PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Intraoral Lipoma: A Case Report

Lipomas are rare in oral and maxillofacial regions although they are the most common tumours of mesenchymal origin in human body. The etiology remains unclear. Various different theories explain the pathogenesis of this adipose tissue tumour and also different histological variants of oral lipoma have been given in literature. A case of intraoral lipoma occurring in mental region in a 77-year-old male is reported along with review of the literature. Wide surgical excision was performed and two-year followup showed excellent healing without any recurrence. Lipomas are benign soft tissue neoplasm of mature adipose tissue seen as a common entity in the head and neck region. Intraoral lipomas are a rare entity which may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. It is mandatory for a clinician to diagnose intraoral lipomas using latest diagnostic methods and conservatively treat them without causing much discomfort

Case Report Intraoral Lipoma: A Case Report

Lipomas are rare in oral and maxillofacial regions although they are the most common tumours of mesenchymal origin in human body. The etiology remains unclear. Various different theories explain the pathogenesis of this adipose tissue tumour and also different histological variants of oral lipoma have been given in literature. A case of intraoral lipoma occurring in mental region in a 77-year-old male is reported along with review of the literature. Wide surgical excision was performed and two-year followup showed excellent healing without any recurrence. Lipomas are benign soft tissue neoplasm of mature adipose tissue seen as a common entity in the head and neck region. Intraoral lipomas are a rare entity which may be noticed only during routine dental examinations. Most of them rarely cause pain, resulting in delay to seek treatment. It is mandatory for a clinician to diagnose intraoral lipomas using latest diagnostic methods and conservatively treat them without causing much discomfort

A secured real-time IoMT application for monitoring isolated COVID-19 patients using edge computing

Internet of Medical Things (IoMT) is an emerging technology whose capabilities to self-organize itself on-the-fly, to monitor the patient's vital health data without any manual entry and assist early human intervention gave birth to smart healthcare applications. The smart applications can be used to remotely monitor isolated patients during this COVID-19 pandemic. Remote patient monitoring provides an opportunity for COVID-19 patients to have vital signs and other indicators recorded regularly and inexpensively to provide rapid and early warning of conditions that require medical attention using secured edge and cloud computing. However, to gain the confidence of the users over these applications, the performance of healthcare applications should be evaluated in real-time. Our real-time implementation of IoMT based remote monitoring application using edge and cloud computing, along with empirical evaluation, show that COVID-19 patients can be monitored effectively not only with mobility but also helps the health care professionals to generate consolidated health data of the patient that can guide them to obtain medical attention. © 2021 IEEE

Investigation on effect of cerium oxide additive in waste plastic oil fueled CI engine

In this study, the effects of incorporating cerium oxide into diesel and WPO blends were investigated to determine the potential of the blend as a fuel additive. The study aimed to assess engine-performance, emission, and combustion properties of the blend. The experiments utilized a single-cylinder diesel engine, and researchers prepared two different blends of WPO with 25% WPO in diesel and 50% WPO in diesel. Cerium oxide was added to these blends at concentrations of 25 ppm and 50 ppm using an ultrasonicator. The results demonstrated that increasing cerium oxide content in the blend (50 ppm) led to reduced CO, HC, and NOx emissions at higher loads. For instance, B50 + 50 ppm exhibited lower CO and NOx emissions, while B25 + 50 ppm demonstrated lower HC and smoke emissions. Furthermore, raising the CeO2 content from 25 ppm to 50 ppm resulted in a 3% increase in brake thermal efficiency. Moreover, cerium oxide positively impacted combustion and performance properties of the blends. Among the tested blends, the B50 + 50 ppm combination showcased the highest brake thermal efficiency, optimal air-fuel ratio, and the lowest specific fuel consumption. In conclusion, employing cerium oxide as a fuel additive in diesel-WPO blends offers a promising approach for realizing a sustainable and environmentally friendly future