Limited post-operative narcotic use in elective laparoscopic cholecystectomy

Purpose: To limit narcotics use Cochrane review: multiple studies have shown postoperative pain can be managed with non-narcotic meds with good outcome Less medication related side effects:N/V, constipation, disorientation Prevents substance addiction/abusehttps://jdc.jefferson.edu/patientsafetyposters/1069/thumbnail.jp

Variability in the Origin of the Obturator Artery

INTRODUCTION: General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported. MATERIALS AND METHODS: The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted. RESULTS: In 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity. CONCLUSION: The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring

Comprehensive Evaluation of Peripheral Nerve Regeneration in the Acute Healing Phase Using Tissue Clearing and Optical Microscopy in a Rodent Model

Peripheral nerve injury (PNI), a common injury in both the civilian and military arenas, is usually associated with high healthcare costs and with patients enduring slow recovery times, diminished quality of life, and potential long-term disability. Patients with PNI typically undergo complex interventions but the factors that govern optimal response are not fully characterized. A fundamental understanding of the cellular and tissue-level events in the immediate postoperative period is essential for improving treatment and optimizing repair. Here, we demonstrate a comprehensive imaging approach to evaluate peripheral nerve axonal regeneration in a rodent PNI model using a tissue clearing method to improve depth penetration while preserving neural architecture. Sciatic nerve transaction and end-to-end repair were performed in both wild type and thy-1 GFP rats. The nerves were harvested at time points after repair before undergoing whole mount immunofluorescence staining and tissue clearing. By increasing the optic depth penetration, tissue clearing allowed the visualization and evaluation of Wallerian degeneration and nerve regrowth throughout entire sciatic nerves with subcellular resolution. The tissue clearing protocol did not affect immunofluorescence labeling and no observable decrease in the fluorescence signal was observed. Large-area, high-resolution tissue volumes could be quantified to provide structural and connectivity information not available from current gold-standard approaches for evaluating axonal regeneration following PNI. The results are suggestive of observed behavioral recovery in vivo after neurorrhaphy, providing a method of evaluating axonal regeneration following repair that can serve as an adjunct to current standard outcomes measurements. This study demonstrates that tissue clearing following whole mount immunofluorescence staining enables the complete visualization and quantitative evaluation of axons throughout nerves in a PNI model. The methods developed in this study could advance PNI research allowing both researchers and clinicians to further understand the individual events of axonal degeneration and regeneration on a multifaceted level

Comparison of hexagon and octagon cylinder models with conventional modelsfor effective thermal conductivity estimation of suspension systems

356-364This study presents hexagon and octagon cylinder models for effective thermal conductivity estimation of suspension system. Algebraic equations were derived based on isotherm approach for two dimensional spatially periodic medium. Model prediction was achieved with minimum (±10.83%) and maximum (±15.58%) deviation from experimental data for suspension systems. Model prediction was comparable with conventional models

Estimation of effective thermal conductivity of two-phase materials using line heat source method

872-878This study presents fabrication of an experimental setup based on line heat source method and automate data acquisition software (LabVIEW) was used to measure thermal conductivity (TC) of two-phase materials (TPMs) with various temperatures. TC measurement of various TPMs has been carried with a minimum value (0.178 W/m°C) for saw dust and maximum value (0.64 W/m°C) for iron powder. Reliability tests were conducted on glycerin to validate experimental set-up. Using TC values at different temperatures, thermal diffusivity can also be found out. Thermal probe method of determining TC is one of the best methods available owing to its simplicity and ease of construction and usage

Shot peening effects on fatigue life, corrosion behavior and surface roughness of low carbon alloy steel

In this present study, the effect of the shot peening process on fatigue life, surface hardness and corrosion properties of a low carbon alloy steel is examined at room temperature. The research article addresses the effect of shot peening by varying the process parameters such as peening distance and pressure with amachrome as shots. The experiment is designed by means of full factorial design. The experimental result reveals that the pressure and distance are the most significant factors in the shot peening process. The results illustrate that the average pressure of 7 bar and distance of 100 mm improves fatigue life by 1.5% of unpeened material under 20 Hz frequency while corrosion resistance improves by 4% with unpeening of the low carbon alloy steel by using amachrome as a shot

Evaluation of dentifrice containing nano-hydroxyapatite for dentinal hypersensitivity: a randomized controlled trial

This randomized, double-blind, parallel arm study was carried out to evaluate and compare the effectiveness between nano-hydroxyapatite (HAP) and a benchmark dentifrice in reducing dentin hypersensitivity.About 36 patients were selected, randomly divided into two groups and was evaluated clinically using three different stimuli, i.e., tactile, air blast, and cold water test. The patient's responses to various stimuli were recorded using a visual analog scale at baseline and after 4 weeks.Statistical analysis was done using unpaired and paired t-tests. It was seen that patients treated in both groups showed significant reductions scores across all sensitivity measures at the end of 4 weeks.The HAP containing toothpaste was effective in reducing dentin hypersensitivity with pre-existing benchmark toothpaste tested and hence can be advocated in the management of hypersensitivity

'Family centric rehabilitation’ for persons with mental illness in India:Conceptual framework using evidence-based case studies

Purpose of the studyIn India, people live in a collective society wherein family members are the primary caregivers for the person suffering from mental illness (PMI). Psychiatric rehabilitative models are individual-centric, focusing on individual level skills (emotional, social, self-management and vocational) and development to enhance successful community reintegration. If the entire family is considered to be a unit for rehabilitation, i.e. family centric rehabilitation, the possibility of empowering the family to function effectively is higher despite the illness. The objective of the case study is to conceptualize the framework ‘Family centric Rehabilitation’.MethodsCase study design.ResultsFamily centric rehabilitation can be conceptualized as ‘a process that facilitates families, dysfunctional due to PMI, to reach their optimal level of independent functioning by harnessing resources available within the community’. Family centric rehabilitation focuses on enhancing global functioning of the “family unit”, in essence all members, rather than just the PMI. Strategies deployed include concurrently addressing and minimizing anticipated challenges across domains including medical, psychosocial, vocational as well as economic, thereby aiding in recovery of the family unit as a whole.ConclusionsFamily centric rehabilitation is an important culture specific concept that aims to provide optimal level of functioning of all family members and can contribute to the family achieving self-sustenance, a sense of autonomy and empowerment.<br/