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Intercostal chest tube (ICD) management has been mostly determined by personal experience of surgeons and prevailing local practices rather than a scientifically validated protocol. This study was done to evaluate the impact of protocol-based management of chest tubes in patients undergoing elective thoracic surgeries. This was a prospective observational study conducted from June 2016 to March 2018 at a tertiary care hospital to study the impact of algorithmic management of chest tubes in patients undergoing non-pneumonectomy elective thoracic surgery. A preformed algorithm was followed in all the patients. Chest tube was removed if all the criteria for chest tube removal were met, i.e., stable patient, no air leak, drainage

Abdominal pain is one of the most frequent and worrisome complaints that brings a patient to the hospital. Patients with undiagnosed abdominal pain usually undergo a battery of investigations, while remaining dissatisfied. Since glucose metabolic imaging with FDG PET has been shown to detect infection, inflammation and malignancies earlier than structural imaging, we planned a pilot study to assess the causes of undiagnosed pain abdomen. The study was carried out at our tertiary care academic institution, from December 2016 to July 2018. A total of 30 patients with no aetiology found on clinical evaluation, laboratory investigations, ultrasound and computerized tomography scan underwent FDG PET CT. PET findings were correlated with clinical parameters to reach a final diagnosis. The results were analysed prospectively to find the utility of PET scan. The mean age was 33.33 years, and 66.67% were females. The number of patients in whom a final diagnosis (relating to pain abdomen) was made with the help of FDG PET was 6; therefore, the yield was calculated as 6/30 = 20.0%. A positive correlation was seen between duration and intensity of pain, raised ESR/positive or borderline Mantoux and presence of findings on PET. The negative predictive value of PET was 100%. Three patients were diagnosed to have tuberculosis, one had aorto-arteritis, one patient had infective foci in lung and one patient had subacute appendicitis. FDG PET scan might be indicated in undiagnosed pain abdomen, especially in patients with chronic pain with raised ESR or positive Mantoux.

Background/Objectives: Globally, the COVID-19 pandemic and its prevention and control policies have impacted maternal and child health (MCH) services. This study documents the challenges faced by patients in accessing MCH services, and the experiences of health care providers in delivering those services during the COVID-19 outbreak, explicitly focusing on the lockdown period in India. Methods: A cross-sectional study (rapid survey) was conducted in 18 districts from 6 states of India during March to June, 2020. The sample size included 540 MCH patients, 18 gynaecologists, 18 paediatricians, 18 district immunisation officers and 108 frontline health workers. Bivariate analysis and multivariable analysis were used to assess the association between sociodemographic characteristics, and challenges faced by the patients. Results: More than one-third of patients (n = 212; 39%) reported that accessing MCH services was a challenge during the lockdown period, with major challenges being transportation-related difficulties (n = 99; 46%) unavailability of hospital-based services (n = 54; 23%) and interrupted outreach health services (n = 39; 18.4%). The supply-side challenges mainly included lack of infrastructural preparedness for outbreak situations, and a shortage of human resources. Conclusions/Recommendations: A holistic approach is required that focuses on both preparedness and response to the outbreak, as well reassignment and reinforcement of health care professionals to continue catering to and maintaining essential MCH services during the pandemic.

Introduction: The world is seeing a growth of the aging population and the number of surgical treatments in this age group which is also true for spinal conditions. The greatest increase in spinal fusion surgery has been observed in patients aged 65 years and above. Only a few works of literature were available on the issue, especially in India. Materials and Methods: An observational study in which 70 patients aged 70 years and above who underwent spinal surgery for degenerative and traumatic spinal injury, from January 2013 to July 2017 in the neurosurgery department of a single institute, were reviewed. Around 53 patients were assessed for disability/functional outcome and their health-related quality of life (HRQOL) using the Oswestry disability index (ODI) and RAND 36-item health survey 1.0 scoring method (SF-36) comparing the preoperative and postoperative status. Result: The mean age was 74.19 years (range 70–91 years). Laminectomy-19 (27.14%) was the most common surgical procedure performed. Overall there were nine (12.85%) major complications with mortality of five (7.14%) patients. There was a significant reduction of crippled patients (14–9, P = 0.009) in the ODI score. SF-36: There was significant improvement in degenerative patient (P = 0.000 to P = 0.012). In traumatic patient, only pain had significant improvement (P = 0.045). Conclusion: This study showed that the age of the patient should not be the limiting factor for the surgical management of a patient with a degenerative or a traumatic spinal condition.

Background: The burden of Non Communicable Diseases (NCDs) is on the rise globally as well as in India. Tobacco use is one of the important behavioural risk factors which can be recognized and modified at a young age. Objectives: To assess tobacco use among school going adolescents and to determine the factors affecting this NCD risk factor.Methods: The study was conducted among adolescents aged 13 years to 15 years studying in class eighth to tenth from two central government schools of New Delhi district. Self-administered questionnaires were used to collect data from students and their parents. Data gathered from 438 students was analyzed using SPSS version 20.Results: 30 participants were found to ever use tobacco, and 25 were current users. Majority (17) ever tobacco users started using tobacco at 11 years or less. Tobacco use among family members, friends was found to be an important predictor for, ever and current tobacco use. Film actors were an important source of inspiration for tobacco use followed by family members and friends. Health education at school had a strong protective effect especially for current tobacco use.Conclusions: A decreasing age of initiation for tobacco use and a strong influence of family members were found. Greater emphasis on health education activities at school may help to decrease tobacco use among children. School based interventions involving families of students may help in controlling this behavioural risk factor.

The IL-1β -511 C/T polymorphism is associated with increased IL-1 production and with increased risk of developing cancers. In this study, 251 patients (125 with gastric cancer [GC] and 126 with oral cancer [OC]) and 207 normal controls from northeast (NE) India were genotyped for the IL-1β -511 C/T polymorphism by PCR-restriction fragment length polymorphism (RFLP) and sequencing. Analysis of results showed betel-quid chewing to be a major risk factor (OR = 2.01, 95% CI = 1.05-3.87; P = 0.035) for OC. Inheritance of the IL-1β -511 CT or TT resulted in a 2.6- to 3.05-fold increase in the risk of developing OC relative to that of participants who possessed the reference genotype (OR = 2.57, 95% CI = 1.06-6.22; P = 0.036 and OR = 3.05, 95% CI = 1.22-7.63; P = 0.017), after adjusting for potential confounders. The dominant genetic model also confirmed the presence of the T allele as a significant risk factor for OC (OR = 2.72, 95% CI = 1.15-6.42; P = 0.02). In GC, interaction of the CT genotype with tobacco and betel-quid chewing habits conferred a significant 78% and 89% reduced risk of cancer, respectively. In conclusion, for the NE Indian population, the IL-1β -511 CC and CT genotypes were significantly associated with increased risk of OC. However, the interaction of the CT genotype with risk habits may play a preventive role for GC but not for OC.