Comparison of Outcome of Bipolar Electrocautery versus Harmonic Scalpel in the Management of Third and Fourth Degree Hemorrhoids

Objective: To compare the outcome of bipolar electrocautery versus harmonic scalpel in the management of third degree hemorrhoids. Methodology: This is a comparative study performed at Different Private Clinics of Karachi from the duration of January 2020 to June 2020. Patients with symptomatic grade III hemorrhoids and grade IV hemorrhoids were randomly divided into two groups. . Either group had 64 patients. One group underwent hemorrhoidectomy using bipolar electrocautery (Group A), other group underwent hemorrhoidectomy using harmonic scalpel hemorrhoidectomy (Group B). Results: The total number of patients was 128 with 64 in either group. The mean operating time in group A was 22 ± 4.7 minutes, while that in group B was 35 ± 2.2 minutes. The mean duration of hospital stay among group A was 1.7 ± 0.5 days while among group B patients was 2.1 ± 1.2 days. Mean VAS score for pain at first post-operative day in group A patients was 7 ± 0.6 days while mean VAS score for pain among group B patients was 8.5 ± .2 days. Conclusion: Our study concludes that harmonic scalpel hemorrhoidectomy offers better post-operative patient satisfaction score as compared to bipolar diathermy. No significant difference in hospital stay was found. The number of patients with post-operative urinary retention were more in harmonic scalpel group while in diathermy group, more patients had post-operative hemorrhage

Do dense molecular cores with broad emission spectra at |l| ≈ 5.4 ◦ , |b| ≈ 0.4 ◦ trace the Galactic bar? : a multi molecular line study from HOPS

We used NH3(1,1) data from the H2O Southern Galactic Plane Survey (HOPS) between −60◦ < l < −2.7◦ and 3.9◦ < l < 30◦ and |b| < 0.5◦ to identify dense molecular regions/clumps of the MilkyWay Galaxy that are likely to form high-mass stars. We identified ∼500 such clumps and in this paper we report on 14 of these clumps near the Central Molecular Zone that show broad emission spectral lines (with observed velocity widths between 19.8 and 47.6 km/s corresponding to intrinsic velocity widths between 7.1 and 25.2 km/s). We find that these clumps are grouped into three clusters of dense molecular cores centred at l ≈ 5.4◦,−5.4◦ and −10◦. We name them ‘Cluster-1’, ‘Cluster-2’ (also known as ‘Bania’s Clump 1’) and ‘Cluster-3’. We find that the same clumps exhibit broad emission spectra for other molecular lines - NH3(2,2), (3,3) and HC3N(3−2). The anti-symmetry of Cluster-1 and Cluster-2 in the l − b plane, and the large velocity dispersion of each clump in these two clusters suggest that clusters 1 and 2 may be associated with the Galactic bar potential x-1 orbits. Our assessments show that the clumps of these three clusters host hot gases and their emission line broadening are associated with shock heating. We find that Cluster-3 is likely to be undergoing high-mass star formation, as suggested by the presence of emission from H2O maser and radio recombination line (H69α) from HOPS

Human vitreous in proliferative diabetic retinopathy: Characterization and translational implications

Diabetic retinopathy (DR) is one of the leading causes of visual impairment in the working-age population. DR is a progressive eye disease caused by long-term accumulation of hyperglycaemia-mediated pathological alterations in the retina of diabetic patients. DR begins with asymptomatic retinal abnormalities and may progress to advanced-stage proliferative diabetic retinopathy (PDR), characterized by neovascularization or preretinal/vitreous haemorrhages. The vitreous, a transparent gel that fills the posterior cavity of the eye, plays a vital role in maintaining ocular function. Structural and molecular alterations of the vitreous, observed during DR progression, are consequences of metabolic and functional modifications of the retinal tissue. Thus, vitreal alterations reflect the pathological events occurring at the vitreoretinal interface. These events are caused by hypoxic, oxidative, inflammatory, neurodegenerative, and leukostatic conditions that occur during diabetes. Conversely, PDR vitreous can exert pathological effects on the diabetic retina, resulting in activation of a vicious cycle that contributes to disease progression. In this review, we recapitulate the major pathological features of DR/PDR, and focus on the structural and molecular changes that characterize the vitreal structure and composition during DR and progression to PDR. In PDR, vitreous represents a reservoir of pathological signalling molecules. Therefore, in this review we discuss how studying the biological activity of the vitreous in different in-vitro, ex-vivo, and in-vivo experimental models can provide insights into the pathogenesis of PDR. In addition, the vitreous from PDR patients can represent a novel tool to obtain preclinical experimental evidences for the development and characterization of new therapeutic drug candidates for PDR therapy