Functional outcomes following various reconstructive methods following various forms of maxillectomies- a tertiary centre experience

Background: The maxilla is the pivotal structure of the midface, separating the oral, antral, and orbital cavities, and providing support to the globes, lower eyelids, cheeks, lips, and nose. In addition, the maxilla play a critical role in speech, swallowing, and mastication. To evaluate the functional outcomes following various reconstructive methods following various forms of maxillectomiesMethods: Retrospective analysis of medical records of patients who underwent various forms of maxillectomies from January 2011 to December 2013. Postmaxillectomy defects were managed by either prosthesis or local flaps.Results: Forty patients had various forms of maxillectomies. Fifteen patients had Browns class 1 maxilectomy and all of these patients underwent reconstruction with Pectoralis major myocutaneous flap. Ten patients underwent class 2a maxillectomy and reconstruction with obturator and Split skin thickness grafting. Nine patients underwent class 3a-b resection and four patients class 4a-b resection and all had reconstruction with temporalis myofascial flap. Two patients underwent orbitomaxillary resection with palate preserved and reconstruction with temporalis myofascial and forehead flap. Mean follow up period was 8 months (Range 6- 24 months). Two patients developed moderate grade of trismus after completion of radiotherapy.  One patient developed recurrence in neck after 6 months of completion of adjuvant radiotherapy. All had moderate to fair speech and eating function which improved over time.Conclusions: There was no difference between flap reconstruction or obturator intervention of maxillary defects in speech and eating function. Small and lateral defects are better reconstructed with obturator and defects involving orbit and total maxilla are better reconstructed with regional flaps. Hence even in the era of microvascular flaps, obturator and regional flaps can still be considered for reconstruction of maxillectomy defects with fairly good outcome

A prospective study on impact of patient counselling on quality of life of patients with atopic dermatitis

Background: Atopic dermatitis is an acute, sub-acute or chronic relapsing skin disorder characterized by intense itching, pruritus and oozing. It adversely affects the routine activities of patients for which effective treatment is to be provided along with proper counselling. The aim of the current study was to evaluate the impact of patient counselling on quality of life (QoL).Methods: A prospective study was conducted in 108 patients recruited from the Department of Dermatology for a period of 6 months. A written informed consent was taken. Out of the 108 patients, 54 patients received tacrolimus and the remaining received corticosteroids. The collected data was analysed and presented. Data was collected by using a suitably designed proforma. Dermatology life quality index (DLQI) was used for assessing QoL. Patients were counselled regarding the disease, drugs and lifestyle modifications using patient information leaflet (PIL).Results: The current study found that patient counselling was effective for both the groups with a p value <0.05. The effect of disease in quality of life improved from severe to mild in both groups (prior to counselling QoL mean value of 2.93±0.61 shifted to 1.18±0.71 post counselling). In the tacrolimus group, QoL mean value of 2.81±0.61 shifted to 0.98±0.71 after counselling. In the corticosteroids group, a shift from a mean QoL value of 3.05±0.59 to a mean of 1.38±0.65 was observed post counselling.Conclusions: The provision of effective counselling was found to have a profound impact on improving patient’s quality of life. A transition from severe effects of the disease to milder effects of the disease on quality of life was observed

Comparison of short-term outcomes following open and laparoscopic resections for colorectal malignancies

Background: The laparoscopic approach for colorectal cancers are still a matter of controversy. In the present study, we tried to compare the laparoscopy with open methods of colorectal resections.Methods: Retrospective study where patients diagnosed with colorectal cancer in our hospital from year 2014 January to December 2016 were taken. Total number of cases were 69 of which, the total number of right colon cases were 26. Out of twenty-six, 12 underwent open procedure and 14 underwent laparoscopic resections. Total number of left colon cancers were 09. Of these, 2 underwent open and 7 underwent laparoscopic procedure. Thirty-four (34) rectal cancers were included in the study. Of these, 12 underwent open rectal procedures and 22 underwent laparoscopic resections. Multiple parameters like duration of surgery, post-operative complications, postoperative stay, pathological T staging, lymph node yield, positive nodes, distal resection margins, circumferential radial margins were compared.Results: Operating time was significantly shorter in open procedure than laparoscopic surgery in both rectal resection and right hemicolectomies. The postoperative stay was significantly shorter in laparoscopic right hemicolectomy compared to open procedure. All other parameters like post-operative complications, T stage, lymph node yield, positive nodes, distal resection margins and CRMs were comparable in both groups. The lymph node yield was similar in upfront and post neoadjuvant carcinoma rectum cases.Conclusions: Laparoscopic colorectal resections have similar rates of complication, with shorter hospital stays with no compromise on oncological clearance with respect to lymph node yield, CRMs, distal resection margins compared to open procedures

Limb salvage surgery for giant cell tumours around knee joint: a single institute experience

Background: Giant cell tumours (GCTs) of bone are benign but locally aggressive tumours. The surgical treatment of GCTs in the around knee joint mainly includes curettage and bone grafting, extended curettage and cement filling, segmental resection and modular endo prosthesis reconstruction.Methods: Retrospective analysis of the presentation, the functional outcome following modular endoprosthetic reconstruction, prosthetic survival and the recurrence rate in 17 patients with Campanacci grade 3 GCTs involving distal femur and proximal tibia, who underwent segmental resection and modular endoprosthesis reconstruction in a single centre from 2015 to 2018. The surgery was performed according to the general principles of limb salvage surgery and modular segmental replacement was used. All stems were cemented in place. Isometric exercises and mobilization with crutches were started on 2nd postoperative day. Knee joint bending was started for proximal tibia patients after 2 to 3 weeks. Functional outcome was scored by musculoskeletal tumour society scoring (MSTS). Immediate post-operative complication like delayed wound healing, flap necrosis, wound infection, foot drop, leg length discrepancies were evaluated.Results: The average MSTS functional score was 78%.3 year prosthetic survival was 100%. None of the patients had recurrence. One patient had left lower lobe metastasis for which wedge resection was done.Conclusions: Segmental resection and endoprosthetic replacement has good functional outcome in patients with tumours around the knee joint. As GCTs are tumours with less chance of local and distant metastasis after complete excision, endoprosthetic prosthesis is a good treatment option after complete excision

Presence of emerging organic contaminants and microbial indicators in surface water and groundwater in urban India

This study presents a first combined assessment of emerging organic contaminants (EOC) and antimicrobial resistance (AMR) indicators in the South Indian city of Bengaluru from multiple sources, addressing a knowledge gap on EOCs and AMR occurrences and relationships in different water sources in urban India. A unique approach in this study was to combine the detection of EOCs with an assessment of the AMR-indicating class 1 integron-integrase gene, intI1. Twenty-five samples collected from groundwater, local surface waters, and tap water imported from the Cauvery Basin were screened for 1499 EOCs. A total of 125 EOCs were detected at concentrations per compound of up to 314 μg/L. Concentrations for a range of contaminants were higher than those previously detected in Indian groundwaters. High concentrations of Per- and polyfluoroalkyl substances (PFAS) were detected with up to 1.8 μg/L in surface water and up to 0.9 μg/L in groundwater. Calculated risk quotients indicated potential AMR development caused by high concentrations of azithromycin, fluconazole, and sulfanilamide in surface waters that have little protection against sewage inflows. Surface waters that have recently undergone environmental restoration (e.g., removing silted bottom layers and enhancing protection against encroachments and sewage inflows) had lower EOC detections and risk of AMR development. Specific EOC detections, e.g., the ubiquitous detection of the sweetener sucralose (in use since ∼2000), indicated recent groundwater recharge and a contribution of imported Cauvery River water for recharge. This study highlights the need for monitoring and water protection, the role of EOCs as potential drivers of AMR, and the success of surface water protection measures to improve freshwater quality

Inactivation of Escherichia Coli and Salmonella Using 365 and 395 nm High Intensity Pulsed Light Emitting Diodes

High intensity pulsed light emitting diode (LED) treatment is a novel approach to inactivate foodborne pathogens. The objective of this study was to evaluate the antibacterial potential of high intensity 365 (UV-A) and 395 nm (NUV-Vis) LED treatments against Escherichia coli and Salmonella enterica at high and low water activity (aw) conditions, and to understand the influence of different process parameters on their antibacterial efficacy. Bacteria at high (in phosphate buffer saline, PBS) and low aw (aw = 0.75) conditions were treated with both the LEDs with specific doses at a fixed distance from the LEDs. The 365 nm LED showed more effectiveness in reducing the dried bacteria compared to 395 nm LED. The dry E. coli showed more resistance to LED treatments compared to Salmonella. The 365 and 395 nm LED treatments with ~658 J/cm2 dose resulted in reductions of 0.79 and 1.76 log CFU/g of Salmonella, respectively, on 0.75 aw pet foods. The LED treatments increased the surface temperature, resulting in water loss in the treated samples. This study showed that the dose, duration of light exposure, bacterial strain, and aw played a major role in the antibacterial efficacy of the 365 and 395 nm LEDs

Understanding the Salmonella Inactivation Mechanisms of 365, 395 and 455 nm Light Pulses Emitted from Light-Emitting Diodes

Salmonella is a foodborne pathogen responsible for several outbreaks in low-water activity (aw) foods. Treatment using light pulses emitted from light-emitting diodes (LED) is an emerging decontamination method to inactivate foodborne pathogens. The objective of this study was to understand the antibacterial mechanisms of light pulses with 365, 395 and 455 nm wavelengths against Salmonella Typhimurium in low-aw conditions. The 365 nm light pulses showed better inactivation efficacy against low-aw&nbsp;S. Typhimurium than the 395 nm light pulses. For instance, the 365 nm LED treatment with an ~217 J/cm2 dose produced a reduction of 2.94 log (CFU/g) in S. Typhimurium cell counts, as compared with a reduction of 1.08 log (CFU/g) produced by the 395 nm LED treatment with the same dose. We observed a significant generation of intracellular reactive oxygen species (ROS) in S. Typhimurium cells after treatments with the 365, 395 and 455 nm light pulses at low-aw conditions. The LED treatments also showed a significant membrane lipid oxidation of S. Typhimurium cells after treatments with 365, 395 and 455 nm light pulses. Overall, a major role of ROS generation was observed in the inactivation efficacy of the 365, 395 and 455 nm light pulses against S. typhimurium at low-aw conditions

Neofidia Strother, a new name for Fidia Baly, 1863 and redescription of Fidia kanaraensis (Jacoby, 1895) with a new host record and notes on natural history (Coleoptera, Chrysomelidae, Eumolpinae)

Neofidia Strother nom. nov., is proposed as the replacement name for Fidia Baly, 1863, a junior homonym of Fidia Motschulsky, 1861 (not 1860, Griffin 1936). A list of the included species of Neofidia Strother nom. nov. and Fidia Motschulsky, 1861 is provided for clarity. Fidia medvedevi nom. nov. is the new replacement name proposed for Lypesthes vietnamicus Medvedev, 2015. Fidia kanaraensis (Jacoby, 1895) is redescribed and habitus, male and female genitalia are figured. Cashew (Anacardium occidentale L.) is reported as a new host of F. kanaraensis and partial information on the life history is provided. Eggs are laid singly on the surface of soil, and are covered with excreta and soil. Larvae tunnel into the tender roots. Adults are nocturnal and feed on tender leaves