Barium Enema in the Diagnosis of Hirschsprung's Disease: A Comparison with Rectal Biopsy

Aim: The aim of the present study was to compare the diagnostic accuracy of a barium enema in Hirschsprung's disease with respect to a rectal biopsy. Materials And Methods: This study was conducted on 60 consecutive patients of clinically suspected cases of Hirschsprung's disease admitted to a tertiary care hospital in Kashmir over a period of three and a half years. All the patients were subjected to a barium enema and a full-thickness rectal biopsy. Results: The mean age was 3.5 + 0.5 years. A rectal biopsy revealed absence of ganglion cells in 36 (60%) patients, absence of ganglion cells with nerve hypertrophy in 4 (6.66%) patients and ruled out Hirschsprung's disease in 20 (33.33%) patients. A barium enema was compatible with Hirschsprung's disease in 20 (33.33%), suggestive in 14 (23.33%) and unremarkable in 26 (43.33%) patients. A barium enema had a diagnostic accuracy of 76.67% with a positive predictive value of 88.23%, a negative predictive value of 61.53%, specificity of 80% and a sensitivity of 75%, and a rectal biopsy had a diagnostic accuracy of 100% (P value < 0.0001). Conclusion: Barium enema is a valuable diagnostic tool for the diagnosis of patients with Hirschsprung's disease. We recommend a barium enema as a routine initial workup in the management of patients of suspected Hirschsprung's disease. [Arch Clin Exp Surg 2013; 2(4.000): 224-228

Review of micro and mini channels, porous heat sinks with hydrophobic surfaces for single phase fluid flow

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.New cohort technology is facing the challenges of cooling the advanced electronic devices with ever greater heat generated due to the densely populated Integrated Circuits (ICs). The commonly used cooling fluids like water, Ethylene Glycol (EG) and oils are not in the position to combat these challenges. To cater these requirements, advance fluids with better thermo physical properties called nano fluids are searched out which are the combination of base fluids and dispersed nano sized particles. Mini/Micro channel heat sinks using Nano fluids are the focus of the recent research. The current study is focused on the review of experimental, numerical and analytical application of the Nano fluids in mini/micro channel Heat sinks for enhanced heat transfer in cooling systems. The uses of Hybrid Nano fluids in different systems are also critically analysed. A brief discussion of porous medium devices, discussion of the correlations developed by different researchers for Hybrid nanofluids and synthesis as well as uses of super hydrophobic surfaces have also been included in this stud

Comparison of Random Forest and Kriging Models for Soil Organic Carbon Mapping in the Himalayan Region of Kashmir

The knowledge about the spatial distribution of soil organic carbon stock (SOCS) helps in sustainable land-use management and ecosystem functioning. No such study has been attempted in the complex topography and land use of Himalayas, which is associated with great spatial heterogeneity and uncertainties. Therefore, in this study digital soil mapping (DSM) was used to predict and evaluate the spatial distribution of SOCS using advanced geostatistical methods and a machine learning algorithm in the Himalayan region of Jammu and Kashmir, India. Eighty-three soil samples were collected across different land uses. Auxiliary variables (spectral indices and topographic parameters) derived from satellite data were used as predictors. Geostatistical methods—ordinary kriging (OK) and regression kriging (RK)—and a machine learning method—random forest (RF)—were used for assessing the spatial distribution and variability of SOCS with inter-comparison of models for their prediction performance. The best fit model validation criteria used were coefficient of determination (R2) and root mean square error (RMSE) with resulting maps validated by cross-validation. The SOCS concentration varied from 1.12 Mg/ha to 70.60 Mg/ha. The semivariogram analysis of OK and RK indicated moderate spatial dependence. RF (RMSE = 8.21) performed better than OK (RMSE = 15.60) and RK (RMSE = 17.73) while OK performed better than RK. Therefore, it may be concluded that RF provides better estimation and spatial variability of SOCS; however, further selection and choice of auxiliary variables and higher soil sampling density could improve the accuracy of RK prediction

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2