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Laparoscopic cholecystectomy is preferred to open cholecystectomy for several reasons. Patients can be discharged home earlier. They have less pain in comparision to open cholecystectomy. Objectives: To investigate the pneumoperitoneum-induced haemodynamic and ventilatory changes in patients undergoing laproscopic cholycystectomy (LC). Methods: It was a prospective study of the age 15 years to 75 years of both sex (males n=80 and females n =320) were included in the study. The study wasdoi:10.22502/jlmc.v1i1.13 fatcat:ohrggko5inhvbowf2njlqssjga
more »... d in Lumbini Medical College Palpa over the two year period in Jan 2010 and Dec 2012. The variables recorded were: Mean arterial pressure (MAP), End- dal CO2, Peak and plateau airway pressures and heart rate. Data were collected immediately after induction of anesthesia at 5 min , after peritoneal insufflations and tilting the table into 30° head-up position at 10 min and finally at 10 min after exsufflation. Results: There was decrease in MAP after head up position but there was little change after pneumoperitoneum. More the weight more the increased in airway pressure was observed. The end tidal CO2 ramained increased after pneumoperitoneum. Conclusion: Peritoneal insufflation of CO2 to create the pneumoperitoneum and tilting the patient to the head-up position necessary for laparoscopy induces intraoperative ventilatory and hemodynamic changes that complicate anesthetic management of laparoscopy.
In this modern era, giant inguinoscrotal hernias are very rare to experience in a medical career. We discuss a case of a 65-year-old man with a history of an inguinoscrotal hernia with progressive growth for the past 35 years. On examination, he had a 20 cm × 15 cm non-reducible swelling with multiple ulcers over the skin surface extending to the mid-thigh with otherwise no other bladder and bowel complications. These large hernias pose a different set of surgical problems. Open surgery wasdoi:10.1093/jscr/rjab458 pmid:34729170 pmcid:PMC8557426 fatcat:mbal65ejxvefxneyja7ya7wipa
more »... ormed, hernial sac opened, contents reverted and left orchidectomy were done with scrotal reconstruction. The defect was closed with Vicryl 1-0 over the muscle layer and the skin was stapled. Daily wound care was provided. Besides, this case also compels us to explore possible reasons for the occurrence of such potentially dangerous surgical problems in low-to-middle income countries (LMIC).
The COVID-19 pandemic has resulted in more than 30.35 million infections and 9, 50, 625 deaths in 212 countries over the last few months. Different drug intervention acting at multiple stages of pathogenesis of COVID-19 can substantially reduce the infection induced mortality. The current within-host mathematical modeling studies deals with the optimal drug regimen and the efficacy of combined therapy in treatment of COVID-19. The drugs/interventions considered include Arbidol, Remdesivir,arXiv:2009.10049v1 fatcat:5uhea6klu5gajffx4glanmvlla
more »... eron (INF) and Lopinavir/Ritonavir. It is concluded that these drug interventions when administered individually or in combination reduce the infected cells and viral load. Four scenarios involving administration of single drug intervention, two drug interventions, three drug interventions and all the four have been discussed. In all these scenarios the optimal drug regimen is proposed based on two methods. In the first method these medical interventions are modeled as control interventions and a corresponding objective function and optimal control problem is formulated. In this setting the optimal drug regimen is proposed. Later using the the comparative effectiveness method the optimal drug regimen is proposed based on basic reproduction number and viral load. The average infected cell count and viral load decreased the most when all the four interventions were applied together. On the other hand the average susceptible cell count decreased the best when Arbidol alone was administered. The basic reproduction number and viral count decreased the best when all the four interventions were applied together reinstating the fact obtained earlier in the optimal control setting. These findings may help physicians with decision making in treatment of life-threatening COVID-19 pneumonia.
Pradeep, Pp. 17780-17806 Malacofaunal inventory in Chintamoni Kar Bird Sanctuary, West Bengal, India -S.K. ... Chhetri, Kusal Gurung, Thinlay Namgyal Lepcha & Bijoy Chhetri, Pp. 17832-17836 Tawny Fish-owl Ketupa flavipes Hodgson, 1836 (Aves: Strigiformes: Strigidae): recent record from Arunachal Pradesh, India ...doi:10.11609/jott.5610.13.2.17832-17836 fatcat:xfsbs7pcfvejvftecfa3zouxgi
Journal of Universal College of Medical Sciences
Pandey tharu (15%), chhetri (14%) magar (11%) and others. ... PATTERN OF PSYCHIATRIC REFERRAL FROM EMERGENCY DEPARTMENT OF A TERTIARY LEVEL ORIGINAL ARTICLE HOSPITAL IN NEPAL Sanjeev Ranjan, Reet Poudel, Pradeep ...doi:10.3126/jucms.v3i2.14283 fatcat:bk5jxqrn75dwzcosidyffoiq6i
Pradeep, Pp. 17780-17806 Malacofaunal inventory in Chintamoni Kar Bird Sanctuary, West Bengal, India -S.K. ... Chhetri, Kusal Gurung, Thinlay Namgyal Lepcha & Bijoy Chhetri, Pp. 17832-17836 Tawny Fish-owl Ketupa flavipes Hodgson, 1836 (Aves: Strigiformes: Strigidae): recent record from Arunachal Pradesh, India ...doi:10.11609/jott.59188.8.131.5243-17846 fatcat:vxoqrwqlvbdarancvywrxrqxvi
Duk Bahadur chhetri for histopathological examination and Dr. Prajwal Ghimire for computer works. ...doi:10.9790/3013-25303437 fatcat:tgukzusck5g43ja6yrbexa7rmu
Pradeep, Pp. 17780-17806 Malacofaunal inventory in Chintamoni Kar Bird Sanctuary, West Bengal, India -S.K. ... Chhetri, Kusal Gurung, Thinlay Namgyal Lepcha & Bijoy Chhetri, Pp. 17832-17836 Tawny Fish-owl Ketupa flavipes Hodgson, 1836 (Aves: Strigiformes: Strigidae): recent record from Arunachal Pradesh, India ...doi:10.11609/jott.53184.108.40.20637-17840 fatcat:asp3dduhrbfy7cuenebc6irdvy
Use of LARCs among Terai/Madhesi other castes (AOR: 0.2; 95% CI: 0.1-0.7) was lower than among Brahmins/Chhetris ( Table 2) . ... The likelihood of using a shortacting method was higher among Newars and Janajatis than Brahmins/Chhetris, while Muslims were less likely to use short-acting method ( Table 2) . ...doi:10.1155/2014/636439 pmid:25405205 pmcid:PMC4163397 fatcat:cf2fd732xvfxzism2mcr3xxxcy
Journal of Evolution of Medical and Dental Sciences
, however an often neglected parameter is the morphology of the placenta, an organ which plays a keyrole for fetal growth (Pradeep S Londhe, 2012). 13 In present study mean weight of placenta is 547.83 ... Chhetri et al (2013) reported that in normal birth weight, in 84 .2% (32 no) cases the mode of umbilical cord insertion was central, 72.7% (16 no) cases itwas marginal and 90% cases (27 no) cases its ...doi:10.14260/jemds/2015/107 fatcat:mgzxd6fo3vajhad7ci477umrnu
A seamless vegetation type map of India (scale 1: 50,000) prepared using medium-resolution IRS LISS-III images is presented. The map was created using an on-screen visual interpretation technique and has an accuracy of 90%, as assessed using 15,565 ground control points. India has hitherto been using potential vegetation/forest type map prepared by Champion and Seth in 1968. We characterized and mapped further the vegetation type distribution in the country in terms of occurrence anddoi:10.1016/j.jag.2015.03.003 fatcat:ijq37ydp65hrpk4fin7f2ojvsm
more »... n, area occupancy, percentage of protected area (PA) covered by each vegetation type, range of elevation, mean annual temperature and precipitation over the past 100 years. A remote sensing-amenable hierarchical classification scheme that accommodates natural and semi-natural systems was conceptualized, and the natural vegetation was classified into forests, scrub/shrub lands and grasslands on the basis of extent of vegetation cover. We discuss the distribution and potential utility of the vegetation type map in a broad range of ecological, climatic and conservation applications from global, national and local perspectives. We used 15,565 ground control points to assess the accuracy of products available globally (i.e., GlobCover, Holdridge's life zone map and potential natural vegetation (PNV) maps). Hence we recommend that the map prepared herein be used widely. This vegetation type map is the most comprehensive one developed for India so far. It was prepared using 23.5 m seasonal satellite remote sensing data, field samples and information relating to the biogeography, climate and soil. The digital map is now available through a web portal (http://bis.iirs.gov.in).
Frequency n (%) Age group Adult 793 (79.5) Elderly 204 (20.5) Gender Male 463 (46.4) Female 534 (53.6) Marital status Married 753 (75.5) Unmarried 150 (15) Widow 94 (9.5) Ethnicity Brahmin 413 (41.4) Chhetri ... 113 (63.8) 177 (60.2) Marital Status Married 117 (45.2) 142 (54.8) 259 (88.0) Unmarried 1 (50.0) 1 (50.0) 2 (0.01) Widow 9 (27.3) 24 (72.7) 33 (11.99) Ethnicity Brahmin 48 (46.2) 56 (53.8) 104 (35.4) Chhetri ...doi:10.31729/jnma.5316 pmid:34506387 pmcid:PMC8028540 doaj:3cd6481542344af192e043e629a8fb62 fatcat:y7vf5vq5jvd4dfrb7z7xf6cmkq
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