Assessment of Hand Grip Strength and Pinch Grip Strength among Healthy Embroidery Workers: Cross-Sectional Study

Background: Embroidery is a craft that decorates fabric or other materials by using a needle to apply thread or yarn. Hand and finger strength is essential during embroidery design to minimize discomfort and risk of upper extremity injuries Aims and objective: This study aims to assess hand grip strength and pinch grip strength among healthy embroidery workers. Methodology: 100 embroidery workers were recruited. Demographic details including BMI were taken in self-designed form. Hand grip strength was assessed by Jamar Hand Held Dynamometer. Pinch grip strength was assessed by a Pinch Guage Dynamometer. Statistical analysis was done using the Python software. Results: The study included 100 subjects that involved all female subjects aged 20 to 40 yrs. with 4 or more than 4 years of experience. The study showed that the hand grip strength of embroidery workers was more affected than the pinch grip strength. This study also showed that age is not related to the hand grip and pinch grip strength. It also showed that an increase in the years of experience increases hand grip and pinch grip strength (p< 0.05) as well as grip strength was more in the dominant hand(p<0.0001).Conclusion: Hand grip strength was found to be affected more than the pinch grip strength. They found no correlation with the age and there was a correlation with years of experience.

Effects of Brain Gym Exercises on Attention and Anxiety in Adolescents – An Experimental Study

Background: The common psychological difficulties in adolescents are anxiety states or minor depression and apart from that the attention span in adolescents is also shrinking as reported. The Brain Gym exercise is said to release learning blocks and cause improvement in areas such as memory, concentration, and focus. The goal of this study is to improve anxiety and attention in adolescents by performing brain gym exercises. Aim: To study the effects of brain gym exercise on attention and anxiety in adolescents. Methodology: The study employed an experimental study including 134 students within a 15-19 years age group, selected through purposive sampling. The primary outcomes are the Hamilton anxiety rating scale and the mindful attention awareness scale. Brain gym exercise was performed thrice a week for four weeks. Results: A statistically significant improvement in anxiety and attention is observed with using brain gym exercise. The pretest mean anxiety score at week 1 was 18.46 and after four weeks the results showed a statistically significant decrease in anxiety with a mean score of 16.14. The pretest attention score in week 1 was 3.67 and the post-intervention score in week 4 was 3.98 showing a statistically significant increase in attention. The data was statistically significant with a p-value of <0.05.Conclusion: The study concludes there’s a significant effect of brain gym exercises in improving attention and anxiety.

Fatal asphyxia due to large laryngeal granuloma

ABSTRACT Laryngeal granuloma, vocal process granuloma, or post-intubation granuloma are benign, inflammatory lesions of the arytenoid cartilage vocal process. The etiology of laryngeal granulomas is multifactorial, such as chronic irritation due to endotracheal intubation, vocal cord injury or trauma, and gastroesophageal reflux disease. They can arise postoperatively after mucosal injury due to orotracheal intubation. Clinical manifestations include voice change and dyspnea, which may start one to four months after extubation and may rarely lead to asphyxia. We presented a case of death due to glottic granuloma occurring after a surgical procedure to remove a laryngeal polyp attributed to previous laryngeal injuries by multiple intubations.

Prognostic significance of serum pro-calcitonin level in paediatric intensive care unit patients

Background: Serum procalcitonin (PCT) is already known predictive marker in serious bacterial infection and it is emphasized that these biomarkers can be used as a marker of increased mortality in critically ill patients. The aim of the study was to evaluate the serial PCT level and find out whether these biomarkers can be used to predict mortality. Methods: This was a prospective observational study. Primary objective was to study the serum PCT as a prognostic marker in critically ill children (2 months to 12 years) admitted in PICU while secondary objective was to find out the association of level of serum procalcitonin with different organ system disease involvement and to compare the results of the serum procalcitonin with the PRISM-3 score in diagnosing the severity of illness in the patient. Patient outcome was assessed at hospital discharge, and the patients were divided into non-survivors and survivors. A p value of <0.05 will be considered statistically significant.Results: A total of 185 patients were enrolled, the median age was 5 years (2 months to 12 years) with 56.76% being males. Majority (34.59%) of patients the primary diagnosis was of respiratory system. The median of serum PCT on day 1, day 3 and day 7 with outcome (p<0.05) in dead was significantly higher as compared to alive. The median PRISM score in dead was 21(13-33) which was significantly higher as compared to alive 11 (8-12.7). Serum PCT and PRISM score had significant discriminatory power to predict mortality. Conclusions: In the present study serum PCT found to be a good prognostic marker for all cause mortality in critically ill patients admitted in PICU.

A case report of a pediatric patient with Hirschsprung’s disease

The objective is to describe an uncommon case of Hirschsprung's disease (HD), also called congenital megacolon. The lack of neuronal ganglion cells from the submucosal and muscular nerve plexuses throughout a segment of varied length characterizes HD. Approx 94% of HD cases are diagnosed below the age of 5 years. A 3 years old male patient was admitted to the male surgery ward under a pediatric surgeon with the chief complaints of chronic constipation since birth with a history of delayed passage of meconium. The patient was diagnosed with a case of HD at the age of 1 year for which he was operated on colostomy was performed with multiple biopsies from narrowed rectosigmoid, from the transitional zone, and from colostomy stoma which confirmed the decision to make colostomy at the ganglionated segment of the colon based on the clinical picture during surgery. Biopsy report of narrowed rectosigmoid segment showed the absence of ganglion cells, while colostomy stoma and dilated proximal colon showed the presence of ganglion cells. The patient underwent a surgical procedure named pull-through surgery for HD, a martin's modification of the Duhamel operation.

Detection and Comparision of Cytopathological Changes in Smokers and Non-Smokers: A Comparative Study

Background: Oral cancer is one of the sixth most common cancers in the world. Oral exfoliative cytology is one of the popular screening tool for oral cancer. Use of tobacco in any form are documented as the most common cause as initiators for dysplastic changes in oral mucosa. The purpose of the study was to detect the cytological changes in buccal mucosa, tongue and palate among non-smokers & smokers. Material & Methods: Smears sample were collected according to site (buccal mucosa, tongue & palate) from 100 subjects among smokers & non-smokers. Smears were then stained using Papanicolaou staining technique. Results: Among the smokers and non-smokers the results were statistically significant. Conclusion: Recent advances in the clinical visualization and detection of the oral mucosa have made the viability of cytological procedures more specific and sensitive. Contact endoscopy and use of autofluorescence devices are the forerunners in this group. The fluorescence characteristics of tissues depend upon their biochemical composition and histomorphological architecture, both of which undergo a change during malignant transformation. These changes are detectable as an alteration in the fluorescence spectral profile of the tissues21. Due to low feasibilities of such devices the benchmark of diagnosis will be microscopic tissue examination. Hence cytological smears will always be highly specific, sensitive, easy to use and reproducible procedures in routine screening of population for potentially and malignant conditions of the oral cavity.

Characterization of Degradation Products of Guanfacine Hydrochloride API: Development and Validation of a Stability-indicating Reversed Phase UHPLC Method

Guanfacine Hydrochloride API was subjected to forced degradation studies under various conditions of hydrolysis (acidic, alkaline, and neutral/water), oxidation, photolysis, and thermal. A short and simple, reverse phase UHPLC method was developed on a Shimadzu, Shimpack GIST, C18, (100 × 2.1) mm, 3.0 ?m column. The gradient method consisted of 0.1% orthophosphoric acid as mobile phase A and acetonitrile as mobile phase B. The flow rate of the mobile phase was 0.3 mL/min. The method was validated using ICH guidelines considering the parameters solution stability, specificity, DL/QL, linearity, accuracy, precision and robustness. The drug was found highly sensitive to alkaline conditions and showed significant degradation. The drug was found sensitive to acidic degradation conditions. Slight degradation was observed in oxidative and water conditions. The drug was found to be stable in thermal and photolytic conditions. The mass compatible UHPLC method was prepared by simply substituting the orthophosphoric acid with formic acid in the mobile phase. Characterization of two major degradation products (DPs) was done. DP1 was characterized with LC–Q-TOF-MS/MS in combination with accurate mass measurements. DP2 was isolated and characterized with NMR, IR and HRMS spectroscopic techniques. The mechanisms of the formation of DPs were proposed.

Prevalence and antimicrobial resistance of Escherichia coli and Salmonella spp. in animal feed in Colombia / Prevalencia y resistencia a los antimicrobianos de Escherichia coli y Salmonella spp. en los alimentos para animales en Colombia / Prevalência e resistência a antimicrobianos de Escherichia coli e Salmonella spp. em ração animal na Colômbia

ABSTRACT Objective. To determine the prevalence and antimicrobial resistance of Escherichia coli and Salmonella spp. in animal feed samples collected between 2018 and 2021 in Colombia. Methods. This was a laboratory-based cross-sectional study using routine data from the program for inspection, surveillance, and control of animal feed at the Colombian Agriculture Institute. Samples of animal feed for swine, poultry, canine, feline, leporine, piscine, and equine species were processed for detection of E. coli and Salmonella spp. using enrichment and selective culture methods. Isolates were tested for antimicrobial susceptibility using an automated microdilution method. Results. Of 1 748 animal feed samples analyzed, 83 (4.7%) were positive for E. coli and 66 (3.8%) for Salmonella spp. The presence of E. coli and Salmonella spp. was highest in feed for poultry (6.4% and 5.5%) and swine (6.1% and 4.3%). Antimicrobial resistance testing was performed in 27 (33%) E. coli isolates and 26 (39%) Salmonella isolates. Among E. coli, resistance was most frequently observed to ampicillin (44.5%) followed by cefazolin (33.3%), ciprofloxacin (29.6%), ampicillin/sulbactam (26%), and ceftriaxone (11.1%). The highest resistance levels in Salmonella spp. isolates were against cefazolin (7.7%) and piperacillin/tazobactam (7.7%). Conclusions. This is the first study from Colombia reporting on the prevalence and antimicrobial resistance of E. coli and Salmonella spp. in animal feed samples. Its results establish a baseline over a wide geographical distribution in Colombia. It highlights the need to integrate antimicrobial resistance surveillance in animal feed due to the emergence of resistant bacteria in this important stage of the supply chain.

RESUMEN Objetivo. Determinar la prevalencia y resistencia a los antimicrobianos de Escherichia coli y Salmonella spp. en muestras de piensos para animales tomadas entre el 2018 y el 2021 en Colombia. Métodos. Se trata de un estudio transversal realizado en el laboratorio a partir de los datos regulares del programa de inspección, vigilancia y control de alimentos para animales del Instituto Colombiano Agropecuario. Se procesaron muestras de alimentos utilizados en la cría de cerdos, aves de corral, cánidos, félidos, lepóridos, peces y equinos con el fin de detectar E. coli y Salmonella spp. por medio de métodos de enriquecimiento y cultivo selectivo. Se analizó la sensibilidad a los antimicrobianos de las cepas aisladas mediante microdilución automatizada. Resultados. De 1748 muestras de alimentos analizadas, 83 (4,7%) resultaron positivas para E. coli y 66 (3,8%) para Salmonella spp. La presencia de E. coli y Salmonella spp. fue mayor en los alimentos para aves de corral (6,4% y 5,5%) y cerdos (6,1% y 4,3%). Se realizaron pruebas de resistencia a los antimicrobianos en 27 (33%) cepas de E. coli y 26 (39%) de Salmonella. En las cepas de E. coli, se observó una mayor resistencia a la ampicilina (44,5%), seguida de la resistencia a la cefazolina (33,3%), la ciprofloxacina (29,6%), la ampicilina/sulbactam (26%) y la ceftriaxona (11,1%). En el caso de las cepas de Salmonella spp., los niveles de resistencia más elevados fueron para la cefazolina (7,7%) y piperacilina/tazobactam (7,7%). Conclusiones. Este es el primer estudio realizado en Colombia en el que se informa sobre la prevalencia y la resistencia a los antimicrobianos de E. coli y Salmonella spp. en muestras de alimentos para animales. Sus resultados establecen una línea de base para una zona geográfica mucho mayor dentro de Colombia. Se subraya la necesidad de integrar la vigilancia de la resistencia a los antimicrobianos en los alimentos para animales debido a la aparición de bacterias resistentes en esta importante etapa de la cadena de suministro.

RESUMO Objetivo. Determinar a prevalência e a resistência a antimicrobianos de Escherichia coli e Salmonela spp. em amostras de ração animal coletadas entre 2018 e 2021 na Colômbia. Métodos. Estudo transversal de base laboratorial, usando dados de rotina do programa de inspeção, vigilância e controle de ração animal do Instituto Colombiano de Agricultura. Amostras de ração animal para as espécies suína, avícola, canina, felina, leporina, piscina e equina foram processadas para detecção de E. coli e Salmonella spp., usando métodos de enriquecimento e cultura seletiva. Os isolados foram testados quanto à suscetibilidade a antimicrobianos usando um método automatizado de microdiluição. Resultados. Das 1.748 amostras de ração animal analisadas, 83 (4,7%) foram positivas para E. coli e 66 (3,8%) para Salmonella spp. A presença de E. coli e Salmonella spp. foi maior em rações para aves (6,4% e 5,5%) e suínos (6,1% e 4,3%). O teste de resistência a antimicrobianos foi realizado em 27 (33%) isolados de E. coli e 26 (39%) isolados de Salmonella. Em E. coli, a resistência observada com maior frequência foi à ampicilina (44,5%), seguida da cefazolina (33,3%), ciprofloxacino (29,6%), ampicilina/sulbactam (26%) e ceftriaxona (11,1%). Os maiores níveis de resistência em isolados de Salmonella spp. foram contra cefazolina (7,7%) e piperacilina/tazobactam (7,7%). Conclusões. Este é o primeiro estudo da Colômbia a notificar a prevalência e resistência a antimicrobianos de E. coli e Salmonella spp. em amostras de ração animal. Os resultados estabelecem uma linha de base com ampla distribuição geográfica na Colômbia. Destaca-se a necessidade de integrar a vigilância da resistência a antimicrobianos na ração animal, devido ao surgimento de bactérias resistentes nesta importante etapa da cadeia de abastecimento.

Multidrug-resistant Salmonella spp. in fecal samples of pigs with suspected salmonellosis in Antioquia, Colombia, 2019-2021 / Salmonella spp. multirresistentes en muestras fecales de cerdos con presunta salmonelosis en Antioquia, Colombia, 2019-2021 / Salmonella spp. multirresistente em amostras fecais de suínos com suspeita de salmonelose em Antioquia, Colômbia, 2019-2021

ABSTRACT Objectives. To determine the proportion of Salmonella enterica in fecal samples of live pigs with suspected salmonellosis analyzed at the diagnostic unit of the University of Antioquia, Colombia between 2019 and 2021, and examine the serotypes and antimicrobial resistance patterns. Methods. This was a laboratory-based cross-sectional study of routine data on fecal samples received from pig farms in all nine subregions of Antioquia state, Colombia. Salmonella spp. detection at the university is done using enrichment, selective culture, and polymerase chain reaction. Serotypes were identified using the Kauffmann-White scheme and isolates were tested for antimicrobial susceptibility using broth microdilution. Results. Of 653 samples tested, 149 (23%) were positive for S. enterica. Nine serotypes were identified. The most common were Salmonella Typhimurium (56%) and its monophasic variant (35%). Resistance to ampicillin (70%) was most frequently observed, followed by ciprofloxacin (55%), and sulfamethoxazole-trimethoprim (52%). No isolates were resistant to amikacin and gentamicin. Multidrug resistance (resistance to ≥ 3 classes of antibiotics) was observed in 61 (44%) isolates. Multidrug resistance was highest in S. Typhimurium (57%) compared with the other serotypes. Serotype was associated with multidrug resistance (p = 0.01), but age of the pig and sub-region were not. Conclusions. The proportion of Salmonella spp. and the associated high levels of multidrug resistance are of concern and may indicate irrational use of antimicrobials and poor management practices in pig production systems in the region. Strengthened surveillance is needed to monitor and improve farm management practices and the use of antimicrobials in farms in Colombia.

RESUMEN Objetivos. Determinar la proporción de Salmonella enterica en muestras fecales de cerdos vivos con presunta salmonelosis analizadas en la unidad de diagnóstico de la Universidad de Antioquia (Colombia) entre el 2019 y el 2021, así como examinar los serotipos y los patrones de resistencia a los antimicrobianos. Métodos. Se trata de un estudio transversal de laboratorio sobre datos ordinarios de muestras fecales provenientes de granjas porcinas de las nueve subregiones del departamento de Antioquia (Colombia). La detección de Salmonella spp. en la universidad se realiza mediante el enriquecimiento, el cultivo selectivo y la reacción en cadena de la polimerasa. Se identificaron los serotipos con el esquema de Kauffmann-White y se examinaron las cepas aisladas para determinar la susceptibilidad antimicrobiana mediante microdilución en caldo. Resultados. De las 653 muestras analizadas, 149 (23%) dieron un resultado positivo para S. enterica. Se identificaron nueve serotipos. Los más comunes fueron Salmonella typhimurium (56%) y su variante monofásica (35%). La resistencia a la ampicilina fue la observada con mayor frecuencia (70%), seguida de la resistencia al ciprofloxacino (55%) y al sulfametoxazol-trimetoprima (52%). Ninguna cepa aislada fue resistente a la amikacina y la gentamicina. Se observó resistencia a múltiples fármacos (resistencia a tres o más clases de antibióticos) en 61 cepas (44%). La resistencia a múltiples fármacos fue más elevada en el caso de S. typhimurium (57%) en comparación con los otros serotipos. Se asoció el serotipo con la resistencia a múltiples fármacos (p = 0,01), a diferencia de la edad del cerdo y la subregión. Conclusiones. La proporción de Salmonella spp. y los elevados niveles asociados de resistencia a múltiples fármacos son preocupantes y pueden ser un indicativo de uso irracional de antimicrobianos y malas prácticas de gestión en los sistemas de producción porcina de la región. Es necesario reforzar la vigilancia para dar seguimiento y mejorar las prácticas de gestión agropecuaria y el uso de antimicrobianos en las granjas en Colombia.

RESUMO Objetivos. Determinar a proporção de Salmonella enterica em amostras de fezes de suínos vivos com suspeita de salmonelose analisadas na unidade de diagnóstico da Universidade de Antioquia, Colômbia, entre 2019 e 2021, e examinar seus sorotipos e padrões de resistência a antimicrobianos. Métodos. Estudo transversal, de base laboratorial, utilizando dados de rotina de amostras de fezes recebidas de suinocultores em todas as nove sub-regiões do estado de Antioquia, Colômbia. A detecção de Salmonella spp. na Universidade é feita por enriquecimento, cultura seletiva e reação em cadeia da polimerase. Os sorotipos foram identificados usando o esquema de Kauffmann-White, e os isolados foram testados quanto à suscetibilidade aos antimicrobianos pelo método de microdiluição em caldo. Resultados. Das 653 amostras testadas, 149 (23%) foram positivas para S. enterica. Foram identificados nove sorotipos. Os mais comuns foram Salmonella Typhimurium (56%) e sua variante monofásica (35%). A resistência à ampicilina (70%) foi observada com maior frequência, seguida pela resistência ao ciprofloxacino (55%) e ao sulfametoxazol/trimetoprima (52%). Nenhum isolado apresentou resistência à amicacina ou gentamicina. Multirresistência (resistência a ≥ 3 classes de antibióticos) foi observada em 61 isolados (44%). A multirresistência foi mais comum em S. Typhimurium (57%), em comparação aos outros sorotipos. Foi constatada associação da multirresistência com sorotipos (p = 0,01), mas não com idade do suíno ou sub-região. Conclusões. A proporção de Salmonella spp. e os níveis elevados associados de multirresistência a antimicrobianos aqui constatados são preocupantes, e podem indicar uso irracional de antimicrobianos e práticas inadequadas de manejo nos sistemas de suinocultura da região. É preciso fortalecer a vigilância para monitorar e melhorar as práticas de manejo agrícola e o uso de antimicrobianos em fazendas na Colômbia.

Weeds infesting Wheat crop in Rohtak, Haryana

Multiple field visits were performed to investigate weed flora of wheat fields in Rohtak district of Haryana, conducted during 2018 which revealed infestation of 28 weed species comprising 15 families of grasses and broadleaf weeds. The weeds were identified with the help of available literature and through comparison with the already identified weed species. Poa annua, Polypogon monspeliensis and broadleaf weeds Chenopodium album, Rumex retroflex, Coronopus didymus were the pre-dominant weeds in moist region, whereas Cynodon dactylon, Fumaria parviflora, Chenopodium album, Polypogon monspeliensis in light soil with low salinity. There was a greater variety of weeds in Bohar and Kharawar villages and the least was found in village Sheria and Garnavati from vegetative to fully grown stage. Maximum number of species were of family Poaceae and Asteraceae. This study will be helpful as an additional tool in maintaining the floristic composition of District Rohtak as well as in controlling the weed problem

Evaluation of visual field changes with retinal nerve fiber layer thickness in primary congenital glaucoma

Purpose: To evaluate visual field changes in primary congenital glaucoma (PCG) with retinal nerve fiber layer thickness on optical coherence tomography. Methods: In this cross?sectional, observational study, consecutive PCG children who underwent combined trabeculotomy with trabeculectomy and on regular follow?up were enrolled. All patients were aged over four years and co?operative for RNFL OCT and visual field examination. Perimetry was done on Humphrey visual field (HVF) analyzer using 30?2 and 10?2 SITA standard algorithms as appropriate. If a reliable automated perimetry was not feasible, kinetic perimetry was done. The following were noted at baseline and every follow?up: age, sex, visual acuity, intraocular pressure (IOP), cup–disc ratio (CDR), corneal diameters, refraction, any topical antiglaucoma medications, surgeries underwent, age at surgery and duration between surgery and final examination. Results: Forty?eight eyes of 34 children operated for PCG and 19 eyes of 17 controls were analyzed. A statistically significant thinner average RNFL thickness of 87.2 ± 28 ?m was noted in PCG eyes as compared to controls with 100.6 ± 7.2 ?m (P = 0.04). The mean cup–disc area ratio on OCT in PCG eyes was 0.43 ± 0.2 (0.02–0.93) and in control eyes was 0.23 ± 0.07 (0.1–0.4) (P < 0.001). On RNFL OCT, there was significant focal RNFL loss in temporal superior (P = 0.003), nasal inferior (P = 0.037) and temporal inferior (P < 0.001) quadrants compared to controls. Among PCG eyes, 20/48 eyes (41.7%), had definitive, reproducible glaucomatous VF defects. Mean baseline IOP in PCG eyes with VF defect was 28.7 ± 5.7 mmHg and in eyes with normal VF was 24.6 ± 5.9 mmHg (P = 0.03). On univariate regression analysis, higher baseline IOP was significantly associated with both RNFL loss (odds ratio (OR): ?2.17) and VF defects (OR: 3.35). Fluctuation in follow?up IOP (OR: 3.33) was also significantly associated with the presence of VF defects. On multivariable regression analysis maximum, IOP was significantly associated with RNFL loss and VF defects. Conclusion: Peripapillary RNFL thickness could be used to identify PCG eyes having visual field loss and possibly poor visual function from PCG eyes without visual field defects. Baseline and follow?up IOP, significantly correlated with RNFL thickness in PCG eyes

Evaluation of lignocaine, dexmedetomidine, lignocaine-dexmedetomidine infusion on pain and quality of recovery for robotic abdominal hysterectomy: a prospective randomized controlled trial

Abstract Background: Acute postoperative pain is associated with poor quality of recovery after surgery. Perioperative use of intravenous lignocaine or dexmedetomidine have demonstrated better pain control, early return of bowel function, and effects on quality of recovery. Methods: Ninety-six women planned for elective robotic abdominal hysterectomy were randomized into four groups. Groups received lignocaine infusion (1.5 mg.kg−1 loading, 2 mg.kg−1.h−1 infusion) (Group I), dexmedetomidine infusion (1 µg.kg−1 loading, 0.6 µg.kg−1.h−1 infusion) (Group 2), lidocaine (1.5 mg.kg−1 loading, 2 mg.kg−1.h−1 infusion), and dexmedetomidine infusions (1 µg.kg−1 loading, 0.5 µg.kg−1.h−1 infusion) (Group 3), and normal saline 10 mL loading, 1 mL.kg−1.h−1 infusion) (Group 4). Primary outcome was visual analogue pain scores at 1, 2, 4, 12, and 24 hours after surgery. Secondary outcomes included postoperative fentanyl requirement, time of return of bowel sounds and flatus, QoR15 score on day 1, 2, and discharge. Results The VAS was significantly lower in Groups 2 and 3 compared to Groups 1 and 4. Total postoperative fentanyl consumption in the first 24 hours was 256.25 ± 16.36 mcg (Group 1), 177.71 ± 16.81 mcg (Group 2), 114.17 ± 16.19 mcg (Group 3), and 304.42 ± 31.26 mcg (Group 4), respectively. Time to return of bowel sounds and passage of flatus was significantly shorter in Groups 2 and 3 (p < 0.01). QoR15 scores after surgery were higher in Group 3 compared to Groups 1, 2, and 4, (p < 0.01) respectively. Conclusion: Combined infusion of lignocaine and dexmedetomidine significantly decreased postoperative pain, fentanyl consumption, and improved quality of recovery score after surgery in patients undergoing Robotic abdominal hysterectomy.

Til Tail (Sesamum Indicum): A Hidden Cause Behind Tamaka Shwasa (Bronchial Asthma): A Literary Review

Respiratory problems are very common due to the devastating pollution, irritants and infections. Asthma is one of the chronic inflammatory respiratory illnesses throughout the world and is characterized by breathlessness, chest tightness, wheeze and coughing. It occurs as a result of hypersensitivity reaction mainly due to allergens. These allergies mostly can be from the food. Like other allergies, sesame allergy is quite common yet unknown but it’s prevalence has been continuously increasing in recent years. A lot of modern researches proved Sesame as a food allergen causing airway inflammation and IgE mediated airway hyper responsiveness and finally causes asthma. In Ayurveda, asthma is well correlated as Tamaka shwasa. In classical texts of Ayurveda like Charaka Samhita and Sushrut Samhita similar etiological factors are described for Shwasa roga, in addition to that dietary factors (Aharaj Nidan) are also mentioned such as Nishpava, Masha, Til tail, Pinyak, Pishti, Aam ksheer etc. which vitiates the Doshas and finally causes Tamaka shwasa. This review article mainly focuses the role of Til tail (Sesamum indicum) in the etiopathogenesis of Tamaka shwasa and also, for better understanding of textual facts and may be used as an effective key to control the mortality and morbidity related to it.

Indian Reality of Clinical Practice and Patient Profile in Diabetes Care: Lessons from the IMPACT survey

India shoulders a heavy burden of diabetes mellitus (DM), the management of which is suboptimal globally. Objectives: Insulin Management: Practical Aspects in Choice of Therapy (IMPACT) survey was designed to gain insight into the ground (in-clinic) reality of DM management by physicians in India. Methods: A survey consisting of 12 multiple-choice questions was conducted by SurveyMonkey ® , focusing on practice profile, patient profile, and other aspects of DM management. Results: The survey included 2424 physicians. Majority of them were general physicians (58.5%) followed by diabetologists (31.1%). Most (49.2%) of the respondents specified that the ideal time for a DM consultation is 15 min. However, 73.4% of them provided consultation of <10 min because of heavy patient load. Nearly half of the respondents reported that their patients consumed a diet with carbohydrate content of 60% to 80%, and 79.4% of them admitted that <50% of their patients adhered to dietary advice. About 73.5% of the respondents believed controlling fasting plasma glucose (FPG) level alone would not adequately control postprandial plasma glucose (PPG) level, and 93.0% of them preferred an insulin therapy at the initiation that controls both FPG and PPG levels. Conclusion: Limited consultation time, high-carbohydrate diet, and a need for choosing insulin regimens that provide control for both PPG and FPG levels are some ground realities of DM management in India. These realities need to be factored in while choosing treatment options to achieve the desired glycemic control and improve the status of diabetes care.

Exploring integrated methodology for phytoremediation and biofuel production potential of Eichhornia crassipes

Eichhornia crassipes (EC) is a well-known invasive weed in different aquatic ecosystems. Its effective and complete eradication remains a challenge. The plant is a heavy metal (HM) hyperaccumulator in water bodies; however, studies regarding its biomass utilisation post-phytoremediation remain limited. The abundant growth rate and biochemical composition make EC a promising lignocellulosic feedstock for biofuel production; hence could be a deterministic approach for solving the twin problems of water pollution and higher energy demand, which are the global pressing issues in today’s scenario. The present study aimed at evaluating the phytoremediation potential of EC followed by proximate and biochemical analysis to investigate its suitability for biofuel production. After two weeks, the EC removed above 90% of Lead (Pb) and 60% of Cadmium (Cd) at all experimental doses. Lower doses of HMs, especially Pb, showed stimulatory effects on E. crassipes leaf biomass (ECLB). The recovered ECLB from Pb contaminated water (1 mg L?1) was further analysed for moisture (89.23±0.86%), dry matter (10.77±0.60%), ash (11.91±1.20%), organic carbon (51.56±1.08%), cellulose (21.89±0.64%), hemicellulose (26.50±1.13%), lignin (5.62±0.83%), total carbohydrate (32.00±1.58%), and protein (20.83±0.52%) content. SEM imaging of harvested ECLB confirmed compact and rigid structure. The recorded peaks in FTIR-spectra (1015.21, 1153.71, 1246.01, 1339.63, 1419.71, 1540.71, 1646.80, 1736.73, 2933.03, and 3263.72 cm?1) indicate the presence of lignocellulosic biomass. XRD peak at 21.55? confirmed the crystalline fraction of cellulose in ECLB. The results of theoretical yields of H2 and CH4 co-generation (HMG) (210.85 mLH2/g DW and 150.28 mL CH4/g DW) and Bioethanol (0.278 g/g DW) derived from cellulose and hemicellulose content of ECLB were comparable to those in reported studies. Overall, this work demonstrates an integrated methodology of phytoremediation followed by biofuel production from the recovered phytobiomass.

Adaptação transcultural, confiabilidade e validade da versão Kannada do questionário de crenças, medo e evitação em dor lombar crônica / Cross-cultural adaptation, reliability, and validity of Kannada version of Fear Avoidance Belief Questionnaire in chronic low back pain

As Atividades da Vida Diária (AVD) entre pessoas com Dor Lombar Crônica (DLC) pode ser determinada pelo Questionário de Crenças, Medo e Evitação (FABQ em inglês) . O FABQ é um questionário de autorrelato válido e confiável que avalia atitudes e crenças do paciente em relação ao efeito da atividade física e dos trabalhos em sua dor lombar. Até a presente data foi traduzido para vários idiomas, mas não está disponível em Kannada. OBJETIVO: Traduzir e estudar a confiabilidade e validade do questionário FABQ para o Kannada (FABQ-KA). MÉTODOS: Tradução e adaptação transcultural realizadas de acordo com os procedimentos recomendados internacionalmente: tradução, síntese, retrotradução, revisão por comitê de especialistas, pré-teste e avaliação por comitê consultivo. A validação de conteúdo foi realizada por um painel de 10 membros pré-identificados que eram especialistas no uso do Kannada e do Inglês. Eles receberam cinco opções, "concordo", "concordo totalmente", "neutro", "discordo" e "discordo totalmente". As propriedades psicométricas foram testadas pela administração do questionário a uma amsotra com 60 participantes (18 a 75 anos), recrutados por amostragem de conveniência. Para a confiabilidade testereteste, as pessoas com DLC foram testadas após uma semana pelo coeficiente de correlação intraclasse (ICC) e a consistência interna foi avaliada pelo alfa de Cronbach (α). RESULTADOS: As dimensões demográficas , idade, altura, peso e IMC para a amostra de DLC (n = 60) foram 41,50 ± 10,59 (anos), 154,37 ± 10,74 (cm), 62 ± 11,04 (kg) e 25,99 ± 4,47 (kg) / m 2 ) respectivamente, com duração de DLC de 20,35 ± 13,62 semanas. A validade de conteúdo do FABQ-KA pelos 10 especialistas foi considerada, I-CVI de itens individuais de FABQ-KA ≥ 0,80 e o S-CVI geral para equivalência idiomática (S-CVI = 89,9 ± 6,33)%, , semântica equivalente (S-CVI = 93 ± 5,16)% e o conteúdo relevante (S-CVI = 90,7 ± 6,61)%. foram ≥ 0,90 ou (≥ 90%). A confiabilidade teste-teste do FABQ-KA foi boa ( ICC (2,1) = 0,83 ). A consistência interna foi boa (alfa de Cronbach = 0,91 ). CONCLUSÃO: Os processos de tradução e adaptação do FABQ-KA foram bem-sucedidos; o instrumento adaptado demonstrou boas propriedades psicométricas. O FABQ-KA provou ser uma ferramenta confiável e válida e pode ser usado em pacientes que falam Kann ada com CLBP.

Activity of daily living (ADL) among the people with Chronic low back pain (CLBP) can be determined by Fear Avoidance Beliefs Questionnaire (FABQ). The Fear Avoidance Beliefs Questionnaire (FABQ) is a valid and reliable self-reporting questionnaire evaluating the patient's attitude and beliefs toward the effect of physical activity and works on their LBP. Till the date it was translated into various languages but is not available in Kannada language. Hence, we aimed to translate FABQ questionnaire into Kannada (FABQ-KA) and to study reliability and validity of Kannada version, FABQKA. METHODS: Translation and cross-culture adaptation were performed according to the guidelines followed internationally. Those are: translation, synthesis, back-translation, revision by expert committee, pretesting and appraisal by advisory committee. Content validation was excuted by the panel of 10 pre-identified members who were experts in using Kannada and English. They were provided with five options, "agree", "strongly agree", "neutral", "disagree" and "strongly disagree". for providing their valuable opinion regarding kannada translated content of FABQ-KA. The psychometric properties were tested by administering the questionnaire to 60 samples (18 to 75 years) was recruited by Purposive sampling. For test-retest reliability, people with CLBP were tested after a week by Intra-class correlation coefficient (ICC) and internal consistency was assessed by Cronbach's alpha (α). RESULTS: The demographic dimensions, age, height, weight and BMI for patients with CLBP recruited, n=60 were 41.50±10.59 (Years), 154.37±10.74 (cm), 62±11.04 (kg) and 25.99±4.47 (kg/m2) respectively with duration of LBP of 20.35±13.62 weeks. The content validity of kannada translated FABQ-KA by a panel of 10 experts were found to be, I-CVI of individual items of FABQ-KA ≥ 0.80 and the overall S-CVI for idiomatic equivalence (S-CVI =89.9±6.33)%,, semantic equivalence (S-CVI =93±5.16)% and content relevance(S-CVI=90.7±6.61)%. were ≥ 0.90 or (≥ 90%). The test-retest reliability of FABQ-KA was good (ICC (2,1) = 0.83). Internal consistency was found to be good (Cronbach's alpha = 0.91). CONCLUSIONS: The FABQ-KA translation and adaptation processes were successful; the adapted instrument demonstrated good psychometric properties. The FABQ-KA has proven to be reliable and valid tool and can be used in the Kannada speaking patients with CLBP.

Effect Of Abdominal Muscle Exercises On Peak Expiratory Flow Rate In Obese Individuals

Background: Expiration is a passive process with active muscle contraction being used more during forceful activities such as coughing or sneezing. The abdominal muscles are major muscles of diaphragm. So it improves the efficiency of expiration. In obese individuals there is deposition of fat around the rib cage and the chest wall. Studies have shown that there is a decrease in the functional residual capacity and expiratory reserve volume in obese individuals. The expiratory flow limitation is important determinant of breathlessness in obese individuals. Abdominal and thoracic fat have direct effects on downward movement of diaphragm and chest wall. Abdominal muscles are powerful expiratory muscles whose actions help to force the diaphragm back to its resting position. Aim: This present study was done to determine the effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals. Methods: In this experimental study 30 obese subjects with decreased peak expiratory flow rate who fulfilled the inclusion and exclusion criteria having a Body mass index of more than 30kg/cm2 were selected for abdominal muscle exercise program for 4 weeks, 2 sets of each exercise, thrice a week for 10 repetitions for each set. The pre and post peak expiratory flow rate were measured by peak expiratory flow meter. Statistical analysis was done using one sample t and Wilcoxon test. Results: There was a significant increase in post peak expiratory flow rate compared to pre peak expiratory flow rate. Conclusion: This study showed that there is significant effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals.

A retrospective study of histopathological exam reports of appendix in appendectomies performed at a teaching hospital in Dehradun

Background: Appendix is a vestigial organ in human body. Inflammation of appendix is termed as appendicitis. The diagnosis of appendicitis still holds dilemma amongst surgeons leading to negative appendectomies on one hand and appendicular perforation on the other hand of therapeutic spectrum. Judicial patient selection for appendectomy and follow up histopathological examination for incidental findings is the cornerstone in management of appendicitis. The current study aims to assess the demographic and histopathological findings of all the appendectomies occurring within study period at our center.Methods: It was a retrospective study over two years done in a teaching hospital of Dehradun. Hospital records were retrieved from medical records department and looked for histopathological findings, demographic details and intervention. The data was analyzed in SPSS version 23. Qualitative and quantitative data were expressed in proportions and mean respectively. T-test was applied for comparison.Results: About 2/3rd of participants were males. The peak age was 20-30 years. 100 underwent open appendectomy and 45 had lap appendectomy. Commonest histopathological exam finding was acute appendicitis (46.2%) followed by peri appendicitis (40%) and resolving appendicitis (28.9%). One specimen had tubercular appendix. There were no negative appendectomies.Conclusions: Elective appendectomy in patients satisfying clinical, lab and radiological criteria can reduce negative appendectomies. Histopathological examination of appendix still holds a valid role for any incidental findings requiring further management.

Erenumab aooe: a milestone for the preventive treatment of migraine

Migraine is a complex neurological condition, which can affect the whole body and can result in many symptoms as nausea, vomiting, photophobia (Increased sensitivity to light), phonobhobia (Increased sensitivity to sound) and osmophobia (Increased sensitivity to smell). Neurological symptoms that include visual disturbances such as blind spots, distorted vision, flashing lights or zigzag patterns. Other common symptoms includes- dizziness, vertigo, tingling sensations in the limbs, an inability to concentrate, confusion, difficulty in speaking, paralysis or loss of consciousness (in very rare cases). These symptoms, often called ‘aura’. Migraine attacks may differ in their frequency, duration and severity, although, normally they last between 4 and 72 hours, and most people are symptom-free between attacks. There are many drugs for the treatment of acute attack of migraine which can be divided into mild, moderate and severe attacks. In mild case NSAIDs like Paracetamol, Ibuprofen are prescribed. In moderate cases Anti-emetics like metoclopramide, domperidone can be prescribe with combinations of NSAIDs or triptans as sumatriptan. In case of severe cases triptans can be prescribed with ergot alkaloids and antiemetics. Following drugs are prescribed for the prophylaxis of migraine as sodium valproate, amitriptyline (Tricyclic antidepressant), propranolol and metoprolol (beta blockers). Erenumab-aooe is a calcitonin gene-related peptide receptor antagonist. It is specifically indicated for the preventative treatment of migraine in adults. Erenumab-aooe is supplied as an injection for subcutaneous use. The recommended dosage is 70 mg injected subcutaneously once monthly. Some patients may benefit from a dosage of 140 mg injected subcutaneously once monthly, which is administered as two consecutive subcutaneous injections of 70 mg each. Erenumab-aooe is a human monoclonal antibody that binds to the calcitonin gene-related peptide (CGRP) receptor and antagonizes CGRP receptor function.

Gender Differences in Risk Factors of Ischemic Stroke Patients in a Tertiary Care Centre in North India

Every year, more than 33 million people worldwide experience an acute stroke. ischemic stroke is caused by loss of blood supply to brain tissues due to sudden occlusion of arterial system by an embolus or a thrombus. Non-modifiable risk factors are age, sex & genetic factors whereas modifiable ones include hypertension, diabetes, smoking, tobacco chewing, dyslipidaemia, obesity, cardiac disease etc. Aim of the present study is to evaluate & compare the presence of various risk factors of ischemic stroke among males & females.METHODSThe study was conducted at BRD Medical College, Gorakhpur, during the academic year 2019-2020. All patients with ischemic stroke on CT Head & age >18 years were included in this cross-sectional study. Detailed history including age, addictions, comorbidities (diabetes, hypertension), previous stroke history & compliance to treatment was taken. A short neurological & laboratory examination was performed in each patient.RESULTSIn this study, a total of 100 patients was included out of which 57 were male & 43 were female. The mean age of stroke was 64.82 years [males-65.62 years, females-63.5 years]. The most common risk factors responsible for ischemic stroke was hypertension- 52% [males- 50.4%, females- 53.57%]. Other risk factors were diabetes- 28% [males- 29%, females- 25.6%], cardiac disease-13% [males-8.8%, females-18.6%], dyslipidaemia-12.3% in males & none of females. Smoking & tobacco chewing were more common among males (54.4% each). Dyslipidaemia & tobacco use was significantly associated with ischemic stroke in male patients.CONCLUSIONSThere is increasing incidence of acute ischemic stroke which is directly related to modifiable risk factors like dyslipidaemia, smoking & tobacco use in male patients. Advanced age is strongly related to acute stroke in both males & females. Hypertension is the commonest risk factor overall for ischemic stroke.