Role of color Doppler ultrasound in the diagnosis of nonpalpable testes

Purpose Color Doppler ultrasound has been used for the diagnosis of torsion of testes. The purpose of this study was to evaluate the sensitivity of this noninvasive tool in detecting impalpable testes.Patients and methods Twenty-five children with nonpalpable testes were treated at the Department of Pediatric Surgery, Institute of Medical Science, Banaras, between 2007 and 2009. Color Doppler ultrasound was used for detecting the position, size, and vascularity of nonpalpable testes. These patients were subsequently revaluated by laparoscopy.Results Out of 25 cases, 15 cases were unilateral and 10 cases were bilateral (a total of 35 nonpalpable testes). The color Doppler ultrasound study successfully localized 30 of the 35 nonpalpable testes, which were confirmed by subsequent laparoscopic examination. The sensitivity of color Doppler in locating testes was 85.71% (95% confidence interval = 0.64–0.97).Conclusion Color Doppler ultrasound is an effective noninvasive method for the initial diagnosis of impalpable testes and for planning its subsequent management.Keywords: color Doppler ultrasound, laparoscopy, nonpalpable teste

Operating Manifold Services in Hospitals: A costly affair?

Manifold services form an important cost centre in hospitals. Most public sector hospitals do not have standard cost accounting system and therefore budget allocation is often difficult for support services such as the manifold. The study was conducted in a 1045 bedded tertiary care hospital in New Delhi, India with the objective of identifying the cost incurred in delivery of manifold services.This traditional costing exercise was conducted from 01 July to 30 Sept 2010 and included classification of costs, identification of the cost centres in the hospital, cost allocation and apportioning. Direct and indirect costs as well as capital and operational costs were calculated. The process of manifold services from delivery to the operational aspects was studied. Tender documents and supply orders were perused to arrive at expenditure on manifold gas pipeline system, equipment & accessories. Total annual cost of manifold services at the hospital was calculated to be $333,676 and per day cost was calculated to be$ 941 .Annual cost per manifold terminal unit was $207.3. The daily cost of manifold system was calculated to be$ 0.56. The annual and daily cost per bed was deduced to be $320 and$ 0.87 respectively.While manifold is a vital support service, the fact remains that it is cost intensive and underutilized and often poorly planned in terms of cost effectiveness. The focus on technology in manifold services needs to be sustained

Minimizing the postoperative complications of severe hypospadias using a simple technique

Background The aim of this study was to decrease complication rates in proximal hypospadias surgery.Methods A simple method of stenting using a polypropylene stent has been developed for the most severe form of hypospadias during the period from January 2008 to January 2011 in the Department of Pediatric Surgery. The total number of patients was 46. The patients were classified into group 1 (n= 23), in which a polypropylene stent was used, and group 2 (n= 23), in which a polypropylene stent was not used.Results In group 1, complications occurred in three patients (13.04%), whereas in group 2 it occurred in 12 patients (52.2%). The difference in the total number of complications between groups was highly significant (P < 0.001). In group 1, no patient needed redo surgery, and in group 2 four patients (17.39%) needed redo surgery (P < 0.05). All other patients responded to repeated dilatation in the follow-up.Conclusion Although the sample size was small, this simple modification can decrease the complication rate significantly in the most severe form of hypospadias. Keywords: polypropylene stent, proximal hypospadias, surgical complications, urethroplast

3D-printing: An emerging and a revolutionary technology in pharmaceuticals

© 2018 EDIZIONI MINERVA MEDICA. One of the novel and progressive technology employed in pharmaceutical manufacturing, design of medical device and tissue engineering is three-dimensional (3D) printing. 3D printing technologies provide great advantages in 3D scaffolds fabrication over traditional methods in the control of pore size, porosity, and interconnectivity. Various techniques of 3D-printing include powder bed fusion, fused deposition modeling, binder deposition, inkjet printing, photopolymerization and many others which are still evolving. 3D-printing technique been employed in developing immediate release products, various systems to deliver multiple release modalities etc. 3D printing has opened the door for new generation of customized drug delivery with built-in flexibility for safer and effective therapy. Our mini-review provides a quick snapshot on an overview of 3D printing, various techniques employed, applications and its advancements in pharmaceutical sciences

Pediatric carcinoma of rectum - Varanasi experience

Background : Primary gastrointestinal system malignancies constitute approximately 2% of pediatric neoplasm and of these; colorectal carcinoma is the second most common malignancy. This is one of the rarer diseases in children. Aim : We reviewed our records to study the clinical features, outcome and the follow-up of this condition with evaluation of the prognostic factors. Settings and Design: Tertiary care Pediatric Surgery centre. Retrospective study. Materials and Methods : The data of all patients with diagnosis of colorectal carcinoma from January 1986 to January 2006 were reviewed. The confirmation of the diagnosis was by biopsy from the lesion. The age, sex, family history, clinical features, response to the treatment and follow-up were studied. Results : There were four male patients. All had bleeding per rectum as the presenting complaint. Three patients had advanced disease at presentation. All the patients had signet cell adenocarcinoma. The two patients expired and one was lost to follow-up. One patient is alive after one year of follow up and is receiving treatment. Conclusion : Colorectal cancer in children though rare can be a reality, hence any children presenting with pain in abdomen along with doubtful history of constipation and rectal bleeding should be examined carefully with special emphasis on digital rectal examination

SARS CoV-2 aggravates cellular metabolism mediated complications in COVID-19 infection.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the primary causative organism in corona virus disease-19 (COVID-19) infections, is a novel member of the human coronavirus family which was first identified in Wuhan, China, towards the end of 2019. This letter reveals new vital missing links in our current understanding of the mechanisms that lead to cell death triggered by ferroptotic stress in COVID-19 infection. It further reveal the importance of homocysteine mediated trans-sulfuration pathway in COVID-19 infection. Hence, Vitamin B6, folic acid, and Vitamin B12 should be incorporated in the treatment regimen for SARS CoV-2 infections to suppress complications, as the virus mediates altered host cell metabolism