Analysis of Advantages of Single Layer Vs Double Layer Anastomosis of Bowel

INTRODUCTION: In the modern day surgical practice, we come across situations in abdominal surgery, where we require resection and anastomosis of bowel. In small bowel resection and anastomosis, conventionally, two layer suturing technique i.e., inner layer with absorbable suture material in continuous fashion and outer layer with non absorbable suture material in a continuous or interrupted fashion, was considered secure. Recently, it has been advocated that anastomosis of small bowel with a single layer suturing using a non absorbable monofilament suture material in a continuous fashion has the same outcome when compared to double layer suturing technique. AIMS AND OBJECTIVES: 1. Complications of Single layer technique and the Double layer technique in emergency and elective surgeries. 2. Time consumption for performing single layer anastomosis as well as double layer anastomosis. 3. Cost effectiveness of single layer anastomosis. MATERIALS & METHODS: All adult patients requiring intestinal anastomosis at Govt. Rajaji Hospital from July 2008 to June 2010 were considered eligible. Totally 60 patients were included in our study. 30 patients under went single layer anastomosis and 30 patients underwent double layer anastomosis. Patients who underwent elective or emergency surgery were included in our study. Based on a careful history and meticulous physical examination, combined with adjunctive investigations, a decision to operate urgently or electively was taken. Baseline laboratory parameters like blood urea, blood sugar, serum creatinine, serum electrolytes, blood grouping and typing were done in all the cases, to rule out co morbid conditions. Evaluation of patients with Acute abdomen: Immediately after receiving the patient, primary survey was done, which included resuscitation secondary survey included definitive management. DISCUSSION: Our study assessed the efficacy and safety of single and double layer anastomosis after intestinal resection, in emergency and elective situations. Generally, conventional two layered technique is being practised. But this causes excessive mucosal inversion, causing narrowing of lumen and may lead to ischaemia of anastomotic site. To overcome this problem little mucosal and complete serosal continuous suturing technique was tried. It has the advantage of good opposition of serosal surfaces, no luminal narrowing and less damage to submucosal vascular plexus. In our study, anastomotic leakage in single layer group was 3.3% which is consistent with the other studies which showed leakage in the range of 1.3 to 7.7%. In emergency situations the anastomotic leak rate in single layer group is 5% The double layer group shows anastomotic leakage around 3.3% again which is consistent with the other studies. In emergency situations the anastomotic leak rate in double layer group 5%. CONCLUSION: Among the two methods of small intestinal bowel anastomosis which we have studied, our observations are ; 1. There is no much difference in the development of the complication in both the methods. However the development of complications in emergency situation is more marked in both the methods. 2. The time required to construct a single layer anastomosis is lesser than that of the double layer anastomosis. 3. Narrowing of the lumen of the bowel is lesser in single layer anastomosis when compared to double layer anastomosis. 4. Bowel movements recovered early in single layer anastomosis when compared to double layer anastomosis. 5. Finally, construction of single layer anastomosis of small bowel is cost effective when compared to that of double layer anastomosis

Comparative Studies on Application of Various Adsorbents in Textile Waste Water

This thesis aims to explore the potential of employing natural adsorbents, such as cashew nut shells, date seeds, orange peels, and coir pith, to mitigate COD levels in textile wastewater. The wastewater used for the study was sourced from a textile industry located in Salem. The investigation involved batch studies, wherein the effectiveness of each selected absorbent in reducing COD was assessed to determine the most efficient among the four sorbents. The initial concentration from the batch research served as a basis for identifying the optimal adsorbent, with the COD of the textile wastewater maintained consistently along with the initial dye concentration. To conduct the study, the adsorbent was incrementally introduced in 10 g portions into conical flasks. Over a10-minute period following a 20-minute contact time, the supernatant liquid from each conical flask was collected using syringes. The COD concentration in the obtained samples was determined using a standard methodology. Results revealed that date seeds exhibited the highest percentage of COD removal at 67%, followed by cashew nut shells at 45%, coir pith at 33%, and orange peels at 23%. The data obtained indicated that cashew nut shells and date seeds achieved the highest percentages of COD reduction, respectively. On the other hand, the Orange Peel Adsorbent displayed the least reduction in COD. Based on the collected findings, date seeds emerge as a promising adsorbent for effectively lowering COD in the treatment of textile wastewater

Fused core-modified meso-aryl expanded porphyrins

The synthesis and characterization of the first examples of singly and doubly fused expanded porphyrins containing dithienothiophene (DTT) cores are reported

Traffic scheduling, network slicing and virtualization based on deep reinforcement learning

The revolutionary paradigm of the 5 G network slicing introduces promising market possibilities through multi-tenancy support. Customized slices might be provided to other tenants at a different price as an emerging company to operators. Network slicing is difficult to deliver higher performance and cost-effective facilities through render resources utilisation in alignment with customer activity. Therefore, this paper, Deep Reinforcement Learning-based Traffic Scheduling Model (DRLTSM), has been proposed to interact with the environment by searching for new alternative actions and reinforcement patterns believed to encourage outcomes. The DRL for network slicing situations addresses power control and core network slicing and priority-based sizing involves radio resource. This paper aims to develop three main network slicing blocks i) traffic analysis and network slice forecasting, (ii) network slice admission management decisions, and (iii) adaptive load prediction corrections based on calculated deviations; Our findings suggest very significant possible improvements show that DRLTSM is dramatically improving its efficiency rate to 97.32%, scalability and compatibility in comparison with its baseline

Regulation and roles of RNA modifications in aging-related diseases

With the aging of the global population, accumulating interest is focused on manipulating the fundamental aging-related signaling pathways to delay the physiological aging process and eventually slow or prevent the appearance or severity of multiple aging-related diseases. Recently, emerging evidence has shown that RNA modifications, which were historically considered infrastructural features of cellular RNAs, are dynamically regulated across most of the RNA species in cells and thereby critically involved in major biological processes, including cellular senescence and aging. In this review, we summarize the current knowledge about RNA modifications and provide a catalog of RNA modifications on different RNA species, including mRNAs, miRNAs, lncRNA, tRNAs, and rRNAs. Most importantly, we focus on the regulation and roles of these RNA modifications in aging-related diseases, including neurodegenerative diseases, cardiovascular diseases, cataracts, osteoporosis, and fertility decline. This would be an important step toward a better understanding of fundamental aging mechanisms and thereby facilitating the development of novel diagnostics and therapeutics for aging-related diseases

PAX8 expression in high-grade serous ovarian cancer positively regulates attachment to ECM via Integrin β3

Background: Ovarian cancer is the third most common cause of death among gynecologic malignancies worldwide. Understanding the biology and molecular pathogenesis of ovarian epithelial tumors is key to developing improved prognostic indicators and effective therapies. We aimed to determine the effects of PAX8 expression on the migrative, adhesive and survival capabilities of high-grade serous carcinoma cells. Methods: PAX8 depleted Fallopian tube secretory cells and ovarian cancer cells were generated using short interfering siRNA. Anoikis resistance, cell migration and adhesion properties of PAX8 silenced cells were analyzed by means of specific assays. Chromatin immunoprecipitation (ChIP) was carried out using a PAX8 polyclonal antibody to demonstrate that PAX8 is able to bind to the 5′-flanking region of the ITGB3 gene positively regulating its expression. Results: Here, we report that RNAi silencing of PAX8 sensitizes non-adherent cancer cells to anoikis and affects their tumorigenic properties. We show that PAX8 plays a critical role in migration and adhesion of both Fallopian tube secretory epithelial cells and ovarian cancer cells. Inhibition of PAX8 gene expression reduces the ability of ovarian cancer cells to migrate and adhere to the ECM and specifically to fibronectin and/or collagen substrates. Moreover, loss of PAX8 strongly reduces ITGB3 expression and consequently the correct expression of the αvβ3 heterodimer on the plasma membrane. Conclusions: Our results demonstrate that PAX8 modulates the interaction of tumor cells with the extracellular matrix (ECM). Notably, we also highlight a novel pathway downstream this transcription factor. Overall, PAX8 could be a potential therapeutic target for high-grade serous carcinoma