A comparative study between laparoscopic and open cholecystectomy in Chengalpattu Medical College

BACKGROUND: Gallstones occurrence is one of the commonest disease processes treated by general surgeon. In 1882 Carl Langenbuch performed the first cholecystectomy, enunciating a principal that the gall bladder needs to be removed not because it contains stones, but because it forms them. Over the years cholecystectomy has been the gold standard in the treatment of gall stone disease. Open cholecystectomy which had been performed unchallenged for over a century now faces an abrupt end with advent of laparoscopic cholecystectomy. In 1985 Philipe Mouret from France performed the first Human Lap Cholecystectomy. Patient acceptance, preference and demand for laparoscopic cholecystectomy is logical since this procedure gives less pain , need for less medication, far shorter hopitalisation and most important it permits an early return to family and normal work and activity. As an added bonus it has an excellent cosmetic result. Laparoscopic cholecystectomy further offers the long term benefit of negligible incidence of wound infection, incisional hernia, nerve entrapment and post operative adhesions. In the field of laparoscopy, laparoscopic cholecystectomy has been the first major surgery performed and has paved the path for laparoscopic intervention for other varied intra abdominal pathologies. So we will study both the techniques and their standing in present scenario. With the background of experience in open cholecystectomy we will commence our work on laparoscopic cholecystectomy. OBJECTIVES OF THE STUDY: 1. Comparative study of the duration of Surgery in both groups. 2. Comparative study of post operative hospital stay, drugs used, Time taken for return to work and Study of conversion rate to open surgery. 3. Comparative study of post-operative complications mortality and morbidity in both groups. MATERIALS AND METHODS: Source of data: Study is a prospective type which includes all patients admitted in Chengalpattu Medical College for elective cholecystectomy. Method of collection of data (including sampling procedure if any: Definition of a study subject: Patients admitted to Department of Surgery, Chengalpattu Medical College for Elective Cholecystectomy. The method of study consists of;- • Detail history taking & clinical examination as per the proforma. • Investigations after taking written informed consent. • Patients will be explained about types of surgeries available-laparoscopic or open cholecystectomy. • Intraoperatively careful note will be made about • Time latent for the procedure • Documentation of any complication encountered during procedure. • If laproscopic procedure converted to open cholecystectomy, reason for the same. • Post operative period will be divide into immediate or in hospital stay and follow up period during in hospital stay, following data will be collected: • Drain removal ,if put. • Post operative hospital stay. • Any complication if occurred. • Patients of both groups will be followed regularly up to 3 months. • Note will made of any complications, time taken to return to work and patients satisfaction. Inclusion criteria: 1. Patients with symptomatic gallbladder diseases 2. Symptomatic gallstones. 3. Acute or Chronic cholecystitis. 4. Mucocele/ Pyocele of gallbladder. Exclusion criteria: 1. Pregnancy. 2. Major bleeding disorder. 3. Cirrhosis with portal hypertension. 4. Generalised peritonitis. 5. Patient not fit for general anaesthesia. 6. Suspected gall bladder malignancy The following investigations will be done after taking written informed consent:- 1. Routine Investigations for General Surgical Procedure Blood Investigation and Urine Investigations :Hb%, TC , DC, Peripheral smear, ESR, Renal function tests, Liver function tests, Lipid profile, FBS/PPBS, HIV, HBsAg, , Urine for albumin, sugars, ketone bodies, microscopy, BT CT. Other investigations : X-ray of the chest, X-ray Erect Abdomen, Ultrasonogram of Abdomen, Serum amylase. In selected cases MRCP, ERCP, CT Abdomen CONCLUSION: The above study is to evaluate the superiority of laparascopic cholecystectomy over open cholecystectomy in Chengalpattu Medical College Hospital during the period September 2015 to October 2016

Exact approaches for designing multifacility buy-at-bulk networks

We study a problem that integrates buy-at-bulk network design into the classical facility location problem. We consider a generalization of the facility location problem where multiple clients may share a capacitated network to connect to open facilities instead of requiring direct links. In this problem, we wish to open facilities, build a routing network by installing access cables of different costs and capacities, and route every client demand to an open facility. We provide a path based formulation and we compare it with the natural compact formulation for this problem. We then design an exact branch-price-and-cut algorithm for solving the path based formulation. We study the effect of two families of valid inequalities. In addition to this, we present three different types of primal heuristics and employ a hybrid approach to effectively combine these heuristics in order to improve the primal bounds. We finally report the results of our approach that were tested on a set of real world instances as well as two sets of benchmark instances and evaluate the effects of our valid inequalities and primal heuristics

Modulatory and regenerative potential of transplanted bone marrow derived mesenchymal stem cells on rifampicin-induced kidney toxicity

Anti-tuberculosis agent rifampicin is extensively used for its effectiveness. Possible complications of tuberculosis and prolonged rifampicin treatment include kidney damage; these conditions can lead to reduced efficiency of the affected kidney and consequently to other diseases. Bone marrow-derived mesenchymal stem cells (BMMSCs) can be used in conjunction with rifampicin to avert kidney damage; because of its regenerative and differentiating potentials into kidney cells. This research was designed to assess the modulatory and regenerative potentials of MSCs in averting kidney damage due to rifampicin-induced kidney toxicity in Wistar rats and their progenies. BMMSCs used in this research were characterized according to the guidelines of International Society for Cellular Therapy

Chemical composition of Moringa oleifera ethyl acetate fraction and its biological activity in diabetic human dermal fibroblasts

Background: Moringa oleifera (MO), commonly known as the drumstick tree, is used in folklore medicine for the treatment of skin disease. Objective: The objective of this study is to evaluate the ethyl acetate (EtOAc) fraction of MO leaves for in vitro antibacterial, antioxidant, and wound healing activities and conduct gas chromatography-mass spectrometry (GC-MS) analysis. Materials and Methods: Antibacterial activity was evaluated against six Gram-positive bacteria and 10 Gram-negative bacteria by disc diffusion method. Free radical scavenging activity was assessed by 1, 1-diphenyl-2-picryl hydrazyl (DPPH) radical hydrogen peroxide scavenging and total phenolic content (TPC). Wound healing efficiency was studied using cell viability, proliferation, and scratch assays in diabetic human dermal fibroblast (HDF-D) cells. Results: The EtOAc fraction showed moderate activity against all bacterial strains tested, and the maximum inhibition zone was observed against Streptococcus pyogenes (30 mm in diameter). The fraction showed higher sensitivity to Gram-positive strains than Gram-negative strains. In the quantitative analysis of antioxidant content, the EtOAc fraction was found to have a TPC of 65.81 ± 0.01. The DPPH scavenging activity and the hydrogen peroxide assay were correlated with the TPC value, with IC50values of 18.21 ± 0.06 and 59.22 ± 0.04, respectively. The wound healing experiment revealed a significant enhancement of cell proliferation and migration of HDF-D cells. GC-MS analysis confirmed the presence of 17 bioactive constituents that may be the principal factors in the significant antibacterial, antioxidant, and wound healing activity. Conclusion: The EtOAc fraction of MO leaves possesses remarkable wound healing properties, which can be attributed to the antibacterial and antioxidant activities of the fraction.Summary: Moringa oleifera (MO) leaf ethyl acetate (EtOAc) fraction possesses antibacterial activities toward Gram-positive bacteria such as Streptococcus pyogenes, Streptococcus faecalis, Bacillus subtilis, Bacillus cereus and Staphylococcus aureus, and Gram-negative bacteria such as Proteus mirabilis and Salmonella typhimuriumMO leaf EtOAc fraction contained the phenolic content of 65.81 ± 0.01 and flavonoid content of 37.1 ± 0.03, respectively. In addition, the fraction contained 17 bioactive constituents associated with the antibacterial, antioxidant, and wound healing properties that were identified using gas chromatography-mass spectrometry analysisMO leaf EtOAc fraction supports wound closure rate about 80% for treatments when compared with control group

Synthesis of (cinnamate-zinc layered hydroxide) intercalation compound for sunscreen application

Background: Zinc layered hydroxide (ZLH) intercalated with cinnamate, an anionic form of cinnamic acid (CA), an efficient UVA and UVB absorber, have been synthesized by direct method using zinc oxide (ZnO) and cinnamic acid as the precursor. Results: The resulting obtained intercalation compound, ZCA, showed a basal spacing of 23.9 Å as a result of cinnamate intercalated in a bilayer arrangement between the interlayer spaces of ZLH with estimated percentage loading of cinnamate of about 40.4 % w/w. The UV–vis absorption spectrum of the intercalation compound showed excellent UVA and UVB absorption ability. Retention of cinnamate in ZLH interlayers was tested against media usually came across with sunscreen usage to show low release over an extended period of time. MTT assay of the intercalation compound on human dermal fibroblast (HDF) cells showed cytotoxicity of ZCA to be concentration dependent and is overall less toxic than its precursor, ZnO. Conclusions: (Cinnamate-zinc layered hydroxide) intercalation compound is suitable to be used as a safe and effective sunscreen with long UV protection effect

Identification of critical paralog groups with indispensable roles in the regulation of signaling flow

Extensive cross-talk between signaling pathways is required to integrate the myriad of extracellular signal combinations at the cellular level. Gene duplication events may lead to the emergence of novel functions, leaving groups of similar genes - termed paralogs - in the genome. To distinguish critical paralog groups (CPGs) from other paralogs in human signaling networks, we developed a signaling network-based method using cross-talk annotation and tissue-specific signaling flow analysis. 75 CPGs were found with higher degree, betweenness centrality, closeness, and ‘bowtieness’ when compared to other paralogs or other proteins in the signaling network. CPGs had higher diversity in all these measures, with more varied biological functions and more specific post-transcriptional regulation than non-critical paralog groups (non-CPG). Using TGF-beta, Notch and MAPK pathways as examples, SMAD2/3, NOTCH1/2/3 and MEK3/6-p38 CPGs were found to regulate the signaling flow of their respective pathways. Additionally, CPGs showed a higher mutation rate in both inherited diseases and cancer, and were enriched in drug targets. In conclusion, the results revealed two distinct types of paralog groups in the signaling network: CPGs and non-CPGs. Thus highlighting the importance of CPGs as compared to non-CPGs in drug discovery and disease pathogenesis

Impact of dengue virus (serotype DENV-2) infection on liver of BALB/c mice: a histopathological analysis

In this research, we characterized the histopathological impact of dengue virus (serotype DENV-2) infection in livers of BALB/c mice. The mice were infected with different doses of DENV-2 via intraperitoneal injection and liver tissues were processed for histological analyses and variation was documented. In the BALB/c mouse model, typical liver tissues showed regular hepatocyte architecture, with normal endothelial cells surrounding sinusoid capillary. Based on histopathological observations, the liver sections of BALB/c mice infected by DENV-2 exhibited a loss of cell integrity, with a widening of the sinusoidal spaces. There were marked increases in the infiltration of mononuclear cells. The areas of hemorrhage and micro- and macrovesicular steatosis were noted. Necrosis and apoptosis were abundantly present. The hallmark of viral infection, i.e., cytopathic effects, included intracellular edema and vacuole formation, cumulatively led to sinusoidal and lobular collapse in the liver. The histopathological studies on autopsy specimens of fatal human DENV cases are important to shed light on tissue damage for preventive and treatment modalities, in order to manage future DENV infections. In this framework, the method present here on BALB/c mouse model may be used to study not only the effects of infections by other DENV serotypes, but also to investigate the effects of novel drugs, such as recently developed nano-formulations, and the relative recovery ability with intact immune functions of host

Graphene Oxide-Gallic Acid Nanodelivery System for Cancer Therapy

Despite the technological advancement in the biomedical science, cancer remains a life-threatening disease. In this study, we designed an anticancer nanodelivery system using graphene oxide (GO) as nanocarrier for an active anticancer agent gallic acid (GA). The successful formation nanocomposite (GOGA) was characterized using XRD, FTIR, HRTEM, Raman, and UV/Vis spectroscopy. The release study shows that the release of GA from the designed anticancer nanocomposite (GOGA) occurs in a sustained manner in phosphate-buffered saline (PBS) solution at pH 7.4. In in vitro biological studies, normal fibroblast (3T3) and liver cancer cells (HepG2) were treated with different concentrations of GO, GOGA, and GA for 72 h. The GOGA nanocomposite showed the inhibitory effect to cancer cell growth without affecting normal cell growth. The results of this research are highly encouraging to go further for in vivo studies