GCS Medical College, Hospital and Research Centre was dedicated to people by Shri Narendra Modi (Hon'ble Prime Minister of India) in 2011. This state-of-the-art infrastructure has been built by Gujarat Cancer Society in 25 acres of area..
BACKGROUND:Colonic diverticulosis (CD) is a prevalent condition marked by small pouches (diverticula) in the colon wall, particularly in those over 50. Many studies have investigated various risk factors, but the relationship between smoking, alcohol consumption, and CD remains to be decided. This meta-analysis analyses the association between these lifestyle factors and the risk of CD and its complications. METHODS:A comprehensive literature search was conducted using PubMed, Embase, and Google Scholar to find relevant studies. Inclusion criteria were based on predefined eligibility standards, focusing on observational studies reporting smoking, alcohol consumption, and CD. Using random effect models, Mantel-Haenszel odds ratios and associated 95% confidence intervals were produced to report the overall effect size. Statistical significance was set at P < .05. Egger's regression test and Begg-Mazumdar's rank test were used to assess publication bias. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS:Sixty-two studies encompassing 5,66,903 patients were included finally, where the mean age was 73.8 years, and 44.53% were female. Smoking increased the risk of CD (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.24-1.48), diverticulitis (OR: 1.59, 95% CI: 1.01-2.51), and diverticular bleeding (OR: 1.51, 95% CI: 1.13-2.02). Ex-smokers also showed a higher risk of CD compared to nonsmokers (OR: 1.31, 95% CI: 1.08-1.59). Alcohol consumption was associated with an increased risk of CD (OR: 1.41, 95% CI: 1.09-1.82). However, no association was found between alcohol consumption and diverticular bleeding (OR: 1.15, 95% CI: 0.77-1.71) or diverticulitis (OR: 1.36, 95% CI: 0.98-1.88). No publication bias was clear in the analysis. CONCLUSION:This meta-analysis suggests an association between smoking, alcohol consumption, and increased risk of CD. Smoking is associated with an increased risk of CD and diverticular bleeding. The relationship between alcohol consumption and diverticular disease requires further investigation. Future research should explore the mechanisms by which these factors influence the development of CD to understand and inform public health recommendations.
Introduction: Del Nido Cardioplegia (DNC) offers prolonged myocardial protection through a single-dose approach.Methods: This retrospective study involved 175 adult patients from five surgical groups (DVR, MIS‑MVR, MVR via sternotomy, AVR, congenital repairs). Statistical analysis was conducted using SPSS v25. Quantitative variables were assessed using t‑tests /Mann–Whitney U tests, while categorical variables were analyzed using chi‑square/Fisher’s exact tests. Significant differences (p<0.05) in ACC and CPB durations were observed across the groups.Results: The return to spontaneous sinus rhythm ranged from 90% to 100% among the groups. Significant variations in ACC and cardiopulmonary bypass (CPB) times were noted (p<0.05). Single‑dose DNC proved to be effective in all cases.Conclusion: DNC demonstrates safety and efficiency in low- and middle-income country (LMIC) settings.
Background: Diabetes has steadily increased in India over the last three decades, with 77 million people having diabetes as of 2019, which is expected to rise to 134 million by 2045. Over 90 % of these cases are of type 2 diabetes. The newer antidiabetics like dipeptidyl peptidase IV (DPP-IV) inhibitors and sodium-glucose transporter-2 (SGLT-2) inhibitors are prescribed nowadays in type 2 diabetic patients. However, the relative efficacy and safety of these two new drug groups are unknown. Objectives: We conducted this study to evaluate the efficacy and safety of DPP-IV inhibitors and SGLT-2 inhibitors as add-on therapies in type 2 diabetic patients attending a tertiary care teaching hospital. Methods: This was a prospective, observational, comparative study conducted at GCS hospital, Ahmedabad, India, from November 2020 to October 2022. Results: In this study, 125 patients of either gender were enrolled and analysed. Of the 125 patients, 82 have been prescribed DPP-IV inhibitors (65.6%), and 43 were prescribed SGLT-2 inhibitors (34.4 %). SGLT-2 inhibitors had a more substantial decrease in HbA1c than DPP-IV inhibitors at weeks 12 (-1.13±1.33 vs -0.39±1.40, P<0.05) and 24 (-1.87±1.74 vs -1.07±1.58, P<0.05). The total number of adverse events was lower in the DPP-IV inhibitor group than in the SGLT 2 inhibitor group (18.3% vs 46.5%). Urinary tract infection was the most common adverse event in the SGLT-2 inhibitor group. While in the DPP-IV inhibitor group, gastrointestinal adverse events were common. Conclusion: Though SGLT-2 inhibitors have shown better efficacy outcomes, their possible adverse drug reactions should be kept in mind by physicians.
Background and Aim: Spinal anaesthesia is widely used for lower limb orthopaedic surgeries due to its effectiveness, safety, and ability to provide excellent intraoperative and postoperative analgesia. Levobupivacaine and ropivacaine are newer long-acting local anaesthetics with reduced cardiotoxicity compared to bupivacaine. This study compared the anaesthetic and analgesic efficacy of intrathecal 0.5% hyperbaric levobupivacaine and 0.75% hyperbaric ropivacaine. Methods: A randomized double-blind controlled study was conducted on 100 patients (ASA I–II, aged 18–75 years) undergoing elective lower limb orthopaedic surgeries under spinal anaesthesia. Patients were randomly allocated into two groups: Group L received 3 mL of 0.5% hyperbaric levobupivacaine and Group R received 3 mL of 0.75% hyperbaric ropivacaine intrathecally. Sensory and motor block characteristics, haemodynamic parameters, postoperative pain scores, time to first rescue analgesia, analgesic consumption, and adverse effects were assessed. Results: Group R demonstrated a significantly faster onset of sensory blockade (88.8±15.5 s vs. 142.4±16.1 s; p<0.001) and earlier attainment of peak sensory level. However, Group L showed significantly longer sensory regression time (125.2±11.7 min vs. 88.5±9.4 min; p<0.001), prolonged motor block duration (243.8±17.6 min vs. 184.1±12.8 min; p<0.001), and longer duration of analgesia (245.2±11.3 min vs. 198.4±14.7 min; p<0.001). Rescue analgesic requirements were lower in Group L. Haemodynamic parameters remained comparable between groups, and adverse effects were minimal. Conclusion: Both agents provided effective spinal anaesthesia. Hyperbaric ropivacaine offered faster onset and earlier recovery, whereas hyperbaric levobupivacaine provided prolonged sensory and motor blockade with superior postoperative analgesia
BACKGROUND:Rheumatoid arthritis (RA) is a chronic autoimmune disease known for its systemic inflammatory effects and associated comorbidities. Chronic obstructive pulmonary disease (COPD) has been increasingly recognized as a significant comorbidity in RA patients. This meta-analysis aims to quantify the prevalence and relative risk of COPD in patients with RA compared to the general population. METHODS:A systematic search of PubMed, Embase, and Google Scholar was conducted until April 30th, 2024. Studies were selected based on predefined inclusion criteria, focusing on those reporting data on COPD in RA patients. Random-effects models were used to estimate pooled prevalence rate and risk ratios, along with 95% confidence intervals (CIs), to report the overall effect size. Statistical significance was set at P < .05. Statistical analyses were conducted using Review Manager and MedCalc software, with results pooled using the Mantel-Haenszel random-effects model. Heterogeneity was assessed using I2 statistics, and publication bias was evaluated using funnel plots, Egger regression, and Begg rank correlation tests. RESULTS:Twenty-four studies with a combined population of 1,710,600 individuals were included. The pooled prevalence of COPD in RA patients was 7.06% (95% CI 4.56-10.13). Subgroup analysis showed a prevalence of 6.36% in Asia and 7.1% in the studies from the rest of the world. RA patients had a significantly higher risk of developing COPD compared to the general population, with an risk ratios of 1.58 (95% CI 1.37-1.82, P < .0001). The relative risk in Asian populations was 1.61 (95% CI, 1.19-2.18, P < .0001) compared to 1.56 (95% CI, 1.24-1.97, P < .0001) in studies from the rest of the world. According to Newcastle-Ottawa Scale, most studies were of high or moderate quality. According to Egger regression and Begg rank correlation tests, all analyses were free of publication bias. CONCLUSION:This meta-analysis offers strong evidence that individuals with RA are at a significantly higher risk of developing COPD. These findings emphasize the need for regular screening for COPD in RA patients and the implementation of proactive management strategies to reduce this risk. Further research is required to fully understand this relationship.
