The versatility of the transumbilical approach for laparotomy in infants

Background/purpose Although the transumbilical approach became very popular for pyloromyotomy, it has not been widely used in other procedures in children. The aim of this work was to evaluate the safety and the versatility of this approach for laparotomy in infants.Patients and methods All hemodynamically stable neonates and infants with gastrointestinal surgical problems or pelvic or abdominal cystic masses were considered candidates for this approach. The umbilicus was incised nearly circumferentially, and the peritoneum was entered in the midline in a cephalic or caudal direction depending on the site of the lesion. The bowel or the mass was delivered outside the peritoneal cavity, and the procedure was completed in the standard open manner. Patients were evaluated with regard to the feasibility of the surgery and or any difficulty to complete the surgery, any complications related to the approach, and the cosmetic outcome.Results A total of 141 infants underwent transumbilicallaparotomy during the period from June 2008 to December  2013. The  primary pathology was hypertrophic pyloric stenosis (n= 65), duodenal, small-intestinal atresia/stricture (n =22), colonic atresia (n= 2), malrotation with/without volvulus (n= 10), ovarian cysts (n= 12), intussusception (n= 9), spontaneous intestinal   perforation (n =7), remnants of vitellointestinal duct (n =4), mesenteric cysts (n= 3), patent urachus (n= 3), postoperative  complications of strangulated inguinal hernia (n= 3), and complications in ventriculoperitoneal shunts (n= 1). Their age ranged  from 1 day to 22 months. The operating time ranged from 30 to 120 min. Three patients required transverse extension of the  wound. Two (1.4%) patients developed dehiscence of the wound that required wound closure. Five (3.5%) patients had superficial periumbilical cellulitis and wound infections, and one patient had suture reaction treated conservatively. Late complications  (adhesive intestinal obstruction) occurred in three (2%) patients. Parents were very satisfied with the final cosmetic outcome.Conclusion The transumbilical approach is both afeasible and a safe approach for a broad spectrum of  surgical procedures in neonates and infants. The cosmetic results are excellent.Keywords: abdominal masses, infants, laparotomy, transumbilical approac

Cytotoxic activity of bimetallic Ag@Se green synthesized nanoparticles using Jerusalem Thorn (Parkinsonia aculeata)

Introduction: The process of green synthesis of metal nanoparticles is considered to be eco-friendly and cost-effective.Methods: In this study, bimetallic Ag@Se-P and Ag@Se-S nanoparticles were synthesized successfully using Parkinsonia aculeata aerial parts and seed extracts. The phytochemical contents in P. aculeata aerial parts and seed aqueous extract serve as reducing and stabilizing capping agents without the need for any chemical stabilization additive in the synthesis of bimetallic nanoparticles.Result and Discussion: The obtained results from UV-vis spectrophotometry, scanning electron microscopy (SEM), X-ray powder diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM), and Fourier-transform infrared spectroscopy (FT-IR) confirmed the successful synthesis of bimetallic nanoparticles with cluster irregular spherical morphology, crystalline nature, and average particle sizes of 17.65 and 24.36 nm for Ag@Se-S and Ag@Se-P, respectively. The cytotoxicity assessment of greenly synthesized nanomaterials using seed and plant extracts showed cell inhibition >50 μg/mL. Ag@Se-S and Ag@Se-P seed and plant extracts significantly reduced LPS-induced inflammation, which was assessed by NO and cytokines IL-1β, IL-6, and TNF-α. The mRNA and protein expression levels of phosphoinositide 3 kinase (PI3K) and nuclear factor kappa B (NFkB) were significantly overexpressed in LPS-induced RAW 264.7 cell lines. Ag@Se-S and Ag@Se-P downregulated the expression of PI3K and NFkB in LPS-induced cell models

PROSPECTIVE EFFECT OF RED ALGAE, ACTINOTRICHIA FRAGILIS, AGAINST SOME OSTEOARTHRITIS AETIOLOGY

Background: Osteoarthritis (OA) is a progressive disease characterized by joints pain and articular cartilage destruction. Most of the current treatment strategies for OA are effective for symptoms relief but are accompanied with adverse side effect. Thus, the present investigation aims to evaluate the potential influence of red algae, Actinotrichia fragilis, in the dry powder form (AFP) or gel form (AFG) on some relevant factors of OA progression as well as assess its safety through in vitro and in vivo experiments. Materials and Methods: In vitro, AFP was analyzed for its chemical constituents screening, amino acid, proteinase inhibitory activity, HRBC membrane stabilization activity, free radical scavenging activity, total antioxidant potency, nitric oxide radical scavenging power. In vivo, Organization for Economic Co-operation and Development (OECD) toxicity test was performed to test the safety of AFP on rats. Results: The present findings revealed that AFP and AFG can be considered as inflammatory-proteinase-oxidant inhibitor and considered to be safe according to the OECD guideline. Conclusion: AFP and AFG may have the potency to become the therapeutic candidate for OA disease as it prevents the key causes of OA initiation

Evaluation of Antibacterial Activity of Pine Tar on Periodontal Pathogenic Bacteria: An In Vitro Study

BACKGROUND: Periodontal pathogens play an important role in etiology and pathogenesis of periodontitis. Microbiological examination of sub gingival plaque is used at the present time in etiological research as well as in clinical treatment of periodontitis to select the appropriate antibiotic agent if indicated. Pine tar has been used for the treatment of various skin diseases. So the study was done to evaluate the effect of Pine Tar oil on bacteria isolated from periodontitis patients.METHODS: Plaque samples from volunteer patients were collected using sterile paper points. Robertson's Cooked Meat (RCM) medium was used for the transportation and cultivation of aerobic, microaerophilic, and anaerobic microorganisms.RESULTS: The result suggests the use of Pine tar oil for topical application in periodontal diseases. Disc diffusion analysis was sufficient enough to illustrate that 75 μl tar oil solution produced growth inhibition of microbial strains.CONCLUSION: Pine tar oil has become one of the important areas of research both in pharmaceutical and periodontal research, hence in vivo studies has to be carried out with various form of pine tar.&nbsp

The influence of different joining processes on mechanical performance of carbon fiber/polyamide (CF/PA6) composites

تستخدم المواد المركبة المصنوعة من مادة البولي أميد (PA6) المقوى بألياف الكربون (CF) على نطاق واسع كمواد هيكلية في صناعات السيارات والفضاء نظرًا لخصائصها المتميزة. ومع ذلك ، نظرًا لمتطلبات السلامة الهيكلية للمواد المركبة ، لا تزال هناك محدودية فيما يتعلق بالإنتاج الفعلي للمواد المركبة المكونة من (CF/ PA6). الروابط القوية لصفائح CF/PA6 مطلوبة بشدة  لعمل تصميم خفيف الوزن يستخدم في العديد من المجالات. بهدف إجراء مقارنات ، تم تدراسة مختلف طرق المعالجة مثل الربط بمواد لاصقة والربط الحراري لتشكيل روابط اللإلفة بين صفحتين مركبتين من (CF/PA6). كما تم دراسة تأثير الطرق المختلفة ومتغيرات المعالجة  المختلفة على مقاومة القص للروابط. أظهرت النتائج أنه من السهل جدًا التعامل مع الروابط اللاصقة التقليدية وقد تتشكل روابط  أقوى إلى حد ما. يمكن استخدام الروابط الحرارية القائمة على التوصيل الكهربائي عن طريق CF لتشكيل توصيلات متلدنة بالحرارة مع المرونة في التصميم. يمكن أن تزيد الروابط الحرارية عن طريق الضغط الساخن من قوة الاتصال؛ عندما تتشكل بالضغط الساخن في ظروف مثالية في درحة حرارة تبلغ 250 درجة مئوية وضغط 2.5 ميجا باسكال ، فإن قوة القص للمفصل 138.85 ميجا باسكال. وبالتالي تم التأكيد على أنه يمكن الحصول على روابط قوية لأجزاء الصفائح للمادة المركبة CF/PA6  عن طريق الالتصاق الحراري عبرعملية الضغط  الساخن.Carbon fiber (CF) reinforced polyamide (PA6) composite materials are broadly used as structural materials in the automotive and aerospace industries due to their distinguished properties. However, due to requirements for the structural integrity of composite materials, there are still limitations in connection of the actual production of CF/PA6 composite. Strong joints of CF/PA6 laminates are highly required for the lightweight design in many fields. Aiming at making comparisons, different processing methods such as adhesive bonding and thermal jointing to form single lap joints between the two CF/PA6 composite laminates are studied. The influences of different processing methods and parameters on the shear strength of joints were also studied. Results showed that conventional adhesive bonding is quite easy to handle and may form rather stronger connections. Thermal joining based on electrical conductors of CF can be used to form a thermoplastic flexible joint design. Thermal joints by hot pressing can further increase the connection strength; when formed by hot pressing under optimum conditions of 250 °C and 2.5MPa, the joint has a shearing strength of 138.85 MPa. It is consequently confirmed that a strong joint of CF/PA6 composite parts could be obtained by thermal joints via the hot pressing process

Effect of Low Versus High-Heeled Footwear on Spinopelvic Alignment at Different Phases of Menstrual Cycle in Young Adult Women: A Biopsychosocial Perspective

High-heeled shoes adversely affect spinal curvature, increase the risk of low back pain, and disturb the normal gait pattern. The purpose of this study was to examine, from a biopsychosocial point of view, the combined effect of wearing two different heel heights and of hormonal oscillation throughout different phases of the menstrual cycle on spinopelvic alignment. Notably, 70 females with an average age of 20.42 ± 1.51 years participated in this study, wearing each female two different heel heights as follows: low (2.5 cm) and high (7 cm). Spinopelvic alignment was evaluated by rasterstereography formetric 3D analysis during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Statistical analysis showed that there was no significant difference (p > 0.05) on spinopelvic alignment [kyphotic angle (KA), trunk inclination (TI), and pelvic inclination] between wearing low- or high-heeled shoes during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Considering that high-heeled shoes are traditionally associated with femininity, body image, beauty, and charm, this research has important biopsychosocial implications that should be explored in detail in future studies

Molecular identification of adenoviruses associated with respiratory infection in Egypt from 2003 to 2010.

BACKGROUND: Human adenoviruses of species B, C, and E (HAdV-B, -C, -E) are frequent causative agents of acute respiratory infections worldwide. As part of a surveillance program aimed at identifying the etiology of influenza-like illness (ILI) in Egypt, we characterized 105 adenovirus isolates from clinical samples collected between 2003 and 2010. METHODS: Identification of the isolates as HAdV was accomplished by an immunofluorescence assay (IFA) and confirmed by a set of species and type specific polymerase chain reactions (PCR). RESULTS: Of the 105 isolates, 42% were identified as belonging to HAdV-B, 60% as HAdV-C, and 1% as HAdV-E. We identified a total of six co-infections by PCR, of which five were HAdV-B/HAdV-C co-infections, and one was a co-infection of two HAdV-C types: HAdV-5/HAdV-6. Molecular typing by PCR enabled the identification of eight genotypes of human adenoviruses; HAdV-3 (n = 22), HAdV-7 (n = 14), HAdV-11 (n = 8), HAdV-1 (n = 22), HAdV-2 (20), HAdV-5 (n = 15), HAdV-6 (n = 3) and HAdV-4 (n = 1). The most abundant species in the characterized collection of isolates was HAdV-C, which is concordant with existing data for worldwide epidemiology of HAdV respiratory infections. CONCLUSIONS: We identified three species, HAdV-B, -C and -E, among patients with ILI over the course of 7 years in Egypt, with at least eight diverse types circulating

Socio-Technical Resilience for Community Healthcare

Older adults at home frequently rely on ‘circles of support’ which range from relatives and neighbours, to the voluntary sector, social workers, paid carers, and medical professionals. Creating, maintaining, and coordinating these circles of support has often been done manually and in an ad hoc manner. We argue that a socio-technical system that assists in creating, maintaining, and coordinating circles of support is a key enabler of community healthcare for older adults. In this paper we propose a framework called SERVICE (Socio-Technical Resilience for the Vulnerable) to help represent, reason about, and coordinate these circles of support and strengthen their capacity to deal with variations in care needs and environment. The objective is to make these circles resilient to changes in the needs and circumstances of older adults. Early results show that older adults appreciate the ability to represent and reflect on their circle of support

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely