Search

Aims and Objectives: To present the design and application of new instrument to make plication of diaphragm safer and easier. Materials and Methods: A New instrument has been designed to help pull the folded lax / paralyzed diaphragm while putting the horizontal mattress sutures to plicate the diaphragm in cases of eventeration of diaphragm. It is a Malleable Copper Retractor with a Slit to push and protect the structures on the other side of diaphragm away from the needle. This is especially useful while doing the plication through right thoracotomy. The retractor with the slit will also make the plication easy even if it is done from below on left side.Since it is malleable with a narrow handle it will be easy to snuggly fit it over the dome of diaphragm which is then pulled up or down through the slit. It can be used in a patient of any age. The instrument with details of dimensions and material along with the photographs of its use at operation will be exhibited on the poster. Result: The data of its usefulness and the experience of different surgeons will be included in the presentation. Conclusion: The safety for the patient & the ease for the surgeon can be achieved by a simple and economical instrument. [ABSTRACT FROM AUTHOR]

Introduction: The majority of Indian women have a poor dietary folate and vitamin B 12 intake resulting in their chronically low vitamin status, which contributes to anaemia and the high incidence of folate-responsive neural-tube defects (NTDs) in India. Although many countries have successfully deployed centrally-processed folate-fortified flour for prevention of NTDs, inherent logistical problems preclude widespread implementation of this strategy in India. Because tea-the second most common beverage worldwide (after water)-is consumed by most Indians every day, and appeared an ideal vehicle for fortification with folate and vitamin B 12 , we determined if daily consumption of vitamin-fortified tea for 2 months could benefit young women of childbearing-age in Sangli, India., Methods: Women (average age=20±2 SD) used teabags spiked with therapeutic doses of 1 mg folate plus either 0.1 mg vitamin B 12 (Group-1, n= 19 ) or 0.5 mg vitamin B 12 (Group-2, n= 19 ), or mock-fortified teabags (Group-0, n= 5 ) to prepare a cup of tea every day for 2 months, following which their pre-intervention and post-intervention serum vitamin and haemoglobin concentrations were compared., Results: Most women had baseline anaemia with low-normal serum folate and below-normal serum vitamin B 12 levels. After 2 months, women in both Group-1 and Group-2 exhibited significant increases in mean differences in pre-intervention versus post-intervention serum folate levels of 8.37 ng/mL (95% CIs 5.69 to 11.04, p<0.05) and 6.69 ng/mL (95% CI 3.93 to 9.44, p<0.05), respectively; however, Group-0 experienced an insignificant rise of 1.26 ng/mL (95% CI -4.08 to 0.16). In addition, over one-half and two-thirds of women in Group-1 and Group-2, respectively, exhibited increases in serum vitamin B 12 levels over 300 pg/mL. There was also a significant post-interventional increase in the mean haemoglobin concentration in Group-1 of 1.45 g/dL (95% CI 0.64 to 2.26, p=0.002) and Group-2 of 0.79 g/dL (95% CI 0.11 to 1.42, p=0.027), which reflected a bona fide clinical response., Conclusion: Tea is an outstanding scalable vehicle for fortification with folate and vitamin B 12 in India, and has potential to help eliminate haematological and neurological complications arising from inadequate dietary consumption or absorption of folate and vitamin B 12 ., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)