Tetralogy of fallot repair at a new centre in North India: our growing experience

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease with complete surgical repair being its most appropriate treatment currently. Although in a developing country, pediatric cardiac surgery is not being practiced as frequently as the adult cardiac surgery either due to limited resources centres or surgeon reluctance. The aim of this study is to evaluate and compare the operative and postoperative outcome of the initial 50 patients with the subsequent 50 patients undergoing corrective surgery of TOF in a new cardiac centre.Methods: This is a comparative descriptive study performed at a single centre comprising of two groups of initial 50 and subsequent 50 patients who underwent complete surgical correction of TOF and compare their operative and postoperative outcomes.Results: The mean age of patients in group I and II were 82.4 and 74.3 months respectively. There was no significant difference in the preoperative characteristics of the patients of both groups. Among operative parameters there was significant improvement in the cardiopulmonary bypass time and aortic cross clamp time in group 2 with p value of 0.0017 and 0.0324 respectively. The requirement for transannular patch also came down in group 2 (p=0.016). Mortality in group 1 and 2 were 6 and 2 respectively (p=0.14), other postoperative characteristics were similar in both groups.Conclusions: With growing experience, proper planning and perseverance pediatric cardiac surgery too can be performed with acceptable results in a new centre.

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Comparison of active calf muscle stretching versus ankle mobilisation on low back pain and lumbar flexibility in pronated foot subjects

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20172020 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1870 ◽

Cited By ~ 1

Author(s):

K. Vadivelan ◽

J. S. Poyyamozhi ◽

G. Dinesh Kumar ◽

C. Rajan Rushender

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Calf Muscle ◽

P Value ◽

Lumbar Region ◽

Low Back ◽

Group I ◽

Significant Difference ◽

Group 3 ◽

Group 2

Background: Low back pain is the common symptom of the lumbar region that more than 80 percent of people experience in their lifetime. Methods: Quasi-experimental study was conducted with three intervention groups. Ankle mobilization (Group I), Active stretching of calf muscle (Group 2), No Intervention (Group 3). This study was carried out in the Department of Physiotherapy at SRM University, Chennai. 21 subjects were included in the study, with 7 subjects in each group. Results: Median age was found to be 20 (19–21), 19 (18–20) and 21 (20–22) in group 1, group 2 and group 3 respectively and no significant difference was seen between the groups, p value 0.11) There was a significant improvement seen in visual analogue scale, in both the intervention groups before and after intervention. The median and IQR for ankle mobilization group pre and post intervention was 6 (IQR, 5–6) and 4 (IQR, 3–5) respectively, with a p value <0.01. Conclusions: Overall results have shown that both the intervention groups have similar effects in reducing lower back pain and improving lumbar flexion, compared to the control group.

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Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

10.2196/preprints.23937 ◽

2020 ◽

Author(s):

Dr. Animesh Ray ◽

Dr. Komal Singh ◽

Souvick Chattopadhyay ◽

Farha Mehdi ◽

Dr. Gaurav Batra ◽

...

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Hospitalized Patients ◽

North India ◽

P Value ◽

Care Hospital ◽

Igg Antibodies ◽

Igg Antibody ◽

Increased Risk ◽

Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

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Comparison of Human Thymus Gland between Young and Old Age

10.53350/pjmhs211561907 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1907-1909

Author(s):

Faiza Mehboob ◽

Ponum Mirani ◽

M. Kamran Ameer ◽

Khurram Shabeer ◽

Muhammad Ali Qamar ◽

...

Keyword(s):

Connective Tissue ◽

Old Age ◽

Age Groups ◽

Young Age ◽

University Hospital ◽

P Value ◽

Old Patients ◽

Human Thymus ◽

Group I ◽

Significant Difference

Aim: Study was conducted to examine the different parameters of human thymus glands of young and old patients and compare the findings between both age groups. Study Design: Comparative/observational study Place and Study: Study was conducted at Anatomy department of Nishtar Medical University Hospital, Multan for duration of six months from 15th January 2020 to 15th July 2020. Methods: Total 54 specimens of human thymus of 54 patients were enrolled in this study. All specimens were divided in to two groups I and II, Group I contains 27 patients with ages <30 years and group II with 27 patients having ages 45 to 60 years. All specimens were fixed in 10% formalin solution and then processed for paraffin embedding. Compare the different parameters such as thickness of interlobular connective tissue and thymic capsule, length and number of Hassal’s corpuscles between both groups. Data was analyzed by SPSS 24.0. Results: In group I 12 (44.44%) patients were ages <15 years and 15 (55.56%) patients were ages >15 years. In group 13 (48.15%) and 14 (51.85%) patients were ages <50 years and >50 years. There was a significant difference observed between both groups regarding thickness of interlobular connective tissue and thymic capsule, quantity and length of Hassal’s corpuscles with p-value <0.05. Conclusion: It is to be concluded that patients with young age had significantly less thickness of thymic capsule and interlobular connective tissue with more in number and decreasing size of Hassal’s corpuscles as compared to old age patients. Keywords: Human Thymus Glands, Young Age, Old Age

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A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽

10.1093/qjmed/hcab109.004 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Basma Helal Mohamed ◽

Othman Ali Othman Ziko ◽

Hisham M Khairy Abd El Dayem ◽

Nancy Ezzelregal Khamis Ahmed

Keyword(s):

Corneal Thickness ◽

Anterior Segment ◽

P Value ◽

Eye Drops ◽

Subconjunctival Injection ◽

Fibrovascular Tissue ◽

Significant Difference ◽

Group 2 ◽

Group 1 ◽

Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

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Results of modern tuboperitoneal infertility treatment

Vojnosanitetski pregled ◽

10.2298/vsp0901057t ◽

2009 ◽

Vol 66 (1) ◽

pp. 57-62 ◽

Cited By ~ 1

Author(s):

Drenka Turjacanin-Pantelic ◽

Dragana Bojovic-Jovic ◽

Biljana Arsic ◽

Eliana Garalejic

Keyword(s):

Statistical Analysis ◽

Surgical Treatment ◽

Infertility Treatment ◽

P Value ◽

Modern Approach ◽

Vitro Fertilization ◽

Group I ◽

Significant Difference ◽

Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

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A Comparative Study of Lipid Profile in Obese and Nonobese Men attending Master Health Checkup

Indian Journal of Medical Biochemistry ◽

10.5005/jp-journals-10054-0024 ◽

2017 ◽

Vol 21 (2) ◽

pp. 73-75

Author(s):

S Vinod Babu ◽

Anusha R Jagadeesan ◽

Jothimalar Ramalingam

Keyword(s):

Comparative Study ◽

Lipid Profile ◽

Total Cholesterol ◽

Ldl Cholesterol ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

P Value ◽

Health Checkup ◽

Group I ◽

Significant Difference

ABSTRACT Introduction Obesity is emerging as an epidemic worldwide. Obesity is associated with a number of comorbid conditions, such as diabetes mellitus, hypertension, cancer, dyslipidemia, cardiovascular abnormalities, anemia, obstructive sleep apnea, and psychosocial abnormalities. Aim This study aims at comparing the lipid profile levels of obese and nonobese men. Materials and methods This was a case—control study conducted at a tertiary care center. Totally, 80 men in the age group of 20 to 47 years attending the master health checkup were included in the study, out of which 40 men with normal body mass index (BMI) of 18 to 25 belonged to group I and 40 men with increased BMI of 30 and above belonged to group II. Lipid profile parameters, such as triglycerides (TGLs), total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol were estimated in them. The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) software version 15.0. Results Statistically significant difference was found in the total cholesterol levels with a p-value of 0.040 while the difference in LDL cholesterol was statistically highly significant with a p-value of 0.040. Conclusion Among lipid profile parameters, only total cholesterol and LDL cholesterol showed significant difference between the obese and nonobese individuals. However, the other parameters like HDL cholesterol and TGLs did not show any significant difference. How to cite this article Babu SV, Jagadeesan AR, Ramalingam J. A Comparative Study of Lipid Profile in Obese and Nonobese Men attending Master Health Checkup. Indian J Med Biochem 2017;21(2):73-75.

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EPICARDIAL PACING

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.01.1980 ◽

2010 ◽

Vol 17 (01) ◽

pp. 55-58

Author(s):

ZAHID PARVEZ ◽

FARID AHMAD CHAUDHARY ◽

AJMAL HASAN NAZQVI ◽

Muniza Saeed

Keyword(s):

Cardiac Surgery ◽

Artery Bypass ◽

Left Ventricular ◽

Right Atrial ◽

Routine Practice ◽

Optimum Time ◽

Pacing Threshold ◽

Significant Difference ◽

Group 2 ◽

The Right

Placement of epicardial wires on the right atrial and right ventricle surfaces is a routine practice in cardiac surgery. These pacingelectrodes are used for invasive pacing of the myocardium for a variety of emergent and elective conditions postoperatively. There is uncertaintyin actual practice about the optimum time for their removal, and practice varies widely between different institutions. Objectives: To determine thetime related efficacy of these pacing electrodes after cardiac surgery, to find out the optimum time of their removal. Period: July 2008 toOctober 2008. Patients & Methods: 47 patients those underwent coronary artery bypass surgery were prospectively enrolled and evaluatedwith standard 12 lead ECG and ventricle pacing threshold immediately after surgery and on the 5t h postoperative day. The patients were dividedinto two subgroups according to their left ventricle ejection fraction ( > 40% verses < 40%). Results: There was significant difference in theeffective pacing threshold in groupl and 2 on immediate post operative period and on day 5. (P = 0.002 and P = 0.02 respectively) The sensingthreshold immediately after operation and on 5t h post operative day also differed significantly (P = 0.009 in group 1 and 0.02 in group 2) Theeffective VVI* pacing was lost in 17 patients (40.5%) on the 5t h post operative day and comparison of effective pacing threshold in the twogroups showed no significant difference during the same period of time (P = NS). "Ventrculo-ventrical inhibition. Conclusions: The epicardialpacing wires have little usefulness after the fifth postoperative day and should be removed by this time. In addition postoperative pacingthreshold was not affected by the decreased left ventricular function.

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The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

International Surgery Journal ◽

10.18203/2349-2902.isj20205423 ◽

2020 ◽

Vol 8 (1) ◽

pp. 24

Author(s):

Ali G. Mohammed Redha ◽

Adil A. Jaber ◽

Aqeel M. Nasser

Keyword(s):

Hernia Repair ◽

Mesh Fixation ◽

Good Alternative ◽

P Value ◽

Absorbable Sutures ◽

Significant Difference ◽

The Difference ◽

Group 2 ◽

One Year ◽

Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.

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Hypogammaglobulinemia as a Predictive Factor of Postoperative Complications in Pediatric Cardiac Surgery

Journal of Bioscience & Biomedical Engineering ◽

10.47485/2693-2504.1058 ◽

2021 ◽

Keyword(s):

Cardiac Surgery ◽

Postoperative Complications ◽

Heart Defects ◽

Blood Stream ◽

Neonatal Unit ◽

Pediatric Cardiac Surgery ◽

Impact On Survival ◽

Group 2 ◽

Attending Physician ◽

Group 1

Hypogammaglobulinemia, developed as a result of cardiac surgery accompanied by cardiopulmonary bypass (CPB), may be caused by hemodilution, destruction of immunoglobulin, extravasation into the interstitial space related to systemic inflammation, and capillary leak syndrome. Therefore, to address this gap, we analyzed the characteristics of the infants who developed hypogammaglobulinemia after cardiac surgery and could benefit from Immunoglobulin supplementation. Methods: This is a retrospective study evaluating infants undergoing surgery for repair of congenital heart defects from October 1, 2019 to June 30th, 2020 in the neonatal unit of our institution. Due to its retrospective design, informed consent was not required. Patients were divided in two groups: Group 1 (IgG >= 340mg/dL) and Group 2 (IgG < 340mg/dL). The value cut point was defined taking into consideration p10 level of Immunoglobulin according to Fujimura. Results: From October 1, 2019 to June 30th, 2020, 62 children were born or admitted in our neonatal unit. Among them, 19 (30%) have their IgG dosed, according to attending physician decision. Among patients with hypogammaglobulinemia, Pseudomonas sp was present in 87.5% of blood stream and/or tracheal secretion cultures. Regarding survival analysis, mortality was not different between Group 1 and 2. Conclusion: Hypogammaglobulinemia has proved to be a predictor factor of postoperative complications in pediatric cardiac surgery. However, prospective trials are needed to determine the incidence of this problem, its real impact on survival, and the appropriate therapy.

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Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.1.16 ◽

2020 ◽

Vol 8 (1) ◽

pp. 65-68

Author(s):

Sumit Jeena ◽

Jaswinder Kaur ◽

Nishant Wadhwa

Keyword(s):

Coeliac Disease ◽

Clinical Symptoms ◽

Tissue Transglutaminase ◽

Pediatric Population ◽

Clinical Manifestations ◽

North India ◽

P Value ◽

Serum Iga ◽

Significant Difference ◽

The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

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