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Background & Objectives: Pratishyaya(Allergic Rhinitis) is one of the commonest and frequently observed ailments in school going children, though seems simple but affects the regular activities. Being the most common allergic condition, acute Allergic Rhinitis affects people of all ages. Inwealthysocieties, it is observed that 20 to 40% of children suffer from Allergic Rhinitis. Hence the present study is intended to evaluate the efficacy of katphaladiyogain the treatment of Pratishyayain pediatric practice. Methods: A sample size of 30, diagnosed cases of Allergic Rhinitis, between the age group of 5 to 15 years were selected from the O.P.D. of SJG Ayurveda Medical College and hospital, camps and other referrals. Katphaladiyogawas given to the study group in a dose of 4 to 14 mashathree times a day along with honey after food for 21 days. Detailed case Performa was prepared and observations were recorded and graded. Results: Results obtained after the clinical trial was analyzed statistically and all the observations were subjected tocreative discussions. The final results showed that after 21 days of the treatment complete cure was observed in 30 patients and showed improvement in the clinical features. Interpretation & Conclusion: The study showed that katphaladiyogawas found effective in relieving the symptoms of Pratishyayain children within the duration of 14 to 21 days. The present study has revealed the scope for conducting more researches in the disease Pratishyayaand the drug katphaladi yogafor its standardization.

Background: Approximately 75% of enterocutaneous stula (ECF) occur following surgery. Due to the high morbidity and mortality associated with ECF, prompt and effective treatment is important. Objectives: To study the outcome and management of patients with enterocutaneous stula. Methods: Total 50 patients developing the enterocutaneous stula following surgery were included. All patients were treated either conservatively or operatively by various means and varying period of time. Treatment was focused on the correction of dehydration, controlling sepsis, management of electrolyte imbalance and nutritional support. Results: out of 50 patients mean age was 39.20±20 years. The study was male preponderance (70%). Around 62% of patients had small bowel stula (20 ileal, 6 duodenal, 5 jejunal) and 38% were large bowel stula. 72% patients had High-output stula. the most common complication was skin excoriation seen in 36% of patients followed by Intra-Abdominal Abscess (24%). 24% of skin excoriation was seen in high-output stula which was not signicant (p=0.33). 14% IAAwas seen in low output stula which was also not signicant. out of 50 patients 8 patients were died during follow up and 42 were recovered. Conclusions: Conservative management with emphasis on improvement of nutrition, control of sepsis, management of uid and electrolyte balance and control of stula output is rst line of management.

Background: The main challenge facing the laparoscopic surgery is the primary abdominal access, as it is usually a blind procedure and associated with many complications including life threading vascular and visceral injuries. Objectives:To compare the efcacy and safety of the open (direct trocar insertion/ DTI) and closed method (veress needle) to gain access in the abdominal cavity for laparoscopic surgery. Methods: This is Prospective Observational study conducted in the department of General surgery, from April 2020 to March 2022 comprising of 100 cases, 50 cases from each methods. The patients admitted in our department for Laparoscopic surgery was taken up for the study. 100 patients of either sex were selected who undergone operative procedure for laparoscopy surgery and written informed consent, appropriate workup is done. Purposive sampling technique was used. SPSS (Version 22.0) was used for analysis. Results: Duration for pneumoperitoneum creation in open method group is shorter as compared to closed method group for pneumoperitoneum creation in laparoscopic surgery and it was statistically signicant (p25 (p

BACKGROUND The study was conducted in an attempt to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with acute myocardial infarction and to assess any influence of serum uric acid levels on predicting prognosis in patients with acute myocardial infarction. Ischaemic heart disease, particularly acute myocardial infarction is one of the leading causes of death across the world accounting for 12.7 % of global mortality. Low and middle-income countries are facing 80 % of the global burden of ischaemic heart disease death. Since the pathophysiology of acute myocardial infarction is complicated, proper risk stratification is essential for appropriate management and better outcome. Serum uric acid levels (SUA) have been correlated with coronary artery calcification and atherosclerosis. High SUA levels also have been identified as a risk marker for cardiovascular disease development, progression and mortality. METHODS The study design was a one-year cross-sectional study. 100 patients admitted with acute myocardial infarction within one day of the start of symptoms in the Department of Cardiology & Medicine were included from September 2018 to September 2019. In this study, patients with known causes of elevated uric acid levels (chronic kidney disease, gout, haematological malignancy, hypothyroidism, metabolic syndrome, myeloproliferative disease, lymphoproliferative disease, drugs– pyrazinamide, diuretics, ethambutol, ethanol, malignancy, G6PD deficiency and psoriasis) were included. Patients on drugs which raise serum uric acid e.g., salicylates (2 gm / d, hydrochlorothiazide, pyrazinamide), and chronic alcoholics were not included. Patients were further subjected to investigations like serum uric acid, ECG, 2D echo and other routine investigations. Urine albumin levels, troponin I, chest x-ray, fundoscopy, and fasting lipid profile were done. Investigation reports were analysed with the clinical profile and the data was compiled and appropriate statistical test was applied. RESULTS There were more cases of myocardial infarction above 40 years as compared to below 40 years of age and males (69 %) were more as compared to females (31 %) with the commonest presentation as chest pain. Majority of the patients had inferior wall myocardial infarction (IWMI) (40 %) and most (91 %) of the patients had left ventricular (LV) dysfunction (mild, moderate and severe). More patients with Killip class III and IV had abnormal uric acid levels as compared to class I, and II. Among 27 patients who expired, 23 were in Killip class III and IV (13 in Killip class III and 10 in class IV) and the mean serum uric acid levels of expired patients were elevated on all the 3 days with maximum elevation on day 1. CONCLUSIONS Patients with higher Killip class had higher levels of serum uric acid in comparison to patients of lower Killip class. Serum uric acid level in association with Killip class is a good predictor of the severity of heart failure and short-term mortality after myocardial infarction.

A 45-year-old multiparous female was admitted 1 week back in Bapuji hospital attached to J J M medical college in view of iron deficiency anaemia and had underwent 3 pints of blood transfusion and was discharged with haematinics. Now after 5 days patient noted purpura and ecchymosis over her all four limbs which has increased from past 2 days. Patient also noticed epistaxis, subconjunctival haemorrhage in the last 1 day which brought her to Bapuji hospital in November 2019. Patient had no history of fever, bleeding per rectum, melena, joint pains, headache, blurring of vision, loss of consciousness, seizures. No past history of bleeding manifestations, blood transfusions and medications altering haemostasis in the family. Complete hemogram showed Hb : 11.1 g/dl, total count: 7210 cells/cumm, platelet count: 22000 cells/cumm. Peripheral smear showed normocytic normochromic anaemia with severe thrombocytopenia. LFT showed serum bilirubin: 2.5 mg/dl, indirect bilirubin: 1.9 mg/dl with normal liver enzymes. Coagulation profile and fever profile was done to rule out other causes of thrombocytopenia and was found to be normal. Serum LDH levels were 856 u/l. Direct and indirect coombs test is negative. ANA was negative. USG abdomen shows no splenomegaly. Patient was transfused with 4 pints of platelets and repeat platelet count after 12 hours shows 19000 cells/cumm. This clinical picture with bleeding manifestation with history of blood transfusion suggested post transfusion purpura, patient was transfused with aphaeretic blood and iv immunoglobulins at 500 mg/kg/day for 5 days and corticosteroid prednisolone was given at the dose of 1 mg/kg body weight. Patient platelet count improved significantly to 72,000 cells/cumm on 3rd day of admission. Patient did not have further bleeding manifestation. Patient’s platelet count improved to 1.60 lakhs/cumm at the time of discharge. Patient couldn’t get anti platelet antibodies and HPA genotyping due to financial constraints.