Despite India’s enormous technological potential, indigenous medicinal knowledge and various initiatives by the government and industry at translational cycle, the country carries a global disease burden of 21%, majorly contributed by dual disease burden. Public health faces the major anomalies of 3A (accessibility, affordability, availability) of the healthcare sector, possibly due to restrictive coordination among stakeholders, transiting disease profile, undeveloped delivery system and regulatory mechanisms. This article emphasizes the significance of integrative approach of using our research and development strength and establishing a strong intellectual property system for conducive healthcare environment, accentuating the significance of 3P (public–private partnership) in addressing the major anomalies of 3A.
In this article, sprawl area of impervious surfaces and their spatial and temporal variability have been studied for Pune city over a period of 19 years, i.e. 1992–2011. Statistical techniques and image classification approach have been adopted to quantify the urban sprawl and its spatial and temporal characteristics. For this purpose, satellite images were obtained from various sensors, viz. Landsat Thematic Mapper and Landsat Enhanced Thematic Mapper Plus. To establish the relationship between urban sprawl and its causative factors, multivariate statistical technique has been used. The determinants of causal factors of urban sprawl such as population, α-population density, β-population density, workforce engaged in secondary and tertiary sectors, road density, and gender gap in literacy collectively explain the 93.09% variation in urban growth. The result also depicts that incessant growth in the built-up area in Pune city has surpassed the rate of population growth. From 1992 to 2011, population in the region grew by 75.40% while the amount of built-up land grew by 227.3%, i.e. more than three times the rate of population growth. To understand the future urban growth of Pune city, a foresight approach is being developed that allows long-term projections. This depicts that by the year 2051, the built-up area in the municipal limits would rise to 212.27 sq. km, which may be nearly 50.0% more than that in 2011 (141.50 sq. km). The vegetative areas, open spaces and areas around the highways are expected to become major targets for urban sprawl due to further increase in the pressure on land.
1 Asst. Prof., Dept of Gynaecologic Oncology, AHRCC, Cuttack, Odisha, India 2 Asst. Prof., Dept of Anaesthesiology, AHRCC, Cuttack, Odisha, India *Corresponding Author Dr Aratiprava Sahu Email: [email protected] Abstract Aim: So many adjuvants have been used with bupivacaine in epidural anaesthesia but none has been found ideal. We have conducted this study to evaluate the effect of epidural dexmedetomidine and ketamine when added to bupivacaine. Methods: Fifty female patients who underwent hysterectomies under epidural anesthesia were included in this study. They were randomly allocated in to two groups of 25 each. Group BK received epidural bupivacaine 0.5%(15ml)+0.5mg/kg of ketamine (1ml) and group BD received epidural bupivacaine 0.5% (15ml)+ 0.5 μg/kg of dexmedetomidine (1ml). Following epidural administration, onset and duration of sensory and motor blockade, maximum dermatomal level achieved, duration of analgesia and incidence of side effects were recorded. Results: Onset of sensory and motor block was earlier in group BD compared to group BK which was statistically significant. Block regression was significantly delayed with the addition of epidural dexmedetomidine (Group BD) as compared to group BK. The duration of analgesia was also significantly prolonged in group BD as compared to group BK. There were no significant difference either in haemodynamic parameters or in the incidence of side effects in both the groups. Conclusion: Dexmedetomidine when added to epidural bupivacaine produces significantly longer sensory and motor blockade along with prolonged postoperative analgesia when compared to epidural ketamine. Dexmedetomidine provided haemodynamic stability without any significant side effects.
1 Asst.Prof., Dept of Gynaecologic Oncology, AHRCC, Cuttack, Odisha, India 2 Asst. Prof., Dept of Anaesthesiology, AHRCC, Cuttack, Odisha, India *Corresponding Author Dr Aratiprava Sahu Email: [email protected] Abstract Aim: Our aim was to assess and compare the effectiveness of prophylactic infusion of ephedrine and phenylephrine given in maintenance of arterial pressure during hysterectomies under sub-arachnoid block. Methods: The present study was conducted on 80 patients undergoing elective hysterectomies under spinal anaesthesia belonging to American society of Anaesthesiologists Grade I and Grade II physical status. Group P– Phenylephrine 15 micrograms/min. Group E– Ephedrine 1.5 mg/min. Haemodynamic data was collected in both the groups and observations of the analysed data are presented as mean ± standard deviation. Results: The prophylactic infusion of phenylephrine and ephedrine were effective in maintenance of arterial pressure within 20% limit of baseline. Additional bolus dose requirement was more in ephedrine group than phenylephrine. There was a reduction in heart rate with Phenylephrine and a rise in heart rate with ephedrine. Conclusion: Although both drugs were effective in maintaining arterial blood pressure within normal range, Phenylephrine is more efficacious in comparison to ephedrine and additional bolus dose requirement is less with phenylephrine. Keyword: phenylephrine, ephedrine, hysterectomies, spinal anaesthesia.
1 Department of Skin and VD, IMS and SUM hospital, Siksha “O” Anusandhan Deemed to be University, K8, Kalinganagar, Bhubaneswar-751003, Odisha, India 2 Medical Research Laboratory, IMS and SUM hospital, Siksha “O” Anusandhan Deemed to be University, K8, Kalinganagar, Bhubaneswar-751003, Odisha, India Corresponding Author* Dr Mahesh Chandra Sahu Assistant Professor, Medical Research Laboratory, IMS and SUM Hospital, Bhubaneswar Email: [email protected] Abstracts Purpose: The bacterial manifestation in Skin ulcer is a common type of disease affecting patients' health and quality of life. Due to increases in antibiotic resistance, the difficulty of its management. Methods: A prospective study was carried out on skin ulcers by collecting the results of bacterial culture sampled of 110 cases from January 2016 to December 2017 at our hospital. We analyzed the constituent ratios of ulcer surface bacteria, the change in the main infectious bacteria and the results of drug sensitivity testing for common bacteria. In addition, the characteristics of bacterial infection of skin ulcers were summarized. Result: Out of 110 samples, 90 isolated bacteria were cultured. 61 samples were Gram-negative bacteria, mainly comprising Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. In addition, 23 isolates were Gram-positive bacteria, mainly comprising Staphylococcus aureus and Enterococcus faecalis. The probability of a negative bacterial culture in 2017 was significantly lower than that in 2016 (16.7% vs. 40.0%, p < 0.01). Moreover, the probability of P. aeruginosa infection in 2017 was significantly higher than that in 2016 (31.7% vs. 14.0%, p < 0.01). P. aeruginosa was resistant to seven commonly used antibiotics. Both K. pneumoniae and E. coli had higher resistance to ampicillin. E. cloacae were not sensitive to piperacillin/tazobactam. Acinetobacter baumannii was resistant to all the tested drugs. S. aureus, E. faecalis and Staphylococcus epidermidis had high resistance to clindamycin. There was other drug resistance to reflect the higher rate of skin bacterial resistance. Conclusion: Skin bacterial resistance rate is high. Gram-negative bacteria gradually account for the majority, and P. aeruginosa becomes the most important skin infection pathogen. These characteristics of bacterial infections of skin ulcers provide a significant reference for guiding the selection of antibiotics, better controlling infections of skin ulcers and accelerating the healing of skin ulcers.
Background: Renal stones are one of the common problems affecting large number of population all over the world. Percutaneous Nephrolithotomy (PCNL) is a promising technique for reducing hospital stay in patients with renal stone surgery. Aims and Objective: To study the stone size and success rate of PCNL in patients with renal calculi. Materials and Methods: Ninety renal calculi patients were studied at SVBP Hospital attached to LLRM Medical College Meerut from June 2016 to Sept 2017. After a thorough history taking, detail of demographic and clinical findings including age, sex, stone size, hospital stay and success rate were recorded for each patient. All the statistical analysis was done using IBM SPSS ver.20 software. Results: Maximum patients belong to age group of 21-60 years with mean age of 36.24±13.81 years. Male preponderance was reported (70%). Majority of the patients had right sided stone (60%), single (72%) and upper calyx was the most common PCN puncture site (54.44%). Maximum (91%) underwent drainage by DJ stent, had duration of hospital stay of 4-6 days (62.2%). Most of the patients had operative time within 60 mins (54.4%). Maximum patients (90%) achieved total clearance. Conclusion: PCNL should be the first-line treatment modality for the management of the renal calculi. In addition to advantage of minimally invasive therapy, it also offers shorter hospital stay and higher stonefree rates.
Previously, it has been stated that the BCR-ABL fusion-protein is sufficient to induce Chronic Myeloid Leukemia (CML), but additional genomic-changes are required for disease progression. Hence, we profiled control and tyrosine kinase inhibitors (TKI) alone or in combination with other drug-treated CML-samples in different phases, categorized as drug-sensitive and drug-resistant on the basis of BCR-ABL transcripts, the marker of major molecular-response. Molecular-profiling was done using the molecular-inversion probe-based-array, Human Transcriptomics-Array2.0, and Axiom-Biobank genotyping-arrays. At the transcript-level, clusters of control, TKI-resistant and TKI-sensitive cases were correlated with BCR-ABL transcript-levels. Both at the gene- and exon-levels, up-regulation of MPO, TPX2, and TYMS and down-regulation of STAT6, FOS, TGFBR2, and ITK lead up-regulation of the cell-cycle, DNA-replication, DNA-repair pathways and down-regulation of the immune-system, chemokine- and interleukin-signaling, TCR, TGF beta and MAPK signaling pathways. A comparison between TKI-sensitive and TKI-resistant cases revealed up-regulation of LAPTM4B, HLTF, PIEZO2, CFH, CD109, ANGPT1 in CML-resistant cases, leading to up-regulation of autophagy-, protein-ubiquitination-, stem-cell-, complement-, TGFβ- and homeostasis-pathways with specific involvement of the Tie2 and Basigin signaling-pathway. Dysregulated pathways were accompanied with low CNVs in CP-new and CP-UT-TKI-sensitive-cases with undetectable BCR-ABL-copies. High CNVs (previously reported gain of 9q34) were observed in BCR-ABL-independent and -dependent TKI, non-sensitive-CP-UT/AP-UT/B-UT and B-new samples. Further, genotyping CML-CP-UT cases with BCR-ABL 0-to-77.02%-copies, the identified, rsID239798 and rsID9475077, were associated with FAM83B, a candidate for therapeutic resistance. The presence of BCR-ABL, additional genetic-events, dysregulated-signaling-pathways and rsIDs associated with FAM83B in TKI-resistant-cases can be used to develop a signature-profile that may help in monitoring therapy.