A comparative study of two different techniques of subcutaneous tissue closure in abdominal surgery

Background: Surgical access to abdomen is required for many operative procedures. The subcutaneous tissue of the anterior abdominal wall can either be sutured or left unsutured with drain in situ. The purpose of this study was to compare the two methods of closure of the subcutaneous tissue and determine the benefit of one over the other.Methods: The study was conducted in a tertiary care centre with sample size of 30 each in study and control group. Patients fulfilling the inclusion criteria were selected and depending on the randomisation the closure of subcutaneous tissue was done either by polyglactin 910, 2-0 or left unsutured with indigenously designed syringe suction drain kept in situ. The patients were followed up till the day of suture removal and further in case of any complications.Results: Total duration taken for the procedure was significantly increased in the study group. There was a significant level of discomfort among the participants due to drain. The rate of surgical site infection, hospital readmission morbidity was significantly higher in the study group.Conclusions: The type of drain studied was indigenously designed where the closed system was not maintained during charging the drain, hence further studies need to be conducted which will compare this with the other closed suction drains to determine the difference in the risk of wound complications

Heterogeneity of diabetes outcomes among asians and pacific islanders in the US: the diabetes study of northern california (DISTANCE).

ObjectiveEthnic minorities with diabetes typically have lower rates of cardiovascular outcomes and higher rates of end-stage renal disease (ESRD) compared with whites. Diabetes outcomes among Asian and Pacific Islander subgroups have not been disaggregated.Research design and methodsWe performed a prospective cohort study (1996-2006) of patients enrolled in the Kaiser Permanente Northern California Diabetes Registry. There were 64,211 diabetic patients, including whites (n = 40,286), blacks (n = 8,668), Latinos (n = 7,763), Filipinos (n = 3,572), Chinese (n = 1,823), Japanese (n = 951), Pacific Islanders (n = 593), and South Asians (n = 555), enrolled in the registry. We calculated incidence rates (means ± SD; 7.2 ± 3.3 years follow-up) and created Cox proportional hazards models adjusted for age, educational attainment, English proficiency, neighborhood deprivation, BMI, smoking, alcohol use, exercise, medication adherence, type and duration of diabetes, HbA(1c), hypertension, estimated glomerular filtration rate, albuminuria, and LDL cholesterol. Incidence of myocardial infarction (MI), congestive heart failure, stroke, ESRD, and lower-extremity amputation (LEA) were age and sex adjusted.ResultsPacific Islander women had the highest incidence of MI, whereas other ethnicities had significantly lower rates of MI than whites. Most nonwhite groups had higher rates of ESRD than whites. Asians had ~60% lower incidence of LEA compared with whites, African Americans, or Pacific Islanders. Incidence rates in Chinese, Japanese, and Filipinos were similar for most complications. For the three macrovascular complications, Pacific Islanders and South Asians had rates similar to whites.ConclusionsIncidence of complications varied dramatically among the Asian subgroups and highlights the value of a more nuanced ethnic stratification for public health surveillance and etiologic research

Influence of organic sources of nutrients on vanilla (Vanilla planifolia) as an intercrop in coconut garden

Performance of vanilla, as influenced by organic source of nutrition when grown as intercrop in coconut garden, was studied in sandy loam soil at ICAR-CPCRI, Kasaragod, Kerala for seven years. Field experiments were carried out with different sources of organic manures, recommended NPK fertilizer and no fertilizer treatments. Application of cow dung slurry (6 tonnes ha-1) resulted in vigorous growth of vine (vine length of 5.5 m) and higher number of beans per vine (208) and a significantly higher mean fresh yield of bean (1.87 kg vine-1). Application of vermicompost (5 kg plant-1) + biofertilizers (Bacillus and Azospirillum) and vermiwash were on par and recorded mean fresh yield of 1.47 kg vine-1 and 1.30 kg vine-1, respectively. Control treatment without fertilizer application recorded significantly lower fresh bean yield (0.55 kg vine-1) due to lower number of beans per vine (72 nos.).  In the rhizosphere of vanilla, no significant difference for either bacterial or actinomycetes population was noticed among the treatments. The fungal population differed significantly among the treatments and the highest population level was found with application of biogas slurry (62.1x103cfu g-1 soil), which was on par with application of cow dung slurry (59x103 cfu g-1 soil). Among the function specific microbial communities, the highest population of  P-solubilisers (98x103 cfu g-1 soil) was recorded in the biogas slurry treatment, and it was the lowest in control and vermiwash application treatments. The average coconut yield realized during experimental period(2004-05 to 2009-10) was 136 nuts per palm, recording 53 per cent increase in yield compared to pre-experimental yield (89 nuts per palm).Â

Introduction to and Screening Visit Results of the Multicenter Pediatric Crohn's Disease Growth Study.

BackgroundStatural growth impairment is more common in males with Crohn's disease (CD). We assessed sex differences in height Z score differences and bone age (BA) Z scores and characterized age of menarche in a novel contemporary cohort of pediatric CD patients undergoing screening for enrollment in the multicenter longitudinal Growth Study.MethodsCrohn's disease patients (females with chronological age [CA] 5 years and older and younger than 14 years; males with CA 6 years and older and younger than 16 years) participated in a screening visit for the Growth Study. Height BA-Z scores are height Z scores calculated based on BA. Height CA-Z scores are height Z scores calculated based on CA. The height Z score difference equals height CA-Z score minus height BA-Z score.ResultsOne hundred seventy-one patients (60% male) qualified for this analysis. Mean CA was 12.2 years. Mean height CA-Z score was -0.4, and mean height BA-Z score was 0.4 in females. Mean height CA-Z score was -0.1, and mean height BA-Z score was 0.2 in males. The absolute value of the mean height Z score difference was significantly greater in females (0.8) than males (0.3; P = 0.005). The mean BA-Z score in females (-1.0) was significantly lower than in males (-0.2; P = 0.002). The median CA at menarche was 13.6 (95% CI, 12.6-14.6) years.ConclusionsOur screening visit data suggest that standardized height gain is lower in males with skeletal maturation and delayed puberty is common in females in CD. We are investigating these findings in the ongoing Growth Study

ProGlycProt: a repository of experimentally characterized prokaryotic glycoproteins

ProGlycProt (http://www.proglycprot.org/) is an open access, manually curated, comprehensive repository of bacterial and archaeal glycoproteins with at least one experimentally validated glycosite (glycosylated residue). To facilitate maximum information at one point, the database is arranged under two sections: (i) ProCGP—the main data section consisting of 95 entries with experimentally characterized glycosites and (ii) ProUGP—a supplementary data section containing 245 entries with experimentally identified glycosylation but uncharacterized glycosites. Every entry in the database is fully cross-referenced and enriched with available published information about source organism, coding gene, protein, glycosites, glycosylation type, attached glycan, associated oligosaccharyl/glycosyl transferases (OSTs/GTs), supporting references, and applicable additional information. Interestingly, ProGlycProt contains as many as 174 entries for which information is unavailable or the characterized glycosites are unannotated in Swiss-Prot release 2011_07. The website supports a dedicated structure gallery of homology models and crystal structures of characterized glycoproteins in addition to two new tools developed in view of emerging information about prokaryotic sequons (conserved sequences of amino acids around glycosites) that are never or rarely seen in eukaryotic glycoproteins. ProGlycProt provides an extensive compilation of experimentally identified glycosites (334) and glycoproteins (340) of prokaryotes that could serve as an information resource for research and technology applications in glycobiology

Delayed involution of lactation presenting as a non-resolving breast mass: a case report

<p>Abstract</p> <p>Introduction</p> <p>Involution of lactation is a physiological process. Rarely, it may be delayed and troublesome for the lactating woman. Though lactation-induced changes in breast are well known, morphological features of delayed involution are not clear.</p> <p>Case presentation</p> <p>We report a case of a 22-year-old lactating mother who presented with a painful, non-resolving breast mass 5 months after delivery. Clinically, it simulated an inflammatory carcinoma. Histopathology, however, revealed involuting lactational changes.</p> <p>Conclusion</p> <p>To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature. The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.</p

Mucosal Integrity and Inflammatory Markers in the Female Lower Genital Tract as Potential Screening Tools for Vaginal Microbicides

Background—In the female genital tract, vaginal colposcopy, endometrial mucosal integrity and inflammatory mediators are potential in vivo biomarkers of microbicide and contraceptive safety. Study Design—A randomized, blinded crossover trial of 18 subjects comparing effects of Gynol II (putative inflammatory gel), HEC (putative inert gel) and no gel exposure on endometrial and vaginal epithelial integrity and endometrial and vaginal inflammatory markers (IL-1β, IL-6, IL-8, MCP-1, MIP-1α, MIP-1β, RANTES, TNF-α, IL-1RA, IL-10, SLPI). Results—Gynol II was associated with more vaginal lesions. No endometrial disruptions were observed across conditions. In the vagina, RANTES (p=0.055) and IL-6 (p=0.04) were higher after HEC exposure than at baseline. In the endometrium, IL-1β (p=0.003) and IL-8 (p=0.025) were lower after Gynol II cycles than after no gel. Conclusions—Gynol II and HEC may modulate inflammatory markers in the vagina and endometrium. How these changes relate to infection susceptibility warrants further study