Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience

Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken

How do green financing and green logistics affect the circular economy in the pandemic situation: key mediating role of sustainable production

Emerging economies are striving to realize their potential for sustainable production in achieving zero-carbon agenda. Due to natural resource constraints, businesses must focus on green production resources to develop the circular economy. Therefore, this study aims to identify the key role of green financing and logistics in adopting sustainable production and circular economy. We have collected the data from 240 respondents from the Chinese manufacturing sector following the COVID-19 peak in late 2020 and analyzed using structural equation modeling. As per research findings, green financing and green logistics have a significant and positive effect on sustainable production and the circular economy. Second, sustainable production has a significant positive influence on the circular economy. Manifestly, sustainable production was discovered to play an important mediating role among these variables. Besides, the novel Importance-performance map analysis shows each constructs performance and importance value towards the circular economy. This paper contributed to the literature and highlighted the importance of each construct. Moreover, the study findings implied that green financing and green logistics should be integrated into organizational procuring and financing strategies for manufacturing green and sustainable goods, and advancing the circular economy goals

Profile and outcome of treatment in non-small cell lung cancer with brain metastasis

Background: Brain metastasis is a common problem in patients with NSCLC. This study was done to study the risk factors associated with the development of brain metastasis and assess treatment response in NSCLC to improve patient survival. Methods: This was a retro-prospective study in which 126 patients with non-small cell lung carcinoma with brain metastasis were taken for the study. Results: The mean age in study group was 56.1±12.72 years. Adenocarcinoma was found in 57.1% and squamous cell carcinoma in 41.3% patients. 65.9% patients received chemotherapy for primary disease followed by targeted therapy in 34 (27.0%) patients. 53.9% patients received WBRT after diagnosis  of brain metastasis and 23% WBRT and systemic chemotherapy while as14.3% received WBRT and targeted therapy and 2.4%  received WBRT, systemic chemotherapy and targeted therapy, 1.6%  patients received systemic chemotherapy, WBRT and local RT to the primary site  and 0.8% each was treated with gamma knife therapy; surgery, WBRT and targeted therapy; SRS and WBRT. Median overall survival of patients with brain metastasis who received WBRT was 2.5 months and patients who received WBRT and systemic chemotherapy was 9.0 months while patients with brain metastasis who received WBRT and targeted therapy was 14.3 months. Conclusions: The median overall survival as per treatment received after diagnosis of brain metastasis was higher in patients who received WBRT and targeted therapy as compared to patients who received WBRT and systemic chemotherapy and patients who received WBRT only

Review Proses Penyangraian Kopi dan Terbentuknya Akrilamida yang Berhubungan dengan Kesehatan

Makalah ini berisi tinjauan komprehensif terhadap literatur tentang proses penyangraian kopi dan pembentukan akrilamida sebagai hasil sampingan proses pengolahan biji kopi diterbitkan antara tahun 2008 hingga 2018. bagian besar penelitian bersifat empiris dan sebagian besar studi berfokus pada proses pengolahan kopi dan efek akrilamida pada kesehatan tubuh. Temuan penting lainnya, sebagian kajian menganggap bahwa kopi mampu meningkatkan kesehatan tubuh. Ulasan ini menyajikan pemahaman yang lebih baik tentang manfaat dan bahaya kopi serta pengaruh penyangraian terhadap mutu kopi yang dihasilkan. Tinjauan ini juga menyoroti tentang alat sangrai kopi yang relatif kurang dieksplorasi. Akademisi, peneliti dan kelompok tani dapat menggunakan hasil kajian ini sebagai pedoman dalam menyangrai kopi. Penyangraian dengan waktu dan suhu yang efektif dapat mengurangi pembentukan akrilamida pada kopi, namun perlu kajian literatur terbaru yang berkaitan dengan proses pengolahan kopi terutama pada proses penyangraian

Electrophysiological changes in patients with liver cirrhosis in a tertiary care hospital in Karachi, Pakistan

Background: Electrophysiological changes in cirrhosis are well known but least investigated especially in our country hence we wanted to see electrophysiological changes especially QT interval in cirrhotic patients. Methods: A cross-sectional study was conducted at Aga Khan University Hospital Karachi (AKUH) in which medical records (duration 2008-2010) of cirrhotic patients were reviewed. Results: Three hundred and eighty cirrhotic patients\u27 charts were studied, 227 (59.7 %) were male and mean age of this cohort was 52.8±12.6 years. The most common cause for CLD was Hepatitis C (CHC) in 260 (68.4%), NBNC in 56(14.7%) and HBV in 51 (13.4%). Only 225 had complete ECG workup, the mean corrected QT interval was 0.44±0.067sec. Among the electrophysiological abnormalities, 79 (35%) had a prolonged corrected QT interval, 7 (3.1%) had a prolonged PR interval (\u3e0.22s) and prolonged QRS duration was seen in 23 (10.4%) patients. QT prolongation was seen in 1 of the 5 patients with Child Class A (20%), 22 of the 73 patients with Child Class B (30.1%), and 25 of the 61 patients with Child Class C (41%). However, this difference however was not statistically significant. (p-value=.331). CONCLUSIONS: We conclude that QT prolongation is more frequent in patients with liver cirrhosis especially when the disease is more advanced like in Child C hence these patients are more prone to sudden cardiac death. Moreover, this study shows that the risk associated with QT prolongation is present through all classes of liver cirrhosis. We recommend that routine cardiac screening with ECG of all cirrhotic patients be performed

Trans-articular chondrosarcoma grade 2 of proximal phalanx resulting in its fracture along with destruction of middle phalanx of 2nd toe right foot: a case report and review of the literature

Foot is an unusual site for chondrosarcoma and involvement of phalanges is extremely rare. We report a case of grade 2 chondrosarcoma of proximal phalanx resulting in its fracture along with transarticular extension to the middle phalanx of the 2nd toe of right foot in a 62 year old female. The patient presented with 1 and ½ year history of pain and swelling in right 2nd toe. X-ray showed presence of expanding lytic lesion with amorphous calcification along with fracture proximal phalanx. Fine needle aspiration cytology showed some pleomorphs, osteoclasts and some giant cells. We went for amputation of toe without a biopsy. Histopathological examination of specimen showed multiple pleomorphic cells, nuclear atypia, hyperchromasia with some giant cells (grade 2 chondrosarcoma)

Antepartum transabdominal amnioinfusion in oligohydramnios - a comparative study

Background: The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion in oligohydramnios with the view to improving pregnancy outcome in oligohydramnios, a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies.Methods: The study comprised of a prospective analysis of 130 pregnant women with oligohydramnios, divided into two groups, the study and control group of 65 patients each and were similar with regard to age, gravidity, parity, gestational age. TAA was performed on all patients in the study group and the results were compared and analyzed.Results: Mean gestational age at first treatment was 29.98 weeks in study group. Mean pre-procedure amniotic fluid index was 4.01 and post-procedure was 12.49. A total of 106 infusions were done on 65 patients (mean1.63). Mean latency period in study group was 49.53 and in controls 26.49. There was significant decrease in fetal distress in patients in study group. 30 % of patients needed caesarean section in study group compared to 60% in controls. Number of preterm deliveries was 18 and 45 respectively in study and control groups. 61% of newborns in the study group weighed more than 2.5 kg compared to only 24% in control group. Neonatal ICU admissions and newborn deaths were lesser in study group.Conclusions: Transabdominal amnioinfusion is an extremely useful procedure to reduce complications arising from oligohyramnios. It significantly increases the latency period, decreases the occurrence of fetal distress preterm deliveries, need for caesarean or instrumental deliveries, improves birth weight of the newborns and significantly reduces the neonatal morbidity and mortality

REVIEW PROSES PENYANGRAIAN KOPI DAN TERBENTUKNYA AKRILAMIDA YANG BERHUBUNGAN DENGAN KESEHATAN

Makalah ini berisi tinjauan komprehensif terhadap literatur tentang proses penyangraian kopi dan pembentukan akrilamida sebagai hasil sampingan proses pengolahan biji kopi diterbitkan antara tahun 2008 hingga 2018. bagian besar penelitian bersifat empiris dan sebagian besar studi berfokus pada proses pengolahan kopi dan efek akrilamida pada kesehatan tubuh. Temuan penting lainnya, sebagian kajian menganggap bahwa kopi mampu meningkatkan kesehatan tubuh. Ulasan ini menyajikan pemahaman yang lebih baik tentang manfaat dan bahaya kopi serta pengaruh penyangraian terhadap mutu kopi yang dihasilkan. Tinjauan ini juga menyoroti tentang alat sangrai kopi yang relatif kurang dieksplorasi. Akademisi, peneliti dan kelompok tani dapat menggunakan hasil kajian ini sebagai pedoman dalam menyangrai kopi. Penyangraian dengan waktu dan suhu yang efektif dapat mengurangi pembentukan akrilamida pada kopi, namun perlu kajian literatur terbaru yang berkaitan dengan proses pengolahan kopi terutama pada proses penyangraian

Cytogenetic abnormalities in myelodysplastic syndromes: An overview

Karyotype is one of the main constituents of the International Prognostic Scoring System (IPSS) and revised-IPSS that are the cornerstones for the prognostication of patients with myelodysplastic syndromes (MDS). Del(5q), -7/del(7q), +8 and -Y are among the most extensively studied cytogenetic abnormalities in MDS. The same applies for normal karyotype. There are hundreds of other rare cytogenetic abnormalities that have been reported in MDS, included but not limited to -X, 3q abnormalities, +13/del(13q), i(17q), +21/-21. However, due to a very low number of patients, their impact on the prognosis of MDS is limited. Knowledge of the molecular consequences of different cytogenetic abnormalities allows us to modify treatment regimens based on drugs most active against the specific karyotype present, allowing for the opportunity to individualize MDS treatment and improve patient care and prognosis