Observational study of scalpel versus electrocautery for subcutaneous incision in elective gynaecological surgeries

Background: Considering higher rate of postoperative wound complications in Government set up hospitals, this study was an attempt to compare incision time, incisional blood loss, hospital stay, post-operative pain and postoperative wound complications when subcutaneous tissue is opened with either scalpel or electrocautery in elective gynaecological surgeries after keeping all other clinical and surgical variables same i.e. age, BMI, haemoglobin, incision depth and hospital stay.Methods: This was a prospective observational comparative study conducted in one of the tertiary teaching hospital in Western Maharashtra, India over 12 months. All patients (n=100) were divided into 2 groups. Group A in which skin and subcutaneous tissue was dissected by using scalpel and Group B in which after skin, anterior abdominal wall was opened by using electrocautery. Data analyzed for indication, incisional blood loss, incision time, postoperative pain, wound complications and hospital stay.Results: There were no significant association between preoperative diagnosis and the development of a post-operative wound complications. Mean incision blood loss was found to be significantly higher in group A compared to group B patients. Postoperative pain was significantly higher in group A (P value <0.05). Among wound complications, no statistically significant differences were seen regarding wound complications for the two groups.Conclusions: Electrosurgical dissection for abdominal incision is safe, less time consuming and with less blood loss during subcutaneous incision and produces less postoperative pain. We conclude that the method of subcutaneous tissue incision was unrelated to the development of postoperative abdominal incision problems

Accuracy of different imaging modalities prior to biventricular repair in Tetralogy of Fallot

The aim of the present study was to determine the diagnostic accuracy of non-invasive tests in patients  with Tetralogy of Fallot prior to biventricular repair, and the need of invasive angiocardiography in specific  subgroups. A retrospective analysis was performed for paediatric patients with Tetralogy of Fallot who  underwent biventricular repair in three consecutive months. Patients were divided into two groups  according to their age: below and above 5 years. We compared the findings of different imaging modalities (e.g. echocardiography, multi-detector Computed Tomography (CT) and invasive angiocardiography) to intraoperative findings to determine their accuracies in different subgroups. Results showed that echocardiography is reliable for preoperative imaging, especially in younger children   (sensitivity=71.43%) and its findings are ‘moderately’ concordant with intraoperative findings  (kappa=0.439). For patients above 5 years of age, its sensitivity (29.41%) declines and findings are  ‘poorly’ concordant with intraoperative findings (kappa=0.093). With addition of multi-detector CT, the  findings of non-invasive means are ‘perfectly’ concordant with the intraoperative findings (kappa=1) in children below 5 years and ‘moderately’ concordant with those (kappa=0.4) in children above 5 years. The findings of CT are ‘moderately’ concordant with those of invasive angiocardiography (kappa=0.4). Tetralogy of Fallot patients below 5 years can directly be subjected to surgery with work-up including detailed echocardiography only. If anatomy is not clearly delineated, CT helps and invasive  angiocardiography is not essential. In patients above 5 years, CT has an important role in defining  anatomy. The need for catheterization is limited to hemodynamic evaluation of prior shunt and  embolization of aorto-pulmonary collaterals.KEY WORDS: Tetralogy of Fallot; Pulmonary artery; Aorto-pulmonary collaterals; Echocardiography; Computed Tomography; Invasive angiocardiograph

The United States COVID-19 Forecast Hub dataset

Academic researchers, government agencies, industry groups, and individuals have produced forecasts at an unprecedented scale during the COVID-19 pandemic. To leverage these forecasts, the United States Centers for Disease Control and Prevention (CDC) partnered with an academic research lab at the University of Massachusetts Amherst to create the US COVID-19 Forecast Hub. Launched in April 2020, the Forecast Hub is a dataset with point and probabilistic forecasts of incident cases, incident hospitalizations, incident deaths, and cumulative deaths due to COVID-19 at county, state, and national, levels in the United States. Included forecasts represent a variety of modeling approaches, data sources, and assumptions regarding the spread of COVID-19. The goal of this dataset is to establish a standardized and comparable set of short-term forecasts from modeling teams. These data can be used to develop ensemble models, communicate forecasts to the public, create visualizations, compare models, and inform policies regarding COVID-19 mitigation. These open-source data are available via download from GitHub, through an online API, and through R packages

Ionic liquid promoted facile and green synthesis of 1,8-dioxo-octahydroxanthene derivatives under microwave irradiation

An efficient and environmentally benign procedure for the synthesis of 1,8-dioxo-octahydroxanthene by condensation reaction between 5,5-dimethyl-1,3-cyclohexanedione (dimedone) and structurally diverse aldehydes using carboxy functionalized ionic liquid under microwave irradiation is described. The methodology provides synergy of ionic liquid and microwave irradiation which offers several advantages such as high yields in shorter reaction time, convenient operation, reusability of catalyst and easy work-up

Oral Lichen Planus: An Update on Etiology, Pathogenesis and Management - A Review of Literature

Background: Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for Oral Lichen Planus (OLP); therefore, follow -up should be considered. There are many unestablished etiological factors for OLP. A genetic predisposition linked to Th, cytokine polymorphisms may promote the T cell-mediated immunological response to an induced antigenic change that is supposed to lead to OLP lesions. Some putative etiologic factors, mainly amalgam restorations and hepatitis C virus have been studied in detail. The diagnosis of OLP can be made from the clinical features if they are sufficiently characteristic, but biopsy is recommended to confirm the diagnosis, exclude dysplasia and malignancy and if active treatment is required. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. The management of OLP is mainly aimed at controlling the symptoms and topical immunomodulators such as powerful corticosteroids and calcineurin inhibitors have been used. However their long-term effects needs to be better explained and understood

Distribution of Coronary Artery Anomalies and Their Evaluation with Different Imaging Modalities

Introduction: Coronary artery anomalies (CAA) are diverse abnormalities. Methods: A retrospective review of coronary imaging of 17,245 patients over 2 years was performed. Patients with CAA detected on echocardiography, invasive coronary angiography (CAG) and multidetector computed tomographic angiography (MDCTA) were compared. Results: CAAs were detected in 257 patients (1.49%). Prevalence were: absent left main trunk- 0.319%, anomalous coronary artery from opposite sinus (ACAOS)- 0.516%, coronary fistulae- 0.203%, myocardial bridge- 0.093%, malignant anomalies- 0.3%. The commonest CAA was absent left main trunk. The yield of echocardiography negatively correlated with age (r=-0.6). CAG and MDCTA were equal (p=1) for detection of absent left main trunk. CAG had low sensitivity (58.3%) and MDCTA was better than it (p&lt;0.01) for detection of abnormal high origin. For ACAOS, detection by both were not different (p=0.5) but the course was delineated better with MDCTA than with CAG (p=0.05). Both were equal for detection of intramyocardial course (p=0.5). However, MDCTA delineated its course better than CAG (p&lt;0.01). Echocardiography had 93% sensitivity for fistula in those &lt;12 years in age. Radiation exposure with CAG, 7.3 ± 2mSv, was lower than that with MDCTA, 14.5 ± 3mSv (p&lt;0.01). It correlated with CAA score (r=0.3), with CAG but not with MDCTA. Contrast exposure correlated with CAA score (r=0.4) for adults with CAG but not with MDCTA. Conclusion: Echocardiography reliably detects CAAs in children. CAG and MDCTA are comparable for detection of most CAA. MDCTA delineates the course better than CAG. For MDCTA, radiation exposure is not correlated with complexity of CAA in contrast to that with CAG