Search

This paper is an attempt to analyze the effect of scrambled response techniques to estimate the current population mean in two-occasion successive sampling when study and auxiliary variables are sensitive in nature. Using additive and multiplicative scrambled response models on both occasions, some generalized estimation strategies of current population mean have been proposed and their properties are examined. Empirical studies are performed on real data (abortion rate in the states of United States) and simulation studies are also carried out to evaluate the performances of the proposed estimators over other estimators. Results have proved the worthiness of the scrambled response techniques in real-life situations. [ABSTRACT FROM PUBLISHER]

In this work, we have suggested some linear combinations of generalized ratio type estimators in estimation of current population mean when non response occur in two occasion successive sampling. Information on multi-auxiliary variables has been used and sub-sampling of non respondents technique is utilized to cope with the negative effect of non response. Properties of the suggested estimation procedures have been examined and suitable optimum replacement strategies are discussed. Empirical studies are carried out to justify the proposition of estimators. Suitable recommendations have been made. [ABSTRACT FROM PUBLISHER]

The present work suggests some effective linear combinations of exponential estimators to estimate the current population mean in two occasion successive sampling in presence of non response. Using the subsampling technique of non respondents, estimation procedures have been developed by utilizing information on an auxiliary variable, which is readily available on both occasions. Properties of the proposed estimation procedures have been examined and related optimum replacement strategies are suggested. Empirical studies are carried out to justify the preposition of estimators. Suitable recommendations have been made. [ABSTRACT FROM PUBLISHER]

The present work utilizes the information on multiauxiliary variables to neutralize the negative effect of non response in estimation of current population mean in two-occasion successive sampling. Generalized exponential type estimators have been proposed for the situation when non response occurs at both occasion or at first occasion or at current (second) occasion in two-occasion successive sampling. Properties of the proposed estimators have studied and empirical studies are carried out to justify the preposition of estimators. Suitable recommendations have been made. [ABSTRACT FROM AUTHOR]

The present paper is an attempt to analyze the effect of non response at both occasions in two-occasion successive sampling. Using the sub-sampling of non respondent technique, exponential type estimators have been proposed to estimate the current population mean. Properties of the proposed estimators are examined and respective optimum replacement strategies are suggested. Empirical studies are carried out to evaluate the performances of the proposed estimators. Results are interpreted and suitable recommendations have been made. [ABSTRACT FROM PUBLISHER]

Introduction: Individuals experiencing mental health disorders encounter numerous challenges while accessing mental healthcare services. Despite the inclusion of mental health in the primary healthcare system, screening and managing mental health disorders remain significantly overlooked. Therefore, there is a need to understand the perceptions of healthcare providers in primary care settings, identify the challenges faced, and gather suggestions for effective mental healthcare delivery., Methods: The present qualitative study was conducted in 13 primary healthcare facilities in the Jodhpur district of Rajasthan, India, from 2023 to 2024 among 25 primary healthcare providers. Semi-structured interview guides were developed for each category of primary healthcare provider, including Medical Officers, Community Health Officers, and General Nurse Midwives, Auxiliary Nurse Midwives and in-depth interviews were recorded, transcribed, and thematically analyzed using codes and sub-codes., Results: Results are summarized under the themes: (i) Navigating Mental Healthcare in Primary Healthcare Facilities, (ii) Challenges and Barriers in Mental Healthcare Delivery, (iii) Recommendation for Enhancing Mental Healthcare Services, and (iv) Approaches for Comprehensive Capacity Building Training and Module and further findings of each theme are presented under various sub-themes., Conclusion: The findings suggest that despite a perceived competence in providing mental health services, there were substantial levels of negative attitudes towards mental health disorders among participants and provide insights for policymakers and healthcare professionals to develop targeted interventions and improve mental healthcare delivery at primary care facilities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sangwan, Kansara, Matoria, Ali, Khetan, Singh, Thakor, Huda and Babu.)

Telemedicine has revolutionized healthcare access by breaking geographical barriers and facilitating remote consultations. The eSanjeevani platform has been pivotal in India, especially during the COVID-19 pandemic. Despite its benefits, implementing telemedicine faces various challenges and barriers. This scoping review aims to identify these challenges, barriers, and facilitators in the Indian context. This review follows the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A comprehensive literature search was conducted using PubMed and Google Scholar to identify studies published between January 2019 and January 2024. Studies on telemedicine adoption, barriers, and facilitators in India were included. Data were extracted and synthesized from 26 quantitative, qualitative, and mixed-methods research studies. Individual-level challenges include limited digital literacy, particularly among older adults and those in rural areas, and health literacy issues. Barriers such as limited smartphone access, unreliable internet connectivity, and socio-cultural preferences for in-person consultations were identified. Facilitators at this level include family involvement, training programs, and community outreach. Provider-level challenges involve a lack of training and concerns about care quality, while barriers include insufficient infrastructure and medico-legal concerns. Facilitators include ongoing training, clear guidelines, and user-friendly telehealth systems. System-level challenges include integrating telemedicine into existing infrastructure and ensuring data security. Barriers include inadequate funding and resistance to change, while facilitators include policy support, investment in infrastructure, and collaborative efforts. Telemedicine holds great potential to enhance remote healthcare access in India, but its successful implementation requires addressing significant challenges and barriers. Strengthening digital infrastructure, enhancing digital literacy, standardizing protocols, and developing clear regulatory frameworks are essential. Collaborative efforts and tailored approaches that respect local cultures can further facilitate telemedicine adoption. Continuous research and public awareness campaigns are necessary to ensure telemedicine's sustainable and effective use in India., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Arora et al.)

Abstract: Inflammatory myofibroblastic tumor (IMT) is a tumefactive proliferation of spindled myofibroblastic cells admixed with inflammatory infiltrate. This tumor has a predilection for the involvement of visceral soft tissues and has a tendency for local recurrence. Occurrence of metastatic or metachronous IMTs is a rare presentation. We report a rare case of a 50-year-old man with metastatic IMTs in the colon and duodenum., (Copyright © 2022 Copyright: © 2022 Journal of Cancer Research and Therapeutics.)

Background: Women's self-help groups (SHGs) have become one of the largest institutional platforms serving the poor. Nutrition behavior change communication (BCC) interventions delivered through SHGs can improve maternal and child nutrition outcomes., Objectives: The objective was to understand the effects of a nutrition BCC intervention delivered through SHGs in rural India on intermediate outcomes and nutrition outcomes., Methods: We compared 16 matched blocks where communities were supported to form SHGs and improve livelihoods; 8 blocks received a 3-y nutrition intensive (NI) intervention with nutrition BCC, and agriculture- and rights-based information, facilitated by a trained female volunteer; another 8 blocks received standard activities (STD) to support savings/livelihoods. Repeated cross-sectional surveys of mother-child pairs were conducted in 2017-2018 ( n  = 1609 pairs) and 2019-2020 ( n  = 1841 pairs). We matched treatment groups over time and applied difference-in-difference regression models to estimate impacts on intermediate outcomes (knowledge, income, agriculture/livelihoods, rights, empowerment) and nutrition outcomes (child feeding, woman's diet, woman and child anthropometry). Analyses were repeated on households with ≥1 SHG member., Results: Forty percent of women were SHG members and 50% were from households with ≥1 SHG member. Only 10% of women in NI blocks had heard of intervention content at endline. Knowledge improved in both NI and STD groups. There was a positive NI impact on knowledge of timely introduction of animal-sourced foods to children ( P < 0.05) but not on other intermediate outcomes. No impacts were observed for anthropometry or diet indicators except child animal-source food consumption ( P < 0.01). In households with ≥1 SHG member, there was a positive NI impact on child unhealthy food consumption ( P < 0.05)., Conclusions: Limited impacts could be due to limited exposure or skills of volunteers, and a concurrent national nutrition campaign. Our findings add to a growing literature on SHG-based BCC interventions and the conditions necessary for their success., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Stem cells are cells that have the ability to self-renew into an undifferentiated cell state, which can further delineate into distinct cell types. There are various sources of stem cells in the human body; some of them include cord blood, placental tissue, bone marrow, adipose tissue, dental pulp, etc.  Breast milk could become an important source of stem cells in the near future because of its non-invasive isolation technique. Based on this nature, this study was conducted to isolate stem cells from breast milk and to show further potential implications of these cells. The total number of cells isolated from the milk ranged from 1.5 × 10 5 cells to 3 × 10 5 cells. As there was prolongation in the lactation period, the number of cells in the milk lowered significantly. There was no significant difference in the cell count in various gestational age groups. The cytochemistry analysis of these cells with their specific cell markers confirmed the presence of a homogenous population of mesenchymal stem cells. Further differentiation of these breast milk stem cell analyses showed transformation into adipocytes, chondrocytes, and osteoblasts in different culture mediums. So the presence of mesenchymal stem cells in human milk, which are multipotent in nature, makes it an important source of stem cells for further regenerative therapies, tissue culture techniques, and gene therapies. Due to this nature, these cells can be redirected to produce various tissues in the human body., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mane et al.)

Background and Aims: Anxiety causing stress is most profound before surgery. Anxiolytics are used routinely to combat perioperative anxiety. Studies have shown that hand-holding and communication are useful in reducing anxiety levels intraoperatively. This study compares the effectiveness of the same with pharmacological interventions in allaying preoperative anxiety., Material and Methods: This is a three-arm parallel-group randomised controlled trial. A total of 90 adult patients aged <45 years and of American Society of Anesthesiologists (ASA) grade 1-2, undergoing laparoscopic surgery were enroled in this study. Patients received either intravenous (IV) midazolam (group M) or hand-holding and conversation (group HC), or a combination of IV midazolam and holding and conversation (group HCM) in the preoperative room. Anxiety, heart rate (HR) and mean blood pressure (MBP) were recorded before and 20 minutes after the intervention. Anxiety was measured using the Amsterdam preoperative anxiety and information scale. The analysis of covariance (ANCOVA) test was done to analyse the difference between the groups., Results: The mean anxiety scores were significantly different in the three groups (p = 0.04) after intervention, with the lowest score in group HCM, followed by group HC and the highest score in group M. The mean heart rates were also significantly different in the three groups after intervention but MBP was not significantly different in the three groups., Conclusion: A combination of hand-holding and conversation and midazolam is best for allaying preoperative anxiety in patients undergoing laparoscopic surgeries than either method alone., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Anaesthesia.)

Background: In India, around 20,000 women die every year due to abortion-related complications. In count data modeling, there is sometimes a prevalence of zero counts. This article is concerned with the estimation of various count regression models to predict the average number of spontaneous abortions among women in Punjab and few northern states in India. The study also assesses the factors associated with the number of spontaneous abortions., Methods: This study includes 27,173 married women of Punjab obtained from the DLHS-4 survey (2012-13) to train the count models. The study predicts the average number of spontaneous abortions using various count regression models, and also identifies the determinants affecting the spontaneous abortions. Further, the best model is validated with other northern states of India using the latest data (NFHS-4, 2015-16)., Results: Statistical comparisons among four estimation methods reveals that the ZINB model provides the best prediction for the number of spontaneous abortions. The study suggests total children born to a woman, antenatal care (ANC) place, place of residence, woman's education, and economic status are the most significant factors affecting the instance of spontaneous abortion., Conclusions: This article offers a practical demonstration of techniques designed to handle count outcome variables. The statistical comparisons among four estimation models revealed that the ZINB model provides the best prediction for the number of spontaneous abortions, and it suggests policymakers to use this model to predict the number of spontaneous abortions. The study recommends promoting higher education among women in Punjab and other northern states of India. It also suggests that women must receive institutional antenatal care and have a limited number of children.

Gall bladder perforation as a sequel of typhoid-induced acalculous cholecystitis is a rare clinical encounter, reported sparsely in literature. Here, we discuss a case wherein successful laparoscopic management of typhoid-induced gall bladder perforation was performed. A 24-year-old female presented with a history of 5 days of fever and acute pain in the abdomen for 2 days. Computed tomography scan suggested gall bladder perforation which was confirmed on diagnostic laparoscopy. Laparoscopic cholecystectomy with peritoneal lavage was performed. The patient did well postoperatively and was discharged on post-operative day 4 after drain removal. One should be aware about the possibility of gall bladder perforation as a sequel of acalculous cholecystitis in typhoid fever. Minimal access surgery techniques can be applied for confirming the diagnosis as well as the definitive treatment., Competing Interests: None

Competing Interests: There are no financial or other issues that might lead to conflict of interest.

With the rise in a number of bariatric procedures, surgeons are facing more complex and technically demanding surgical situations. Robotic digital platforms potentially provide a solution to better address these challenges. This review examines the published literature on the outcomes and complications of bariatric surgery using a robotic platform. Use of robotics to perform adjustable gastric banding, sleeve gastrectomy, roux-en-y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch and revisional bariatric procedures (RBP) is assessed. A search on PubMed was performed for the most relevant articles in robotic bariatric surgery. A total of 23 articles was selected and reviewed in this article. The review showed that the use of robotics led to similar or lower complication rate in bariatric surgery when compared with laparoscopy. Two studies found a significantly lower leak rate for robotic gastric bypass when compared to laparoscopic method. The learning curve for RYGB seems to be shorter for robotic technique. Three studies revealed a significantly shorter operative time, while four studies found a longer operative time for robotic technique of gastric bypass. As for the outcomes of RBP, one study found a lower complication rate in robotic arm versus laparoscopic and open arms. Most authors stated that the use of robotics provides superior visualisation, more degrees of freedom and better ergonomics. The application of robotics in bariatric surgery seems to be a safe and feasible option. Use of robotics may provide specific advantages in some situations, and overcome limitations of laparoscopic surgery. Large and well-designed randomised clinical trials with long follow-up are needed to further define the role of digital platforms in bariatric surgery.

Purpose: The gold standard technique for the repair of groin hernias has always been a controversial issue. Richard Ger introduced the endoscopic approach for the repair of groin hernias in 1991.The endoscopic technique follows the basic principle of preperitoneal placement of a polypropylene mesh over the myopectineal orifice. During the course of dissection of the preperitoneal space, occult obturator and femoral hernias were discovered., Methods: Patients who underwent endoscopic totally extraperitoneal repair of inguinal hernias over a period of 2 years were included in this retrospective study., Results: A total of 305 cases of groin hernias were operated in 208 patients over a period of 2 years from January 2010 to January 2012 in a single institution. Eleven synchronous clinically occult obturator hernias were found in 8 patients (3.84%) and 5 synchronous clinically occult femoral hernias were found in 5 patients (2.40%) during repair., Conclusions: Preoperative and perioperative findings were discordant in quite a few cases. Preperitoneal dissection discovered coincidental occult hernias in 6.25% of patients.

Background and Objectives: This study evaluates our technique for robot-assisted sleeve gastrectomy for morbidly obese and super obese patients and our outcomes., Methods: A retrospective analysis of patients who underwent robot-assisted sleeve gastrectomy at a single center was performed. The procedure was performed with the da Vinci Si HD Surgical System (Intuitive Surgical, Sunnyvale, California). The staple line was imbricated with No. 2-0 polydioxanone in all cases. The super obese (body mass index≥50 kg/m2) subset of patients was compared with the morbidly obese group in terms of demographic characteristics, comorbidities, operative times, perioperative complications, and excess body weight loss., Results: A total of 35 patients (15 female and 20 male patients) with a mean body mass index of 48.17±11.7 kg/m2 underwent robot-assisted sleeve gastrectomy. Of these patients, 11 were super obese and 24 were morbidly obese. The mean operative time was 116.3±24.7 minutes, and the mean docking time was 8.9±5.4 minutes. Mean blood loss was 19.36±4.62 mL, and there were no complications, conversions, or perioperative deaths. When compared with the morbidly obese patients, the super obese patients showed no significant difference in operative time, blood loss, and length of hospital stay. There was a steep decline in operating room times after 10 cases of robot-assisted sleeve gastrectomy., Conclusion: This study shows the feasibility and safety of robot-assisted sleeve gastrectomy. Robotic assistance might help overcome the operative difficulties encountered in super obese patients. It shows a rapid reduction in operative times with the growing experience of the entire operative team. Robot-assisted sleeve gastrectomy can be a good procedure by which to introduce robotics in a bariatric surgery center before going on to perform Roux-en-Y gastric bypass and revision procedures.

Introduction: There are few case reports of retroperitoneal tumor excision using the robotic technique. We describe a case of a 13 × 9 × 7- cm retroperitoneal schwannoma that was excised using robot-assisted surgery to provide a minimally invasive benefit to the patient., Case Report: A 45-year-old woman presented with a right paracaval retroperitoneal lump with well-defined margins displacing the inferior vena cava, the right kidney, the head of pancreas, and the duodenum. She underwent a robot-assisted excision of the tumor using the da Vinci Si HD surgical system using three robotic arms. The biopsy results revealed a well-encapsulated schwannoma diffusely positive for S100. The patient was discharged on the third postoperative day and was still doing well at 1-month follow-up., Conclusion: Use of robotic technology assists in providing minimally invasive benefits to the patient. It is a safe and effective technique for retroperitoneal surgery.

Spigelian hernias, also known as spontaneous lateral ventral hernias, are rare primary ventral hernias arising in the Spigelian, or semilunar, line located at the lateral border of recti. Because of its varied presentation, clinical examination is often inconclusive. Traditional repair of such hernias use the open approach. Herein we report on three cases of Spigelian hernias. All were diagnosed and treated laparoscopically at our institution between March 2011 and June 2012. Multiple surgeons performed the repairs using the laparoscopic transabdominal preperitoneal technique of mesh reinforcement and reperitonization. There were no perioperative or postoperative complications. All three were discharged 1 day postoperatively. A complete resolution of preoperative symptoms was observed at follow-up at 1 week, 1 month and 6 months. Laparoscopic transabdominal preperitoneal repair of Spigelian hernia is safe, easy, and feasible for experienced laparoscopic surgeons., (© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.)

Background: Intraperitoneal onlay mesh repair is an established modality to treat large ventral hernias. Various techniques of laying the mesh are utilized. We present the Double Rolling and Center Hitch technique to lay a large intraperitoneal onlay mesh., Objective: The aim of the study is to devise and adopt a method to reduce the difficulty in manoeuvring a large mesh inside the peritoneal cavity. It should also help in correct placement of mesh and decrease the operative time., Materials and Methods: The DRACH technique was used in eighteen patients with large ventral hernias between May 2010 and September 2011. The Mesh size used was 15x20cm and more (considered to be large mesh)., Results: All the procedures were completed successfully. Mesh handling was significantly easier with the DRACH technique. The average mesh deployment time (MDT) was 15mins. In all cases the mesh was adequately centred with a margin of 3-5cm from the defect., Conclusion: The DRACH technique can be employed to lay large intraperitoneal meshes in order to reduce the handling difficulties associated with large meshes, and to aid in better placement of meshes so as to centered over the defect.

Introduction: Single-incision laparoscopic surgery (SILS) appendectomy seeks to further minimise the trauma of parietal access of laparoscopic appendectomy., Methods: We present our initial experience of 17 cases of SILS appendectomy which were completed using conventional laparoscopic instruments. We utiliesd a single-incision multi-port laparoscopic appendectomy (SIMPLA) technique., Results: The operative time was 63 ± 20 min, blood loss 6.5 ± 5 mL, bowel movement (passing stool) occurred in 2.6 ± 0.6 days. Most patients were discharged on the first operative day on oral diet. The analgesic usage and pain scores were similar to multi-port laparoscopic appendectomy. No complications were noted at follow-up till 4 weeks and the surgical wound healed in all patients with an inconspicuous scar., Conclusion: Our initial experience with SILS appendectomy demonstrates its feasibility and supports the promise of minimising further the access of laparoscopic surgery. The clear advantage is its cosmetic benefit.

Clinical data of 104 hospitalized children during the 2003 epidemic of encephalitis in Andhra Pradesh state was retrospectively analysed to know the clinical profile and risk factors associated with mortality. Fever was the first symptom associated with altered sensorium, seizures, diarrhoea and vomiting. Evolution of illness was very rapid with high fatality (47%). Majority of deaths occurred within the first 24 h of illness due to brainstem involvement. On multiple logistic regression analysis, high-grade fever, absent oculocephalic reflex and Glasgow coma score <7 were found to be significantly contributing to the mortality. Evidence of Chandipura virus was detected in these cases as the etiological agent.