Methods: This RCT included 60 patients (30 in control and 30 in intervention) between 18 and 80 years old, scheduled for elective single or double-level lumbar spine surgeries through the posterior approach. Intervention group (MBP) received PEGLEC, tablet Metronidazole 400 mg twice daily (BD), tablet Cefuroxime 500 mg BD, and probiotic (Bacillus clausii ) on pre-operation day, whereas the control (non-MBP) had no specific bowel preparation but received only a placebo. Outcome parameters included time to first flatus, bowel sound, and first defecation, which were compared between the two groups. Results: Demographic data such as age, sex, body mass index, level of surgery, and intraoperative data such as duration of surgery and blood loss were similar without significant differences. The time to first flatus, bowel sounds, and first defecation was not statistically significant, but POI was seen in 6.67% of patients, all belonging to the MBP group. No correlation observed between the duration of the ileus and the intraoperative blood loss and duration of surgery. Conclusions Bowel preparation may not be necessary for patients undergoing posterior lumbar spine surgery involving a maximum of two levels.

Objective: A cluster of leptospirosis and brucellosis cases in a semi-nomadic, pastoral community was reported in October 2023 from Village A, Uttarakhand State, India. This cluster was investigated to describe the epidemiology and potential exposures. Methods: Suspected cases were residents with sudden-onset fever or myalgia occurring from 1 August 2023 to 7 January 2024; confirmed cases were suspected cases with laboratory confirmation. Suspected cases were identified through a house-to-house case search and were interviewed regarding sociodemographic variables, symptoms and exposures. Those who consented were tested. Data were cleaned and analysed in Microsoft Excel. Results: Fifty suspected cases were identified among a total of 300 residents across 85 households. Among these, 27 agreed to be tested, and 25 were confirmed (13 with leptospirosis, 7 with brucellosis and 5 with both leptospirosis and brucellosis). The cases began in September 2023 following flooding and continued until January 2024, with no deaths. The median age (range) of cases was 30 (17–82) years for leptospirosis, 39 (25–56) years for brucellosis and 39 (22–50) years for coinfection. Altogether, females accounted for 92% (12/13) of leptospirosis cases, 57% (4/7) of brucellosis cases and 80% (4/5) of coinfections. Symptoms included fever, myalgia and arthralgia. All cases reported contact with floodwater and animal abortus. Discussion: This was a laboratory-confirmed co-occurring cluster of leptospirosis and brucellosis, including five cases of coinfection, following flooding, predominantly affecting female Van Gujjar dairy farmers. Education was provided to the community about the hygienic disposal of animal waste.

Background: Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals. Methods: This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022. Results: Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%). Conclusions Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.

Background: Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals. Methods: This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022. Results: Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%). Conclusions Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Background: Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals. Methods: This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022. Results: Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%). Conclusions Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.

Background: Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals. Methods: This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022. Results: Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%). Conclusions Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.