The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

IMIDE SILANES-ADHESION PROMOTERS FOR POLYIMIDE

117scopu

Anti-inflammatory and Anti-ulcerogenic Effect of Crotalaria juncea Linn. in Albino Rats

The aim of this study was to evaluate the antiarthritic activity of ethanolic extract of the leaves of Crotalaria juncea   (CJE) in Complete Freund's Adjuvant (CFA) induced arthritis model in rats, and also to evaluate anti-ulcerogenic activity of CJE.Arthritis was induced in male albino Wistar rats by injection of CFA (0.1 mL) into the left foot pad of the animals. Treatment with CJE at 200 and 400 mg/kg and standard indomethacin (0.3 mg/kg) was started on the same day and continued up to day 12. The paw volume was measured on day 1, 5, 12 and 21 for both the paws and antiarthritic activity was evaluated. Anti-ulcerogenic potential of CJE was also evaluated. For possible mechanism of anti-ulcerogenic potential, appetite suppressant activity was recorded. The drug CJE produced reduction in the inflammation of the paw produced due to CFA. The antiarthritic action started on the day 5 and continued till day 12 and the activity was comparable to that of the standard on both days. In indomethacin treated animals ulcer was observed, where as CJE was found to protect the animals from ulcer formation which may be due to appetite suppressant activity.CJE significantly inhibited adjuvant induced arthritis and has significant anti-inflammatory effect (p<0.001). It has anti-ulcerogenic property compared to indomethacin, which may be due to appetite suppressant activity

Opportunistic Packet Scheduling in Body Area Networks

Abstract. Significant research efforts are being devoted to Body Area Networks (BAN) due to their potential for revolutionizing healthcare practices. Energy-efficiency and communication reliability are critically important for these networks. In an experimental study with three different mote platforms, we show that changes in human body shadowing as well as those in the relative distance and orientation of nodes caused by the common human body movements can result in significant fluctuations in the received signal strength within a BAN. Furthermore, regular movements, such as walking, typically manifest in approximately periodic variations in signal strength. We present an algorithm that predicts the signal strength peaks and evaluate it on real-world data. We present the design of an opportunistic MAC protocol, named BANMAC, that takes advantage of the periodic fluctuations of the signal strength to achieve high reliability even with low transmission power.