Carcinoid Klatskin tumour: A Rare Cause of Obstructive Jaundice

Carcinoid tumours of the extrahepatic biliary ducts represent an extremely rare cause of bile duct obstruction. We report a case of obstructive jaundice secondary to carcinoid tumour arising at the hilar confluence. Resection of the primary tumour was done and the patient is doing well on follow-up. This case demonstrated that surgery offers the only potential cure for biliary carcinoid and aggressive surgical therapy should be the preferred treatment in cases of potentially resectable biliary tumours

Remediation and Management of Sewage Sludge

In recent times, along with urbanization, the population of the city is also increasing rapidly. In this regard, the discharge of municipal sewage is increasing year by year, which is a worrying situation for living beings as well as the environment. In fact, wastewater is an important by-product of modern industry and contributes significantly to polluting the aquatic environment. Its sources are based on many industries and anthropogenic pollutants. The nature of wastewater is organic and inorganic. Many harmful pollutants especially heavy metals are present in sewage sludge and wastewater. Phytoremediation has become a significant experimental and practical strategy to use plants to remove heavy metals from sewage waters, sludges, spillage sites, and polluted places

Lack of association of methylenetetrahydrofolate reductase 677C\u3eT mutation with coronary artery disease in a Pakistani population

Pakistanis belong to the South Asian population which has the highest known rate of coronary artery disease. Folic acid deficiency also appears to be highly prevalent in this population. Methylenetetrahydrofolate reductase (MTHFR) 677C\u3eT polymorphism decreases the activity of this enzyme and can be associated with mild to moderate hyperhomocysteinemia in homozygotes, particularly when there is folic acid deficiency, as well as with coronary artery disease. To assess the value of genotyping the MTHFR 677C\u3eT dimorphism, we carried out a case-control study of dimorphism 677C\u3eT for putative association with myocardial infarction (MI) among Pakistani nationals. We investigated a sample population of 622 Pakistanis consisting of 225 controls and 397 patients with clinical diagnosis of acute MI (AMI). MTHFR C677T alleles were determined by assays based on polymerase chain reaction and restriction endonuclease analysis. Frequencies of C alleles were 0.87 among controls and 0.86 among AMI patients. The MTHFR 677C\u3eT dimorphism showed no association with MI (chi(2) = 0.25, 1df, P=0.62), serum levels of folate and vitamin B12 and plasma level of vitamin B6. A significant association, however, was found between homozygous 677T genotype and plasma levels of homocysteine. Multivariate analysis of the data showed that in case of log homocysteine, age and MTHFR genotypes were significantly different (PT polymorphism, though associated with homocysteine levels, confers no significant risk of coronary artery disease in the Pakistani population investigated here. We suggest that the higher incidence of AMI in South Asia occurs through mechanisms other than the MTHFR related pathways

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Enhanced visible light-driven photocatalytic degradation of crystal violet dye using Cr doped BaFe12O19 prepared via facile micro-emulsion route

The Cr ion doping effect on various properties of Cr doped BaCrxFe12-xO19 nanoparticles was investigated, which were synthesized via a facile microemulsion approach and properties were studied using XRD, SEM, FTIR, Raman, photoluminescence and UV–visible techniques along with dielectric, optical and ferroelectric properties. The BaCrxFe12-xO19 structure was hexagonal involving P63/mmc space group with average crystalline size of 9–18 nm. The NPs exhibited agglomerated platelet heterogeneous morphology. The presence of the Ba-O-Fe functional group was also confirmed by FTIR analysis. The PL analysis revealed that the doping reduced the recombination rate and charge (e−-h+) separation is facilitated. The coercivity (Hc) and saturation polarization (Ps) increased with doping content and dielectric loss reduces with frequency and dopant concentration. The dopant contents also increased the AC conductivity and the optical bandgap found in 1.75–2.83 (eV) range. The BaCrxFe12-xO19 exhibited a significantly higher photocatalytic efficiency versus BaFe12O19, and 91 % CV dye was degraded in 90 min under visible light irradiation. Additionally, a recycling experiment was conducted to confirm the stability of the prepared photocatalyst and Cr doped BaCrxFe12-xO19 exhibited excellent stability and reusability. The Cr doping affected the dielectric, optical and ferroelectric properties and based on photocatalytic properties of BaCrxFe12-xO19, it has potential applications for the destruction of dyes in wastewater under visible light exposure, which will make the process highly feasible for photocatalytic applications

Stabilization of zirconia nanoparticles by collagen protein and calcium carbonate extracted from eggshell and its biodegradation, radical scavenging and mineralization activity

In this current study, collagen protein extracted from eggshell membrane and calcium carbonate (a main component of eggshell) are used as additive to enhance the stability and hardness of the zirconia crystals. Five different samples are prepared by adding membrane containing eggshell content as, 1 g, 2 g, 3 g, 4 g and 5 g in aqueous zirconium oxychloride sol. Phase purity is confirmed by XRD and FTIR. Phase pure and dense particles divulges the high hardness (∼1389 HV) and fracture toughness (12.89 MPa m1/2). FESEM analysis illustrates the formation of dense, well separated, non-agglomerated and spherical nanoparticles at 5 g of eggshell content. Eggshell works as a surfactant and stabilizer for formation of phase pure tetragonal spherical nanoparticles. Biodegradation study of optimized tetragonal zirconia (t-ZrO2 )in phosphate buffered saline (PBS) presents that minor change in weight and hardness after 72 h of immersion. Antioxidant study shows the 96% of radical scavenging activity (RSA). In vitro bio-mineralization study shows the formation of new bone after 5 weeks. After 5 weeks all pores were filled and minerals were deposited on the surface of the scaffolds. SEM images confirms that eggshell-zirconia composite form new bone. So eggshell addition results in formation of phase pure t-ZrO2 nanoparticles with well-defined boundaries which exhibit higher hardness, fracture toughness, stability and enhanced antioxidant properties

Mg1-xNixFe2-xCrxO4 synthesis via hydrothermal route: Effect of doping on the structural, optical, electrical, magnetic and photocatalytic properties

A pristine MgFe2O4 and a series of Ni and Cr substituted magnesium ferrite NPs have been fabricated via hydrothermal route. The influence of double ions substitution on MgFe2O4 was examined attributed to structural, optical, electrical, magnetic and photocatalytic properties. X-ray diffraction analysis revealed cubic geometry having fd3m space group with an average crystalline size in 25–33 nm. From hysteresis loop saturation polarization (Ps), coercivity and remanence polarization (Pr)was evaluated and found that the value of Ps and Pr were improved on increasing dopants content. VSM analysis confirms the ferromagnetic behavior of Mg1-xNixFe2-xCrxO4. Furthermore, the dielectric loss decreased by increasing frequency as well as the amount of dopant. UV–Vis absorption spectrum exhibited red-shift and band-gap energy reduced i.e., 2.58 to 2.29 eV. PCA study evaluated using crystal violet (CV) dye and Mg1-xNixFe2-xCrxO4 NPs exhibited higher efficiency and 97 % dye degradation was observed for Mg1-xNixFe2-xCrxO4 versus MgFe2O4 (59 %) under sunlight irradiation in 100 min. Moreover, the stability of NPs was confirmed through recycling experiment and Mg1-xNixFe2-xCrxO4 showed promising stability and reusability. Thus, the enhanced photocatalytic activity under solar light revealed its application for remediation of dyes in industrial waste under sunlight irradiation, it will make the process highly feasible