Ultrasonographic Characters of Uterine Myoma as Predictors for Successful Laparoscopic Myomectomy at Mansoura University Hospital

Background: Myomectomy is the surgical procedure of choice for symptomatic myoma in the reproductive age, especially if future fertility is desired. LM is the surgical removal of uterine myoma through small incisions in the abdomen. It is an appropriate, if not preferred, alternative to abdominal myomectomy in well-selected patients since it offers shorter hospitalization, short recovery period and resumption of activities within 1–2 weeks, reduced risk of blood transfusion, and intraoperative adhesions. Aim: The aim of the current study was to determine the diagnostic accuracy of different ultrasonographic characters of uterine myoma in predicting success of laparoscopic myomectomy. Methods: The present study was prospective interventional study that was carried out on 35 cases with Chronic pelvic pain. All patients had radiological evaluation by TVS and TAS. All Laparoscopic myomectomies done under general anaesthesia. Outcomes included determining ultra-sonographic predictors for successful laparoscopic myomectomy as regards site, size, and character of Myoma, presence of capsule and line of separation around myoma. Results: The most common complain among the studied cases was bleeding followed by pain and lastly infertility. Regarding location, the most common site was posterior followed by fundal, then anterior and lastly at the cornu. Operative times, blood loss amount, method of extraction, need laparoscopic suturing, complications during surgery recovery and hospital stay after operation demonstrated significant relation with outcomes. Myoma characters, numbers and type demonstrated insignificant relation with outcomes. Conclusion: The current study concluded that, myoma characters, numbers and type could not be used as predictors for successful LM; outcomes. However, operative times, blood loss amount, complications during surgery recovery and hospital stay after operation were less in successful LM than in LAM; and laparoscopic suturing and morcellation have less time consumption and better results than LAM

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Influence of the Manufacturing Method (3D Printing and Injection Molding) on Water Absorption and Mechanical and Thermal Properties of Polymer Composites Based on Poly(lactic acid)

The manufacturing method influences the properties of the produced components. This work investigates the influence of manufacturing methods, such as fused deposition modeling (3D printing) and injection molding, on the water absorption and mechanical and thermal properties of the specimens produced from neat bio-based poly(lactic acid) (PLA) polymer and poly(lactic acid)/wood composites. Acrylonitrile butadiene styrene (ABS) acts as the reference material due to its low water absorption and good functional properties. The printing layer thickness is one of the factors that affects the properties of a 3D-printed specimen. The investigation includes two different layer thicknesses (0.2 mm and 0.3 mm) while maintaining uniform overall thickness of the specimens across two manufacturing methods. 3D-printed specimens absorb significantly higher amounts of water than the injection-molded specimens, and the increase in the layer thickness of the 3D-printed specimens contributes to further increased water absorption. However, the swelling due to water absorption in 3D-printed specimens decreases upon increased layer thickness. The tensile, flexural, and impact properties of all of the specimens decrease after water absorption, while the properties improve upon decreasing the layer thickness. Higher porosity upon increasing the layer thickness is the predominant factor. The results from dynamic mechanical analysis and microscopy validate the outcomes. The results from this experimental study highlight the limitations of additive manufacturing

Phases, phase transitions and confinement effects in a series of antiferroelectric liquid crystals

Using a variety of optical and electrooptical techniques as well as dielectric spectroscopy, we have investigated three homologues in the chiral liquid crystal series nF1M7, where n denotes the length of the unbranched side-chain. The main focus of the study is the series of smectic C subphases, i.e. SmCa*, SmC1/3* and SmC1/4*. During switching in the SmCa* phase, a peculiar redirection of the plane of biaxiality, distinguishing this phase from SmA* and SmC*, was observed. We present a simple explanation for this behaviour which correlates well with the clock model description of the SmCa* phase. We found a zero mesoscopic polarisation for the SmC1/4* phase and a non-zero mesoscopic polarisation for SmC1/3*, observations which are consistent with a distorted clock model. The dielectric spectroscopy investigations, performed at several different cell gaps, clearly show that the dielectric response in these materials is easily dominated by surface-induced structures if the cell gap is reduced, and thus reflects the bulk thermodynamic phase in very thick cells only

Study of the level of stem cell factor in patients with bronchial asthma

Aim of the work: The aim of this study was to assess serum level of stem cell factor in asthmatic patients and its relation to disease severity. Methods: This case control study was carried out on 70 individuals classified into 20 healthy control subjects and 50 asthmatic patients that were admitted in Chest Department, Benha university hospital in the period between March 2013 and December 2014. Asthma diagnosis (history and PFT) and assessment of its severity were conducted according to the guidelines of Global Initiative for Asthma (GINA, 2011). Eosinophil percentage in the sputum of asthmatic patients was done. Measurement of stem cell factor (SCF) in the sera was done by Enzyme-Linked Immunosorbent Assay. Results: Our results found a statistically significant difference (P value < 0.001) between asthmatic patients and control subjects in the mean values of SCF (1192.34 ± 789.89 versus 326.29 ± 274.38 respectively). There was a statistically significant difference (P value = 0.001) between eosinophilic and non eosinophilic phenotype (1457.77 ± 648.83 versus 130.59 ± 83.27 respectively). There was a statistically significant difference in the level of SCF among different degrees of asthma severity (P = 0.001). Also, there was a significant negative correlation (r = −0.288) between SCF levels and FEV1% and significant positive correlation between SCF levels and sputum (r = 0.712) and blood (r = 0.548) eosinophils% in asthmatic patients. Conclusion: This study demonstrated that the serum level of SCF was higher in asthmatic patients especially among eosinophilic phenotype than among healthy control subjects. Also there was a significant association between higher SCF and higher levels of asthma severity, sputum and blood eosinophil%

Facile Synthesis of Fe(0)@Activated Carbon Material as an Active Adsorbent towards the Removal of Cr (VI) from Aqueous Media

A novel adsorbent substrate based on zero-valent iron in activated carbon (Fe(0)@AC) was introduced in this work, and was evaluated as a cheap adsorbent for the removal of Cr(VI) from aqueous solutions. The as-prepared Fe(0)@AC material was chemically prepared via NaBH4 reduction in the presence of ferric chloride as an iron source, followed by the addition of powdered activated carbon. The different physicochemical tools confirm the successful preparation of Fe(0) composite with activated carbon as a heterogeneous composite with heterogeneous morphology of the rock-shape structure, which could play a role in the metal adsorption application. Interestingly, the removal efficiency (RE) of Cr(VI) was increased from 52% to 84% due to the Fe(0)@AC adsorbent being changed from 0.2 to 0.4 g/100 mL. Following this, the increase rate was stabilized, and the RE reached 95% in the case of 0.8 g/100 mL from Fe(0)@AC adsorbent. This result could be due to the increase in the sorbent active sites with more contents from Fe(0)@AC. The adsorption model based on the Langmuir approach could successfully describe the experimental outcomes for Cr(VI) removal by Fe(0)@AC with the correlation coefficient of 0.977. To conclude, Fe(0)@AC heterogeneous material is an active adsorbent for Cr(VI) removal from aqueous solutions