Re-do cytoreductive surgery with hyperthermic intra-peritoneal chemotherapy (HIPEC): Risk factors and complications.

ABSTRACT: An effective multi-modal treatment option for patients with peritoneal surface metastatic malignancies has progressed and developed over the decades as cytoreductive surgery (CRS), and hyperthermic intra-peritoneal chemotherapy (HIPEC) delivers highly concentrated, heated chemotherapy drugs directly to the abdomen during surgery. Peritoneal metastasis and high staging abdominal malignancies were considered incurable and end up with the palliation only; the CRS+HIPEC combination approach increases the median survival rate and gives a better quality of life to these patients. It is a complicated surgery which poses a high rate of complications and challenges which are difficult to manage and requires a multi-disciplinary approach. The aim of this study is to elaborate the perioperative possible physiological changes, risk factors, and related complications after re-do HIPEC.

Ecological covariates based predictive model of malaria risk in the state of Chhattisgarh, India.

Malaria being an endemic disease in the state of Chhattisgarh and ecologically dependent mosquito-borne disease, the study is intended to identify the ecological covariates of malaria risk in districts of the state and to build a suitable predictive model based on those predictors which could assist developing a weather based early warning system. This secondary data based analysis used one month lagged district level malaria positive cases as response variable and ecological covariates as independent variables which were tested with fixed effect panelled negative binomial regression models. Interactions among the covariates were explored using two way factorial interaction in the model. Although malaria risk in the state possesses perennial characteristics, higher parasitic incidence was observed during the rainy and winter seasons. The univariate analysis indicated that the malaria incidence risk was statistically significant associated with rainfall, maximum humidity, minimum temperature, wind speed, and forest cover (p < 0.05). The efficient predictive model include the forest cover [IRR-1.033 (1.024-1.042)], maximum humidity [IRR-1.016 (1.013-1.018)], and two-way factorial interactions between district specific averaged monthly minimum temperature and monthly minimum temperature, monthly minimum temperature was statistically significant [IRR-1.44 (1.231-1.695)] whereas the interaction term has a protective effect [IRR-0.982 (0.974-0.990)] against malaria infections. Forest cover, maximum humidity, minimum temperature and wind speed emerged as potential covariates to be used in predictive models for modelling the malaria risk in the state which could be efficiently used for early warning systems in the state.

Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011-12.

BACKGROUND: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. OBJECTIVE: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. MATERIAL AND METHODS: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. RESULTS: Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR <= 2.7. The next left side branch was again married illiteracy with splits at 23% to determine TFR <= 2.1. CONCLUSION: We conclude that female married illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial.

INTRODUCTION: Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders. METHODS: A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups. RESULTS: The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group. CONCLUSION: Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction.

Yoga Nidra as a complementary treatment of anxiety and depressive symptoms in patients with menstrual disorder.

BACKGROUND: Emotional insecurity, stress, depressive or/and anxiety symptoms are common with variable severity among patients with menstrual disorder. Yogic relaxation therapy (Yoga Nidra) leads to conscious and subconscious recognition of these underlying psychological factors and helps releasing of suppressed conflicts. OBJECTIVE: To evaluate the effect of Yoga Nidra on anxiety and depressive symptoms in patients with menstrual disorders. MATERIALS AND METHODS: Subjects were recruited from the Department of Obstetrics and Gynecology, C.S.M. Medical University (erstwhile KGMU), Lucknow Uttar Pradesh, India. The subjects were randomly divided in to two groups: Intervention group (with yogic intervention) and control group (without yogic intervention). Assessments of all subjects were carried out by administering Hamilton anxiety scale (HAM-A) and Hamilton rating scale for depression (HAM-D) at baseline and after six months. RESULTS: The mean age with S.D of the intervention group was 27.67 ± 7.85 years, and for control group was 26.58 ± 6.87 years (among completed intervention group nn = 65 and control group nn = 61). There was significant reduction of scores in HAM-A (P<0.003) and HAM-D (P<0.02) respectively in subjects with mild to moderate anxiety and depressive symptoms after six months of yoga therapy (Yoga Nidra) in intervention group in comparison to control group. CONCLUSION: The patients with mild to moderate anxiety and depressive symptoms improve significantly with 'Yoga Nidra' intervention. There is no significant improvement in the patients with severe anxiety and depressive symptoms.

Impact of Yoga Nidra on psychological general wellbeing in patients with menstrual irregularities: A randomized controlled trial.

BACKGROUND: Yogic relaxation therapy (Yoga Nidra) has been effectively prescribed in conjunction with other medical and yogic procedures in the management of severe psychosomatic diseases, including cancer, bronchial asthma, colitis, peptic ulcer and menstrual irregularities. AIM OF THE STUDY: To assess the impact of Yoga Nidra on psychological problems in patients with menstrual disorders. MATERIALS AND METHODS: Patients were recruited from the Department of Obstetrics and Gynecology, C.S.M. Medical University (erstwhile KGMU), Lucknow, Uttar Pradesh, India. A total of 150 female subjects were randomly divided into two groups: 1) group of 75 subjects (with yogic intervention) and 2) a control group of 75 subjects (without yogic intervention). Assessment of psychological general wellbeing (tool) was used for all the subjects Assessment of psychological general well being (tool) was used for all the subjects (Cases and controls). This assessment was done twice first time in the beginning (baseline) and then after six months. RESULTS: Anxiety decreased significantly (P<0.003) and depression decreased significantly (P<0.01) in the Yoga group. Positive wellbeing and general health improved significantly (P<0.02), and vitality improved significantly (P<0.01) after six months of Yoga therapy (Yoga Nidra) in the Yoga group compared with the control group. CONCLUSION: The current findings suggest that patients with menstrual irregularities having psychological problems improved significantly in the areas of their wellbeing, anxiety and depression by learning and applying a program based on Yogic intervention (Yoga Nidra).

Six-month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform symptoms.

BACKGROUND: Yoga Nidra is a successful therapy for both recent and long-standing psychological disturbances of all kinds especially depression and high anxiety level and neurotic patterns. OBJECTIVE: The purpose of the present work, therefore, was to conduct a preliminary randomized study of Yoga Nidra as a treatment in the patients of menstrual disorders with somatoform symptoms. MATERIALS AND METHODS: Patients were recruited from Department of Obstetrics and Gynecology, CSM Medical University (erstwhile KGMU) Lucknow, Uttar Pradesh, India. One hundred and fifty female patients with menstrual disorders were randomly divided in to two groups 1- Intervention group: 75 subjects (Yoga Nidra intervention and medication) 2- control group: 75 subjects (without Yoga Nidra intervention only medication). Schedule for clinical assessment in neuropsychiatry tool was used. RESULTS: There was significant improvement in pain symptoms (P<0.006), gastrointestinal symptoms (P<0.04), cardiovascular symptoms (P<0.02) and urogenital symptoms (P<0.005) after 6 months of Yoga Nidra therapy in Intervention group in comparison to control group. CONCLUSION: Yoga Nidra appears to be a promising intervention for psychosomatic problems. It is cost-effective and easy to implement. The results indicate that somatoform symptoms in patients with menstrual disorder can be decreased by learning and applying a program based on Yogic intervention (Yoga Nidra).