Internet of Bio Nano Things-based FRET nanocommunications for eHealth

The integration of the Internet of Bio Nano Things (IoBNT) with artificial intelligence (AI) and molecular communications technology is now required to achieve eHealth, specifically in the targeted drug delivery system (TDDS). In this work, we investigate an analytical framework for IoBNT with Forster resonance energy transfer (FRET) nanocommunication to enable intelligent bio nano thing (BNT) machine to accurately deliver therapeutic drug to the diseased cells. The FRET nanocommunication is accomplished by using the well-known pair of fluorescent proteins, EYFP and ECFP. Furthermore, the proposed IoBNT monitors drug transmission by using the quenching process in order to reduce side effects in healthy cells. We investigate the IoBNT framework by driving diffusional rate models in the presence of a quenching process. We evaluate the performance of the proposed framework in terms of the energy transfer efficiency, diffusion-controlled rate and drug loss rate. According to the simulation results, the proposed IoBNT with the intelligent bio nano thing for monitoring the quenching process can significantly achieve high energy transfer efficiency and low drug delivery loss rate, i.e., accurately delivering the desired therapeutic drugs to the diseased cell

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Abnormal uterine bleeding in midlife: The role of levonorgestrel intrauterine system

Abnormal uterine bleeding is a common gynecological complaint affecting 10-30% of women in midlife and constitute about one-third of all outpatient gynecological visits. It adversely affects the quality of woman′s life and can lead to psychological, social, medical, and sexual problems and thus necessitating appropriate and adequate management. Different treatment modalities for such problems are available, yet the levonorgestrel intrauterine system (LNG-IUS) has recently provided a good treatment option effective in treating such complaints and at the same time, having a reliable contraceptive effect which is desired by such age group. For women in their reproductive years, the LNG-IUS has become one of the most acceptable medical treatments for menorrhagia, reducing referrals to specialists, and decreasing the recourse to operative treatments. It is easy to insert, has a sustained effect, cost-effective, and well tolerated besides providing reliable contraception

Hysteroscopic evaluation of tubal peristaltic dysfunction in unexplained infertility

It has been realised that rhythmic peristalsis of the ostia and tubes can be observed during hysteroscopy. The aim of this study was to examine the presence of tubal peristaltic dysfunction in unexplained infertility (UI). Hysteroscopy was performed in 35 women with UI and in 37 healthy fertile women. Bilateral tubal peristalses were assessed hysteroscopically by the observation of methylene blue injection and its transport to the Fallopian tubes. Tubal patency was evaluated with laparoscopic chromopertubation. Two women in control group (6.67%) and eight women in UI group (30.77%) had no tubal peristalsis, at least one tube with normal tubal patency. The difference was statistically significant (p = .019). Tubal peristaltic dysfunction may be a hidden cause of subfertility in women with bilateral patent Fallopian tubes. There is a definite need for larger trials to identify tubal peristaltic dysfunction as a cause of UI.Impact statement What is already known on this subject? Unexplained infertility has no identified pathophysiologic basis. It has been realised that rhythmic peristalsis of the ostia and tubes can be observed during hysteroscopy. What do the results of this study add? Tubal peristaltic dysfunction was detected in two tubes (3.70%) in a control group and nine tubes (19.57%) in women with unexplained infertility, when the tubes were patent. The difference was statistically significant (p = .012). What are the implications of these findings for clinical practice and/or further research? In cases of bilateral patent Fallopian tubes such as in unexplained infertility, tubal peristaltic dysfunction may be a hidden additional cause of subfertility

Laparoscopic management of ovarian dermoid cysts

Objective: To evaluate the safety and potential advantages of laparoscopic approach for management of ovarian dermoid cysts. Design: Retrospective study. Methods: From May 1999 to February 2002, 28 patients underwent laparoscopic removal of dermoid cysts. Intervention: Exposure of Douglass pouch and avoidance of Trenedelenberg's position offered guarantee that any spilled material will be collected and confined to Cul de sac only with no further spread. After removal of cyst, we perform forceful jet wash lavage and aspiration simultaneously using wide bored 2 canulae from both lateral ports using copious amount of fluid (8-12 liters) Results: Thirty-one dermoid cysts with mean diameter of 7.5 centimeter were removed successfully in 28 patients. The operative techniques employed were ovarian cystectomy for 28 cysts, salpingo-oophrectomy for 3 cysts and one case had salpingo-oophrectomy together with LAVH. In one case we performed concomitant hysteroscopic excision of complete uterine septum. Fourteen cysts were removed through enucleation and removal through trocar sleeve. Ten cases were treated via enucleation and removal within impermeable endobag. Seven cases were managed by removal of cysts via posterior colpotomy; one of them was associated during step of LAVH. We encountered total of fourteen spillages during the procedures. Spillage occured in 10 cases (71%) in instance of trocar removal without the use of endo bag, one case (10%) for removal within impermeable endo bag, and 3 cases (42%) in cases of colpotomy removal. No spillage occurred in the case of LAVH. Mean hospital stay after surgery was 0.9 day, and there were no significant intraoperative complications apart from inferior epigastric injury at site of secondary puncture. Conclusion: After we did review of 14 studies in the literature added to our study, we revealed only 0.2% incidence of chemical peritonitis following laparoscopic removal of dermoid cysts. Laparoscopic approach allows proper exposure of Cul de sac and allows forceful jet lavage aspiration ensuring pelvic clean out from any microscopic material of the dermoid cyst. A situation may not be available during open laparotomy

Accuracy of a new hysteroscopic method in the assessment of tubal patency: Hysteroscopic Chromotubation

Objective The aim of this study was to evaluate the diagnostic accuracy of hysteroscopic chromopertubation (HCT) in the assessment of tubal patency by comparing its results with laparoscopic chromopertubation (LCT). Study Design The population of this prospective cohort study consisted of both fertile and infertile women. Sixty-four women were included to the study. HCT was assessed by the observation of the transport of highly concentrated methylene blue from uterine cavity to tubal ostia. The results of HCT were compared with the results of LCT as a gold standard. The accuracy of HCT, sensitivity, specificity, positive and negative predictive values in diagnosing tubal patency were calculated. Results The results of HCT and LCT were evaluated for right and left tubes, separately. One hundred and twenty-eight tubes were determined. Sensitivity, specificity, positive and negative predictive values for HCT were; 85.85%, 59.09%, 91% and 46.43%, respectively. Conclusion This study’s result showed that HCT had high sensitivity and moderate specificity values in the assessment of tubal patency. HCT during office hysteroscopy could give the chance to practitioners to assess tubal patency without subjecting the patient to multiple procedures

The percentage of protein expression of different studied markers in the studied groups

<p><b>Copyright information:</b></p><p>Taken from "The possible role of cell cycle regulators in multistep process of HPV-associated cervical carcinoma"</p><p>BMC Clinical Pathology 2007;7():4-4.</p><p>Published online 24 May 2007</p><p>PMCID:PMC1894982.</p><p></p