Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

<p>Abstract</p> <p>Background</p> <p>Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome.</p> <p>Methods</p> <p>A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK) Pakistan, from 1st September 2005 – 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled.</p> <p>Results</p> <p>The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6%) and gastric ulcer 1.3%. followed by small bowel tuberculosis (21%) and typhoid (17%). large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%). Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%).</p> <p>Conclusion</p> <p>The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular. Malignant perforations are least common in our setup.</p

Aspects of Homogeneous Heterogeneous Reactions for Nanofluid Flow Over a Riga Surface in the Presence of Viscous Dissipation

The aim of our study is to delineate the characteristics of fluid flow comprising single-wall and multi-wall carbon nanotubes (SWCNTs and MWCNTs) along the surface of a Riga plate fixed in a porous environment. We carried out in-depth comparative analysis to depict the behavior of SWCNTs and MWCNTs when water and kerosene oil are used as base fluids. Homogeneous&ndash;heterogeneous reactions generated a significant impact on flow dynamics; furthermore, we also discuss the impact of viscous dissipation. We assembled numerical solutions for non-dimensionalized ordinary differential equations with the help of the shooting technique; moreover, by employing the same procedure, we report the conduct of dominating parameters on velocity, temperature, and concentration profiles. The results show highly desirable skin friction coefficient and Nusselt number values, which we exhibit in terms of tabular data

Aspects of Homogeneous Heterogeneous Reactions for Nanofluid Flow Over a Riga Surface in the Presence of Viscous Dissipation

The aim of our study is to delineate the characteristics of fluid flow comprising single-wall and multi-wall carbon nanotubes (SWCNTs and MWCNTs) along the surface of a Riga plate fixed in a porous environment. We carried out in-depth comparative analysis to depict the behavior of SWCNTs and MWCNTs when water and kerosene oil are used as base fluids. Homogeneous–heterogeneous reactions generated a significant impact on flow dynamics; furthermore, we also discuss the impact of viscous dissipation. We assembled numerical solutions for non-dimensionalized ordinary differential equations with the help of the shooting technique; moreover, by employing the same procedure, we report the conduct of dominating parameters on velocity, temperature, and concentration profiles. The results show highly desirable skin friction coefficient and Nusselt number values, which we exhibit in terms of tabular data

Antioxidants with proven efficacy and elastin‐conserving vitamin C—A new approach to free radical defense

BackgroundThis paper describes the background research and validation related to the formulation of a novel antioxidant product. Two defined outcomes were sought. Firstly, a combined efficacy of antioxidant ingredients in quenching free oxygen radicals. Secondly, the investigation into whether a vitamin C derivative sodium salt was elastin conserving in contrast to current vitamin C/l-ascorbic acid variations that have been reported to negatively affect elastin constitution and regeneration.Materials and methodsA leading l-ascorbic acid antioxidant available on the market was compared with the experimental new product in two studies. In the first experiment, the products were compared to assess their antioxidant properties. The evaluated products TOPICAL ANTIOXIDANT 1 and TOPICAL ANTIOXIDANT 2 were applied to human skin cultures (25-30 mg/cm2 ) for a total of 72 h of treatment and exposed to oxidative stress. The generation of free radicals was semi-quantitatively assessed by measuring the fluorescence intensity of the deacetylation and oxidation of the probe dichlorofluorescein diacetate (DCFH-DA). In the second experiment, an ex vivo skin model (derived from patients undergoing facelift procedures) was used to assess elastin preservation. Three skin explants were topically subjected to the two formulations daily for 7 days. The skin was then prepared and fixed for immunofluorescent assessment after staining with CD44 and tropoelastin antibodies. Images were then analyzed using ImageJ.ResultsA full description of the different components selected for the new formulation is presented. In the first study, the experimental formulation performed with absolute equivalence to the comparator in its radical quenching capacity; both showed extremely effective antioxidant function. In the second study, the comparator negatively affected the existing elastin with areas of breakdown and diminished staining. In contrast, the new formulation showed good conservation of healthy elastin in all sections demonstrating elastin preservation.ConclusionA new antioxidant formulation was carefully designed with multiple actives that show an equivalent antioxidant capacity to a leading product on the market. More importantly, the vitamin C component shows direct elastin conservation and improvement as opposed to the comparator, which had negative effects on elastin preservation. This is in keeping with little-known literature reports on vitamin C and its negative effects on elastin and validates the use of a sodium salt derivative, which appears to have protective effects on elastin. These findings support the overall regenerative extracellular matrix changes seen with TriHex® technology in other products

COMMUNISM AND ISLAM: AN ANALYSIS OF AMERICAN MEDIA PRACTICES DURING CONFLICTS

The clashed imports of westerners are seemed to be hybrid about Islamic perspective and communists that cause dispute among the clash of emperors, humanity and doctrine. Among these disputes, the fight of kings can be thought as for the sake of powerful regime and its enlargement while others including the clash of people and ideology related to the treasury. The religion of Islam is sighted as inspiring strength in which nothing of human biography is thrown behind the curtain while Communism has an ideological mindset. It can be said that westerners ignore both Communists and Muslims by their media and in the political field. It is considered as a natural mindset of the west. It makes no difference in the Islam &amp; Communism when their parameters of concord, legislation and secular approach, they are known with their ideological and religious values. Both are depicted as Villain, scoundrel, enemy, rival, extremist, anti-American or anti-west and thought as an enemy. By keeping these concepts in mind, Hollywood films petitioned widely "us" &amp; "them" for both targets. On the other hand, Hollywood portrayed Americans as heroic, patriotic and travellers of the right path

Designing Electron-Deficient Diketone Unit Based Non-Fused Ring Acceptors with Amplified Optoelectronic Features for Highly Efficient Organic Solar Cells: A DFT Study

Organic solar cells (OSCs) made of electron-acceptor and electron-donor materials have significantly developed in the last decade, demonstrating their enormous potential in cutting-edge optoelectronic applications. Consequently, we designed seven novel non-fused ring electron acceptors (NFREAs) (BTIC-U1 to BTIC-U7) using synthesized electron-deficient diketone units and reported end-capped acceptors, a viable route for augmented optoelectronic properties. The DFT and TDDFT approaches were used to measure the power conversion efficiency (PCE), open circuit voltage (Voc), reorganization energies (λh, λe), fill factor (FF), light harvesting efficiency (LHE) and to evaluate the potential usage of proposed compounds in solar cell applications. The findings confirmed that the photovoltaic, photophysical, and electronic properties of the designed molecules BTIC-U1 to BTIC-U7 are superior to those of reference BTIC-R. The TDM analysis demonstrates a smooth flow of charge from the core to the acceptor groups. Charge transfer analysis of the BTIC-U1:PTB7-Th blend revealed orbital superposition and successful charge transfer from HOMO (PTB7-Th) to LUMO (BTIC-U1). The BTIC-U5 and BTIC-U7 outperformed the reference BTIC-R and other developed molecules in terms of PCE (23.29% and 21.18%), FF (0.901 and 0.894), normalized Voc (48.674 and 44.597), and Voc (1.261 eV and 1.155 eV). The proposed compounds enclose high electron and hole transfer mobilities, making them the ideal candidate for use with PTB7-Th film. As a result, future SM-OSC design should prioritize using these constructed molecules, which exhibit excellent optoelectronic properties, as superior scaffolds

Staphylococcus epidermidis protease EcpA can be a deleterious component of the skin microbiome in atopic dermatitis

BackgroundStaphylococcus aureus and Staphylococcus epidermidis are the most abundant bacteria found on the skin of patients with atopic dermatitis (AD). S aureus is known to exacerbate AD, whereas S epidermidis has been considered a beneficial commensal organism.ObjectiveIn this study, we hypothesized that S epidermidis could promote skin damage in AD by the production of a protease that damages the epidermal barrier.MethodsThe protease activity of S epidermidis isolates was compared with that of other staphylococcal species. The capacity of S epidermidis to degrade the barrier and induce inflammation was examined by using human keratinocyte tissue culture and mouse models. Skin swabs from atopic and healthy adult subjects were analyzed for the presence of S epidermidis genomic DNA and mRNA.ResultsS epidermidis strains were observed to produce strong cysteine protease activity when grown at high density. The enzyme responsible for this activity was identified as EcpA, a cysteine protease under quorum sensing control. EcpA was shown to degrade desmoglein-1 and LL-37 in&nbsp;vitro, disrupt the physical barrier, and induce skin inflammation in mice. The abundance of S epidermidis and expression of ecpA mRNA were increased on the skin of some patients with AD, and this correlated with disease severity. Another commensal skin bacterial species, Staphylococcus hominis, can inhibit EcpA production by S epidermidis.ConclusionS epidermidis has commonly been regarded as a beneficial skin microbe, whereas S aureus has been considered deleterious. This study suggests that the overabundance of S epidermidis found on some atopic patients can act similarly to S aureus and damage the skin by expression of a cysteine protease

Competition between skin antimicrobial peptides and commensal bacteria in type 2 inflammation enables survival of S. aureus.

During inflammation, the skin deploys antimicrobial peptides (AMPs) yet during allergic inflammation it becomes more susceptible to Staphylococcus aureus. To understand this contradiction, single-cell sequencing of Il4ra-/- mice combined with skin microbiome analysis reveals that lower production of AMPs from interleukin-4 receptor α (IL-4Rα) activation selectively inhibits survival of antibiotic-producing strains of coagulase-negative Staphylococcus (CoNS). Diminished AMPs under conditions of T helper type 2 (Th2) inflammation enable expansion of CoNS strains without antibiotic activity and increase Staphylococcus aureus (S.&nbsp;aureus), recapitulating the microbiome on humans with atopic dermatitis. This response is rescued in Camp-/- mice or after topical steroids, since further inhibition of AMPs enables survival of antibiotic-producing CoNS strains. In conditions of Th17 inflammation, a higher expression of host AMPs is sufficient to directly inhibit S.&nbsp;aureus survival. These results show that antimicrobials produced by the host and commensal bacteria each act to control S.&nbsp;aureus on the skin