Three port versus four port laparoscopic cholecystectomy: a prospective comparative clinical study

Background: Although, traditional laparoscopic cholecystectomy is performed using four-port technique, various modifications were made to further enhance the advantages of laparoscopic cholecystectomy. Aim of the study is to compare the results of three-port and four-port laparoscopic cholecystectomy at single center in terms of technical feasibility, safety of the procedure, operative time, intra-operative complications, postoperative pain and post-operative analgesia requirementMethods: It was a  prospective comparative study conducted  in the department of surgery Skims Medical college Srinagar, India from July 2015 to March 2017. The study was performed on all adult patients with ultrasound documented cholelithiasis and gall bladder Polyposis. The total number of patients studied was 100 which were divided into two groups of 50 each.Results: The average operative time in three port group was 29.2 minutes (range, 15-37) compared to 30.66 minutes (range, 15-42) in four port group, which was statistically insignificant. The final visual analog scores for pain in the postoperative period was 2.30 vs 2.86 in three port and four port group respectively, with a P value=0.008, which was statistically significant.Conclusions: The three-port technique is as safe as the standard four-port technique and can be a viable alternative to four port cholecystectomy with an advantage of less pain and less analgesic requirement and better cosmetic results

Chest X-Ray as a Diagnostic and Prognostic Tool For Covid-19; A Tertiary Care Hospital Based Study

Introduction: The radiological investigations are not diagnostic of COVID-19 disease but help in management. CT scan is not available worldwide; therefore, x-ray chest (CXR) is ideal for assessment of disease severity using scoring system. This study was conducted to see various CXR findings and relation of severity with outcome. Materials and Methods: This study was conducted at Dallah hospital Saudi Arabia. All admitted confirmed cases of COVID-19, above age of 18-year were included. CXR were done at baseline, after 5-7 days and after 13-15 days. Patient with previous heart failure, chronic obstructive pulmonary diseases or pulmonary fibrosis, Pregnant and lactating ladies were also excluded. Results: Out of total 629 patients 67.6 % were males. There was no statically significant difference in mortality in male to female patients. The mean age was 42.67+15.13 (range 18-83) years. Patients with age more than 50-year were 58.9% and had severe infection (p=0.041) with high mortality (p=0.045). The 63% patients had abnormal CXR at baseline. The common CXR features detected were consolidation (45%), followed by ground glass appearance (43%). Only 0.8% patients had pleural effusion and one patient with pneumothorax. Patients with bilateral lung infiltration was 67.5% and mostly it was in lower zones (63%). The follow-up CXR revealed an increase in severity score related to mortality (p<0.001). Conclusion: In COVID-19 infection CXR may be a predictor of severity of disease and monitoring of disease may be done by serial CXR

2-[2-(1,3-Dioxoisoindolin-2-yl)acetamido]­acetic acid

The title mol­ecule, C12H10N2O5, is non-planar with dihedral angles of 89.08 (7) and 83.21 (7)° between the phthalimide and acetamide mean planes, and the acetamide and acetic acid mean planes, respectively. In the crystal, symmetry-related mol­ecules are linked via N—H⋯O and O—H⋯O hydrogen bonds, forming an undulating two-dimensional network. There are also a number of weak C—H⋯O inter­actions, leading to the formation of a three-dimensional arrangement

Extensive study of flow characters for two vertical rectangular polygons in a two-dimensional cross flow

Fluid dynamics problems have a significant impact on the growth of science and technologies all over the world. This study investigates viscous fluid’s behavior when interacting with two rectangular polygons positioned vertically and aligned in a staggered configuration. Two physical parameters, Reynolds Number and Gap spacings, are discussed using the Lattice Boltzmann Method for two-dimensional flow. Results are discussed in vortex snapshots, time trace histories of drag and lift coefficient, and power spectra analysis of lift coefficient. Nine distinct flow vortex streets are identified based on increasing gap spacings between the pair of two rectangular polygons. The vortex shedding mechanism is disturbed at small gap spacings and becomes optimal at large gap spacings. Different physical parameters of practical importance, like mean drag coefficient, root mean square values of drag coefficient, root mean square values of lift coefficient, and Strouhal number, approach the single rectangular polygon value at large gap spacings

catena-Poly[[triphenyl­tin(IV)]-μ2-[3-(cyclo­hexyl­carbamo­yl)propanoato-κ2 O 1:O 3]]

The Sn atom in the polymeric title compound, [Sn(C6H5)3(C10H16NO3)]n, is five-coordinated within a trans-C3O2 donor set that defines an approximate trigonal-bipyramidal geometry. The carboxyl­ate ligand is monodentate and the amide O atom bridges a symmetry-related Sn atom, generating a chain along [010] with a linear topology. An intra­molecular carboxyl­ate–carbonyl N—H⋯O hydrogen bond is responsible for the curved conformation within the carboxyl­ate ligand