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Severe knee flexion contracture greater than 80° is rare and challenging to manage. It is a common complication which occurs after a prolonged course of the rheumatoid arthritis. The case was a 45 year old female patient of Ama vata (rheumatoid arthritis) with sandhijadya and sankoca (contracture deformity) who was hospitalized for 2 months. She was unable to walk since 1 year due to contracture of both knee joints. The patient came on a wheel chair and was unable to walk even with support. She was advised for contracture repair surgery which she refused. After hospitalization she was treated with Nadi svedana twice a day for 20 min each. Simultaneously, passive stretching for 45 s in every 5 min interval was done. She was treated for 2 months. The patient was instructed to continue other Ayurvedic remedies given as the Ama vata (rheumatoid arthritis) treatment. After Nadi svedana, goniometric assessment of the knees contracture was performed every week. She got satisfactory result in stiffness and pain and has been able to walk with support. Extension of both knee joints has improved up to 20° with increased range of motion. Her height has also been increased up to 1.5 cm due to improvement in the extension of the knee joints with better feeling in daily activities during 3 months of follow-up period., (Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.)

Background Laparoscopic cholecystectomy is the gold standard for the surgical treatment of cholelithiasis. Routine drainage after elective LC is an issue of considerable debate. Objective To evaluate the advantages and disadvantages of drainage in patients undergoing Laparoscopic cholecystectomy. Method The study was conducted at the department of surgery in Nepalgunj Medical College and Teaching Hospital, Kohalpur between March 2013 and May 2014. During the period of study, sixty patients underwent laparoscopic cholecystectomy for symptomatic gall stone. Sixty patients were randomized before surgical procedure into two groups. Group A consisted 30 patients in whom a drain was placed in subhepatic space and group B consisted 30 patients without drain. Postoperative pain was assessed using a 10-point visual analog scale. The two groups were evaluated and compared regarding postoperative pain, the time needed for surgery, length of postoperative hospital stay and the incidence of postoperative complications. Result The mean operative time in group A was 6.16 minutes longer when compared with group B (p>0.05). Although the postoperative mean pain score was same at 6 hours after surgery in both groups (7.53 vs 7.23), the postoperative pain was higher in the group A by more than two points on the average in VAS (visual analogue score) at 24 hours and 48 hours. The proportion of the patients staying in the hospital for more than two days was higher in group A, 14 (46.66%) and 8 (26.66%) in group B (p < 0.05). There was no statistical difference in the rate of wound infections, shoulder pain, nausea, vomiting, and respiratory infections between the two groups. Conclusion The routine drainage of gallbladder bed after elective laparoscopic cholecystectomy may not be justified and appears to cause more postoperative pain and more postoperative complications and prolongs the hospital stay.

India like any other country is facing a silent epidemic of chronic renal failure (CRF)- a facet of the health transition associated with industrialization partly fuelled by increase in sedentary lifestyle, low birth weight and malnutrition. Increasing figures by many folds seen is posing a difficult situation to overcome with respect to economy and health of the working and earning population of the nation. There is an urgent need to explore, highlight new interventions and modify modifiable risk factors as a basis for treatment strategies to prevent the development and progression of CRF. The present study was taken up to evaluate the role of trial formulation tab. Punarnavadi compound in the management of chronic renal failure. This was an open clinical comparative study in controlled circumstances wherein 67 patients were studied for two months in three groups- Group A (allopathic control), Group B (ayurvedic control) and Group C (ayurvedic test). It was a multi-centric study; patients were registered from Anandababa charitable dialysis centre, Jamnagar, Kayachikitsa O.P.D. of I.P.G.T. and R.A. Jamnagar and P. D. Patel Ayurveda hospital, Nadiad. Results were assessed on 15 parameters using Students (paired) 't' test. Group A patients showed comparatively better results in eight parameters- weight, platelet count, serum urea, serum uric acid, serum sodium, potassium, chloride and total proteins. Parameter Hemoglobin% showed better results in Group B patients and in Group C patients comparatively better results in six parameters viz.- quality of life (breathlessness, weakness, general functional capacity), total count, serum creatinine and serum calcium - were observed. Throughout the study, trial drug tab. Punarnavadi compound did not show any adverse drug reaction. The results of this study will help in developing a cheap and safe treatment for the management of CRF.

Uncontrolled kallikrein activation is involved in diseases such as hereditary angioedema, bacterial septic shock and procedures such as cardiopulmonary bypass. Here we report a series of small molecule compounds that potently inhibit kallikrein activity in vitro. Kinetic studies indicate that some of these compounds are slow binding inhibitors of kallikrein with Ki final less than a nanomolar. The ability of these compounds to inhibit the activity of kallikrein was further confirmed in a plasma model by quantitating the release of bradykinin, an endogenous cleavage product of plasma kallikrein. To understand the inhibitory mechanism of the selected compounds toward kallikrein, the interactions between the selected compounds and kallikrein was explored using molecular modeling based on the information of crystal structures of TF/FVIIa and kallikrein. The information presented in the current study provides an initial approach to develop more selective and therapeutically useful small molecule inhibitors.

Although the sigmoid colon is commonly afflicted with disease, studies on its anatomical dimensions are scarce. It is suspected that dimensions of the sigmoid colon change with age. This study documents data on the anatomical measurements of the sigmoid colon in 70 Indian subjects (51 live and 19 cadavers). Seven parameters of sigmoid colon anatomy measured included length and width of the sigmoid colon and mesocolon at specific points. Three mesocolic indices (width to length ratios) were calculated. Comparisons of measurements in the live and cadaver subjects and in the two sexes were made. The relationship of change in parameters with age was assessed. Appropriate statistical methods were used and the differences were considered significant at P < or = 0.05. The study showed wide ranging variations in the values of various measured parameters of the sigmoid colon. Seven patterns of the shape of the sigmoid loop were identified. In the commonest pattern the sigmoid mesocolon was vertically longer than wide (dolichomesocolic), the sigmoid loop having its maximum convexity located just a little proximal to the apex. Patterns where the width of the mesocolon was greater than the vertical length (brachymesocolic) were also observed. The gender analysis showed that the sigmoid mesocolon of the female was brachymesocolic (wider than long), whereas that of the male was dolichomesocolic (longer than wide). This might explain the higher incidence of sigmoid volvulus in the male. This study also showed that the measurements of the sigmoid colon and its mesocolon do not change significantly within the age range of 16-60 years in the two sexes. Also noteworthy is the observation that in the cadaver the sigmoid colon shows considerable shrinkage, particularly of its mesocolon; consequently the data from cadaver subjects, though valuable for anthropometric use, have limitations when used for clinical applications., (Copyright 2004 Wiley-Liss, Inc.)

The authors evaluated a magnetization preparation scheme with a "notched" section profile for T1-weighted first-pass myocardial perfusion magnetic resonance (MR) imaging at 1.5 T. The pulse sequence consisted of a preparation sequence followed by an interleaved gradient-echo echo-planar sequence. Image contrast was evaluated in a feasibility study in 12 adult patients. The notched saturation pulse allowed long magnetization recovery times without sacrificing section coverage. Image contrast between normal and ischemic myocardium was excellent.

The high residual pressure indicated less chances of success with notable exceptions while lower residual pressure tended to indicate better chances of success in the negative as well as the positive pressure equalization tests.

MR tagging has shown great promise for detailed noninvasive cardiac motion imaging. Our research uses low-frequency tags coupled with gradient-based optical flow estimation to compute cardiac motion. We develop here a novel, fast, fully automated optical flow method for tagged MRI by exploiting the Fourier content of the tagged images. This new method, called bandpass optical flow, works by extracting various subband images from tagged cardiac data, and then formulating multiple optical flow constraints for each subband. The resulting system is solved by least squares pseudo-inversion. The proposed method is validated on simulated and real tagged data.

Incidence and predominant causes of deafness in 20 neonates, 100 infants and 1340 school going population in the northern region of the Indian subcontinent, was investigated by the E. N. T. Department, of Dayanand Medical college and Hospital, Ludhiana, Punjab.The recorded incidence of deafness in school going children was 12.16% comprising conductive loss (98%) and S. N. loss 2%. Out of many cases more notable were chronic rhinitis, tonsillitis, adenoiditis etc.

The routine use of a single radionuclide for patient imaging in nuclear medicine can be complemented by studies employing two tracers to examine two different processes in a single organ, most frequently by simultaneous imaging of both radionuclides in two different energy windows. In addition, simultaneous transmission/emission imaging with dual-radionuclides has been described, with one radionuclide used for the transmission study and a second for the emission study. There is thus currently considerable interest in dual-radionuclide imaging. A major problem with all dual-radionuclide imaging is the "crosstalk" between the two radionuclides. Such crosstalk frequently occurs, because scattered radiation from the higher energy radionuclide is detected in the lower energy window, and because the lower energy radionuclide may have higher energy emissions which are detected in the higher energy window. The authors have previously described the use of Fourier-based restoration filtering in single photon emission computed tomography (SPECT) and positron emission tomography (PET) to improve quantitative accuracy by designing a Wiener or other Fourier filter to partially restore the loss of contrast due to scatter and finite spatial resolution effects. The authors describe here the derivation and initial validation of an extension of such filtering for dual-radionuclide imaging that simultaneously 1) improves contrast in each radionuclide's "direct" image, 2) reduces image noise, and 3) reduces the crosstalk contribution from the other radionuclide. This filter is based on a vector version of the Wiener filter, which is shown to be superior [in the minimum mean square error (MMSE) sense] to the sequential application of separate crosstalk and restoration filters.

A case of recurrent pyogenic meningitis is reported. The focus for recurrent meningeal infection was frontal bone osteomyelitis secondary to a road accident which the patient sustained ten years earlier.

In the present study 90 cases of carcinoma penis were studied. The disease is more common after the age of 40 years; phimosis was found to be most important predisposing factor. Most common presentation was proliferative lesion with commonest involvement of glans penis. All the cases were of squamous cell carcinoma except one case of malignant melanoma. Clinical determination of lymph node metastasis is falacious as there was discrepancy between clinical and histopathological stage of the disease in 26.67% of cases. Therefore lymph node biopsy at the time of primary surgery is advocated. The result of total amputation is better than other mode of treatment.

Changes in blood levels of Glucose, Pyruvic acid, Lactic acid, Glycogen, Free Fatty Acids and total Serum Cholesterol have been studied in normal healthy human adults under the effect of mental stresses of pre-examination tension and pre-operative apprehension. A highly significant rise in all the parameters was noted.