A comparative study of laparoscopic cholecystectomy with and without abdominal drain

Background: Laparoscopic surgery has several advantages when compared to open surgery, including faster post-operative recovery and lower pain scores. Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Routine drainage after laparoscopic cholecystectomy is an issue of considerable debate.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sub hepatic fluid collection on first ultrasound at 24hrs was higher in drained group than in non-drained groups. Further, the difference became insignificant on subsequent ultrasound at 72hrs. Incidence of post-operative drain site pain was present in 25% of patients with drain (more at drain site). Incidence drain site infection was present in 16.6% of patients in drain group. Majority of the patients with drain group (n=24) required hospital stay for ≥3 days, while for majority of patients without drain group (n=20), required hospital stay was 1 day.Conclusions: An uncomplicated gall stone disease can be treated by laparoscopic cholecystectomy without need for drain with reasonable safety by an experienced surgeon. With no usage of drain, it is significantly advantageous in terms of post-operative pain, use of analgesics and hospital stay

Role of triple assessment modalities in diagnosis of palpable breast lump

Background: One fourth of women suffer from breast disease in their lifetime. Carcinoma of breast is the second most common cancer in the world. Timely and accurate diagnosis of breast lump with early intervention can be life saving. There are various modalities for the diagnosis of breast lump such as USG, FNAC and Mammography, MRI etc. but none of them is perfect. There are numerous reports suggesting that if the results of clinical assessment, mammography and FNAC are all combined, the diagnostic accuracy is nearly 100%. Furthermore, these techniques also provide information about tumor size, number, extent and grade preoperatively.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sensitivity, specificity and accuracy of triple test in present study were 98.68%, 87.5%, and 96% respectively. Out of 100, 76 patients were confirmed as having benign lesion and 24 patients having malignant lesion by histopathology examination.Conclusions: Results of triple assessment are same as the results by histopathology examination in majority of cases. It is highly accurate, can be used as a confirmatory diagnostic tool for breast lump, thus there is no need to perform diagnostic open biopsy for breast lump

A study of skin closure of surgical wound by subcuticular sutures with polyglactin 910 fast (rapide vicryl) in planned surgery

Background: The skin is the largest and among the most complex organs of the body. Although the skin functions simply as a protective barrier to interface with our environment, its structure and physiology are complex. Suturing is commonly used today as a mean by which wounds are closed to prevent infection and fasten healing with minimal scarring. Cosmetic results of healed wound are also important and as awareness is increasing among general population, they are more concerned with cosmetic scar. Various techniques are developed to give cosmetically better scar, like subcuticular suture, adhesive tapes, staplers, etc.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: Cosmetic result of the study were good; 87% patients were having good to excellent cosmetic results. And 13% patients were having scar which was cosmetically not good (scar was either hypertrophied or thickened). complication was not significant (only 3% having on post-operative day 5).Conclusions: Surgical wound closure with subcuticular suture with absorbable suture material gives excellent cosmetic results, cheaper and cost-effective compare to other technique of wound closure having similar cosmetic result. As the removal of suture is not required, no follow up visit needed, and it saves the extra time and expenditure of patient

DNA binding shifts the redox potential of the transcription factor SoxR

Electrochemistry measurements on DNA-modified electrodes are used to probe the effects of binding to DNA on the redox potential of SoxR, a transcription factor that contains a [2Fe-2S] cluster and is activated through oxidation. A DNA-bound potential of +200 mV versus NHE (normal hydrogen electrode) is found for SoxR isolated from Escherichia coli and Pseudomonas aeruginosa. This potential value corresponds to a dramatic shift of +490 mV versus values found in the absence of DNA. Using Redmond red as a covalently bound redox reporter affixed above the SoxR binding site, we also see, associated with SoxR binding, an attenuation in the Redmond red signal compared with that for Redmond red attached below the SoxR binding site. This observation is consistent with a SoxR-binding-induced structural distortion in the DNA base stack that inhibits DNA-mediated charge transport to the Redmond red probe. The dramatic shift in potential for DNA-bound SoxR compared with the free form is thus reconciled based on a high-energy conformational change in the SoxR–DNA complex. The substantial positive shift in potential for DNA-bound SoxR furthermore indicates that, in the reducing intracellular environment, DNA-bound SoxR is primarily in the reduced form; the activation of DNA-bound SoxR would then be limited to strong oxidants, making SoxR an effective sensor for oxidative stress. These results more generally underscore the importance of using DNA electrochemistry to determine DNA-bound potentials for redox-sensitive transcription factors because such binding can dramatically affect this key protein property

Redox Couples of Inducible Nitric Oxide Synthase

We report direct electrochemistry of the iNOS heme domain in a DDAB film on the surface of a basal plane graphite electrode. Cyclic voltammetry reveals Fe^(III/II) and Fe^(II/I) couples at −191 and −1049 mV (vs Ag/AgCl). Imidazole and carbon monoxide in solution shift the Fe^(III/II) potential by +20 and +62 mV, while the addition of dioxygen results in large catalytic waves at the onset of Fe^(III) reduction. Voltammetry at higher scan rates (with pH variations) reveals that the Fe^(III/II) cathodic peak can be resolved into two components, which are attributable to Fe^(III/II) couples of five- and six-coordinate hemes. Digital simulation of our experimental data implicates water dissociation from the heme as a gating mechanism for ET in iNOS

Unnatural Amino Acid Incorporation into Virus-Like Particles

Virus-like particles composed of hepatitis B virus (HBV) or bacteriophage Qβ capsid proteins have been labeled with azide- or alkyne-containing unnatural amino acids by expression in a methionine auxotrophic strain of E. coli. The substitution does not affect the ability of the particles to self-assemble into icosahedral structures indistinguishable from native forms. The azide and alkyne groups were addressed by Cu(I)-catalyzed [3 + 2] cycloaddition: HBV particles were decomposed by the formation of more than 120 triazole linkages per capsid in a location-dependent manner, whereas Qβ suffered no such instability. The marriage of these well-known techniques of sense-codon reassignment and bioorthogonal chemical coupling provides the capability to construct polyvalent particles displaying a wide variety of functional groups with near-perfect control of spacing

A complete 3D numerical study of the effects of pseudoscalar-photon mixing on quasar polarizations

We present the results of three-dimensional simulations of quasar polarizations in the presence of pseudoscalar-photon mixing in the intergalactic medium. The intergalactic magnetic field is assumed to be uncorrelated in wave vector space but correlated in real space. Such a field may be obtained if its origin is primordial. Furthermore we assume that the quasars, located at cosmological distances, have negligible initial polarization. In the presence of pseudoscalar-photon mixing we show, through a direct comparison with observations, that this may explain the observed large scale alignments in quasar polarizations within the framework of big bang cosmology. We find that the simulation results give a reasonably good fit to the observed data.Comment: 15 pages, 8 figures, significant changes, to appear in EPJ

Targeting the glycine-rich domain of TDP-43 with antibodies prevents its aggregation in vitro and reduces neurofilament levels in vivo

Cytoplasmic aggregation and concomitant nuclear clearance of the RNA-binding protein TDP-43 are found in similar to 90% of cases of amyotrophic lateral sclerosis and similar to 45% of patients living with frontotemporal lobar degeneration, but no disease-modifying therapy is available. Antibody therapy targeting other aggregating proteins associated with neurodegenerative disorders has shown beneficial effects in animal models and clinical trials. The most effective epitopes for safe antibody therapy targeting TDP-43 are unknown. Here, we identified safe and effective epitopes in TDP-43 for active and potential future passive immunotherapy. We prescreened 15 peptide antigens covering all regions of TDP-43 to identify the most immunogenic epitopes and to raise novel monoclonal antibodies in wild-type mice. Most peptides induced a considerable antibody response and no antigen triggered obvious side effects. Thus, we immunized mice with rapidly progressing TDP-43 proteinopathy (rNLS8 model) with the nine most immunogenic peptides in five pools prior to TDP-43 Delta NLS transgene induction. Strikingly, combined administration of two N-terminal peptides induced genetic background-specific sudden lethality in several mice and was therefore discontinued. Despite a strong antibody response, no TDP-43 peptide prevented the rapid body weight loss or reduced phospho-TDP-43 levels as well as the profound astrogliosis and microgliosis in rNLS8 mice. However, immunization with a C-terminal peptide containing the disease-associated phosphoserines 409/410 significantly lowered serum neurofilament light chain levels, indicative of reduced neuroaxonal damage. Transcriptomic profiling showed a pronounced neuroinflammatory signature (IL-1 beta, TNF-alpha, Nf-kappa B) in rNLS8 mice and suggested modest benefits of immunization targeting the glycine-rich region. Several novel monoclonal antibodies targeting the glycine-rich domain potently reduced phase separation and aggregation of TDP-43 in vitro and prevented cellular uptake of preformed aggregates. Our unbiased screen suggests that targeting the RRM2 domain and the C-terminal region of TDP-43 by active or passive immunization may be beneficial in TDP-43 proteinopathies by inhibiting cardinal processes of disease progression