The role of laparoscopy in patients with abdominal trauma

Background: Use of laparoscopy in penetrating trauma has been well established; however, its application in blunt trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted.Methods: All adult patients who presented with abdominal trauma laparoscopic surgery was considered in patients who were deemed fit for the same in the Department of General Surgery, MMIMSR, Mullana, Ambala during a period of 18 months starting from January 1st 2015 to June 30th 2016. Data was analysed using descriptive statistics.Results: A total of 53 patients with either blunt or penetrating abdominal trauma that required surgery were included in the study. Exploratory laparotomy was performed in 45 patients (84.91%) and laparoscopy was performed in 8 patients (15.09%). Overall mesenteric injury (45.28%) was the most common intra-abdominal injury noted. The most common organ involved in blunt trauma was the spleen (68.97%). The mean operating time of laparoscopy was lesser by 57 minutes as compared to exploratory laparotomy. The use of laparoscopy avoided negative and non-therapeutic laparotomy in 2 patients (25%). Therapeutic laparoscopy was performed in 3 patients with repair of bowel and mesenteric injuries. There was no documented procedure‑related morbidity and mortality.Conclusions: The positive outcomes from the study suggest that laparoscopy can be safe and feasible in both diagnostic and therapeutic interventions in carefully selected blunt abdominal trauma patients

Multi Targeted Non Invasive Photoceutical Therapeutic Approach for Combat and Traumatic Soft Tissue Injuries

Combat and soft tissue traumatic injuries pose unique challenges in terms of their severity, complexity, and thus need for the exploration of rapid, novel therapeutic interventions. Traditionally, combat injuries have been managed through invasive surgical procedures associated with potential complications and prolonged recovery times. However, advancements in non-invasive treatment modalities have opened up new possibilities for managing combat injuries more effectively and efficiently. The present article aims to provide a comprehensive overview of non-invasive, drug-free, biophysical therapeutic approaches for combat and external traumatic injuries, focusing on their benefits, efficacy, and potential applications. The non-invasive nature and favourable safety profile of photobiomodulation therapy (PBMT) make it an attractive option for combat injury management. The evidence on underlying mechanistic insights supports the efficacy of PBMT in promoting tissue repair, reducing pain, inflammation, oxidative stress, and facilitating functional recovery. In conclusion, the present review highlights the significant potential of non-invasive PBMT using dual/multi-wavelength light energy as a valuable therapeutic approach for traumatic soft tissue and combat injuries and extensively explores associated mechanistic insights. Further research on combination therapies using potential pharmacological agents in conjunction with PBMT, with optimal irradiation protocols and other energy-based healing modalities will favour the translation of potential non-invasive healing intervention for combat and traumatic injuries in clinical applications

Effect of Pulsed 810 nm Laser Photobiomodulation on Dermal Wound Healing and Oxidative Stress in Immunosuppressed Rats

Under immunosuppression, the sequential overlapping wound repair phases get hampered due to dysregulated or persistent inflammation leading to non-healing chronic wounds formation. The present study investigates the effect of low-power 810 nm diode laser (70 mW mean output power; 40 mW/cm2 average irradiance; 24 J/cm2 total fluence; 10 Hz pulse frequency; duty cycle 50 per cent; 10 min. illumination time once daily for seven days) photobiomodulation (PBM) on dermal penetration ability, wound healing and oxidative stress in hydrocortisone-induced immunosuppressed rats. The results of the penetration ability of 810 nm laser irradiation to the depth of the sub-dermal region revealed that the transmitted power of laser at 10 Hz pulsed-mode was better and easier than continuous-mode. The present findings clearly delineated that PBM with 810 nm laser at 10 Hz significantly augmented healing and reduced oxidative stress as evidenced by decreased free radicals, nitric oxide (NO) levels, enhanced superoxide dismutase (SOD) enzyme activity and wound area contraction facilitating the cellular redox homeostasis and promoting the tissue repair process. In conclusion, PBM with NIR 810 nm laser at pulsed-mode 10 Hz frequency showed better penetration and accelerated dermal wound healing in immunosuppressed rats

Role of H2S Supplementation on Burn Wound Healing and Molecular Chaperones

Treatment of non-healing burn injuries is a major challenge for the current scientific research. Hydrogen sulfide (H2S) is an endogenous gasotransmitter, which regulates redox homeostasis and cytoprotection during pathophysiological conditions. Similarly, heat shock proteins (HSPs) are molecular chaperones, which also confer cytoprotection during the wound repair process. Notably, the role of H2S as a regulator of HSPs during burn wound healing is still elusive. The present study investigated the effects of H2S supplementation on molecular chaperones during full-thickness, third-degree burn wound healing in the experimental rats. The animals were treated with sodium hydrosulphide (NaHS) as H2S donor (5 mg/kg body weight, intraperitoneal) daily for 10 days prior to burn-induction and continued till the fifth-day post-wounding. Histopathological analysis (Masson’s trichrome) revealed enhanced wound healing evident by increased collagen fiber deposition, cellular proliferation and re-epithelialisation in NaHS administered group as compared to the burn control. Furthermore, immunoblot analyses demonstrated significantly increased protein expression of molecular chaperons viz. HSP90, HSP70, HSP27, and GRP78 in H2S treated group as compared to control. Therefore, the present study signifies that H2S supplementation upregulates the protein expression levels of molecular chaperones, which could facilitate the cytoprotection during the tissue repair process and accelerates the burn wound healing

Theoretical Analysis of Plasma Parameters on Film Deposition in planer and Cylindrical Magnetron Sputtering

174-179Thin film deposition using plasma sputter is done by experimental methods, though Numerical simulation and theory are capable of generating realistic and useful results. In present exploration a theoretical model for sputtering with consequence of different plasma parameters with the help of electromagnetic lenses for planar (Tp) and cylindrical (Tc) magnetron sputteringhas been conversed. The plasma of helium gas on nickel metal objectwhich contains the velocity shear instability is considered, and Tp,Tc, under the influence of shear scale length(Ai), homogeneous DC electric field(E0), magnetic field (B0), density gradient (ɛnρi) have been evaluated. Tp, and Tcare found to be maximum in the range of 0.815–0.91, and 0.57–0.90, respectively. Also growth rate showed direct relation to E0 and Ai but inversely varies with B0 and ɛnρi.</em

Theoretical Analysis of Plasma Parameters on Film Deposition in planer and Cylindrical Magnetron Sputtering

Thin film deposition using plasma sputter is done by experimental methods, though Numerical simulation and theory are capable of generating realistic and useful results. In present exploration a theoretical model for sputtering with consequence of different plasma parameters with the help of electromagnetic lenses for planar (Tp) and cylindrical (Tc) magnetron sputteringhas been conversed. The plasma of helium gas on nickel metal objectwhich contains the velocity shear instability is considered, and Tp,Tc, under the influence of shear scale length(Ai), homogeneous DC electric field(E0), magnetic field (B0), density gradient (enri) have been evaluated. Tp, and Tcare found to be maximum in the range of 0.815–0.91, and 0.57–0.90, respectively. Also growth rate showed direct relation to E0 and Ai but inversely varies with B0 and enri

The study of clinico-pathological correlation and treatment outcome in acute allograft rejection in the immediate post renal transplant period

Background: The kidney Tx is the treatment of choice for patients with ESRD. However, episodes of AR have a negative impact on short- and long-term graft survival. In spite of immunosuppressive medications, CNI, MMF and steroid, the AR remains a crucial problem for Tx. This analysis was performed to evaluate the changing profile of early AR (during first week of transplant) and its repercussions on graft survival.Methods: This study was an observational cohort study and included 50 renal transplant patients irrespective of age, sex and race who developed bx proven AR within first week of transplant. Three groups were made according to histopathology: ACR, AMR and mixed rejection group. The patients were followed for 6 months thereafter.Results: AR within a week of renal Tx were less symptomatic except decrease in UO. ACR was more common (72%) than AMR and mixed rejections. AMR and Mixed group required more therapeutic modalities than ACR. More patients required HD during AR in AMR and mixed rejection group than ACR. The mean s.cr at 6 months was 1.3,1.5 and 1.6 in ACR, AMR and mixed group respectively. There were more incidences of BK viremia, CMV infection UTI and rejection fronts follow up in AMR and mixed group than ACR group.Conclusions: Acute rejections within a week are less symptomatic and ACR occurred more frequently than AMR and mixed rejection There were more incidences of BKV, CMV and UTI for 6 months follow up in AMR and Mixed rejection group

Implementation of High Efficiency, High Lifetime and Low Cost Converter for an Automatic Photovoltaic Water Pumping Station

A novel idea of photovoltaic (PV) energy based converter for water pumping system without the USAge of fuel cells or batteries. In proposed system, the design of a three phase induction motor drive is directly supplied by using photovoltaic system energy. Presence of a three phase induction motor has better performance with optimized efficiency compared to the commercial water pumping system of DC motor. The developed resonant of Two Inductor Boost Converter (TIBC) and voltage quadruple with three phase Voltage Source Inverter (VSI) are based on the current fed multi resonant converter. Low input current ripple and high voltage gain are the features of TIBC. So the classical topology used to improve the system with a constant duty cycle control and a non dissipative snubber circuit along with a hysteresis controller to improve its efficiency. Due to the non existence of electrolytic capacitors the system is required to have a high lifetime and total system cost is low. As a result, in isolated locations the system has an optimistic solution and it provide water to poor societies