Accidental Death due to Carbon Monoxide: Case Report

Background: Carbon monoxide (CO) is a colorless, odorless gas produced as a by-product of incomplete combustion of hydrocarbons. CO binds rapidly to Haemoglobin (Hb), leading to the formation of carboxyhemoglobin (COHb), so the oxygen carrying capacity of the blood will be decreased and causing tissue hypoxia.Case Report: A 35-years-old male mechanic was found unconscious at automobile garage and he was dead after hospitalization on same day after one hour. On external examination, Rigor mortis had occurred all over the body. Cherry red postmortem lividity was present over back. Hypostasis, sub-scalpel tissue, muscles of chest and abdominal wall were cherry red in color suggestive of carbon monoxide toxicity. The chemical analysis report of blood and viscera confirmed toxicity due to carbon monoxide poisoning.Conclusion: Accidental carbon monoxide poisoning in vehicles can occur due to leaking exhausts and inadequate ventilation, but some cases in fatal concentration of CO was found even with garage door had opened or in the absence of defective exhaust systems. Each of the CO poisoning hazard scenarios reflects either product malfunction resulting in high CO emissions and/or some failure to adequately remove CO from the living or recreational environment. Use of catalytic converters in vehicles has reduced carbon monoxide emission considerably. The sudden death of a mechanic due to excessive inhalation of the carbon monoxide gas due to defective exhaust systems and poorly ventilated in automobile garage.

Enhancing colorectal anastomotic safety with indocyanine green fluorescence angiography: An update.

Reducing anastomotic leak (AL) continues to be a main focus in colorectal research. Several new technologies have been developed with an aim to reduce this from mechanical devices to advanced imaging techniques. Fluorescence angiography (FA) with indocyanine green (ICG) in colorectal surgery is now a well-established technique and may have a role in reducing AL. By using FA, we are able to have a visual representation of perfusion which aids intraoperative decision making. The main impact is change in the level of bowel transection at the proximal side of an anastomosis and provide a more objective and confident assessment of bowel perfusion. Previous studies have shown that routine FA use is safe and reproducible. Recent results from randomized control trials and meta-analyses show that FA use reduces the rate of anastomotic leak. The main limitation of FA is its lack of ability to quantify perfusion. Novel technologies are being developed that will quantify tissue perfusion and oxygenation. Overall, FA is a safe and feasible technique which may have a role in reducing AL

Role of Digital Resources in Minimally Invasive Colorectal Surgery Training

Laparoscopic techniques have become the standard for many benign and malignant colorectal pathologies. Recently, the application of robotic-assisted technologies has been, and continues to be, explored. These new technologies require different skill sets and bring novel training challenges, and today's trainees must demonstrate competence in more techniques than ever. Compounding this is the reducing time spent operating in current training programs due to caps on working hours and service pressures. The need for adjunctive training strategies outside the operating room has prompted development of multimedia and digital resources to build the cognitive skills crucial in both nontechnical and technical aspects of surgery. Many are based on principles of cognitive task analysis, breaking down operations, and key decisions into nodal points to be mentally rehearsed. Resources built on this technique have shown improvements in both operative and nonoperative skills, suggesting these resources can advance trainees along the learning curve in minimally invasive surgical techniques. More work to fully elucidate the clinical benefits of such resources is required before their role as a substitute for lost operative training hours can be established. Despite this, alongside other developing technologies such as simulation, they are a promising addition to the armamentarium of the modern-day colorectal trainee

Hereditary sensory autonomic neuropathy II, a rare disease in a large Pakistani family

Hereditary Sensory Autonomic Neuropathy II (HSAN II) is a rare genetic disorder, characterized by severe loss of pain, temperature and touch sensation. Injuries in these patients can progress to necrosis and shedding of digits and limbs. Here we report two cases of HSAN II belonging to a Pakistani family. Individual 1, a forty five year old man, had complete loss of pain sensation since birth. Self-mutilation and complication of injuries resulted in the shedding of all the digits and right foot and surgical amputation of left leg. Individual 2, a five year old girl,had delay in healing of wounds and self-mutilation. Examination showed a complete lack of pain sensation throughout her body and hyporeflexia. As the genetic cause of HSAN II is unknown, identification of more patients will allow further research on this disease and possibly develop a cure

TO ASSESS THE KNOWLEDGE AND ATTITUDE OF ADOLESCENTS REGARDING THE ADVERSE EFFECTS OF SOCIAL NETWORKING AT S.G.R.R PUBLIC SCHOOL, PATEL NAGAR, DEHRADUN, UTTRAKHAND

Objectives: The aim of the study is to assess the knowledge and attitude of adolescents regarding the adverse effects of social networking. Methods: A descriptive research design was adopted for the study, conducted at S.G.R.R Public School, Patel Nagar, Dehradun, Uttarakhand. Non-probability purposive sampling technique is used for data collection, knowledge questionnaire and Likert scale is used for the study. Results: The study results reveals that 2.5% of participants were having adequate knowledge. Moderate knowledge score was 92.5%. Inadequate knowledge score was 5%. Likert scale shows that 42% of adolescents are agree, 35.2% are strongly disagree, 28.8% are strongly agree, 28.4% are neutral, and 26.4% are disagree. Conclusion: The conclusion of the study reveals that the moderate knowledge score was 92.5% and in Likert scale highest percentage, 42% of adolescents are agree, so the attitude regarding adverse effects of social networking is positive

The adsorptive removal of a cationic drug from aqueous solution using poly (methacrylic acid) hydrogels

This study describes adsorptive removal of the antibiotic drug ciprofloxacin hydrochloride from simulated water using poly(methacrylic acid) (PMAA) as adsorbent. The adsorbent was characterised by various instrumental techniques such as X-ray diffraction (XRD), differential scanning calorimetry (DSC), and Fourier transform infrared (FTIR) spectroscopy. The adsorption equilibrium data, as studied at 3 temperatures, namely, 15, 25 and 37°C, were best interpreted by the Langmuir adsorption isotherm model.  Moreover, an increase in temperature reduces drug uptake. A pH of the adsorption system in the range of 5.0 to 8.0 causes maximum adsorption of the drug. The presence of drug molecules in the adsorbent particles was shown by various techniques: X-ray diffraction (XRD), differential scanning calorimetry (DSC), Fourier transform infrared (FTIR) spectroscopy and  scanning electron microscopy (SEM) analysis. Antibacterial studies also  reveal the adsorption of the drug from solution.Keywords: Adsorption, ciprofloxacin, Langmuir isotherm, X-ray diffraction, Fourier transform infrared (FTIR) spectroscop

The Challenge of Augmented Reality in Surgery

Imaging has revolutionized surgery over the last 50 years. Diagnostic imaging is a key tool for deciding to perform surgery during disease management; intraoperative imaging is one of the primary drivers for minimally invasive surgery (MIS), and postoperative imaging enables effective follow-up and patient monitoring. However, notably, there is still relatively little interchange of information or imaging modality fusion between these different clinical pathway stages. This book chapter provides a critique of existing augmented reality (AR) methods or application studies described in the literature using relevant examples. The aim is not to provide a comprehensive review, but rather to give an indication of the clinical areas in which AR has been proposed, to begin to explain the lack of clinical systems and to provide some clear guidelines to those intending pursue research in this area