JA Group Research Articles

Clinical and functional outcomes of open versus minimally invasive surgeries in single-level prolapsed intervertebral disc in lumbar region at tertiary care center: A prospective study

Background: Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Modern MIS techniques allow spine surgeons to achieve the same goals of open surgery while minimizing the collateral damage associated with the open approaches. Aims and Objectives: The aim of MIS is to do an efficient “Target Surgery” with a minimum of iatrogenic trauma. Materials and Methods: This is a prospective study done in the Department of Neurosurgery, JA group of hospitals, Gajra Raja Medical College, Gwalior, from July 2021 to July 2022. Study was conducted on 30 randomly selected patients whose presentation and imaging showed indication for surgery. Results: Better symptomatic relief was seen in patients with MIS at 7 days with about 80% of them having a visual analog scale score between 0 and 2; however, not much difference was noted at 1 month. Not much difference was noted for wound status, neurological improvement, and Oswestry Disability Index at 1 month. However, gross difference was noted at the rate of return to work by the patients with approximately 93.3% of patients undergoing MIS returning to work within 1 month in comparison to only 20% in case of open surgery. Conclusion: Minimally invasive techniques are remarkably better option to traditional open surgeries, as these procedures showed a significant reduction in immediate post-operative pain, duration of hospital stay, and return to work by the patient. However, not much difference was noted in status of pain at 1 month, rehospitalization, degree of disability at 1 month, wound status, and neurological improvement of the patient.

Clinicoradiological evaluation and outcome assessment of single-stage posterior correction of atlantoaxial dislocation

Background: Atlantoaxial dislocation (AAD) refers to loss of stability between atlas and axis vertebrae, resulting in loss of normal articulation. It may be due to congenital, traumatic, or inflammatory reasons. Various techniques of atlantoaxial fixation have been described and used in patients over the years, but each has its own merits and demerits. Aims and Objectives: The aim of the study was to study clinicoradiological evaluation and outcome assessment of single-stage posterior correction of AAD. Materials and Methods: This is a prospective study done in the Department of Neurosurgery, JA group of hospitals, Gajra Raja Medical College, Gwalior, from July 2021 to July 2022. The study was conducted on 20 randomly selected patients whose presentation and imaging showed indication for surgery. Results: C1 lateral mass C2 pars screw fixation had one Frankel grade improvement in 6 months in 96% patient with a fusion rate of 100% and the patient also has modified Japanese orthopedic association score improvement of 15.25±0.98. Conclusion: This study reviewed single-stage posterior correction of AAD using C1 lateral mass and C2 pedicle screw and rod fixation; it enables the stabilization of atlantoaxial motion and preserves motion at occipito-atlantal level with high fusion rates, good neurological recovery, and minimal complications.

A PROSPECTIVE STUDY OF EPIDEMIOLOGICAL FACTORS AND OUTCOME IN PATIENTS OF DIABETIC FOOT WOUND ATTENDING J.A. GROUP OF HOSPITALS: A TERTIARY CARE CENTRE

Objectives: To study about epidemiological factors related to diabetic foot wound such as age, sex, duration of diabetes, relation to ongoing retinopathy, and nephropathy. Methods: After obtaining approval from ethical committee, the present study is to be conducted on 100 patients of diabetic foot in the Department of Surgery, JA Group of Hospitals and GR Medical College, Gwalior (MP) during January 2020 to June 2021 after getting written informed consent from the patients. Results: In our study, out of 100 cases, most of the diabetic foot wound cases observed were in the 50–59 years age group with a mean age of 52.23 and a standard deviation of ±14.92. Out of 100 cases, 82 (61.%) were male and 29 (38.66%) were female. Therefore, male: female ratio was 4.5:1. In our study of 100 patients, 70 (70%) presented with ulcer with or without necrotic patch, gangrene and 30 (30%) with cellulitis with or without abscess. Among all patients of diabetic foot, wound 62 (62%) were associated with retinopathy and 47 (47%) were associated with diabetic nephropathy. Conclusion: Diabetic foot wound is more common in men due to their increased susceptibility to trauma and occupation. Diabetic patients at risk for foot complication must be educated about risk factors and the importance of foot care, including the need for self-inspection and surveillance, monitoring, daily foot hygiene, use of proper footwear, good diabetes control, and prompt recognition and early standard treatment of newly discovered lesions.

Outcomes of Decompressive Craniectomy in Patients with Supratentorial Ischaemic Stroke: A Longitudinal Study

Introduction: Decompressive Craniectomy (DC) is a surgical procedure that entails removing a section of the skull with the aim of preventing neuronal damage and improving the patient’s prognosis. The goal was to determine if DC is associated with reduced risk of death and improved outcomes. Aim: To study the outcome, morbidity and mortality associated with DC in patients with intracranial ischaemic infarct. Materials and Methods: A longitudinal single-centre study was carried in the Department of Neurosurgery, GR Medical College and JA Group of Hospitals, Gwalior, Madhya Pradesh, India, from January 2019 to June 2020. A total of 25 cases were operated on and subsequently followed-up. Patients who were admitted with life-threatening supratentorial infarction and deemed eligible for DC based on clinical assessment {National Institute of Health Stroke Scale, Glasgow Coma Scale (GCS)} and neuroimaging with computed tomography head or Magnetic Resonance Imaging (MRI) brain were prospectively included in the study. The outcomes of the study were evaluated based on the functional impairment experienced by patients after a stroke. This was assessed using the Modified Rankin Scale (mRS), a seven-point scale that ranges from 0 (no symptoms) to 6 (death). The assessments were conducted at discharge, three months and six months. Paired t-test was used to analyse the functional outcomes of patients at admission, discharge, 3-month, and 6-month follow-up, using the mRS as the tool of evaluation. The relationship between patient characteristics and neurological outcome was analysed using the Chi-square test. Results: In the study, 25 patients were analysed, with 76% being males. The right hemisphere was affected in 13 (52%) patients, while 12 (48%) patients had left hemisphere involvement. At admission, 23 (92%) patients had a mRS score of five and only 2 (8%) patients had an mRS score of 4. During hospitalisation, 8 (32%) patients died. After discharge, 7 (28%) patients had a mRS score of 4 or less, which increased to 9 (36%) patients at three months follow-up and 12 (48%) patients at six months follow-up. Conclusion: The results of the present study revealed that decompressive hemicraniectomy improved neurological outcomes of patients with supratentorial ischaemic infarcts, with patient characteristics playing a significant role.

Synthesis of a novel injectable alginate impression material and impression accuracy evaluation.

This work aimed to synthesize a novel injectable alginate impression material and evaluate its accuracy. Certain proportions of sodium alginate, trisodium phosphate dodecahydrate, potassium fluorotitanate, diatomaceous earth, and other ingredients were dissolved in water and mixed evenly with a planetary centrifugal mixer to obtain a certain viscosity base paste. Certain proportions of calcium sulfate hemihydrate, magnesium oxide, glycerin, and polyethylene glycol (PEG) 400 were mixed evenly with a planetary centrifugal mixer to obtain the reactor paste with the same viscosity as the base paste. The base and reactor pastes were poured into a two-cylinder cartridge at a 2∶1 volume ratio. A gun device was used to accomplish mixing by compressing materials into a mixing tip. The samples were divided into three groups: injectable alginate impression materials (IA group) as the experimental group, and Jeltrate alginate impression materials (JA group) and Silagum-putty/light addition silicone rubber impression materials (SI group) as the two control groups. Scanning electron microscopy (SEM) showed that the injectable alginate impression materials had a denser structure and fewer bubbles than the commercial alginate impression material. The accuracy of the three kinds of impression materials was evaluated by 3D image superposition. The deviations between the three test group models and the standard model (trueness) were 49.58 μm±1.453 μm (IA group), 54.75 μm±7.264 μm (JA group), and 30.92 μm±1.013 μm (SI group). The deviations of the models within each test group (precision) were 85.79 μm±8.191 μm (IA group), 97.65 μm±11.060 μm (JA group), and 56.51 μm±4.995 μm (SI group). Significant differences in trueness and precision were found among the three kinds of impression materials (P<0.05). The accuracy of the new injectable alginate impression material was better than that of the traditional powder-type alginate impression material but worse than that of the addition silicone rubber impression materials. The novel injec-table alginate impression material demonstrated good operation performance and impression accuracy, showing broad application prospect.

A clinico-epidemiological hospital based study of oral cancer patients in Gwalior district

Oral cancer is the most common form of carcinoma of oral cavity and ranks as the 12th most common cancer in the world. Oral cancer is one of the major social &amp; health problems in India and Indian subcontinent countries. Tobacco use in different forms is the main etiological factor for oral carcinoma. (i) To define relations of oral cancer with respect to gender, age group, socioeconomic status and risk habits; (ii) To observe the distribution of affected oral cavity sites and observe the clinical profile in oral cancer patients.A cross-sectional study of 340 oral cancer patients from January 2019 to December 2019 was carried out in Department of oncology &amp; radiotherapy, JA Group of hospital, G. R. Medical Gwalior, Madhya Pradesh India. Details of patient's sex, age, tobacco habit and site of cancer and status were noted. Data were analyzed by probability of patient with risk factors and chi-squire (χ) test. The prevalence of oral cancer was significantly (p &amp;#60; 0.001) higher in males (91.5.9%) than females (8.5%). In both the sexes, most affected sites were the buccal mucosa and gingivo-buccal sulcus. However, the consuming form of tobacco was found to be significantly associated with oral cancer, in both sex. The study revealed that oral cancer is more common in men, probably due to habit of large tobacco consumption.

A STUDY OF POST OPERATIVE WOUND INFECTION AND MANAGEMENT

OBJECTIVE:-this study was designed to evaluate the postoperative wound Infection, common risk factors and the different organisms which were involved in cases of clean and clean-contaminated, contaminated and dirty surgeries. Method and materials: - The study was conducted in the department of surgery, JA group of hospital, Gwalior in collaboration with departmental of microbiology. G.R.MEDICAL COLLEGE GWALIOR. For duration of one year. The bio data of the patients, together with their clinical features, diagnosis, the type of surgery which was performed and the development of any complications, which included wound infections, was noted and the data was analyzed. RESULTS:-out of 150 patients, we found that age of more than 60 years was to be more risk factor 20%(5 of out of 25) and less risk factor to be present in below 20 years age group 8.33%(1 out of 12). The incidence amongst the clean case was 2.7 %(1 out of 36), among the clean contaminated cases , it was 9.3% (6 out of 64), among the contaminated cases it was 17.6%(3 out of 17), among the dirty cases , it was 24.2%(8 out of 33). Positive cultures were obtained from the infected wounds. The commonest bacterial isolates were staph aureus(32%), S.epid, E.coli, Ps.aureginosa, Klebseilla

A comparison of a novel endoscopic \u201cSu-Wang technique\u201d with the open \u201cJaboulay\u2019s procedure\u201d for the surgical treatment of adult primary vaginal hydrocele

This paper was aimed to introduce and compare outcomes of a novel “Su-Wang (S-W) technique” for endoscopic treatment of adult hydrocele with conventional open hydrocelectomy with “Jaboulay’s (JA) procedure” regarding adverse events (AEs) and patient satisfaction. In the randomized controlled trial, adult males with primary hydroceles were prospectively assigned into S-W or JA group. We recorded perioperative data and postoperative AEs (incision length, recurrence, hematoma, wound infection and edema vanished time). Finally, a total of 42 adult patients underwent the S-W (n = 22) or JA (n = 20) procedure. Procedures were successfully completed for all 42 patients. No significant differences were found between the two groups regarding age, symptom duration, body mass index, and size of the hydrocele. The incision length was significantly shorter in the S-W group (1.00 ± 0.24 cm) than in the JA group (6.10 ± 1.46 cm). After 6 months’ follow-up, complete data of 90.5% (38/42) were obtained. Severe AEs did not occur in any patient. Recurrence, hematoma, wound infection, edema vanished time values, and satisfaction in the S-W group were superior to those in the JA group. All patients in the S-W group were satisfied with this novel procedure, particularly due to the minimally invasive incision. In conclusion, the novel “S-W technique” for hydrocelectomy provided satisfactory cosmetic results with a 1-cm scrotal incision only. With the near-complete excision of the parietal TV, it resulted in no recurrence, fewer AEs, and rapid postoperative rehabilitation in comparison to the traditional “JA procedure.” The endoscopic “S-W technique” may be a viable alternative for the surgical treatment of adult primary vaginal hydrocele.

A prospective study of demography, clinical presentation and risk factors of cerebral venous thrombosis in pregnant and postpartum women

Introduction: Cerebral venous thrombosis (CVT) is reported in pregnant and postpartum women showing different characteristic because of specific physiology associated with pregnancy and puerperium. Aims and Objectives: To study sociodemographic features and risk factors of CVT in pregnant and postpartum women. Materials and Methods: A total 100 pregnant and postpartum women having CVT were studied at Kamla Raja Hospital and JA Group of Hospital at GR Medical College, Gwalior Madhya Pradesh for study period of 2016 to 2017. Detailed patient’s history, risk factors, symptoms, booking and referral status, place and mode of delivery was recorded. Results: CVT was most common in women with 2nd decade of life (84%), were 2nd gravida (39%), belonging to rural community (82%) and low socioeconomic status (85%). Maximum women came directly to the centre (58%), were unbooked (96%), presented in postpartum period (95%) and were delivered in hospital (86%). Maximum patients were delivered at various district hospitals (25.5%). Most common risk factor for CVT was anemia (56%) followed by hypertension (30%) and infection (17%) Most common clinical presentation was seizure (65%), headache (48%), paresis (26%) and nausea and vomiting (15%). Conclusion: CVT is associated with varied symptoms in pregnancy and postpartum period. Young age, rural community, low socioeconomic class, caesarean delivery, anemia and preeclampsia were the prevailing risk factors. Keywords: Pregnancy, Postpartum period, Anemia, Caesarean delivery, CVT.

Clinical and biochemical profile of non-diabetic chronic kidney disease patients: A prospective study

Background: Chronic kidney disease (CKD) is one of the raising health issues globally. Patients who are in the last stage (Stage 5) of CKD can only be treated using renal replacement therapy mainly hemodialysis. Patients undergoing hemodialysis often face disturbed routine life and also report dissatisfaction following treatment. Objectives: The objectives of this study were to study the clinical and biochemical profile of non-diabetic CKD patients. Materials and Methods: A total of 100 CKD patients were studied in the Department of Medicine, GR Medical College and JA Group of Hospitals, Gwalior, from February 2014 to November 2015. After detailed history, complete blood count, blood urea, serum creatinine, serum albumin, total protein, albumin-to-creatinine ratio, and albumin excretion ratio were estimated in all the patients. Results: Most of the patients in cases (23%) belong to the age group of 51–60 years with male predominance (56%). The most common symptom was swelling of legs (70%) followed by oliguria (62%), whereas the most common sign was pallor (76%) followed by edema (70%). Most of the patients (61%) were hypertensive. Maximum patients were from glomerular filtration rate G5 category (69%). Most of the patients were of A3 albuminuria category (76%). Mean hemoglobin, blood urea, serum creatinine, total protein, and serum albumin in non-diabetic CKD patients were 8.06 ± 2.34, 156 ± 92.32, 7.56 ± 5.22, 6.11 ± 0.93, and 3.11 ± 0.65, respectively. Conclusion: CKD was common in male patients who were in the 6th decade of life. Swelling of legs, oliguria, pallor, and edema were the common signs and symptoms in non-diabetic CKD patients. Awareness regarding the factors responsible for CKD is important to lower the incidence and even delay the progression to end-stage renal disease.

Comparing lipid profile in healthy participants with and without smoking: A prospective study

Background: Smoking can induce cancer, stroke, and heart disease and also has been reported to cause periodontal disease, gastric ulcer, sudden infant death syndrome, and metabolic syndrome. Objectives: The objective is to study and compare alterations of lipid profile among smokers and non-smokers in different age groups. Materials and Methods: One hundred participants were studied at JA Group of Hospitals and GR Medical College, Gwalior, from June 2014 to October 2015 after dividing them into Group A (n = 50, non-smokers) and Group B (n = 50, smokers). Lipid profile including total cholesterol (TC), triglycerides (TGs), low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), and HDL/TC ratio was estimated. Results: The mean age of participants in Group A and Group B was 34.56 ± 12.12 and 36.45 ± 62.22 years, respectively. TC, TG, and LDL were higher in Group B compared to Group A, whereas HDL and HDL/TC ratio were lower in Group B compared to Group A across all age groups. Conclusion: Significantly higher serum level of TC, TG, LDL, and very LDL with lower level of HDL suggests that smoking is associated with dyslipidemia. Dyslipidemia is an independent risk factor for vascular diseases, so it can be used as a biomarker to identify smokers at risk.

“A Retrospective And Prospective Study of Epidemiological Factors, Clinico-Pathological Profile, And Treatment Plans in Patients of Oral Cavity Cancers Admitted In JA Group of Hospitals and GR Medical College Gwalior”

“A Retrospective And Prospective Study of Epidemiological Factors, Clinico-Pathological Profile, And Treatment Plans in Patients of Oral Cavity Cancers Admitted In JA Group of Hospitals and GR Medical College Gwalior”

An Observational Study to Assess the Level of Satisfection Amongst Patients Operated As Elective Basis in Department of Surgery, G.R. Medical College &amp; Ja Group of Hospitals

An Observational Study to Assess the Level of Satisfection Amongst Patients Operated As Elective Basis in Department of Surgery, G.R. Medical College &amp; Ja Group of Hospitals

Profile of patients attending Anti Rabies Clinic at Madhav Dispensary, JA Group of Hospitals, Gwalior

Profile of patients attending Anti Rabies Clinic at Madhav Dispensary, JA Group of Hospitals, Gwalior

A study to assess delays in reporting time and completion of treatment at anti rabies clinic, JA group of hospitals, Gwalior, Madhya Pradesh, India

Background: Rabies in humans is 100% preventable through prompt appropriate medical care. 20,000 people are estimated to die every year from rabies in India primarily because of stray dogs. Rabies continues to be a public health problem in India as there is no organised system of surveillance of rabies cases and there is hence a lack of reliable data. The present study was undertaken to assess reporting time to medical facility, timely completion of vaccination and use of indigenous treatment. Methods: It was a cross sectional study conducted for the duration of six months in anti-rabies clinic of Madhav dispensary at J.A. group of hospitals Gwalior. All newly registered patients who consented to participate were included in the study. The sample size calculated was 1200 and the tool for collecting information was a semi structured questionnaire. Results: 46.09% cases reported within >24-72 hours, 21.40% within >72 hours to 07 days while 18.17% cases reported to medical facility after seven days. Financial problem was the cause of delay in maximum (35.83%) number of cases. 62.95% (712) cases delayed the completion of treatment. 51.50% took one or more type of indigenous/home treatment. Conclusion: Health education about consequences of animal bite and their appropriate vaccination including wound management should be promoted through media and other channels. Indigenous methods of treatment should be discouraged .

Comparative Study of Different Anastomotic Technique- Single Layer Extra Mucosal Versus Conventional Double Layer Anastomosis in Elective and Emergency Laparotomy

The present study was conducted to compare the efficacy of Two hand sewn techniques of gut anastomosis (i.e. single and double layer). This prospective study was conducted in department of Surgery, JA Group of Hospitals, G.R.M.C Gwalior. 80 patients requiring intestinal anastomosis were included in this study from October 2011 to October 2012. In this study 43 single layer extramucosal and 37 conventional double layered anastomosis were observed and Comparison was made in terms of time required for anastomosis, anastomotic leak and other complications, and the cost incurred. Single layer anastomosis was performed with a continuous 2-0 polyglycolic acid suture & two layer anastomosis was constructed using 2-0 silk lembert suture for the outer layer & a continuous 2-0 polyglycolic acid suture for inner layer. 80 patients were subjected to intestinal anastomsis either single or double layer in emergency or electively by senior surgeon (Registrar or consultant). In 43 cases single layer anastomsis was done (18 emergency + 25 elective). In 37 cases double layer anastomosis was done (14 in emergency + 23 elective). In our study single layer anastomosis took 16-22 minutes whereas double anastomosis took 26-36 minutes. The average postoperative stay in hospital was 11.45 days for single layer and 13.45 days for double layer. The study shows that there was low incidence of anastomotic failure and setpic complications in single layer as compared with the double conventional methods of gut anastomosis. Hence the single layer anastomosis is safe and cost effective.

The Rice Business of JA Group under the Rice Policy Reform(The Directions of Rice Marketing and Growing Districts under the Rice Policy Reform,Symposium Reports at 2004 Annual Meeting of the Society)

The Rice Business of JA Group under the Rice Policy Reform(The Directions of Rice Marketing and Growing Districts under the Rice Policy Reform,Symposium Reports at 2004 Annual Meeting of the Society)

Lower level of education in young adults with arthritis starting in the early adulthood

An appropriate education may lead to less work disability in patients with arthritis. The aim of the study was to determine the educational level in two groups of young adults with arthritis. Patients with juvenile arthritis (JA, n = 32) and patients with early adult onset of arthritis (EA, n = 47) were examined with the Quality of Life Scale (QOLS) and a questionnaire concerning education and profession counselling. Comparisons with a reference group (n = 95) from the general population were made. The EA group had lower level of education (p< 0.01), compared to the reference group. Among the EA patients, 62% had not discussed their choice of occupation with anybody, compared to 19% in the JA group. The educational level was lower in patients with rheumatic disease starting in early adulthood. Educational issues and counselling should be focused on the care of young adults with arthritis.

Molecular variation within some Japanese isolates of Verticillium dahliae

Eight isolates of Verticillium dahliae from Japan, classified into four groups based on pathogenicity to differential hosts, were compared with isolates in previously defined RFLP groups. Within each of two of the pathogenicity groups (JB and JC) the pairs of haploid isolates were closely related but those in a third group (JA; isolates not pathogenic to sweet pepper or tomato) were not. Only one of the six haploid isolates (one of the two in the JA group) could be placed in an existing RFLP group. The two diploid isolates (the JD pathogenicity group) were similar to RFLP group D and only distantly related to the six haploid isolates. Of the Japanese pathogenicity groups, only JD corresponded to an existing RFLP group.

Studies on the effect of adding Jerusalem artichoke flour to pig milk replacer

In three experiments, piglets were fed either a control milk replacer (CONT) (total 18 piglets) or one containing added immunoglobulins (+IG) (total of 18 piglets) or Jerusalem artichoke flour (+JA) (total of 18 piglets). Piglets had been left with the sow for one day to receive colostrum before starting the three experiments and had zero mortality. Scouring was not a problem in any group. In all experiments, +JA group consumed less milk than the other 2 groups. The weight gain data were variable, but in 2 of the 3 experiments the +JA group gained the least amount of weight. Key words: Milk replacer, Jerusalem artichoke, neonate