A study on bed utilization in the gynaecological ward of a district hospital in West Bengal

A study was conducted in a non-paying gynaecological ward of the district hospital, South 24 Parganas, West Bengal to assess different bed efficiency indicators. Total 331 patients were admitted in 23 study beds (12 OPD beds and 11 emergency beds) during an observation period of six months. Overall average number of admissions were 14.4 and average length of stay 14.7days. Bed turnover rate was 13.8 and was higher for emergency beds (22.1) compared to OPD beds (9). Bed occupancy rate was 61.3% with significant difference between OPD beds (57.5%) and emergency beds (65.4%).     

Video assisted thoracoscopic (VATS) Thymectomy-a better alternative

Background With the introduction of video imaging technique in late 1980s the field of thoracoscopy was expanded into video assisted thoracic surgery (VATS) in 1990. VATS has several unique advantages like reducing repiratory complications, hospital stay and post operative pain due to avoidance of thoracotomy/sternotomy. It is indicated in almost all thoracic surgical procedures-both diagnostic and therapeutic. VATS thymectomy is being practised more and more replacing conventional thymectomy with thoracotomy/sternotomy. Methods From 2000 to 2003 we have performed 22 cases of VATS thymectomy in Myesthenia Gravis. Surgery was performed in supine decubitus under General anaesthesia with Double Lumen E T Tube for epsilateral Lung Collapse. Three ports were made on the right chest at 2nd space parasternal, 4th space anterior axillary line and at 5th space just below the nipple. At the end of the procedure a chest drain was introduced through the lowest port. Results Out of 22 patients 12 were females and 10 males. Median age was 36 years (Range 16 years to 64 years). Median operating time was 2 hours and drainage was 200 ml. Median ventillation time was 6 hours. Median hospital stay was five days. There was no mortality and no major complications. Conclusion VATS thymectomy is a suitable alternative to conventional thymectomy with thoracotomy/sternotomy. Results are comparable. VATS is now developing into an exciting adjunct in thoracic surgery. The morbidity associated with this procedure is extremely low. VATS has become an essential component of all thoracic surgical units and more and more thoracic surgical dieases will be managed with this minimally invasive technique in future.     

Scientific evidence on the use of high-intensity focal ultrasound (HIFU) in the treatment of prostatic carcinoma

ObjectivesTo evaluate in the literature scientific evidence on the use of High-Intensity Focal Ultrasound (HIFU) in the treatment of prostatic carcinoma (PC).MethodThree database are searched: PubMed, Cochrane Library, HTA database. Several articles were selected taking into account number of cases, inclusion criteria, duration of follow-up period. We have evaluated the best evidence available thorugh a systematic review of clinical efficacy and cost-effectiveness of HIFU in the treatment of PC. We analized global survival, diseasefree survival, and quality of life, including complications, adversal effects and acceptance of the technique.ResultsPublications available are focused on two main indications of the therapy: first step of management of PC and salvage therapy for locally recurrent PC after external beam radiotherapy. It was very difficult to draw conclusions on the relative benefits of the HIFU: lack of high or medium quality evidence and no comparisons between this technique an standard treatments. In relation to results on cost-effectiveness, no relevant studies were identified in order to get conclusions on the quality of the treatment. Most of reports offered disparity in the definition of free survival disease concept. This fact produce some misunderstanting of results and conclusions cannot be drawn correctly. Inclusion criteria were also heterogeneous between authors.ConclusionsNo high-quality clinical evidence can be established currently on the utility of HIFU as treatment of prostatic cancer. An important fact to stress is the capacity of therapy to produce tumour necrosis both as first-step treatment and as salvage therapy. No conclusions can be drawn in the long-term due to the paucity of controlled and randomized trials with adequate follow-up to establish benefits in terms of global survival and quality of life (balance adversal effects/benefits), lack of comparisons with standard options as long as different definitions of free-survival disease.     

Inhibition of puerperal lactation. A double blind study of bromocriptine and placebo.

Bromocriptine and placebo were randomly allocated for three weeks to 52 postpartum patients requiring lactation suppression. Bromocriptine significantly lowered plasma prolactin levels and suppressed breast milk, breast pain and engorgement quicker than placebo. No side-effects were noted and rebound lactation did not occur. Menstruation appeared to re-start sooner when Bromocriptine was given.     

Polymerization of N-vinylearbazole with vanadium compounds. Part I. Polymerization with vanadium pentoxide and metal vanadates

Bulk polymerization of N-Vinylcarbazole (NVC) has been carried out using vanadium pentoxide as the contact catalyst. The rate of polymerizatlon has been found to depend upon catalyst to monomer ratio. A cationic mechanism has been suggested and the role of V₂O₅ surface in the polymerization has been tentatively analyzed. The π-acid characteristies of V^5⊕ ion is believed to be involved in initiating the polymerization. The effect of a number of additives on the polymerization rate has been studied, which endorses the cationic mechanism. The catalytic efficiency of a number of metal vanadates for the polymerization of NVC has also been studied. A fairly good correlation between the activity and electronegativity of the metallic moiety has been established.     

Percutaneous administration of progesterone: blood levels and endometrial protection

There is controversy about the beneficial effects of topical progesterone creams used by postmenopausal women. A major concern is that serum progesterone levels achieved with progesterone creams are too low to have a secretory effect on the endometrium. However, antiproliferative effects on the endometrium have been demonstrated with progesterone creams when circulating levels of progesterone are low. Thus, effects of topical progesterone creams on the endometrium should not be based on serum progesterone levels, but on histologic examination of the endometrium. Despite the low serum progesterone levels achieved with the creams, salivary progesterone levels are very high, indicating that progesterone levels in serum do not necessarily reflect those in tissues. The mechanism by which the serum progesterone levels remain low is not known. However, one explanation is that after absorption through the skin, the lipophilic ingredients of creams, including progesterone, may have a preference for saturating the fatty layer below the dermis. Because there appears to be rapid uptake and release of steroids by red blood cells passing through capillaries, these cells may play an important role in transporting progesterone to salivary glands and other tissues. In contrast to progesterone creams, progesterone gels are water-soluble and appear to enter the microcirculation rapidly, thus giving rise to elevated serum progesterone levels with progesterone doses comparable to those used in creams.     

The clinical spectrum and treatment outcome of retinoblastoma in Indian children

PURPOSE: To study the clinical spectrum and treatment outcome of retinoblastoma in Indian children. PATIENTS AND METHODS: This retrospective study analyzed 488 eyes of 355 retinoblastoma patients treated at a tertiary care ophthalmic hospital in southern India during a 14-year period. RESULTS: Retinoblastoma involved one eye in 177 (50%) and both eyes in 178 (50%) patients. Mean age at presentation was 23.98 +/- 23.37.