Comparison between bipolar diathermy and silk ligation technique during tonsillectomy

Objective: to compare the use of bipolar diathermy and silk ligation in tonsillectomy with respect to operative time and post op hemorrhage, in our setting. Study design: randomized controlled trail. Place and duration of study: nishtar hospital, multan from May 2016 to May 2018.  Methodology: After consent, 234 patients of chronic tonsillitis of 5 to 35 year of age were selected as per inclusion and exclusion criteria. They were randomly divided in to two groups by using lottery method. In group A, tonsillectomy was done and suture ligation was applied for hemostasis. In group B, tonsillectomy was done and bipolar diathermy was used for hemostasis. Data was entered and analyzed by using SPSS software. Results: In our study, mean age was 13.84 + 5.83 years. Majority of patients 55.13% were between 5-15 years of age. Out of 234 patients, 71.37% were male and 28.63% were females. The mean operative time in group A was 29.45 + 9.71 minutes and in group B was 16.37 + 4.38 minutes with p-value <0.0001. Secondary hemorrhage was seen in 2.56% patients in group A (suture ligation group) and 10.56% patients in group B (Bipolar diathermy group) with p-value of 0.016. Conclusion: bipolar diathermy method of hemostasis in tonsillectomy is fast but associated with statistically increase risk of secondary hemorrhage compared to silk ligation. Keywords: tonsillectomy, silk ligation, bipolar diathermy, operative interval, secondary hemorrhage

Mesoporous silica nanoparticles as a compound delivery system in zebrafish embryos

Silica nanoparticles can be efficiently employed as carriers for therapeutic drugs in vitro. Here, we use zebrafish embryos as a model organism to see whether mesoporous silica nanoparticles (MSNPs) can be incorporated to deliver compounds in vivo. We injected 35–40 nL (10 mg/mL) of custom-synthesized, fluorescently-tagged 200 nm MSNPs into the left flank, behind the yolk sac extension, of 2-day-old zebrafish embryos. We tracked the distribution and translocation of the MSNPs using confocal laser scanning microscopy. Some of the particles remained localized at the injection site, whereas others entered the bloodstream and were carried around the body. Embryo development and survival were not significantly affected by MSNP injection. Acridine orange staining revealed that MSNP injections did not induce significant cell death. We also studied cellular immune responses by means of lysC::DsRED2 transgenic embryos. MSNP-injected embryos showed infiltration of the injection site with neutrophils, similar to controls injected with buffer only. In the same embryos, counterstaining with L-plastin antibody for leukocytes revealed the same amount of cellular infiltration of the injection site in embryos injected with MSNPs or with buffer only. Next, we used MSNPs to deliver two recombinant cytokines (macrophage colony-stimulating factor and receptor for necrosis factor ligand) to zebrafish embryos. These proteins are known to activate cells involved in bone remodeling, and this can be detected with the marker tartrate-resistant acid phosphatase. Coinjection of these proteins loaded onto MSNPs produced a significant increase in the number of tartrate-resistant acid phosphatase-positive cells after 2–3 days of injection. Our results show that MSNPs can be used to deliver bioactive compounds into zebrafish larvae without producing higher mortality or gross evidence of teratogenicity

The Operative versus Conservative Approaches in the Management and Treatment of Lumbar Spinal Stenosis

Background: Lumbar Spinal stenosis is the narrowing of the spinal canal at any lumber level. Lumbar spinal stenosis has multiple severities and both conservative and operative treatment options. The objective of the current study was to compare the results of operative and conservative approaches in spinal stenosis treatment. Methods: This cross-sectional study was conducted from January 2019 to June 2019. The data was collected from different hospitals in Lahore (Ittefaq, General, Jinnah, and Hameed Latif). Participants (n=121) of both genders, pre-diagnosed with Lumbar spinal stenosis and symptoms history of 10 weeks (confirmed on imaging) were included. Interventions were decompressive surgery and conventional conservative management. The outcome measures were body pain, functional activities, and the Oswestry Disability Index. An independent sample t-test was used to compare the results between the two groups. A p≤ 0.05 was considered statistically significant. Results: The patients undergoing surgery had statistically significant (p=0.00) advantages of surgery compared to the non-surgical group at 3 months. The 25(36%) of patients remained the same after conservative treatment with 51(72%) having pain radiation and 47(66%) with neurological deficit. The effect of treatment for body pain was 7.8 (95%CI, 8.6, 6.9), physical function −1.3 (95%CI, −0.6, −2.2), and Oswestry Disability Index was −3.4 (95%CI, −2.7, −4.1). Conclusion: Patients who had surgery of spinal stenosis showed marked improvements in body pains, functional activities, and Oswestry disability index compared to conservatively treated. Patients, health care providers, and other stakeholders may get benefit from the findings of this study

4-Bromo-N-cyclo­hexyl­benzene­sulfonamide

The title compound, C12H16BrNO2S, adopts an L-shaped conformation with the central C—S—N—C torsion angle being −77.8 (3)°. The crystal packing features N—H⋯O hydrogen bonds, which lead to C(4) chains propagating in [010]; the second O atom is involved in short intra­molecular C—H⋯O contacts

Volatile Constituents of Leaves of Trifolium alexandrinum

This study presents the volatile constituents from leaves of Trifolium alexandrinum from Pakistan. The dried leaves were subjected to hydrodistillation for extraction and extracted volatile oil was subsequently characterized by gas chromatography-mass spectrometry technique. A total of 22 compounds were identified where the most dominant constituents were: phytol (46.00%), palmitic acid (9.26%), phytol acetate (6.44%), and linolenic acid (3.47%). Most of these are well-known constituents to exhibit antibacterial, antioxidant, antitumor, and anti-inflammatory activities

N-[4-(N-Cyclo­hexyl­sulfamo­yl)phen­yl]acetamide

In the title compound, C14H20N2O3S, the cyclo­hexyl ring adopts a chair conformation: the four coplanar C atoms of this ring make a dihedral angle of 64.8 (2)° with the benzene ring. In the mol­ecule, an intra­molecular C—H⋯O contact generates an S(6) ring motif. In the crystal structure, mol­ecules are linked via inter­molecular N—H⋯O hydrogen bonds into two-dimensional layers propagating in (100)

Preparation of cellulosic Ag-nanocomposites using an ionic liquid

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Cellulose-based nanocomposites have gained much attention due to their remarkable biological properties such as biodegradability, biocompatibility, and low toxicity. In this research work, 1-h-3-methylimidazolium hydrogen sulfate ionic liquid was employed as an efficient solvent for preparation of cellulosic Ag-nanocomposites (CRC/AgNPs composite) from Neem plant. Ionic liquid plays a dual role in obtaining cellulose-rich compound (CRC; removing lignin and hemicellulose components) and plant’s extract (phenolic compounds such as flavonoids, tannins, etc.) that reduces the AgNO 3 into AgNPs for preparation of CRC/AgNPs composite. The prepared CRC/AgNPs composite was characterized using XRD, FTIR and SEM techniques. The XRD and FTIR spectral analysis showed the characteristic peaks assigned to cellulosic constituent and AgNPs. SEM analysis revealed the particles in the range from 26 to 56 nm. The CRC/AgNPs composite was evaluated for its antibacterial and mechanical properties. The antibacterial activity against S. aureus and E. coli for CRC/AgNPs composite was observed in comparison to CRC. Cell viability and morphology were performed on MC3T3-E1 cells which showed no as such toxicity for the prepared CRC/AgNPs composite. Moreover, the addition of CRC/AgNPs composite as a filler increased the compression strength of polymeric materials

Developing A Synthetic Composite Membrane For Cleft Palate Repair

An oronasal fistula is a passage between the oral and nasal cavity. Currently, surgical procedures use mucosal flaps or collagen grafts to make a barrier between oral and nasal cavities. Our aim was to develop a cell-free synthetic repair material for closure of nasal fistulas. We surface functionalized electrospun polyurethane (PU) and poly-L-lactic acid (PLLA) and composite polymer (PU-PLLA) membranes with acrylic acid through plasma polymerization. Membranes were treated in a layer-by-layer approach to develop highly charged electrostatic layer that could bind heparin as a pro-angiogenic glycosaminoglycan. The properties were evaluated through physical, chemical, and mechanical characterization techniques. Cytotoxicity was tested with MC3T3 pre-osteoblast cell lines for 3, 7, and 14 days, and vasculogenesis was assessed by implantation into the chorio-allantoic membrane in chick embryos for 7 days. In vivo biocompatibility was assessed by subcutaneous implantation in rats for 1, 3, and 6 weeks. The membranes consisted of random fibers of PLLA-PU with fiber diameters of 0.47 and 0.12 μm, respectively. Significantly higher cell proliferation and migration of MC3T3 cells at 3, 7, and 14 days were shown on plasma-coated membranes compared with uncoated membranes. Further, it was found that plasma-coated membranes were more angiogenic than controls. In vivo implantation of membranes in rats did not reveal any gross toxicity to the materials, and wound healing was comparable with the native tissue repair (sham group). We therefore present a plasma-functionalized electrospun composite polymer membrane for use in the treatment of fistulas. These membranes are flexible, non-cytotoxic, and angiogenic, and we hope it should lead to permanent closure of oronasal fistula

Evaluating the current ecological status and proposing rehabilitation interventions for the low flooded riparian reserve forest in Punjab Pakistan

Aim of Study: The complex community of riparian reserve forest has become of great concern for researchers to develop more viable management strategies. The paper aimed to evaluate the current structural diversity of vegetation and its association with the physical environment of low-lying forest for proposing the rehabilitation interventions.  Area of Study: We studied two forests, Chung-Mohlanwal and Dhana-Bheni on both riverbanks along river Ravi in the Jhok riparian reserve forest situated in the southwest of Lahore, Pakistan.Material and Methods: A methodological framework was developed based firstly, on direct comparison of diversity (measured by Hill numbers) and structure of existed vegetation layers (trees, shrubs, herbs, and grasses) and environmental factors (canopy structure, anthropogenic activities, microclimate, and soil characteristics) between the two forests and secondly, on environment-vegetation association using Canonical Correspondence Analysis (CCA) ordination method.Results: Dhana forest was more diverse vegetation layers (Shannon Diversity index 1D < 11) and intact due to plantation of uneven-aged tree stands of varied stand basal area and stem density. Microclimate under this forest could not support the dominant understory positively unlike the monoculture forest. On the contrary, Chung-Mohlanwal forest was under the influence of uncontrolled grazing activities, fuelwood extraction, and invasive species. Multivariate analysis CCA elucidated that most variance was shown by soil characteristics (38.5 %) for understory vegetation in both forests.Research Highlights: Overstory stand structure, species composition, distance to nearby communities, and soil characteristics should be considered for developing forest planting and management strategies.Keywords: Vegetation Structure; Hill Numbers; Grazing; Environment; Management.Abbreviation used: CCA (Canonical Correspondence Analysis); 1D (Shannon Diversity); Ca + Mg (Calcium + Magnesium); Na (Sodium); ECe (Electrical Conductivity); DBH (Diameter at Breast Height); IUCN (International Union for Conservation of Nature); SBA (Stand Basal area); BA (Basal Area); 0D (Richness); 2D (Simpson Index); IVI (Importance Value Index); LU (Livestock Unit); GPS (Global Positioning System); OC (Organic Carbon); OM (Organic matter); SAR (Sodium Adsorption Ratio); N (Nitrogen); P (Phosphorous); K (Potassium); DCA (Detrended Correspondence Analysis); S (Shrub); H (Herb); G (Grass)

Does the ultrasound imaging predict lower limb tendinopathy in athletes: a systematic review

Abstract Background To conduct a systematic review looking into the possibility of US imaging to anticipate and identify future patellar or Achilles tendinopathy symptoms. Methods The studies that were taken into consideration for this review were prospective studies that employed baseline US imaging of the patellar OR Achilles tendons in asymptomatic patients and follow-up measures of pain and/or function. Two impartial reviewers evaluated the study’s quality using the Critical Appraisal Skills Programme instrument. Results Participants in the included studies in this review came from various sports. The systematic review revealed a link between baseline tendon abnormalities in the US and a higher chance of developing both patellar and Achilles tendinopathy as well as their future occurrence. Nine of the included studies examined the patellar tendon alone, eight the patellar and Achilles tendon together, and four the Achilles tendon exclusively. For both tendons, US administration is done in a largely consistent manner. The tendon abnormalities of tendon thickness, hypoechogenicity and vascularity at baseline were associated with an increased risk of both Achilles and patellar tendinopathy. Conclusions This systematic review shows that abnormal tendon structures seen by US in asymptomatic persons can predict the development of tendinopathy