A Comparative Study of the Effects of Anterior Nasal Packing versus Trans-Septal Suturing in Post-Septoplasty Patients

Introduction  Following  septoplasty,  the  usual  norm  is  to  pack  the  nose  using polyvinyl alcohol or  white petroleum  jelly impregnated gauze. But  due  to  side  effects  like  pain,  respiratory  problems, headache  or  pain  during  pack  removal,  trans-septal  suturing  is  recommended  as  it  provides  stability  and  prevents  septal  hematoma  formation  without  causing  the  above mentioned  complaints.  This  study  aims  to  conduct  an  in-depth  comparison  of  the  outcomes  of  the  two  aforementioned  methods  in  an  Indian  population. Materials and Methods  A  prospective  randomized  comparative  study  was  done  for  30  patients  between  18-50  years  undergoing  septoplasty,  while  excluding  those  requiring  additional  surgical  interventions.  Trans-septal  suturing  was  done  for  15  patients  and  polyvinyl alcohol  nasal  packing  for  the  rest.  Visual  Analogue  Scale  was  used  to  record  discomfort  levels  1  day  post-operatively.  A  vast  multitude  of  symptoms  were  assessed  during  regular  visits  for  3  months  after  surgery.  Results Post-operatively,  nasal  pain,  headache,  dyspnoea,  sleep  disturbance,  post-nasal  drip,  crusting,  and  epiphora  were  found  to  be   reduced  in  patients  who  underwent  trans-septal  suturing  when  compared  with  packing,  deeming  it  to  be  a  superior  choice  of  method.  However,  nasal  bleeding  was  comparable  in  both  groups. Conclusion Trans-septal  suturing  reduces  pack  related  problems  and  post-operative  complications,  without  significantly  increasing  the  duration  of  surgery.  Hence,  we  recommend  the  practice  of  placing  sutures  to  positively  improve  patients’  quality  of  life  post-surgery

On wealth and the diversity of friendships: High social class people around the world have fewer international friends

This is the final published version. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.paid.2015.07.040Having international social ties carries many potential advantages, including access to novel ideas and greater commercial opportunities. Yet little is known about who forms more international friendships. Here, we propose social class plays a key role in determining people’s internationalism. We conducted two studies to test whether social class is related positively to internationalism (the building social class hypothesis) or negatively to internationalism (the restricting social class hypothesis). In Study 1, we found that among individuals in the United States, social class was negatively related to percentage of friends on Facebook that are outside the United States. In Study 2, we extended these findings to the global level by analyzing country-level data on Facebook friends formed in 2011 (nearly 50 billion friendships) across 187 countries. We found that people from higher social class countries (as indexed by GDP per capita) had lower levels of internationalism—that is, they made more friendships domestically than abroad

The direct synthesis of hydrogen peroxide over Au and Pd nanoparticles:A DFT study

Catalysts consisting of Au, Pd and their alloys have been shown to be active oxidation catalysts. These materials can use dioxygen or hydrogen peroxide as the oxidant with CO and activated organic molecules using O2(g) while more challenging cases, such as methane to partial oxygenates, relying on H2O2. Although H2O2 is a green oxidant, the incorporation of dioxygen greatly reduces overall cost and so there is an incentive to find new ways to reduce the reliance on H2O2. In this study we use DFT calculations to discuss the direct synthesis of H2O2 from H2(g) and O2(g) and use this understanding to identify the important surface species derived from dioxygen. We cover the adsorption of oxygen, hydrogen and water to model Au and Pd nanoclusters and the oxidation of the metals, since reduction of any oxides formed will consume H2. We then turn to the production of a surface hydroperoxy species; the first step in the synthesis of H2O2. This can occur via hydrogenation of O2(ads) with H2(ads) or via protonation of O2(ads) by solvent water. Both routes are found to be energetically reasonable, but the latter is likely to be favoured under experimental conditions

India’s biofuel policies: progress or boondoggle?

The government of India approved the National Policy on Biofuels on December 24, 2009. The aim of the policy was to supplement transport fuels with an “indicative target to replace 20% of petroleum fuel consumption with biofuels (gasoline with bio-ethanol and diesel with bio-diesel) by 2017”. Today at the brink of 2014, halfway to target the deadline, it is appropriate to assess the relevance and the performance of the policy, say Asit K. Biswas and Nishtha Manocha

Challenges for setting up psychiatric services in a trauma centre in India

Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients

Mathematical modelling of reversible transition between quiescence and proliferation

<div><p>Cells switch between quiescence and proliferation states for maintaining tissue homeostasis and regeneration. At the restriction point (R-point), cells become irreversibly committed to the completion of the cell cycle independent of mitogen. The mechanism involving hyper-phosphorylation of retinoblastoma (Rb) and activation of transcription factor E2F is linked to the R-point passage. However, stress stimuli trigger exit from the cell cycle back to the mitogen-sensitive quiescent state after Rb hyper-phosphorylation but only until APC/C^Cdh1 inactivation. In this study, we developed a mathematical model to investigate the reversible transition between quiescence and proliferation in mammalian cells with respect to mitogen and stress signals. The model integrates the current mechanistic knowledge and accounts for the recent experimental observations with cells exiting quiescence and proliferating cells. We show that Cyclin E:Cdk2 couples Rb-E2F and APC/C^Cdh1 bistable switches and temporally segregates the R-point and the G1/S transition. A redox-dependent mutual antagonism between APC/C^Cdh1 and its inhibitor Emi1 makes the inactivation of APC/C^Cdh1 bistable. We show that the levels of Cdk inhibitor (CKI) and mitogen control the reversible transition between quiescence and proliferation. Further, we propose that shifting of the mitogen-induced transcriptional program to G2-phase in proliferating cells might result in an intermediate Cdk2 activity at the mitotic exit and in the immediate inactivation of APC/C^Cdh1. Our study builds a coherent framework and generates hypotheses that can be further explored by experiments.</p></div

Temporal dynamics of quiescence to proliferation in the presence of mitogens.

<p><b>(a)</b> Wild type, <b>(b)</b> in the absence of Cyclin D (k_scycdm = 0, k_scycds = 0), <b>(c)</b> inhibition of Cyclin D post-G1entry (k_dcycd = 0.1) and <b>(d)</b> in the presence of stress (k_scki = 0.6) before APC/C^Cdh1 inactivation. Simulations are shown for S = 1 (mitogen level). The arrow represents the time of Cyclin D inhibition and exposure to stress.</p

The molecular mechanism controlling the commitment points in the mid and late G1 phase of the mammalian cell cycle.

<p>The molecular mechanism controlling the commitment points in the mid and late G1 phase of the mammalian cell cycle.</p

Bifurcation analysis of G1/S transition.

<p>The effect of increasing Cyclin E:Cdk2 activity on <b>(a)</b> Cdh1 inactivation and <b>(b)</b> Emi1 accumulation are shown. Filled circle represents the stable steady state and empty circle represents the unstable steady state. The arrow shows the transition from G1 to S-phase.</p