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Cancer Research Anti-Cancer Activity PHPC Compound
Research Objective
The Study indicates that research provides chemo preventive effects
Significant reduction in cancerous cells
Indicative suppression of growth of tumor
Quantifying and analyzing DNA damage in individual cells

PHPC Compound is the patent and proprietary medicine developed by Benmoon Pharma Research Pvt Ltd., Ahmedabad. The entire study was planned to do evaluation of efficacy and safety of PHPC Compound in experimental animal’s models. First it was screened in-vitro using breast cancer cell line using MTT assay method, wherein it has shown significant reduction in viable cancerous cells.
After promising result in in-vitro study, safety was checked using Acute toxicity study (OECD 425), wherein it was found safe till the dose of 2000-5000mg/kg, orally.

Further, for long term usage of this formulation, its sub-chronic (90 days) oral toxicity study was done (AYUSH & OECD 408 guideline) in rats and guinea pigs, wherein it shows no significant toxic sign, symptoms and in histology too. To check whether it retards toxic effects against chemotherapeutic agents induced toxicity, it was evaluated against 5-FU model, wherein also it has shown chemo-preventive activity.

To check its effectiveness against breast cancer, it was further screened against DMBA-induced cancer model, wherein also it has shown significant reduction in occurrence of tumor, reduction in tumor size and volume. DMBA induced breast cancer by DNA mutation and increasing free radicals level. The treatment of PHPC Compound reduces free radical levels as evident by significant increase in SOD and Catalase level. Further, it reduces serum level of SGOT and SGPT level, which usually get secreted during tissue damage.
Further to check the effectiveness of the PHPC Compound on DNA damage in individual cells of cancer cell line. In the present study, in 5-FU (5.0μg/ml ) treated cell line, there was reduction in % Head and increase in % Tail, which indicates DNA damage in L929 and MCF-7 cell line. Wherein in case of Test drug (20, 40 and 60 μg /ml) groups, there was significant increase in % Head and decrease in % Tail, which indicates that test drug provides chemo preventive effects. In brief, PHPC Compound has shown promising level of safety and efficacy in experimental animal models.

The purpose of the research study on cancer is to develop safe and effective methods to prevent, detect, diagnose, treat, and, ultimately, cure the collections of diseases we call cancer. Ideas for new cancer research studies are often inspired by findings from earlier research, research on other cancers, and even findings from research done on other diseases, such as diabetes or immune disorders. Its aim is to reduce the number of deaths from cancer.
The research reports that covers cytotoxicity study evaluated for cytotoxicity against human adenocarcinoma cell for performing Anti - Cancer Activity effect on cellular DNA damage with his research called PHPC Compound has shown significant reduction in occurrence of tumor, reduction in tumor size and volume, having conducting clinical researches, investigating methods of prevention, diagnosis & treatment studies for several years . The results revealed that the formulation showed significant cytotoxicity on cell line. Overall, the cell growth inhibition by the PHPC observed in this study synergistic response rates. In brief, PHPC Compound has showing promising level of results in experimental models. To check the effect of PHPC Compound on cellular damage against normal cell line and breast cancer cell line using commet assay method. Cell count, Splitting of cells, ratio analysis of the cells and cells viability following the procedure mentioned allow the cell to grow and divided into groups.

To check the effect of formulation PHPC Compound on cellular DNA damage against normal celline and against breast cancer cell line MCF 7 using single cell gel electrophoresis technique commet assay. The scope covers comet assay of given test samples as per in house method. Evaluation of DNA damage for visualization of DNA damange, observations are made of SyBR-stained DNA using a 40x objective on a fluoroscent microscope.
Women breast cancer is the most important cause of mortality in the world. Now a day, some cytotoxic agents are used for its treatment including 5- flurouracil, doxorubicin, daunorubicin, bleomycin, and cisplastin. However, they are costly and known to induce several side effects such as myelosuppression, anemia, and most importantly the generation of cellular resistance. For this, it is important to find alternative therapies or drugs to overcome these drawbacks. Therefore in the present study,the polyherbal formulation screened for its anticancer activity using MCF-7 cell lines. The formulation PHPC Compound was subjected to cell proliferation assay by MTT. The results revealed that the formulation showed significant cytotoxicity on MCF-7 cell line. Overall, the cell growth inhibition by the polyherbal formulation observed in this study synergistic response rates.

Summary of Findings
Mammary tumors were successfully induced by oral administration. PHPC Compound produced significant anti-cancer activity, which was evident by significant reduction in incidence of solid tumor in PHPC Compound treated group. This was clearly indicated by means of results of tumor as compared to diseases control group and histopathology of mammary gland. PHPC Compound significantly increased the level of antioxidant enzymes like SOD and catalase, which were reduced in case of diseased controlled groups. This indicates chemo-protective effect of PHPC Compound.

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Dr. Dinesh Kacha Diabetes Reversal Through Ayurvedic Lifestyle
For more than 32 years, Dr. Dinesh Kacha has led the health care industry with innovative products and discoveries. Known as the 'Follower of Ayurveda , Dr. Dinesh Kacha compiles traditional blend of ancient wisdom with modern-day Science to develop research based formulations for patients across generations and geographies with his deep-rooted philosophy of creating perfect health for everybody.

Dr. Dinesh Kacha addresses the root cause of insulin resistance and lack of insulin, reversing diabetes through ayurvedic lifestyle & fixing the metabolic damage  that will not just prevent the disease but also reverse it as his researches believes that focus on lifestyle through the approach of Aahar Vihar Ausadh  based on ayurvedic principles and processes will help the management of disease.

The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems. To understand diabetes, first you must understand how glucose is normally processed in the body.
Glucose comes from two major sources: food and your liver.

Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
Your liver stores and makes glucose.
When your glucose levels are low, such as when you haven’t eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.

Metabolic damage occurs when our body’s metabolism (essentially how our bodies utilize energy) has adjusted into “survival mode” from periods of intense restriction, exercise, and/or stress. It’s actually better described as ‘metabolic acclimation’ because it has acclimated or gotten used to the new ‘norm’ of energy utilization it is experiencing.

Research suggests that people who are obese are up to 80 times more likely to develop type 2 diabetes than those who are not. In obese persons, cells of fat tissues have to process more nutrients than they can manage. The stress in these cells triggers an inflammation that releases a protein known as cytokines.

Studies suggest that abnormal fat causes fat cells to release
‘pro-inflammatory’ chemicals, which can make the body less sensitive to the insulin it produces by disrupting the function of insulin responsive cells and their ability to respond to insulin.
Diabetes cases in the world have increased due to drastic change in lifestyle, unhealthy eating habits and high stress levels. People with diabetes are 2 to 4 times more likely to suffer from heart disease or a stroke as compared to those who do not have diabetes. Diabetes is a condition that hinders your body's ability to respond to insulin that eventually leads to abnormal metabolism of carbohydrates, leading to spiked blood sugar levels
Ayurveda can control diabetes. Since the disease is an acquired lifestyle disorder, Ayurveda can trigger the remission process. The focus must be to reduce the dependency on medication (Ayurveda/Allopathy) and to adapt to a newer, improved lifestyle. Efforts must be made to improve your diet, daily routines, yoga or exercise schedule, and stress management techniques.

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ALL About to know Fistula
Dr. Samrat Jankar is one of the most expert reliable and ethical fistula specialists in Pune. He is a qualified surgical gastroenterologist and colorectal surgeon and had been awarded a gold medal for fellowship in colorectal surgery by the ACRISI (Association of Colon & Rectal Surgeons of India) board. Furthermore, he has been an international faculty member in this field. Recently, he has been awarded the First Prize for the best video presentation at FISTULACON 2021 for the LASER LIFT procedure in complex fistula in Ano in an international summit organized by ACRSI. He delivered talks on fistula at many national and international conferences and had a live demonstration of fistula surgery at many conferences. He had trained many surgeons for LASER fistula surgery. Dr. Samrat Janakr had been trained for complex fistula in ano surgery under renowned fistula surgeons Dr. Parvez Sheikh (Mumbai) and Dr. Arun Rajunasakul (Bangkok). He is an expert in many surgical procedures for fistula treatment and also pioneered his own surgical technique PILTEC for complex fistula treatment which has the highest success rate. Dr. Samrat Jankar had successfully Performed more than 5000+ successful Anal Fistula Surgeries.

Fistula (Bhagandar) Treatment in Pune
An anal fistula is a tunnel connecting the skin near the anus to the inside of the bowel (usually the rectum). This means that the inside of the bowel is connected to the outside of the body through an additional opening. An anal fistula often results from a previous or current anal abscess. As many as 50% of people with an abscess get a fistula. However, a fistula can also occur without an abscess.

Fistula in Ano treatment options
Surgery is usually necessary to treat an anal fistula as they usually do not heal by themselves or only with medication. The goal of any surgery for a fistula in ano is to balance between getting rid of the fistula and protecting the anal sphincter muscles, which could cause incontinence if damaged. In fistula treatment in Pune what matters most is recurrence and incontinence, the only expert in fistula surgery will have a clear understanding of it. Looking for the best doctor for fistula in ano treatment in Pune, Dr. Samrat Jankar an Internationally recognized surgeon at KAIZEN Gastro care, Wakad Pune offers holistic treatment for complex fistula with the least recurrence rate & almost zero incontinence rate.

Types of Fistual in Ano
Fistulas are classified by their relationship to parts of the anal sphincter complex (the muscles that allow us to control our stool). They are classified as

Intersphincteric is the most common and Extrasphincteric is the least common. These classifications are important in helping the surgeon make treatment decisions

What is Complex Fistula?
The Standards Committee for the American Society of Colon and Rectal Surgeons (ASCRS) divided anal fistula into simple and complex types based on the complexity of fistula, risk of recurrence, and risk of incontinence.

Simple fistula:

Simple fistulas are those that are Intersphincteric or low Transsphincteric involving less than 30% of the external sphincter where the risk of incontinence is low.

Complex fistula:

“Complex” fistulas included those with

More than 30% sphincter muscle involvement
Anterior fistulas in female patients
Recurrent fistulas
Fistula associated with preexisting fecal incontinence, inflammatory bowel disease, or prior radiation.
There are several different procedures. The best option for you will depend on the position of your fistula and whether it’s a single channel or branches off in different directions. Surgery aims to heal the fistula while avoiding damage to the sphincter muscles, the ring of muscles that open and close the anus, which could potentially result in loss of bowel control.

The main options are outlined here:
1. Fistulotomy:
The most common type of surgery for anal fistulas is a fistulotomy. This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar. A fistulotomy is the most effective treatment for many anal fistulas, although it’s usually done in simple fistula where the risk of incontinence is less. This procedure is not suitable in complex fistula in ano in cases where the risk of incontinence is considered too high, sphincter preserving procedures are recommended.

At KAIZEN Gastro Care, Dr. Samrat Jankar Fistula Specialist Surgeon in Pune uses a LASER as an adjunct to Fistulectomy to minimize the risk of damage to the sphincter muscle. Thus, with the added advantage of Laser, the chances of post-operative pain will be negligible.

2. Ligation of the intersphincteric Fistula Tract (LIFT):
The ligation of the intersphincteric fistula tract (LIFT) procedure is a best treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky. This is a Highly efficient procedure with almost no recurrences or incontinence. Dr. Samrat Jankar, a well-known colorectal surgeon in Pune, specializes in complex fistula surgery

Moreover, he is adept in LIFT, an advanced procedure for fistula treatment in Pune. Being well-trained with the LIFT procedure under Dr. Arun Rajunasakul (pioneer of the LIFT procedure, to date, Dr. Jankar has performed more than 1000 modified LASER LIFT procedures with excellent results. Had been awarded the best video award at an international conference for the management of complex fistula.

3. FiLaC ( Fistula-tract Laser Closure):
It is a minimally invasive fistula-in-ano surgery that keeps the sphincter intact. This technique attempts to gently remove the anal fistula by using laser energy. The flexible, all-around radiating fiber-optic probe is inserted into the fistula tract from the outside. Then the laser is slowly withdrawn. The inflammatory tissue is destroyed in a controlled manner and the fistula tract contracts. The anal gland that originally caused the fistula is inactivated


Video-assisted anal fistula treatment (VAAFT) is a new minimally invasive and sphincter-saving endoscopic treatment for complex fistulas. The fistula tract and internal fistula are localized using a fistuloscope inserted through the external opening and under direct vision fistula tract is destroyed from the inside and closure of the internal opening is done by stapling or suturing or cutaneous-mucosal flap.


No surgical wounds on the buttocks or perianal region.
The internal opening is precisely located which is important in the treatment of any fistula.
Less chance of damage to the sphincter muscle
Potential drawbacks

The biggest argument against VAAFT is its high rate of recurrence (~30%)
Higher cost of treatment
The fistula plug is a 100% synthetic bio-absorbable scaffold. This plug is placed in the fistula tract. Over time cells from the body migrate into the scaffold and new tissue is generated as the body gradually absorbs the plug material, leaving no permanent material in the body.

Advantages of Fistula Plug

No cutting involved and no operation wound. Therefore it is associated with less pain and faster recovery.
No damage to the sphincter muscle.

Potential Drawbacks

Failures can occur due to the dislodgement of the plug from the fistula tract.
The plug can get infected
Failure of treatment can occur in 25-30% of cases
6. PILTEC: a modification of the LIFT procedure
Dr. Samrat Jankar an internationally recognized fistula surgeon pioneered the LASER procedure named PILTEC having the highest cure with zero incontinence rate. He had demonstrated at many surgical conferences and workshops. He had trained many surgeons in fistula treatment using the PILTEC procedure.

Why does the Fistula recur again and again?
Anal fistula treatment remains a challenge for surgeons owing to its persistence or recurrence. Recurrent anal fistulas after surgery are more difficult to treat as there is even more risk of re-recurrence. Now, the challenge is that, even with the availability of so many techniques, there is a high risk of recurrence of the fistula after surgical intervention depending upon the location of the fistula, the kind of procedure performed, the expertise of the surgeon, extent of disturbing anatomy of the perianal region, unexpected findings, the effect of excess fibrosis and scarring after surgery and lack of proper postoperative care in the early and late periods following the surgery. This means that fistulas can keep on coming back even after surgery.

According to Dr. Samrat Jankar, a successful fistula surgery requires proper diagnosis, a perfectly performed and reported MRI, along with the surgeon’s expertise and the method of surgery. Dr. Samrat Jankar, the best fistula surgeon in Pune pioneer of the PILTEC procedure. In almost all cases Dr. Samrat Jankar performs a single-setting surgery with a success rate of more than 98% including fistula with perianal abscess. It is not only about surgery at kaizen gastro care dr Samrat Jankar and their team provide very good postoperative care which is one of the most important components in the complete cure of fistula.

What symptoms does anal fistula surgery address?
The signs and symptoms of an anal fistula include:

Frequent anal abscesses
Pain and swelling around the anus
Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains.
Irritation of the skin around the anus from drainage
Pain with bowel movements
Fever, chills, and a general feeling of fatigue
Anal fistula surgery aims to correct an anal fistula and treat all of its associated symptoms. If you have any of the above symptoms or you’re concerned about having an anal infection, abscess or fistula, speak with Kaizen fistula specialist Dr. Samrat Jankar, the best fistula doctor in Pune.

How is an anal fistula diagnosed at Kaizen Gastro Care:
Dr. Samrat Jankar at KAIZEN Gastro Care usually diagnoses an anal fistula by examining the area around the anus. He will look for an opening (the fistula tract) on the skin, then try to determine how deep the tract is, and the direction in which it is going. In many cases, there will be drainage from the external opening. Some fistulas may not be visible on the skin’s surface. Most of the time need further tests to better understand fistula relations with sphincter. An anoscopy is a procedure in which a special instrument is used to see inside your anus and rectum. Also in most cases, he advises an MRI fistulogram of the anal area to get a better view of the fistula tract. Some atypical cases need a colonoscopy to rule out IBD which will be the cause of the recurrence of fistula.

What causes an anal fistula?
The leading causes of an anal fistula are clogged anal glands and anal abscesses. Other, much less common, conditions that can cause an anal fistula to include:

Crohn’s disease (an inflammatory disease of the intestine)
Radiation (treatment for cancer)
Sexually transmitted diseases
Colorectal Cancer
Post-operative care after fistula surgery
Take sitz baths (sit for 15-20 minutes in warm water with antiseptic solution) three times a day and after each bowel movement for the first few days.
If you were given a topical ointment, place this over the anal skin and a little into the anal canal 2-3 times a day.
Don’t worry if you have some bleeding, discharge, or itching during your recovery. This is normal.
Avoid constipation.
Take stool softener before bedtime every day till wound healing.
The use of dry toilet tissue should be avoided. After bowel movements use a jet water cleaning, if possible, followed by taking a warm bath.
If you were given a prescription for an ointment, apply these two or three times a day at the edge of the anal opening and inside by finger (not by applicator).
Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
Connect with your surgeon if your temperature is greater than 101 degrees, significant bleeding, and unbearable pain.

Why Choose Kaizen Gastro Care for Fistula Treatment:
Experienced Fistula Specialist Team: Dr. Samrat Jankar is renowned as the best Fistula Specialist in Pune which is available at Kaizen Gastro Care Pune for treating various Piles, Fistula, and other anal diseases.
Advanced diagnosis and treatment: Kaizen Gastro Care provides a full range of diagnostic tests and innovative treatments which are used for the diagnosis and management of different Piles and Ananl conditions.
Clinic Location: Kaizen Gastro Care Clinic is located at the Pune and PCMC Prime location i.e. Wakad Area. This is the central location of Pune city. The patient can easily come with all public transport.
Leading-edge technology: Kaizen Gastro Care is equipped with leading-edge technology such as Endoscopy tests, Manometry, 24 Hr Ph Monitoring, Biopsy, and biofeedback. Also equipped with Piles Specialists and nutritionists.
A Dedicated Center for Fistula Treatment: Kaizen Gastro Care is the First Dedicated center for Fistula and different Anal Disease treatments in Pune and all over Maharashtra.
We Manage Your Care for the Long Term: We at Kaizen Gastro Care manage Piles, Fistula, and Anal disease for the long term. Kaizen Gastro Care manages the patients for the long term, taking regular follow-ups and long-term care.

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Liposuction in Delhi for Fat Removal by Dr Ashish Khare
Body contouring with liposuction surgery is a popular procedure for removing fat from areas such as the waist, abdomen, hips and thighs. Liposuction is especially effective for people with localized pockets of fat that diet and exercise cannot seem to remove. For those looking for Liposuction near me, there are many experienced surgeons in Delhi who specialize in body contouring with liposuction.

Liposuction is a surgical procedure that sucks fat from the body by using a suction device. Local, or general anesthesia can be used depending on the area and size of the area being operated on. The procedure involves making small incisions in the targeted area and sucking out the fat cells to contour the body. It usually takes 1-2 hours depending on the extent of the operation.

When performed by a qualified surgeon, liposuction will remove fat cells permanently. Patients should be aware that some amount of fat may come back if they are not aware of their diet and exercise regime. After surgery it is important to keep the affected area clean and dry to allow the area to heal properly.

Overall liposuction is a safe and effective way to improve body shape and contour.

To avail the benefits of liposuction in Delhi, book a consultation with Dr. Ashish Khare today!

Get more info at:

Disclaimer: All the text, videos, techniques, and images available on this post are for awareness purposes only. It must not be considered as a substitute for medical advice. Results may vary from person to person, depending on the medical needs.

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A Breast Lift Can Improve the Position of Your Breasts
A breast lift is a cosmetic surgery procedure that helps improve the shape and position of breasts by removing excess skin, reshaping tissue, and possibly repositioning the nipples. Breast lifts can be done to one or both breasts with the aim of restoring the appearance of perkier, more youthful breasts. As one of the fastest growing cosmetic surgeries, the treatment has become increasingly popular in Delhi in recent years, with patients eager to benefit from a breast lift surgery.

The breast lift surgery in Delhi can be tailored to each patient’s specific needs, allowing you to achieve your desired outcome. By removing excess skin, a breast lift can raise the breasts so they sit higher on the chest wall, giving you a more youthful look. The nipples can also be re-positioned to a lifted, more natural position. After the breast lift procedure, your breasts will look firmer and perkier, helping you feel more confident and attractive in your body.

The benefits of a breast lift go beyond improving your appearance; it can also help you feel more physically and emotionally comfortable in your own skin. Choosing to undergo a breast lift in Delhi is a highly personal decision, and you should talk to your surgeon to ensure it is the right!

To avail the benefits of best cost of breast lift treatment in Delhi, book a consultation with Dr. Ashish Khare today!

Contact Us
Kalosa Aesthetics & Cosmetic Gynaecology Clinic
Tara, B - 33, 34, Crescent Rd, Qutab Institutional Area, New Delhi - 110016
Phone: +91-8619751479, +91-9818816485

Disclaimer: All the text, videos, techniques, and images available on this post are for awareness purposes only. It must not be considered as a substitute for medical advice. Results may vary from person to person, depending on the medical needs.

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6 Signs You Need to See an Orthopedic Doctor | Dr. Ashwini Gaurav
6 Signs You Need to See an Orthopedic Doctor
Do you have knee or back pain daily? Do you feel sore after sleeping or inactive for a long time? Do you have an injury that doesn’t seem to be healing? These are some common 6 Signs You Need to See an Orthopedic Doctor. But what are some other reasons? An orthopedic doctor specializes in the treatment of the musculoskeletal system. The musculoskeletal system includes bones, joints, tendons, muscles, ligaments, and cartilage. Orthopedic doctors treat injuries through both surgical and non-surgical means and will help you decide the right course of treatment. Let’s get over some of the common reasons explained by Dr. Ashwini Gaurav about When you need to see an Orthopedic Doctor. He is known as the Best Orthopedic Doctor in Patna.

You have difficulty performing everyday activities:
Bad posture, age, and overall lifestyle can bring bone and joint pain, which can be a block to your daily activities. You may struggle to do the easiest of tasks like climbing stairs or even walking. Orthopedic issues may cause difficulty in walking or standing. If you have instability or feel shaky when walking, standing up, sitting down, or remaining standing, an Orthopedic doctor can help diagnose the problems and treat them. They may recommend physical therapy or surgery to improve your quality of life and restore your ability to perform essential activities
You have a fracture:
Orthopedic surgeons can fix broken bones and injuries to tendons and muscles and help improve function and decrease or eliminate pain. If you have serious fractures or breaks, you have referred to an orthopedic surgeon to have the right treatment. Some fractures can be fixed by wearing a cast or splint to immobilize the area, but other fractures are more complex, such as compression fractures or stress fractures. Fractures in the wrists, hips, vertebrae, and kneecaps are not as easy to treat as a simple fracture in the arm. An orthopedic doctor can treat these types of fractures with surgery or other methods.
You have soft tissue injury not improved in 48 hours:
Have you just suffered from a soft tissue injury, such as a twisted knee, sprained ankle, or busted wrist? Use the RICE method to see if the pain and swelling decrease within two days. If you have not noticed any major improvements after the first 48 hours, you .should seek medical attention. If there is an injury to the muscles, tendons, ligaments, or bones, Orthopedic doctors can diagnose and treat the problem.
Your range of motion is limited:
Are your joints supposing tighter and tighter as the days go by? If pain and stiffness are keeping you from moving freely, then orthopedic doctors can help with that. Limited motion is often a symptom of arthritis, injury, and other joint conditions. You should seek treatment when you notice that you are losing range of motion so that the condition does not get more destructive and require more aggressive treatment.
You experience orthopedic trauma:
If you are in an accident, have a fall, or have a sports injury, you may show signs or symptoms consistent with a traumatic injury. You should be examined and monitored by an orthopedic doctor promptly to confirm that there is no irreversible harm to your bones, joints, or muscles.
You have chronic pain:
Chronic pain is defined as any pain staying more than 12 weeks. Experiencing a few days of pain is one thing but after several weeks and months of it. that’s a sign you should see a doctor.
How to Book An Appointment?
If you face any problem regarding joint pain then you must visit the best orthopedic doctor in Patna. For more information about our comprehensive treatment options, or to request an appointment with Dr. Ashwini Gaurav, call 9386737895 or Click on Book Appointment for online booking.

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Best Trauma surgery Surgeon in Patna | Trauma Surgery Doctor: Dr. Ashwini Gaurav
What is Trauma?

Trauma is that the injuries suffered when an individual experiences a blunt force or a penetrating injury. You will also hear trauma named as “major trauma.” Many trauma patients are the victims of car crashes, stabbings, and gunshot wounds. Trauma may also be caused by falls, crush type injuries, and pedestrians being struck by a car.

Traumatic injuries can affect internal organs, bones, the brain, and therefore the other soft tissues of the body. No area of the body is resistant to trauma, but trauma can range from minor (hitting your finger with a hammer) to major (being hit by a car traveling at a high rate of speed or fall off of a building).

What do we do in Trauma Surgery?
In the case of severe trauma like a car crash and fall off from a building the surgery team not only includes trauma surgeons but also general surgeons, orthopedic surgeons, vascular surgeons, and other surgeons as needed. The trauma includes not only surgeons but also paramedics, nurses, anesthetists, respiratory therapists, radiographers.

Trauma physicians are highly trained to diagnose and stabilize patients who are having traumatic injuries. They have to address things in a particular order. We have to fix which of the patient’s injuries need treatment first.

Usually, the first stop the bleeding.
Then, they eliminate any contamination threat to the wounds.
Next, whether the patient is stable enough for immediate surgery or if the patient should be sent to the intensive care unit (ICU).
Traumatic injuries often include the following:
Spine fractures and spinal cord injury
Sudden amputation
Traumatic brain injury (TBI)
Crush injury
Acoustic trauma
Broken or dislocated jaw
Skull fracture
Severe cuts and puncture wounds
Cost of Trauma Surgery
Dr. Ashwini Gaurav is a well-known orthopedic doctor and trauma surgeon in Patna. We, not only understand the complexity of major trauma but also treat them with an advanced treatment approach.

The cost of trauma surgery depends upon the patient’s medical condition. We provide the Best and Affordable Trauma / Fracture Surgery services in Patna. Feel free to contact us, we are always there to serve you.

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Types of bariatric surgery
Bariatric surgery is considered the most effective treatment for obesity in terms of long-term weight loss and improvement in obesity-related co-morbidities.
<a href="">Best Bariatric Surgeon in Delhi</a> procedures cause weight loss by limiting the amount of food that can be held in the stomach, causing malabsorption of nutrients or a combination of gastric restriction and malabsorption. Bariatric procedures also bring about desirable hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic surgery).

How do I know if I am eligible for slimming surgery?

Weight loss surgery is only recommended if you can't lose a lot of weight and keep it off with diet, behavior changes, and exercise alone. Doctors often use body mass index (BMI) and health conditions such as type 2 diabetes and high blood pressure to determine which patients are most likely to benefit from weight loss surgery. Patients with concomitant comorbidities such as diabetes, etc., or with a BMI greater than 37.5 kg/m2, with or without concomitant comorbidities.

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D-backs Exchange Deadline programs
PHOENIX -- Just before opening their 4-recreation sequence with the Giants upon Thursday, the D-backs dealt outfielder Tim Locastro towards the Yankees within just change for Very little League specifically-hander Keegan Curtis.Even at the time their 5-3 acquire around the Giants at Chase Business, the D-backs locate them selves buried deep in just the Nationwide League West with a 23-60 history. It was specifically Arizona 3rd acquire within just its closing 27 video games and all 3 of these online games were being started out via Merrill Kelly, who authorized a few operates previously mentioned 7 innings with 7 strikeouts. Josh Reddick and Pavin Smith paced the offense as each individual homered off Giants newbie Johnny Cueto.Though there will virtually undoubtedly be further moves just before the July 30 Exchange Deadline, enthusiasts anticipating in the direction of perspective a carefully substitute D-backs staff members within just August are almost certainly in direction of be frustrated.I put on't check out any large transformation of our latest roster, reported assistant GM Amiel Sawdaye, who is taking care of the personnel working day-towards-working day functions even though GM Mike Hazen is upon a bodily go away of deficiency. "I have on't imagine we need a complete teardown. I can comprehend why followers need a entire teardown . I dress in't feel we need to have that. I consider coming into this calendar year we sure didn't be expecting this personnel in direction of visual appeal such as this, yet I moreover believe it's a great deal less difficult towards say, Oh, accurately rip it aside and rebuild. It's not that very simple toward do that. Generating trades is not an basic point toward do within just the league.That doesnt signify there wont be some alterations.There incorporate been rumors linking infielder Eduardo Escobar, who is within just the best calendar year of his deal, in the direction of the White Sox, still the D-backs are not merely moving toward offer you him absent.There much too been sound above Arizona becoming open up in the direction of working David Peralta, who would be a small more durable in direction of stream than Escobar as the outfielder is down below deal all through the 2022 time, manufacturing $7.5 million within the supreme yr of his package.Catcher Stephen Vogt is a no cost consultant at period finish as is outfielder Reddick, who consists of a lot of postseason encounter.However it not as basic as a workers boasting it desires in direction of exchange avid gamers."For each and every Arizona Diamondbacks vendor that is out there, there are other groups that are marketing that consist of superior avid gamers, as well, and a constrained selection of groups that purchase, Sawdaye stated. It's a current market, instantly? On your own've acquired towards consist of potential buyers and distributors . That's aspect of the problem at moments."Whilst it will come toward avid gamers that groups would nearly completely be fascinated inside, these as outfielder Ketel Marte or catcher Carson Kelly, either of whom are upon the hurt record, the D-backs imagine they are gamers who may be element of the main of a potential contending personnel.At the close of April, we observed Carson Kelly with a 1.000 OPS, and if we imagine inside that, it's not simple in the direction of locate a catcher towards switch Carson , who we felt includes rather occur into his individual as a rather Fantastic defensive catcher and was likely, prior to he bought problems, upon his path in the direction of remaining an All-Star , Sawdaye reported.Kelly, who as well strike an RBI solitary in opposition to San Francisco, would surely focus groups as he consists of a rather economical employees preference for 2022 at $5.25 million, still all over again, he could possibly be unachievable for the D-backs towards aspect with presented that he is their highest regular newbie.It's additionally relevance holding inside of thoughts that the D-backs put on't consist of in the direction of do all their business enterprise ahead of the Exchange Deadline -- the offseason is frequently an less difficult season in direction of offer avid gamers quite than in just the warm of a time.On your own use't merely require in direction of press components during at the Deadline simply just towards press them all through considering the fact that it's the Deadline, Sawdaye explained. I do believe that there may be option dynamics at enjoy inside the offseason than there may perhaps be within just the upcoming 3 or 4 months."

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Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones
Original Research
Efficacy of surgical techniques and factors affecting residual stone rate in
the treatment of kidney stones
Dr. Anil Haripriya

1Associate professor, Department of General Surgery CIMS, Bilaspur (C.G.), India;
2Associate Professor, Department of General Surgery, NSCB Medical College, Jabalpur (M.P.), India
Background: The present study was conducted to assess efficacy of surgical techniques and factors affecting residual stone
rate in the treatment of kidney stones. Materials & Methods: 102 patients of kidney stones of both genders were divided
into 3 groups. Group I patients underwent open stone surgery, group II patients underwent percutaneous nephrolithotomy
(PNL) and group III underwent retrograde intrarenal surgery (RIRS). Surgical techniques complications were evaluated.
Results: In group I mean stone burden was 3.2 cm2

, in group II was 2.5 cm2

and in group III was 1.9 cm2
. The mean
operative time in group I was 84.2 minutes, in group II was 118.4 minutes and in group III was 78.6 minutes. There were 9
cases in group I, 7 in group II and group III was 5 cases. There were 7 cases of fever in group I, 4 in group II and 2 in group
III, infection 2 in group I and 3 in group III, urine leakage 5 in group III and persistent pain 6 in group I and 1 in group II.
The difference was significant (P< 0.05). Conclusion: PNL and RIRS have been seen as safe and effective methods as
compared to open method in case of kidney stones.
Key words: Percutaneous nephrolithotomy, Retrograde intrarenal surgery, Kidney stone.
Received: 13 September, 2020 Accepted: 18 November, 2020
Correspondence: Dr. Arvind Baghel, Associate Professor, Department of General Surgery, NSCB Medical College,
Jabalpur (M.P.), India
This article may be cited as: Haripriya A, Baghel A. Efficacy of surgical techniques and factors affecting residual stone
rate in the treatment of kidney stones. J Adv Med Dent Scie Res 2020;8(12):55-58.
Urinary system stone disease is one of most
frequently encountered diseases in the urology
practice. The stones are frequently observed in the
renal localization, and most of them require
intervention.1 Kidney stone disease, also known as
urolithiasis or renal calculi contributes to one of the
most common health problems in the daily lives of
men and women. It occurs when a solid piece of
material (stone) forms in the urinary tract.2
Approximately 12% of men and 6% of women in the
USA and 10 to 15% of people in Europe and North
America are affected by it. Calcium oxalate (CaOx) is
found to one component of the most common kidney
stones. It has been proposed that the most likely stone
formation mechanism for people with idiopathic
CaOx stones is caused by CaOx overgrowth in renal
papillary Randall’s plaque.
Preventive measures such
as dietary therapy and therapeutic treatments such as
drugs and surgical techniques have been verified to be

effective in the treatment of renal calculi. Dietary
modification is a safe and economical preventive
measure for dietary therapy, and in some cases, drugs
are important to reduce the risk of stone formation.
Unfortunately, since the 1980s, there have been no
new drugs developed for the prevention of renal
calculi after the introduction of potassium citrate.4
Some of these methods include percutaneous
nephrolithotomy (PCNL), extracorporeal shockwave
lithotripsy (SWL), retrograde intrarenal surgery
(RIRS), etc. Extracorporeal shock wave lithotripsy
(ESWL) into clinical practice after 1980s, a new era
had begun in the treatment of urinary system stone
disease. In recent years, percutaneous
nephrolithotomy (PNL) has taken increasingly greater
part in the treatment of stone disease with success
rates nearing to 80 percent.5 The present study was
conducted to assess efficacy of surgical techniques
and factors affecting residual stone rate in the
treatment of kidney stones.
Journal of Advanced Medical and Dental Sciences Research
@Society of Scientific Research and Studies NLM ID: 101716117
Journal home page: doi: 10.21276/jamdsr Index Copernicus value = 85.10

(e) ISSN Online: 2321-9599; (p) ISSN Print: 2348-6805

Haripriya A et al. Treatment of kidney stones.


Journal of Advanced Medical and Dental Sciences Research |Vol. 8|Issue 12| December 2020
The present study was conducted among 102 patients
who underwent surgical treatment of kidney stones of
both genders in the department of general surgery in a
medical college hospital. All were informed regarding
about the study and their consent was obtained.
Data such as name, age, gender etc. was recorded.
Patients were divided into 3 groups. Group I patients
underwent open stone surgery, group II patients
underwent percutaneous nephrolithotomy (PNL) and

group III underwent retrograde intrarenal surgery
Endoscopic stone surgery was performed for stone
fragmentation in all patients using pneumatic
lithotriptor or Holmium: YAG laser. Surgical
techniques complications were evaluated. Stones
equal or larger than 4 mm were considered as residual
stones. The dimensions of the stones were calculated
and measured in cm2

. Results thus obtained were
subjected to statistical analysis. P value less than 0.05
was considered significant.

Table I Distribution of patients

Groups Group I Group II Group III
Methods Open stone surgery PNL RIRS
M:F 34 34 34

Table I shows that group I patients underwent open stone surgery, group II patients underwent PNL, and group
III underwent RIRS. Each group had 34 patients.
Table II Assessment of parameters

Parameters Group I Group II Group III P value
Stone burden (cm2

) 3.2 2.5 1.9 0.01
Operative time (mins) 84.2 118.4 78.6 0.001
Length of hospital stay 3.2 3.0 1.4 0.05
Cases with residual stone 9 7 5 0.02
Table II shows that in group I mean stone burden was 3.2 cm2

, in group II was 2.5 cm2

and in group III was 1.9

. The mean operative timein group I was 84.2 minutes, in group II was 118.4 minutes and in group III was
78.6 minutes. There were 9 cases in group I, 7 in group II and group III was 5 cases. The difference was
significant (P< 0.05).
Table III Assessment of complications in groups

Complications Group I Group II Group III P value
Fever 7 4 2 0.02
Infection 2 0 3 0.05
Urine leakage 0 0 5 0.05
Persistent pain 6 1 0 0.001

Table III, graph I shows that there were 7 cases of fever in group I, 4 in group II and 2 in group III, infection 2
in group I and 3 in group III, urine leakage 5 in group III and persistent pain 6 in group I and 1 in group II. The
difference was significant (P< 0.05).
Graph I: Assessment of complications in groups


Fever Infection Urine leakage Persistent pain





0 0






Group I
Group II
Group III

Haripriya A et al. Treatment of kidney stones.


Journal of Advanced Medical and Dental Sciences Research |Vol. 8|Issue 12| December 2020
Currently, a diverse range of non-invasive, minimally
invasive and invasive methods have been reported as
treatment approaches for renal calculi. Recent studies
have reported that flexible ureterorenoscopy
(URS)/holmium laser lithotripsy can be an alternative

treatment for patients with renal calculi. The micro-
percutaneous nephrolithotomy (microperc) is a

recently described technique in which percutaneous
renal access and lithotripsy are performed in a single
step. Microperc has been found to be safe and
effective in removing small renal calculi in the adult
and pediatric populations with a high stone-free rate
and lower complication rate.6 Despite all the new
approaches, shock wave lithotripsy (SWL) remains
the first line treatment modality that is widely used for
renal, ureteral and intermediate-size renal calculi. Its
success rates from contemporary series vary from 60
to 90%. However, during an SWL procedure,
physicians should consider the association between
SWL-related pain and patients’ positioning, which
may negatively affect the SWL success rate as well as
its potential complications. PCNL can be divided into
two types: minimally invasive percutaneous
nephrolithotomy (mini-PCNL) and standard
percutaneous nephrolithotomy (standard PCNL).7
Mini-PCNL has a higher efficacy and better safety in
the management of small renal calculi, while standard
PCNL is still regarded as the conventional technique
for the treatment of large renal stones in the upper
urinary tract. However, in the recent years, there has
been a shift in trend to favor a mini-PCNL approach
in order to reduce the morbidities.8The present study
was conducted to assess efficacy of surgical
techniques and factors affecting residual stone rate in
the treatment of kidney stones.
In present study, group I patients underwent open
stone surgery, group II patients underwent PNL, and
group III underwent RIRS. Each group had 34
patients. Ayedemir et al9

included records of 109
cases of kidney stones. Patients were divided into
three groups in terms of surgical treatment; open stone
surgery, percutaneous nephrolithotomy (PNL) and
retrograde intrarenal surgery (RIRS). Patients’ history,
physical examination, biochemical and radiological
images and operative and postoperative data were
recorded.The patients had undergone PNL (n=74;
67.9%), RIRS (n=22;20.2%), and open renal surgery
(n=13; 11.9%). The mean and median ages of the
patients were 46±9, 41 (21–75) and, 42 (23–67) years,
respectively. The mean stone burden was 2.6±0.7 cm2
in the PNL, 1.4±0.1 cm2 in the RIRS, and 3.1±0.9
cm2 in the open surgery groups. The mean operative
times were 126±24 min in the PNL group, 72±12 min
in the RIRS group and 82±22 min in the open surgery
group. The duration of hospitalisation was 3.1±0.2
days, 1.2±0.3 days and 3.4±1.1 days respectively.
While the RIRS group did not need blood transfusion,
in the PNL group blood transfusions were given in the
PNL (n=18), and open surgery (n=2) groups. Residual

stones were detected in the PNL (n=22), open surgery
(n=2), and RIRS (n=5) groups.
We found that in group I mean stone burden was 3.2
, in group II was 2.5 cm2

and in group III was 1.9

. The mean operative time in group I was 84.2
minutes, in group II was 118.4 minutes and in group
III was 78.6 minutes. There were 9 cases in group I, 7
in group II and group III was 5 cases. Stone-free rate
in percutaneous nephrolithotomy can vary dependent
on the stone location, and size, as reported in the
literature, it increases up to 90 percent. In the AUA
guideline, this rate has been given as 78 percent. In
our study, in 74 patients, a 70.3% stone-free rate has
been detected. Size, location, composition of the
stone, anatomy of the affected kidney, and experience
of the surgeon are effective on success, and
complications of PNL.10
We found that there were 7 cases of fever in group I, 4
in group II and 2 in group III, infection 2 in group I
and 3 in group III, urine leakage 5 in group III and
persistent pain 6 in group I and 1 in group II.
Lingeman et al11reported 88–91% success rates for
stones with a diameter of 1–3 cm, mean success rate
decreased to 75% in stones larger than 3 cm in
diameter. Still Clayman et al12reported success rates
as 89.2, and 97–100% for stone with a stone burden of
>2, and <2 cm2

, respectively.
Authors found that PNL and RIRS have been seen as
safe and effective methods as compared to open
method in case of kidney stones.
1. Karatag T, Buldu I, Inan R, Istanbulluoglu MO: Is
MicropercutaneousNephrolithotomy Technique Really
Efficacicous for the Treatment of Moderate Size Renal
Calculi? Yes. UrolInt 2015;95:9-14.
2. Kim BS: Recent advancement or less invasive treatment
of percutaneous nephrolithotomy. Korean J Urol
3. Hyams ES, Munver R, Bird VG, Uberoi J, Shah O:
Flexible ureterorenoscopy and holmium laser lithotripsy
for the management of renal stone burdens that measure
2 to 3 cm: a multi-institutional experience. J Endourol
4. Sabnis RB, Ganesamoni R, Ganpule AP, Mishra S,
Vyas J, Jagtap J, Desai M: Current role of microperc in
the management of small renal calculi. Indian J Urol
5. Knoll T, Buchholz N, Wendt-Nordahl G: Extracorporeal
shockwave lithotripsy vs. percutaneous nephrolithotomy
vs. flexible ureterorenoscopy for lower-pole stones.
Arab J Urol 2012;10:336-341.
6. Capitanini A, Rosso L, Giannecchini L, Meniconi O,
Cupisti A: Sepsis complicated by brain abscess
following ESWL of a caliceal kidney stone: a case
report. IntBraz J Urol 2016;42:1033-1036.
7. Kim JK, Ha SB, Jeon CH, Oh JJ, Cho SY, Oh SJ, Kim

HH, Jeong CW: Clinical Nomograms to Predict Stone-
Free Rates after Shock-Wave Lithotripsy: Development

and Internal-Validation. PLoS One 2016;11:e0149333.

Haripriya A et al. Treatment of kidney stones.


Journal of Advanced Medical and Dental Sciences Research |Vol. 8|Issue 12| December 2020
8. Kang JH, Lee SW, Moon SH, Sung HH, Choo SH, Han
DH: Relationship Between Patient Position and Pain
Severity During Shock Wave Lithotripsy for Renal
Stones With the MODULITH SLX-F2 Lithotripter: A
Matched Case-Control Study. Korean J Urol
9. Aydemir H, Budak S, Kumsar Ş, Köse O, Sağlam HS,
Adsan Ö. Efficacy of surgical techniques and factors
affecting residual stone rate in the treatment of kidney
stones. Turkish journal of urology. 2014 Sep;40(3):144.
10. Wong C, Leveillee RJ. Single upper-pole percutaneous
access for treatment of > or = 5-cm complex branched

staghorn calculi: is shockwave lithotripsy necessary? J
Endourol. 2002;16:477–81.
11. Lingeman JE, Coury TA, Newman DM, Kahnoski RJ,
Mertz JH, Mosbaugh PG, et al. Comparison of results
and morbidity of percutaneous nephrostolithotomy and
extracorporeal shock wave lithotripsy. J Urol.
12. Clayman RV, Mcdougall EM, Nakada SY. Endourology
of the upper urinary tract: percutaneous renal and
ureteral procedures. In: Wals PC, Retik AB, Vaughan
EJ, Wein AJ, editors. Campbell’s urology. Philadelphia:
WB Saunders; 1998; 2789–874.

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