Use of an electromagnetic colonoscope to assess maneuvers associated with cecal intubation

<p>Abstract</p> <p>Background</p> <p>Safe and effective colonoscopy is aided by the use of endoscopic techniques and maneuvers (ETM) during the examination including patient repositioning, stiffening of the endoscope and abdominal pressure.</p> <p>Aim</p> <p>To better understand the use and value of ETM during colonoscopy by using a device that allows real-time imaging of the colonoscope insertion shaft.</p> <p>Methods</p> <p>The use of ETM during colonoscopy and their success was recorded. Experienced colonoscopists and endoscopy assistants used a commercially available electromagnetic (EM) transmitter and a special adult variable stiffness instrument with 12 embedded sensors to examine 46 patients. In 5 of these a special EM probe passed through the instrument channel of a standard pediatric variable stiffness colonoscope was used instead of the EM colonoscope.</p> <p>Results</p> <p>Thirty-nine men and 7 women with a mean age of 64 years (range 33–90) were studied. The cecum was intubated in 93.5% (43/46). The mean time to reach the cecum was 10.6 minutes (range 3–25). ETM were used a total of 174 times in 41 of the patients to assist with cecal intubation. When ETM were required to reach the cecum, and the cecum was intubated, an average of 3.82 ETM/patient was used. While ETM were used most often when the tip of the colonoscope was in the left side of the colon (rectum 5.0%, sigmoid colon 20.7%, descending colon 5.0%, and splenic flexure 11.6%), when the instrument was in the transverse colon (14.8%), hepatic flexure (20.7%) and ascending colon (19.8%) the use of ETM was also required. When the colonoscope tip was in the transverse colon, hepatic flexure and ascending colon, ETM success rates were less (61.1%, 52.0%, and 41.7% respectively) compared to the left colon success rates (rectum 83.3%, sigmoid colon 84.0%, descending colon 100%, and splenic flexure 85.7%).</p> <p>Conclusion</p> <p>The EM colonoscope allows imaging of the insertion shaft without fluoroscopy and is a useful device for evaluating the efficacy of ETM. ETM are important tools of the colonoscopist and are used most often in the left colon where they are most effective.</p

Formulations of Plant Growth-Promoting Microbes for Field Applications

Development of a plant growth-promoting (PGP) microbe needs several steps starting with isolation of a pure culture, screening of its PGP or antagonistic traits by means of different efficacy bioassays performed in vitro, in vivo or in trials under greenhouse and/or field conditions. In order to maximize the potential of an efficient PGP microbe, it is essential to optimize mass multiplication protocols that promote product quality and quantity and a product formulation that enhances bioactivity, preserves shelf life and aids product delivery. Selection of formulation is very crucial as it can determine the success or failure of a PGP microbe. A good carrier material should be able to deliver the right number of viable cells in good physiological conditions, easy to use and economically affordable by the farmers. Several carrier materials have been used in formulation that include peat, talc, charcoal, cellulose powder, farm yard manure, vermicompost and compost, lignite, bagasse and press mud. Each formulation has its advantages and disadvantages but the peat based carrier material is widely used in different part of the world. This chapter gives a comprehensive analysis of different formulations and the quality of inoculants available in the market, with a case study conducted in five-states of India