Aim: The aim of this study was to evaluate the simple tube cystostomy procedure for management of urethral obstruction cases in ruminants. Materials and Methods:Tube cystostomy was used to treat a total of 58 ruminants, which included 35 buffalo calves and 23 goats. Diagnosis of the disease was made with the history of anuria, clinical signs, and physical examinations. Physical parameters like heart rate, respiratory rate, rectal temperature dehydration status of animals by skin tenting test, and intraoperative findings were compared.Results: Young ruminants were most commonly affected and the mean age was 4-5 months in both species. Only male were considered for the study in which buffalo calves were not castrated but in goat's 73.91% animal were castrated and 34.7% not castrated. Rupture of bladder was more common in buffalo calves as compared to goats. The confirmed cases of obstructive urolithiasis were selected for tube cystostomy with Foley's catheter. Postoperatively all cases were administered with broad spectrum antibiotic, anti-inflammatory agent, and caliculolytic agents like ammonium chloride. Postoperative complications recorded only in 10 animals and remaining 48 animals had an uneventful recovery. Conclusion:Tube cystostomy is a simple and effective procedure particularly in intact urinary bladder, which can be adopted at field level.
Introduction:The selection of a prophylactic regimen involves a balance between efficacy and safety. Surgeons are particularly concerned about bleeding because it can lead to hematoma formation, infection, a reoperation, and a prolonged hospital stay. The selection of a prophylactic agent is also influenced by the more frequent use of regional anesthesia. Methodology: The total cases include 51 cases of total hip arthroplasties, 40 cases of knee arthroplasties and 10 cases of hip hemiarthroplasty. The indications for hip arthroplasties in this study include fracture proximal femur, avascular necrosis, secondary or primary osteoarthritis. Knee arthroplasties had been performed for either primary osteoarthritis or rheumatoid arthritis patients. A thorough detailed history regarding factors that influence DVT incidence had been elicited from all patients. Results: One hundred and one patients who underwent joint replacement surgery for various indications have been included in our study. There were 58 women and 43 men in our study. Eight patients in our study had sonographically proven deep vein thrombosis. Two among those had developed pulmonary embolism as a sequel to DVT. One patient had a fatal pulmonary embolism and died on the 6 th postoperative day Conclusion: Deep vein thrombosis is no longer to be considered a rarity among Indian patients.
Background: The traditional method of classification of ascites by AFTP offers little insight into the pathophysiology of ascites formation and it has many drawbacks. In order to overcome it, the classification of ascites based on SAAG has emerged. Even SAAG has some draw backs like non correlation with ascites due to non-alcoholic cirrhosis and difficulty in identifying the ascites due to mixed etiology. This study is conducted to compare the diagnostic accuracies of SAAG and AFTP in identifying the pathophysiology of ascites.Methods: A total of fifty patients who were admitted with ascites were included in the study. Ascitic fluid total protein and SAAG were calculated. They were classified on the basis of SAAG into High SAAG and Low SAAG and on the basis of AFTP into Transudate and Exudate. After the etiology of ascites evaluated by various diagnostic procedures, the sensitivity, specificity and diagnostic accuracy of SAAG and AFTP in identifying the pathophysiology of ascites calculated sepereately. The diagnostic accuracies of SAAG and AFTP were compared statistically.Results: The sensitivity of SAAG was found to be 86.84% and that of AFTP 60%. The specificity of SAAG was found to be 83.33% and that of AFTP was found to be 60%. The diagnostic accuracy of SAAG was found to be 86% and that of AFTP was found to be 60%. The diagnostic accuracy of SAAG and AFTP for individual etiologies of ascites were found and compared. SAAG was found to be superior to AFTP with a P value of <0.01 which was statistically significant.Conclusions: The sensitivity and specificity of SAAG was superior to AFTP in identifying the etiology of ascites.
In a defined geographic area in rural India (1,60,000 population), osteoporosis detection and calcium and vitamin D supplementation program was instituted. Of the eligible 15,386 subjects, 5,992 (38%) participated in the program; 2,882 (48%) had osteopenia and osteoporosis; supervised calcium and vitamin D supplementation was instituted; 2,113 (73.3% of those identified) completed 2 years of supplementation. The mean duration of the follow-up was 5 years (range 2–8 years). On follow-up, three groups emerged; those who were regular, those who were irregular, and those who did not take supplements. In those who were regular with calcium and vitamin D supplementation, we found a significant reduction in fractures (RR 0.27, 95% CI 0.09–0.81) compared with those who did not take supplements. There was no significant difference in falls between the three groups. Mortality was significantly lower (RR 0.53, 95% CI 0.31–0.91) in those who were regular with calcium and vitamin D supplements compared to those who did not take supplements. While the reduction in fractures was probably due to calcium and vitamin D supplementation, the reduction in mortality was probably because those who took regular supplements accessed healthcare services more readily for other comorbidities as part of their follow-up program.
Uncontrolled diabetes mellitus predisposes to variety of infections which are very difficult to manage. Here we report a case of diabetes mellitus with pulmonary tuberculosis who did not respond to anti tubercular therapy (ATT). On further evaluation patient found to have nocardiosis co-infection which usually occurs in immunocompromised patients like malignancy/ in HIV virus infected patients. This patient did not have any such condition other than uncontrolled diabetes mellitus which predisposed to nocardiosis co-infection. This co-infection of pulmonary tuberculosis and nocardiosis is very uncommon in HIV negative individuals and is reported because of this rare presentation.
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