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Background A comprehensive understanding of the anatomy of the extra pelvic course of the pudendal nerve and its variations is crucial when undertaking perineal and perirectal procedures to safeguard the integrity of the extrapelvic segment of the pudendal nerve and its branches. So we aimed to identify the changes in the pudendal nerve's extrapelvic branching pattern before it enters the pudendal canal and its relationships and connections. Materials and Methods A cross-sectional descriptive study was carried out on 26 formalin embalmed adult human cadavers between 20 to 65 years (16 male and 10 female) of north Indian origin. Anatomical course, variations, and connections of the pudendal nerve before entering the pudendal canal were noted. Results The extrapelvic course of the pudendal nerve was examined in 52 hemipelves (26 cadavers) after meticulous dissection. Single pudendal nerve trunk (type I) was identified in 51.9% of hemipelves. Two trunked pudendal nerve with inferior gluteal nerve piercing the sacrospinous ligament (type IIa) was observed in 13.5% of hemipelves. 23.1% of hemipelves exhibited two trunked pudendal nerves with inferior gluteal nerve not piercing the sacrospinous ligament(type IIb). Three trunked pudendal nerve (type III) was observed in 11.5% of hemipelves. In 14/52 hemipelves (26.9%), communication with the sciatic nerve was noted, whereas, in 38/52 hemipelves (73.1%), no communication with the sciatic nerve was present. Conclusion The extrapelvic course of the pudendal nerve may present with an earlier subdivision or even an aberrant connection with the sciatic nerve. These anatomical variations of the extra pelvic course of the pudendal nerve, its variations, and connections are essential for all surgeons and anesthetists operating in the perineal and perirectal region to avoid unwanted complications.
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Background: Coronavirus disease (COVID-19) vaccination becomes a crucial weapon in the pandemic's control. Two vaccines, Covishield and Covaxin, are approved in India to vaccinate against the virus. Hence, the present study was done to determine the factors associated with the development of adverse events after taking the COVID-19 vaccine in a tribal state of India. Materials and Methods: This was a cross-sectional analytical study. All persons who were willing to participate in our study and had received the first or second dose of the COVID-19 vaccine from January 1 to March 31, 2021, were included. We got 1497 complete responses via (free, web-based Google Docs Editors suite offered by google, Founders- Larry Page Sergey Brin. Menlo Park, California, United States). So our final sample size came out to be 1497 in which analysis was done. The data was compiled in MS excel sheets (Microsoft version 2013, Microsoft Corporation, Redmond, Washington, United States) and a template was generated which was further analyzed in SPSS version 20 (version 25.0; IBM Corp., Armonk, NY, USA). Results: The total number of respondents who participated in the surveillance of adverse events following immunization (AEFI) was 1497. Among them, a majority have taken the Covishield vaccine followed by Covaxin. The majority of participants were female of age group less than 30 years and above 18 years with a mean age of 33.63 ± 51.51. The most common AEFI was pain at the site of injection, after the first and second dose followed by fever after the first and second dose within 24 h following immunization. Conclusion: We conclude that factors like the type of vaccine, gender, and participants who have allergies have a higher risk of presenting the adverse events after the COVID-19 vaccination.
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Ivermectin was popular drug on trial for preventive and therapeutic role in COVID-19. However, there is disagreement concerning the validity of its clinical efficacy. Hence, we conducted a Meta-analysis and Systematic review for effect of Ivermectin Prophylaxis in prevention of COVID-19. The online databases of PubMed (Central), Medline, and Google scholar for randomized controlled trials, non-randomized trial and prospective cohort study were searched up to March 2021. Nine studies were included for analysis, out of which four were Randomized controlled Trial (RCTs), Two Non-RCTs and three cohort studies. Four randomized trial evaluated prophylactic drug Ivermectin, two combination of topical nasal carrageenan and oral Ivermectin two study used in combination of personal protective equipment (PPE) one with Ivermectin and one with Ivermectin/ Iota-Carrageenan (IVER/IOTACRC). In the pooled analysis we observed non-significant less COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (Relative Risk (RR) = 0.27 and Confidence Interval (CI) = 0.05, 1.41) with significant heterogeneity (I2 = 97.1%, P < 0.001) The pooled analysis involving the Non-RCTs studies also did not observe significant reduction in the COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (RR = 0.01 and CI = 0.00, 7.97) with significant heterogeneity between the studies (P < 0.001).Hence,we conclude that Ivermectin is not the 'magical silver weapon' against COVID-19.
