A prospective comparative study of Lichtenstein procedure with and without mesh-fixation for inguinal hernia repair

Background: Repair of inguinal hernia is one of the most common elective operations performed in general surgery worldwide. Mesh-hernioplasty became the gold standard, because of its low recurrence rate in comparison with tissue repairs. The ideal repair must be simple, safe, easy to perform and require minimal dissection which provides enough space, should be cost effective with less hospital stay, less pain and less recurrence. The present study aimed at comparing the effect of mesh fixation and non-fixation in Lichtenstein technique for inguinal hernia repair.Methods: Hundred (100) patients with primary uncomplicated, unilateral inguinal hernia were treated between April 2019 and September 2020. Patients with inguinal hernia underwent Lichtenstein repair with mesh-fixation (group A) (n=50) and non-fixation (group B) (n=50). The mean operative time, post-operative pain score, average hospital study, post-operative complications and recurrence rates were compared between the two groups.Results: Mean operative time in non-fixation group- (group B) (32.24 min) was shorter as compared to fixation group-(Group A) (49.36 min) with a p value of 0.002. Post-operative pain score was lower in (group B) at 12 and 24 hours (3.71±1.409 and 2.2±0.8169) as compared to Group A at 12 and 24 hours (4.77±1.196 and 2.98±1.295) with a p value of <0.0001. The analgesia required in (group B) was less as compared to (group A). The post-operative complication and recurrence rates were almost identical in both the groups, with lesser incidence of groin pain and paresthesias in group B.Conclusions: In Lichtenstein inguinal hernia repair, non-fixation of mesh is safe and preferable option, with less operative time and less postoperative pain

Effect of membrane performance including fouling on cost optimization in brackish water desalination process

Membrane selection is a crucial step that will affect the economic feasibility of the membrane water treatment process. A comprehensive evaluation consisting of Verberne Cost Model, assessment of membrane performance and fouling propensity, osmotic pressure differential (OPD) and specific energy consumption (SEC) was employed to determine the potential of nanofiltration (NF 270, NF 90 and TS 80) and low pressure reverse osmosis (XLE) membranes to be used in brackish water desalination process. The aim was to save costs by replacing the typical brackish water reverse osmosis (BW 30) membrane. Verberne Cost Model showed that higher flux NF membranes resulted in lower overall costs. However, after assessing the membrane performance, NF 270 and TS 80 were excluded due to their high fouling propensity and their failure to reduce total dissolved solids (TDS) in the solution. Instead, NF 90 membrane which produced water with acceptable TDS and has moderate permeability ended up to be more cost competitive compared to BW 30 membrane, with 17%-21% lower total costs and 13%-17% lower water costs. Apart from this, OPD and SEC were applied to justify the selection of optimal membrane recovery rate based on the water costs calculated. It was determined that the optimal recovery rate was 80% where the SEC and water costs were close to available water treatment plants. Overall, this study showed that the selection of membrane can be carried out by using Verberne Cost Model assisted by assessment of membrane performance and fouling propensity, OPD and SEC

Exploring the current state of play for cost-effective water treatment by membranes

This article presents a perspective on the current development and application of membranes for the treatment of water. We examine how membranes contribute to the global challenge of sustainable supply of clean water. The main theme is on desalination and how innovative science and emerging technology is being applied. Thus, we appraise how techniques such as advanced membrane materials, biomimetic membranes, hybrid systems, forward osmosis, and membrane distillation are being used to improve production to meet the increasing global demand for water

PERFORMANCE ANALYSIS OF OPTICAL CDMA SYSTEM USING VC CODE FAMILY UNDER VARIOUS OPTICAL PARAMETERS

The intent of this paper is to study the performance of spectral-amplitude coding optical code-division multiple-access (OCDMA) systems using Vector Combinatorial (VC) code under various optical parameters. This code can be constructed by an algebraic way based on Euclidian vectors for any positive integer number. One of the important properties of this code is that the maximum cross-correlation is always one which means that multi-user interference (MUI) and phase induced intensity noise are reduced. Transmitter and receiver structures based on unchirped fiber Bragg grating (FBGs) using VC code and taking into account effects of the intensity, shot and thermal noise sources is demonstrated. The impact of the fiber distance effects on bit error rate (BER) is reported using a commercial optical systems simulator, virtual photonic instrument, VPITM. The VC code is compared mathematically with reported codes which use similar techniques. We analyzed and characterized the fiber link, received power, BER and channel spacing. The performance and optimization of VC code in SAC-OCDMA system is reported. By comparing the theoretical and simulation results taken from VPITM, we have demonstrated that, for a high number of users, even if data rate is higher, the effective power source is adequate when the VC is used. Also it is found that as the channel spacing width goes from very narrow to wider, the BER decreases, best performance occurs at a spacing bandwidth between 0.8 and 1 nm. We have shown that the SAC system utilizing VC code significantly improves the performance compared with the reported codes

Steps toward translocation-independent RNA polymerase inactivation by terminator ATPase ρ

Factor-dependent transcription termination mechanisms are poorly understood. We determined a series of cryo–electron microscopy structures portraying the hexameric adenosine triphosphatase (ATPase) ρ on a pathway to terminating NusA/NusG-modified elongation complexes. An open ρ ring contacts NusA, NusG, and multiple regions of RNA polymerase, trapping and locally unwinding proximal upstream DNA. NusA wedges into the ρ ring, initially sequestering RNA. Upon deflection of distal upstream DNA over the RNA polymerase zinc-binding domain, NusA rotates underneath one capping ρ subunit, which subsequently captures RNA. After detachment of NusG and clamp opening, RNA polymerase loses its grip on the RNA:DNA hybrid and is inactivated. Our structural and functional analyses suggest that ρ, and other termination factors across life, may use analogous strategies to allosterically trap transcription complexes in a moribund state

Absence of RNA-binding protein FXR2P prevents prolonged phase of kainate-induced seizures.

Status epilepticus (SE) is a condition in which seizures are not self-terminating and thereby pose a serious threat to the patient's life. The molecular mechanisms underlying SE are likely heterogeneous and not well understood. Here, we reveal a role for the RNA-binding protein Fragile X-Related Protein 2 (FXR2P) in SE. Fxr2 KO mice display reduced sensitivity specifically to kainic acid-induced SE. Immunoprecipitation of FXR2P coupled to next-generation sequencing of associated mRNAs shows that FXR2P targets are enriched in genes that encode glutamatergic post-synaptic components. Of note, the FXR2P target transcriptome has a significant overlap with epilepsy and SE risk genes. In addition, Fxr2 KO mice fail to show sustained ERK1/2 phosphorylation induced by KA and present reduced burst activity in the hippocampus. Taken together, our findings show that the absence of FXR2P decreases the expression of glutamatergic proteins, and this decrease might prevent self-sustained seizures

Aberrant right subclavian artery in a cadaver: a case report of an aortic arch anomaly

In early embryogenesis, aortic anomalies occur as a consequence of disorders in the development of the primitive aortic arches system. Aberrant right subclavian artery, also known as arteria lusoria, is one of the important congenital anomalies of the aortic arch, in which the right subclavian artery arises from the arch of aorta instead of the brachiocephalic trunk. During routine dissection of a female cadaver, we observed retro-oesophageal aberrant right subclavian artery arising as the fourth branch from the aortic arch. In this case, the brachiocephalic trunk was absent. Early detection of aortic arch anomalies through diagnostic interventions is helpful to avoid complications during surgical procedures

Spectrum of Paediatric Lysosomal Storage Disorders in Oman

Objectives: The aim of this study was to look at the spectrum of paediatric lysosomal disorders in Oman. Lysosomal storage disorders (LSDs) are a heterogeneous group of inherited metabolic diseases. Few studies on the birth prevalence and prevalence of LSDs have been reported from the Arabian Peninsula. Methods: We studied 86 children with LSDs diagnosed over a period of nine years, from June 1998 to May 2007. Detailed clinical data, including age of onset, sex, age and mode of first presentation, and presence of consanguinity were collected. Results: Our data showed the combined birth prevalence for all LSDs in Oman to be around 1 in 4,700 live births. Sphingolipidoses was the most common group of disorder encountered (47.7%), followed by neuronal ceroid lipofuscinoses (NCL) (23.2%) and mucopolysaccharidoses (MPS) (23.2%). The proportion of consanguineous marriages in our series was found to be 87.5%. Conclusion: Our data represent the birth prevalence and clinicalspectrum of such disorders in Oman, one of the highly consanguineous societies in the Middle East.

Realisasi Pembangunan Komposter Permanen di Pasar Desa Mutih Kulon, sebagai Solusi Permasalahan Sampah Pasar Desa

Desa Mutih Kulon merupakan sebuah desa yang terletak di Kecamatan Wedung, Kabupaten Demak, Jawa Tengah. Desa ini memiliki sebuah pasar desa yang aktif berkegiatan di pagi hari dan berkontribusi memutar perekonomian warga. Adanya pasar desa ini memberikan berbagai dampak, baik positif maupun negatif. Salah satu dampak negatif yang ditimbulkan dari eksistensi pasar desa ini adalah adanya gundukan sampah yang terletak di sudut pasar. Diperlukan adanya suatu upaya pengelolaan limbah pasar agar tidak menimbulkan bau yang tidak sedap, pemandangan yang tidak enak, dan sumber penyakit. Berangkat dari sebuah inisiasi yang digagas oleh kelompok KKN UNS “Membangun Desa” perangkat desa dan karang taruna bersama-sama merealisasikan pembangunan komposter permanen di pasar desa. Selain membangun komposter untuk pengelolaan sampah organik, juga dibangun tempat sampah untuk menampung sampah anorganik yang ada. Hasil dari kegiatan ini adalah lebih tertata nya penampungan sampah di pasar desa. Selain itu, produk sampingan dari adanya komposter ini adalah terciptanya pupuk organik yang bisa dimanfaatkan oleh masyarakat. Hal tersebut dapat memberikan manfaat untuk masyarakat sekitar yang masih banyak penduduk yang bekerja dalam bidang pertanian. Selain itu, hal ini juga memberikan dampak pada lingkungan yang lebih indah, nyaman dan sehat untuk warga Desa Mutih Kulon, khususnya yang aktif berkegiatan di sekitar pasar desa

Realisasi Pembangunan Komposter Permanen di Pasar Desa Mutih Kulon, sebagai Solusi Permasalahan Sampah Pasar Desa

Desa Mutih Kulon merupakan sebuah desa yang terletak di Kecamatan Wedung, Kabupaten Demak, Jawa Tengah. Desa ini memiliki sebuah pasar desa yang aktif berkegiatan di pagi hari dan berkontribusi memutar perekonomian warga. Adanya pasar desa ini memberikan berbagai dampak, baik positif maupun negatif. Salah satu dampak negatif yang ditimbulkan dari eksistensi pasar desa ini adalah adanya gundukan sampah yang terletak di sudut pasar. Diperlukan adanya suatu upaya pengelolaan limbah pasar agar tidak menimbulkan bau yang tidak sedap, pemandangan yang tidak enak, dan sumber penyakit. Berangkat dari sebuah inisiasi yang digagas oleh kelompok KKN UNS “Membangun Desa” perangkat desa dan karang taruna bersama-sama merealisasikan pembangunan komposter permanen di pasar desa. Selain membangun komposter untuk pengelolaan sampah organik, juga dibangun tempat sampah untuk menampung sampah anorganik yang ada. Hasil dari kegiatan ini adalah lebih tertata nya penampungan sampah di pasar desa. Selain itu, produk sampingan dari adanya komposter ini adalah terciptanya pupuk organik yang bisa dimanfaatkan oleh masyarakat. Hal tersebut dapat memberikan manfaat untuk masyarakat sekitar yang masih banyak penduduk yang bekerja dalam bidang pertanian. Selain itu, hal ini juga memberikan dampak pada lingkungan yang lebih indah, nyaman dan sehat untuk warga Desa Mutih Kulon, khususnya yang aktif berkegiatan di sekitar pasar desa