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Background: Inguinal Hernia mesh repair surgery is one of the most commonly conducted surgical procedures. Between two approaches: open and laparoscopic, which is better for the patient in terms of cost and outcome in terms of quality of life and return to economic activity. To facilitate comparability across studies, cost effectiveness analysis requires measurement of both costs and quality adjusted life years (QALY). Methods: Descriptive, observational study which entails classifying costs, identifying cost centres, tracing all costs related to the elective procedures for inguinal mesh hernioplasty by both open and laparoscopic methods followed by checking the Quality of life pre and post-surgery of these patients through the EQ-5D-3L by telephonic interview. A Cost Effective analysis was conducted by the end of the study. Based on available data, we took 35 cases of laparoscopic procedure and 45 cases of open surgery as a universal sample size. Results: Traditional costing showed a difference of approximately INR 3245.93/- in the 2 procedures with laparoscopic surgery being costlier. Significant improvements were noted in patients post laparoscopic surgeries with less people complaining of post operative pain/discomfort and early resumption of daily activities and mobility within a month after the surgery. ICER is tilted in favour of laparoscopic surgeries by a value of Rs 1,08,197.66 per QALY. Conclusions: The difference in cost is minimal but the difference in the QALY scores and ultimately the ICER determines that laparoscopic surgery has an edge over open surgery in terms of outcome and patient comfort.
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Background: Vitiligo, a chronic skin disorder characterized by depigmentation and white patch formation, not only poses a cosmetic challenge but also imposes a significant psychological burden. The relationship between vitiligo and depression remains underexplored, despite growing recognition of their potential association. This observational study aimed to investigate the prevalence of depression and assess the quality of life (QoL) among patients with vitiligo attending a tertiary care center. Methods: A cross-sectional study was conducted at the dermatology and psychiatry departments of SRVS Medical College, Shivpuri, involving 150 vitiligo patients aged 18 to 60 years. Participants were assessed using the patient health questionnaire (PHQ-9), vitiligo area scoring index (VASI), and dermatology life quality index (DLQI). Statistical analyses were performed using statistical package for the social sciences (SPSS) version 26. Results: The mean age of participants was 38.55±14.82 years, with 69.3% being female. Nonsegmental vitiligo accounted for 84% of cases, and 42.6% had active disease. The mean DLQI score was 8.45±6.12, with female gender and active disease significantly associated with lower QoL scores. A strong correlation was observed between depressive symptoms and impaired QoL (DLQI). The prevalence of depression (PHQ-9 score ?9) was 14.6%, with employed individuals showing a significantly higher prevalence compared to other groups. Conclusions: Our findings highlight the significant burden of depression and impaired QoL among vitiligo patients attending a tertiary care center. Addressing the psychosocial aspects of vitiligo alongside its dermatological manifestations is crucial for optimizing patient care and enhancing overall well-being. Further longitudinal research is warranted to elucidate the complex relationship between vitiligo and depression.
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Present study was undertaken to estimate the G x E interactions and identify the stable genotypes for yield traits in field pea. A total of 43 field pea genotypes were evaluated in Randomized Complete Block Design (RCBD) in three replications along with three different dates of sowing at BSP Soybean Unit, Department of Genetics and Plant Breeding, College of Agriculture, JNKVV, Jabalpur during Rabi Season 2022-2023. The analysis of variance was applied on 16 different quantitative traits both individually and pooled under various environmental conditions. The stability analysis for seed yield per plant was assessed using Eberhart and Russell's model, revealing significant variations among different genotypes and environmental conditions. The mean squares attributed to both environments and genotype-environment interactions (E + G x E) indicated significant interactions between genotypes and environments. Further, partitioning of genotype-environment (linear) interactions was found to be highly significant for seed yield per plant. Genotypes Shikha, KPMR 485 and HFP 94-12 were found ideal and stable genotypes for seed yield per plant as that possessed mean value higher than general mean, regression coefficient near to unity (Bi=1) with minimum deviation from regression (S2di~0). Thus, identified stable genotypes can be utilized for different seasons and regions for obtaining the stable yield performance.
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In order to determine the cicadas spotted on the Eucalyptus plants grown nearby to the college, Anand Agricultural University, Jabugam, between April and June 2022, an investigation was conducted. Adults were brought to the Department of Entomology lab at the College of Agriculture, Anand Agricultural University, Jabugam, for identification in addition to do further research. It is confirmed that the pest is cicadas on the Eucalyptus plant that have been reported from Gujarat, India, based on the morphological traits of the adults and DNA fingerprinting.
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Background: Obesity is a positive risk factor in development of hypertension, diabetes, gallbladder diseases, coronary heart diseases, and few types of cancers. Body mass index (BMI) is an inexpensive and easy screening method for weight category: Underweight, healthy weight, overweight, and obesity. Only a few studies have been conducted until now which focuses on finding any relationship between BMI and blood group of school going children. Aims and Objectives: The aims of this were as follows: (a) To find out BMI in school children of study center and (b) to find out correlation of BMI with blood groups and other variables of participants. Materials and Methods: It was a cross-sectional study conducted among 101 children of school going age group 10–15 years at one of the private schools of Ahmedabad, Gujarat. A questionnaire was prepared which included sections of demographic details, blood group, diet history, and family history. Results: About 50% of participants were from of either age 13 or 14. There was almost same proportion of participants of both sexes. About 70% of participants were found to be underweight, while about 15% were overweight. Overweight category of BMI is most commonly seen in children having blood group “A” while no child of “O” blood group was found to be overweight. This association was statistically significant. Conclusion: Almost 70% of participants were underweight, while about 15% were overweight. Overweight was most commonly seen in children having blood group “A.” No child of “O” blood group was found to have overweight.
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Background: The pattern of new drug approval is changing across the world as shown by the study using Center for Drug Evaluation and Research and European Medicines Agency data in US and UK with more drug approval for anti-cancer and immunomodulator drugs. There is a need to generate similar database for developed South East Asian countries too. Aims and Objectives: This study was conducted for one such country- Singapore for the new drug approval pattern of last 5 years (2017–2021). Materials and Methods: This was a pharmacoepidemiological study, in which government drug regulatory website data available in public domain was searched. The new drug approval data were classified according to active ingredient, drug approval date, new drug application category, indication of drugs, and World Health Organization Anatomic Thoracic Classification. Results: In this study, 418 new drug approvals were found in last 5 years in Singapore. From this maximum, drug approvals were given to anti-neoplastic and immunomodulator category drugs. In anti-neoplastic category new drugs approval few examples were Trastuzumab deruxtecan and Tucatinib for breast cancer therapy and Tepotinib and Capmatinib for non-small cell lung cancer therapy. Conclusion: This study shows that drug development in anti-cancer drug and immunomodulator is significant in Singapore. This trend is quite matching with other country such as US and UK.
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A geomagnetic storms is a global disturbance in Earth's magnetic field usually occurred due to abnormal conditions in the interplanetary magnetic field (IMF) & solar wind plasma emissions caused by various solar phenomenon. 138 solar wind streams in solar cycle 22 & 173 solar wind streams in solar cycle 23, have been found, which are associated with proton density, observed during 1986 to 2010. We have analyzed & studied them statistically. We have found that yearly occurrences of geomagnetic streams are strongly correlated with proton density in 11-years sunspot cycle, but no significant correlation between the maximum & minimum phase of solar cycle 22 & 23 have observed
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Background:Tonsillectomy is one of most commonly performed surgical procedure in otorhinolaryngology. In past, various surgical techniques for tonsillectomy have been de veloped. And coblation tonsillectomy is one of the latest techniques developed. We carried this study to check feasibility of powered instrument (coblator) in view of patient and surgeons benefit with advantages and disadvantages for tonsillectomy. Material And Methods:We carried out this study in randomly selected total 125 patients who presented to our ENT department with chief complain of recurrent tonsillitis. All patients underwent coblation techniques and were analysed for total time consumption during operation, amount of bloodloss during operation, immediate postoperative pain, postoperative haemorrhage whether primary or secondary, time needed to return back to the normal activity and diet ,total percentage of healing post operatively. Each patient had preoperative blood investigation to exclude any coagulation disorder and anemia. Postoperative analgesics and broad spectrum antibiotics were administered. Result:Mean operation time was 12±2.45 minutes in coblation group. Intraoperative blood loss turned out to be 20.00±5.0 ml for the coblation. Mean return to normal diet period was significantly shorter (5.00±1.50). Otherwise, return to normal behaviour was significantly earlier with coblation(10.50±2.00 ). Postoperative we have not seen any case of primary hemorrhage or secondary hemorrhage in our study.Conclusion:We found that coblation technique for tonsillectomy offers considerable advantages in the operation time and intra operative blood loss. Coblation is related with timely return to routine activities and normal adequate diet. To endorse its significance over conventional tonsillectomy warrants further study.
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Background:Tuberculosis (TB) is a worldwide leading public health problem even today. It affects all tissues of the body, but pulmonary tuberculosis is the most common type of tuberculosis (80% total tuberculosis cases). Extrapulmonary TB (EPTB) has major challenge for its clinical detection, definitive diagnosis and treatment. Out of all extrapulmonary cases, TB occurring in head and neck region is uncommon.Material And Methods:A prospective analytical studyof 50 patients who presented toENT OPD setupof ourtertiary carehospital with extra pulmonary TB. We look at the various clinical and laboratory aspects of tuberculosis of theotorhinolaryngeal region that would help to diagnose this uncommon but important form of extra pulmonary tuberculosis.Result:Male: Female ratio was 1.8:1 exhibiting male preponderance. Majority of the patients belonged to the age group of 20-40 years. Our study included patients with tuberculous cervical lymphadenopathy (84%), laryngeal TB (2%), tuberculous otitis media (12%), and retropharyngeal abscess (2%). FNAC seems to be de finitive and easier mode to diagnose TB of cervical nodes and Excision Biopsy can be done when FNAC is inconclusive.Conclusion:Extra pulmonary TB is significant health problem worldwide. It presents as a challenging task for diagnosis and overall surveillance of the treatment. The ear, nose, PNS, pharynx, larynx and cervical nodes are very important anatomical sites of extra pulmonary affliction. Its early diagnosis and definitive management will seize its sequence and further complications. The practical implications of an awareness of ENT tuberculosis are a benefit of anti-tubercular therapy and hence conservative management usually suffices.
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Background:The objective was to assessthe usefulness of Homoeopathic genus epidemics (Arsenic alba30C) for the prevention of Covid 19 during its pandemic outbreak in the state of Gujrat District Anand, City Anand, India.Materials and Methods:A non-randomized, clinical trial was conducted in Anand city for prevention of Covid 19 during the pandemic outbreak in June 2020 to December 2020.Arsenic alba30C was randomly administered to 1133 participants. Healthy participants (absence of fever, runny nose, cough etc., but comorbidity like DM & HTN included) were eligible for the study (Arsenic alba30 Cn=1133). Monthly follow-up was done for 6 months. Infection rate in the study groups was analyzed and compared by use of cluster analysis.Results:The findings showed that only 4 persons out of1133 persons ofArsenic alba30 C group suffered from Covid 19. Cluster analysis showed significant prevention during Pandemic without any vaccine or other medications. [Incidence rate = 0.35%].Conclusion:Arsenic alba30C as genus epidemics is much better in decreasing the incidence of Covid 19 in cluster in Anand. The efficacy ofgenus epidemicusneeds to be replicated in different areas.
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Background:Abrasives are the insoluble components added to dentifrices to aid the physical removal of stains, plaque and food debris. However, replete of abrasivity cause enamel abrasion, dentin hypersensitivity, damaging the smile as well as masticatory apparatus.The aim of this study is to evaluate the enamel surface abrasivity using three different herbal dentifrices and a customised brushing machine under profilometer.Materials And Method:A total of 30 enamel blocks are prepared from buccal surface of maxillary central incisor which are randomly divided into three groups. Group-1 Specimensbrushed with Colgate Vedshakti, Group-2 Specimens brushed withPatanjali Dant Kanti, Group-3 Specimens brushed with Dabur Red. All specimens were brushed using a customised brushing model with Oral-B powered brush for 30 minutes. Surface roughness of all three groups specimens were analysed using a surfaceroughness tester-profilometer. Statistical analysis used in this study was one-way analysis of variance (ANOVA) followed by post hoc turkey’s test.Results:Statistically significant difference was observed in value of enamel abrasion amongst Group1, 2 and 3. (p<0.05)Conclusion:Toothpaste with higher relative enamel abrasivity has the potential to abrade the enamel and cause hypersensitivity.The least enamel abrasion was observed in Colgate Vedshakti when compared with Patanjali Dant Kanti and Dabur Red toothpaste.
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Inner ear malformations account for only 20 % of cases of congenital sensorineural hearing loss.A narrow internal auditory canal (IAC) with duplication is a very rare congenital anomaly that can be associated with other malformative ear abnormalities. Identification and characterization of these abnormalities will be crucial for the proper management of patients.We report two cases of bilateral duplicated internal auditory canal with other associated inner ear anomalies.
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Purpose: Recently, drug delivery system with controlled and targeted drug release at the tumor sites emerged as an attractive option for improving anticancer therapeutics. Advanced Nano therapeutics must not be limited to nano scale but should find their way to target the solid tumor via direct or indirect way. Pegylation on the surface of liposome helps to become liposome as long circulating and indirect or passive targeting to tumor. Purpose of this study is to develop and optimize the critical process parameters which plays important role in the quality pegylated liposome. Design of experiment (DOE) was used to study the impact of critical process variables like hydration temperature, extrusion process temperature, ethanol concentration, drug loading temperature and drug loading time.
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Objective: The primary objective of the current research was to prepare rilpivirine loaded Nanoparticles containing Chitosan using the ionic gelation method for HIV infections. Methods: The nanoparticles of rilpivirine were prepared using the ionic gelation technique. Further, nanoparticles were characterized by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and in vitro drug release. Results: The optimized nanoparticles were found with a particle size of 130.30±5.29 nm (mean±SD) and entrapment efficiency (% EE) of 77.10±0.50%. Scanning electron microscopy technique exposed spherical particles with uniform size. It was observed that the nanoparticles created showed the absence of the crystalline nature of the drug and its switch to the amorphous state. Results showed that more than 45% of the pure drug is released in 50 min and after 90 min almost about 95% of the drug is released. Conclusion: The research study concluded that the in vitro release profile of nanoparticles was found to be sustained up to 24 hr. Sustained release of the rilpivirine could improve patient obedience to drug regimens, growing action effectiveness.
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Corneoscleral tunnel infection is a potentially sight threatening complication of cataract surgery. Microbiological investigations are mandatory and early surgical intervention helps in achieving favourable outcomes. Fungal infection of tunnel incisions can pose a diagnostic and therapeutic challenge. We report a case of post-operative tunnel infection with curvularia. Prompt surgical intervention and intensive topical therapy helped attain a good tectonic as well as visual recovery.
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Bacillus cereus incorporates the most important group of endospore-forming micro organism and can cause emetic and diarrheal food poisoning. A total of 42 B. cereus strains isolated from marketed raw chicken meat and human subjects swab samples were assessed by a triplex and multiplex PCR for the presence of enterotoxin genes. The detection rate of nheB, hblA, hblD, cytK, nheA,CER, hblC and entFM enterotoxin genes among all B. cereus strains was 83.33%, 80.95%, 69.04%, 21.42%, 47.61%, 0%, 61.90%, and 92.85% respectively. Enterotoxigenic profiles were determined in enterotoxin-producing strains showed 19 different patterns. The results offer essential information on toxin genes prevalence and toxigenic profiles of B. cereus from sources of origin. The present study was taken into consideration about extreme fitness danger for public health and insuring extra ability in difficulty to food safety amongst all B. cereus group members. Also, there may be need for extensive and continuous tracking of food products embracing both emetic toxin and enterotoxin genes.
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The study was designed to isolate predominance contamination of Pseudomonas aeruginosa in marketed raw buffalo milk (n=122) samples, collected from private dairy farms from different places of south Gujarat, India. Pre-enrichment of 1 ml of each sample was done with inoculation in 9 ml tryptone soya broth and incubated at 37ºC for 24 hrs. A loopful of culture was taken from broth and streaked on selective Pseudomonas agar F plates and incubated at 37ºC for 24 hrs, after completion of incubation period, the colonies characteristics were studied and further confirmed by various biochemical tests and found 14 samples contaminated with P. aeruginosa, were further more biochemical testes are used and give positive results with IMViC, Motility test, catalase and sugar fermentation confirm at 37ºC for 24 hrs incubation. All biochemically conformed isolates were further subjected for molecular characterization and were also tested for antimicrobial susceptibility by using various antibiotics discs such as vancomycin, penicillin, tylosin, cefixime, chloramphenicol, kanamycin, ceftriaxone, cefixime, tetracycline, streptomycin, ciprofloxacin, enrofloxacin, oxytetracycline and gentamicin, which has shown multi drug resistant ranging from seven to nine antimicrobials and Multiple Antibiotic Resistance (MAR) index ranges from 0.50 to 0.64.The isolates of P. aeruginosa in the present study are extremely resistant to vancomycin, penicillin, tylosin, cefixime, chloramphenicol and maximum sensitive to ciprofloxacin and enrofloxacin followed by gentamicin. Further statistical analysis of antibiotics wise zone diameter interpretative standard (mm) reveled susceptibility phenotypes under significant of difference at P≤0.05 in one way ANOVA using Duncan’s multiple range test and found ciprofloxacin having maximum sensitivity among antibiotic tested and it could be considered as a drug of choice for controlling P. aeruginosa mediated animal and human infections in the studied regions for insuring food safety as well.
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Background: In the dental field, patient satisfaction played a very important role, specifically finding the strength and weakness in the dental clinic. It also assists in improving the quality of treatment as well as better future planning of treatment. Objective: The present study was planned and conducted with an objective to assess the level of satisfaction among patients attending the outpatient department in a private dental hospital. Materials and Methods: A prospective, cross-sectional, and questionnaire-based study was undertaken in a private dental hospital. Patients of age more than 18 years and of both gender attending outdoor patient department were included in the study. For the purpose of this survey, consecutive sampling was carried out until a sample size of 200 was achieved. The patient satisfaction was assessed using dental satisfaction survey 2002 – questionnaire. Results: Among 31 items, none of the respondents indicated strong agreement or disagreement for 30 items, only for one item, item no. 14 regarding the explanation of cost, respondents indicated strong agreement (106, 53.00%). More than 40% of respondents indicated strong agreement (indicating satisfaction) with the statement for seven items. None of the items have <10% of respondents indicated strong agreement. The respondents expressing strong disagreement (indicating dissatisfaction) with any statement was <10% on 23 of the 31 items. The inter-item reliability of all 31 items of the questionnaire was tested, and the overall satisfaction scale (all items 1–31) produced a high Cronbach’s alpha value of 0.92. Conclusion: Patients’ satisfaction was observed not only for overall satisfaction but also in all sub-scales – context, content, outcome, cost, and facilities.
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Background: Immunization is the most valuable indicator to assess the health services and outcomes of the population. Even though much is being done about improving immunization status by governmental and nongovernmental institutes, still there are some areas left with low immunization coverage. Objectives: The objectives of the study were (i) to assess the immunization status under 5 years age of children and (ii) to identify the reason for partial and unimmunized status. Material and Methods: The present study was carried out in Surendranagar city. A coverage evaluation survey was done among children aged 0–5 years, using the WHO 30 cluster survey methodology. Results: In our study 64% fully immunized, 30% partially immunized, and 6% unimmunized children were found. The association between education of the mother and immunization status of children was found statistically significant. A high percent of unimmunized children (15%) was found in Muslim families compared to Hindus (4%). Conclusion: The study revealed that the education of mother has an important role to play in health services utilization in the families and the difference was statistically significant. Muslim children were less vaccinated than Hindu children. Education and awareness campaigns for behavioral change can improve immunization coverage.
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Background: Meckel’s diverticulum (MD), a congenital anomaly of the gastrointestinal tract due to failed vitelline duct obliteration, affects 2% of population. It is a true diverticulum located along the antimesenteric border of distal ileum within 100 cm of the ileocecal valve. It contains heterotropic mucosa, 60% of which is gastric mucosa followed by pancreatic acini, colonic mucosa, etc. The key surgical principle is to completely remove symptomatic ectopic tissue. Objectives: The objectives of the study were to investigate clinical features and common complications of MD in different ages and genders that serve as a reminder to clinicians evaluating potential cases and help them giving proper management. Materials and Methods: A combined prospective and retrospective study of 30 patients operated for MD found incidentally on operative table or planned electively was done. Results: In our study, there was a clear male predominance with 21 cases (70%). It was more common in young and middle age (11–40 years) with 26 cases (86%). Common symptomatic presentations were obstruction (30%), perforation (13%), and diverticulitis (10%). The cases were surgically managed according to the size of base and length of the diverticulum. Post-operative complications were commonly seen in older age and symptomatic patients. Conclusion: MD is having low incidence, overlapping signs and symptoms of other conditions and higher post-operative complications. Hence, it is quite important to include it in differential diagnosis, diagnose it early and apply prompt surgical management.