaired helps to provide adequate assistance to medication use and improve proper health care services in them

Performance investigation of ANFIS and PSO DFFP based boost converter with NICI using solar panel

The modeling and development of the boost DC to DC converter with Partial Swarm Optimization with Distinctive Feed Forward Propagation (PSO-DFFP) controller for hybrid power systems including solar panels. The static and dynamic investigation of the developed PSO DEEP controller is presented. The PSO-DFFP controller has been designed to improve the operating efficiency and reduces the input converter current ripple. The PSO DFFP controller is developed and performance is compared with ANFIS and FLC. The developed system reduces the switching losses and voltage drops in switching modes. The designed system is demonstrated and developed with 200W, 100kHz model. The investigation results is exposed that the developed PSO DEEP system is an acceptable for SOLAR applications

A Mathematical Model for Micropolar Fluid Flow Through an Artery with the effect of Stenosis and Post Stenotic Dilatation

The effects of both stenosis and post stenotic dilatation have been studied on steady flow of micropolar fluid through an artery. Assuming the stenosis to be mild, the equations governing the flow of the proposed model are solved. Closed form expressions for the flow characteristics such as velocity, pressure drop, and volumetric flow rate, resistance to the flow and wall shear stress are derived. The effects of various parameters on resistance to the flow and wall shear stress have been analyzed through the graphs. It is found that the resistance to the flow increases with the height and length of the stenosis, but the resistance to the flow decreases with stenotic dilatation. With the increase of the coupling number the resistance to the flow increases. However, the effect of coupling number is not very significant. The resistance to the flow decreases with the micropolar fluid parameter. The wall shear stress increases with coupling number and stenosis height, but it decreases with micropolar fluid parameter and stenotic dilatation