Comparison of a Fistulectomy and a Fistulotomy with Marsupialization in the Management of a Simple Anal Fistula: A Randomized, Controlled Pilot Trial

Bhupendra Kumar Jain,Kumar Vaibhaw,Pankaj Kumar Garg,Sanjay Gupta,Debajyoti Mohanty 대한대장항문학회 2012 Annals of Coloproctolgy Vol.28 No.2

Purpose: This randomized clinical trial was conducted to compare a fistulectomy and a fistulotomy with marsupialization in the management of a simple anal fistula. Methods: Forty patients with simple anal fistula were randomized into two groups. Fistulous tracts were managed by using a fistulectomy (group A) while a fistulotomy with marsupialization was performed in group B. The primary outcome measure was wound healing time while secondary outcome measures were operating time, postoperative wound size, postoperative pain, wound infection, anal incontinence, recurrence and patient satisfaction. Results: Postoperative wounds in group B healed earlier in comparison to group A wounds (4.85 ± 1.39 weeks vs. 6.75 ±1.83 weeks, P = 0.035). No significant differences existed between the operating times (28.00 ± 6.35 minutes vs. 28.20 ± 6.57minutes, P = 0.925) and visual analogue scale scores for postoperative pain on the first postoperative day (4.05 ± 1.47 vs. 4.50 ± 1.32, P = 0.221) for the two groups. Postoperative wounds were larger in group A than in group B (2.07 ± 0.1.90 cm2vs.1.23 ± 0.87 cm2), however this difference did not reach statistical significance (P = 0.192). Wound discharge was observed for a significantly longer duration in group A than in group B (4.10 ± 1.91 weeks vs. 2.75 ± 1.71 weeks, P = 0.035). There were no differences in social and sexual activities after surgery between the patients of the two groups. No patient developed anal incontinence or recurrence during the follow-up period of twelve weeks. Conclusion: In comparison to a fistulectomy, a fistulotomy with marsupialization results in faster healing and a shorter duration of wound discharge without increasing the operating time. Purpose: This randomized clinical trial was conducted to compare a fistulectomy and a fistulotomy with marsupialization in the management of a simple anal fistula. Methods: Forty patients with simple anal fistula were randomized into two groups. Fistulous tracts were managed by using a fistulectomy (group A) while a fistulotomy with marsupialization was performed in group B. The primary outcome measure was wound healing time while secondary outcome measures were operating time, postoperative wound size, postoperative pain, wound infection, anal incontinence, recurrence and patient satisfaction. Results: Postoperative wounds in group B healed earlier in comparison to group A wounds (4.85 ± 1.39 weeks vs. 6.75 ±1.83 weeks, P = 0.035). No significant differences existed between the operating times (28.00 ± 6.35 minutes vs. 28.20 ± 6.57minutes, P = 0.925) and visual analogue scale scores for postoperative pain on the first postoperative day (4.05 ± 1.47 vs. 4.50 ± 1.32, P = 0.221) for the two groups. Postoperative wounds were larger in group A than in group B (2.07 ± 0.1.90 cm2vs.1.23 ± 0.87 cm2), however this difference did not reach statistical significance (P = 0.192). Wound discharge was observed for a significantly longer duration in group A than in group B (4.10 ± 1.91 weeks vs. 2.75 ± 1.71 weeks, P = 0.035). There were no differences in social and sexual activities after surgery between the patients of the two groups. No patient developed anal incontinence or recurrence during the follow-up period of twelve weeks. Conclusion: In comparison to a fistulectomy, a fistulotomy with marsupialization results in faster healing and a shorter duration of wound discharge without increasing the operating time.

Reclassification of Bacillus beijingensis Qiu et al. 2009 and Bacillus ginsengi Qiu et al. 2009 as Bhargavaea beijingensis comb. nov. and Bhargavaea ginsengi comb. nov. and emended description of the genus Bhargavaea

Verma, Pankaj,Pandey, Prashant Kumar,Gupta, Arvind Kumar,Seong, Chi Nam,Park, Seong Chan,Choe, Han Na,Baik, Keun Sik,Patole, Milind Shivaji,Shouche, Yogesh Shreepad Microbiology Society 2012 International journal of systematic and evolutiona Vol.62 No.10

<P>We have carried out a polyphasic taxonomic characterization of <I>Bacillus beijingensis</I> DSM 19037<SUP>T</SUP> and <I>Bacillus ginsengi</I> DSM 19038<SUP>T</SUP>, which are closely related phylogenetically to <I>Bhargavaea cecembensis</I> LMG 24411<SUP>T</SUP>. All three strains are Gram-stain-positive, non-motile, moderately halotolerant and non-spore-forming. 16S rRNA gene sequence analyses showed that the strains constituted a coherent cluster, with sequence similarities between 99.7 and 98.7 %. The percentage similarity on the basis of amino acid sequences deduced from partial <I>gyrB</I> gene nucleotide sequences of these three type strains was 96.1-92.7 %. Phylogenetic trees based on the 16S rRNA gene and GyrB amino acid sequences, obtained by using three different algorithms, were consistent and showed that these three species constituted a deeply rooted cluster separated from the clades represented by the genera <I>Bacillus</I>, <I>Planococcus</I>, <I>Planomicrobium</I>, <I>Sporosarcina</I>, <I>Lysinibacillus</I>, <I>Viridibacillus</I>, <I>Kurthia</I> and <I>Geobacillus</I>, supporting their placement in the genus <I>Bhargavaea</I>. All three type strains have menaquinone MK-8 as the major respiratory quinone and showed similar fatty acid profiles. The main polar lipids present in the three type strains were diphosphatidylglycerol and phosphatidylglycerol, and the three strains showed peptidoglycan type A4α with l-lysine as the diagnostic diamino acid. The DNA G<I>+</I>C contents of <I>Bacillus beijingensis</I> DSM 19037<SUP>T</SUP>, <I>Bacillus ginsengi</I> DSM 19038<SUP>T</SUP> and <I>Bhargavaea cecembensis</I> LMG 24411<SUP>T</SUP> were 53.1, 50.2 and 53.7 mol%, respectively. The level of DNA-DNA hybridization among the three strains was 57-39 %, indicating that they are members of different species of the genus <I>Bhargavaea</I>. The phenotypic data are consistent with the placement of these three species in a single genus and support their differentiation at the species level. On the basis of these data, we have emended the description of the genus <I>Bhargavaea</I> and propose the reclassification of <I>Bacillus beijingensis</I> and <I>Bacillus ginsengi</I> to the genus <I>Bhargavaea</I>, as <I>Bhargavaea beijingensis</I> comb. nov. (type strain ge10<SUP>T</SUP> = DSM 19037<SUP>T</SUP> = CGMCC 1.6762<SUP>T</SUP>) and <I>Bhargavaea ginsengi</I> comb. nov. (type strain ge14<SUP>T</SUP> = DSM 19038<SUP>T</SUP> = CGMCC 1.6763<SUP>T</SUP>).</P>

Influence of Stacking Sequence and Orientation on Tensile and Flexural Properties of Jute/glass/carbon Fiber Epoxy-based Hybrid Composites

Rajesh Kumar Dewangan,Samarjit Singh,Biplab Das,Manish Bhaskar,Pradeep Patanwar,Pankaj Kumar Gupta,Sung Soo Han(한성수),Rakesh Bhaskar 한국고분자학회 2023 폴리머 Vol.47 No.5

A Multicentre, Multinational, Open-Label, 52-Week Extension Study of Gemigliptin (LC15-0444) Monotherapy in Patients with Type 2 Diabetes Mellitus

양세정,민경완,Sandeep Kumar Gupta,박중열,Vyankatesh K. Shivane,Pankaj Kumar Agarwal,김두만,김용승,백세현 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4

The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (-0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was -0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was -0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.