Day case laparoscopic cholecystectomy in Sudan

Background: Laparoscopic surgery faces lots of constraints in the less developing countries. The aim: To audit day-case laparoscopic cholecystectomy in our set up in Sudan. Method: Prospective collection of data for 602 consecutive laparoscopic cholecystectomies. 136 patients were discharged 10 hours after surgery. They were selected according to clinical and social criteria. Pain, nausea and vomiting, operative time, period of hospitalization and patient satisfaction were studied. Results: 136 patients operated as day case have mean (±SD) age 46.92(± 14.95) years and ASA score I (n = 122), II (n = 14) and their mean operative time (±SD) was 61.62 (±24.17) (range 25-150) min. There was no conversion or common bile duct injury. 122 patients were pleased with the day case procedure, 12 were satisfied and two thought that overnightstay could have been better. Conclusion: Success of day case laparoscopic cholecystectomy is reflected by the annual steadily increasing number of patients from 25 in 1998 to 50 in 2002. Good planning, patient selection, and encouragement of early mobilization make postoperative hospitalization unnecessary in the majority of cases. Keywords: ambulatory cholecystectomy, laparoscopic cholecystectomy Sudan Journal of Medical Sciences Vol. 1(1) 2006: 48-5

Sponge media drying using a swirling fluidized bed dryer

Surface preparation today has seen the introduction of sponge media as an alternative product against the traditionally used abrasive materials. Being soft and elastic, the sponge media reduces air borne emission significantly during surface preparation with capability to be re-used. However the environmental conditions limit the sponge media usage whereby wet surroundings prohibit the re-use of the sponge without being dried properly. This study proposes the swirling fluidized bed dryer as a novel drying technique for sponge media. Batch experiments were conducted to study the bed’s hydrodynamics followed by drying studies for three bed loadings of 0.5 kg, 0.75 kg and 1.0 kg at three drying temperatures of 80°C, 90°C and 100°C. It was found that, minimum fluidization velocities for the wet sponge particles were found to be 1.342, 1.361 and 1.382 m/s with minimum swirling velocities of 1.400, 1.469 and 1.526 m/s. Drying times were recorded between 6 to 16 minutes depending on bed loading and drying temperature. Smaller bed weights exhibits faster drying with constant-rate drying period while higher drying temperature and larger bed load resulted in falling-rate drying period. Thin layer modelling for the falling-rate region indicates that Verma et. al model provides the best fit for the present experimental data with coefficient of determination, R2 = 0.98773, root mean square error, RMSE = 0.05048, residuals = 0.3442 and reduced chi-square, χ2 = 0.00254. The effective diffusivity, Deff, for 0.5 kg bed load was found to be 3.454 x 10-9 m2/s and 1.751 x 10-9 m2/s for 0.75 kg bed load. In conclusion, SFBD was found to be a viable and efficient method in drying of sponge media for various industrial applications particularly surface preparation

Chest wall reconstruction still has place in Today’s modern practice:" a tertiary center experience"

Background: The key factor following chest wall resection is the preservation of the stability and integrity of the chest wall to support the respiration and protect the underlying organs. The present study aims to evaluate the use of the available grafts and prosthetic materials at our center in chest wall reconstruction with adherence to the proper surgical techniques, good perioperative and postoperative care to obtain good results. Methods: This is a retrospective single center study that concludes all patients underwent chest wall reconstruction for a variety of defects resulting from resection of tumors, trauma due to primarily firearms or motor car accidents, resection of radio necrotic tissues, infection and dehiscence of median sternotomy wounds after cardiac surgery.  Results: Study population consisted of 30 patients between January 2015and may 2018, among them were 20 male (70%) and 10 female patients (30%), with a median age of 43 ± 16.3 years, resection and reconstruction was performed in 23 cases (15 neoplastic,5 infective and  3 firearm cases) while reconstruction alone was performed in 7 (traumatic flail chest)  cases. Eighteen patients, underwent rib resection with an average 4.18 ± 2.2 ribs (range 2-6). Associated lung resection was performed in 5 patients (27.8 %): diaphragmatic resection was done in 2 cases in addition total sternal resection was performed in 5 cases. Most of the patients (96.7%) had primary healing of their wounds. there was one death (3.3%) in the early postoperative period. The average length of hospital stay for all patients was 8.7 days (range: 5–15). Respiratory complications occurred in three cases in the form of atelectasis and pneumonia at the ipsilateral side of reconstruction. Three cases suffered wound seroma which successfully managed by daily dressing and antibiotic coverage. Conclusions: according to our study and the analysis of similar studies, adequate perioperative preparation of patient undergoing chest wall resection and reconstruction with adherence to effective surgical techniques allowed us to use the available materials at our center for chest wall reconstruction with good and effective results without adding burden in terms of cost on the patient

Ascorbic Acid Induces the Increase of Secondary Metabolites, Antioxidant Activity, Growth, and Productivity of the Common Bean under Water Stress Conditions

One of the most vital environmental factors that restricts plant production in arid and semi-arid environments is the lack of fresh water and drought stress. Common bean (Phaseolus vulgaris L.) productivity is severely limited by abiotic stress, especially climate-related constraints. Therefore, a field experiment in split-plot design was carried out to examine the potential function of ascorbic acid (AsA) in mitigating the adverse effects of water stress on common bean. The experiment included two irrigation regimes (100% or 50% of crop evapotranspiration) and three AsA doses (0, 200, or 400 mg L−1 AsA). The results revealed that water stress reduced common bean photosynthetic pigments (chlorophyll and carotenoids), carbonic anhydrase activity, antioxidant activities (2,2-diphenyl-1-picrylhydrazyl free radical activity scavenging activity and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical cation assay), growth and seed yield, while increased enzymatic antioxidants (peroxidase), secondary metabolites (phenolic, flavonoids, and tannins), malondialdehyde (MDA), and crop water productivity. In contrast, the AsA foliar spray enhanced all studied traits and the enhancement was gradual with the increasing AsA dose. The linear regression model predicted that when the AsA dose increase by 1.0 mg L−1, the seed yield is expected to increase by 0.06 g m−2. Enhanced water stress tolerance through adequate ascorbic acid application is a promising strategy to increase the tolerance and productivity of common bean under water stress. Moreover, the response of common bean to water deficit appears to be dependent on AsA dose

Magnetotransport properties of La0.67Ca0.33MnO3 with different grain sizes

The magnetotransport and magnetoresistive (MR)properties of manganese-based La0.67Ca0.33MnO3 perovskite with different grain sizes are reported. The electrical resistivity was measured as a function of temperature in magnetic fields of 0.5 and 1 T. The insulator–metal transition temperature, TIM, shifted to a higher temperature with the application of the magnetic field. In zero field, TIM is almost constant (∼271 K) for all samples except for the sample with the largest grain size, where TIM = 265 K. The temperature dependence of resistivity was fitted with several equations in the metallic (ferromagnetic) region and the insulating (paramagnetic) region. The density of states at the Fermi level, N(EF), and the activation energy of electron hopping were estimated by fitting the resistivity versus temperature curves. The ρ–T 2 curves are nearly linear in the metallic regime, but the ρ–T 2.5 curves exhibit a deviation from linearity. The variable range hopping model and small polaron hopping model fit the data well in the high-temperature region,indicating the existence of the Jahn–Teller distortion that localizes the charge carriers. MR was found to increase with an increase in the magnetic field, an effect which is attributed to the intergrain spin tunneling effect

Cisplatin augments the anti-schistosomal effect of praziquantel in a schistosoma-infected cancer model

Schistosomiasis is the third most devastating tropical disease worldwide caused by blood flukes of the genus Schistosoma. Praziquantel (PZQ) is the drug of choice for treating all species of schistosomes. However, PZQ kills only adult Schistosoma worms, not immature stages. The inability of PZQ to abort early infection or prevent re-infection, and the lack of prophylactic effect prompt the need for novel drugs and strategies for the prevention of schistosomiasis. Tumor burden can be developed in Schistosoma-infected patients. The present study aimed to determine the host responses to mutual interaction between cancer, represented by Ehrlich ascites, and infection, represented by Schistosomiasis. Mice infected with Schistosoma and challenged with tumor 4-5 weeks later showed the same anti-schistosomal (worm and egg burden) and antitumor (total tumor cell count and mouse survival) parameters when compared to mice infected with Schistosoma alone or challenged with tumor cells alone. As expected, combinatorial treatment with PZQ and cisplatin of Schistosoma-infected mice that were challenged with tumor cell line decreased the tumor burden as well as the worm and egg burden after treatment as compared to the non-treated controls; while the worm burden and egg counts were significantly decreased (P <0.001) in treated group (VI) treated with cisplatin (0.5 mg/kg), group (VII) treated with cisplatin (2 mg/kg), group (VIII) treated with PZQ/ cisplatin (0.5 mg/kg) and group (IX) treated with PZQ / cisplatin (2 mg/kg) by 44.55% , 74%, 100% and 97.8% in worm burden, and by 47%, 78.7%, 96% and 97% in liver egg count , respectively than that of group (II) non treated S. mansoni infected alone and (IV) non treated S. mansoni/EAC alone. Also, Group IX caused a significant reduction (P <0.05) in worm burden than that of group VI. Also, total ascetic volume and the tumor cell counts in Ehrlich's ascites carcinoma (EAC)-cells were significantly decreased (P <0.001) in groups VIII and IX than that of the group (III) non-treated (EAC) inoculated alone. There was no mutual interaction between schistosomiasis infection and tumor burden. Also, whereas, PZQ did not affect on the antitumor parameters, cisplatin even at low doses had anti-schistosomal effects

Wearable activity technology and action-planning (WATAAP) to promote physical activity in cancer survivors: Randomised controlled trial protocol

Background/Objective: Colorectal and gynecologic cancer survivors are at cardiovascular risk due to comorbidities and sedentary behaviour, warranting a feasible intervention to increase physical activity. The Health Action Process Approach (HAPA) is a promising theoretical frame-work for health behaviour change, and wearable physical activity trackers offer a novel means of self-monitoring physical activity for cancer survivors. Method: Sixty-eight survivors of colorectal and gynecologic cancer will be randomised into 12- week intervention and control groups. Intervention group participants will receive: a Fitbit AltaTM to monitor physical activity, HAPA-based group sessions, booklet, and support phone-call. Participants in the control group will only receive the HAPA-based booklet. Physical activity (using accelerometers), blood pressure, BMI, and HAPA constructs will be assessed at baseline, 12-weeks (post-intervention) and 24-weeks (follow-up). Data analysis will use the Group x Time interaction from a General Linear Mixed Model analysis. Conclusions: Physical activity interventions that are acceptable and have robust theoretical underpinnings show promise for improving the health of cancer survivors

Influx of diverse, drug resistant and transmissible Plasmodium falciparum into a malaria-free setting in Qatar

Background: Successful control programs have impeded local malaria transmission in almost all Gulf Cooperation Council (GCC) countries: Qatar, Bahrain, Kuwait, Oman, the United Arab Emirates (UAE) and Saudi Arabia. Nevertheless, a prodigious influx of imported malaria via migrant workers sustains the threat of local transmission. Here we examine the origin of imported malaria in Qatar, assess genetic diversity and the prevalence of drug resistance genes in imported Plasmodium falciparum, and finally, address the potential for the reintroduction of local transmission. Methods: This study examined imported malaria cases reported in Qatar, between 2013 and 2016. We focused on P. falciparum infections and estimated both total parasite and gametocyte density, using qPCR and qRT-PCR, respectively. We also examined ten neutral microsatellites and four genes associated with drug resistance, Pfmrp1, Pfcrt, Pfmdr1, and Pfkelch13, to assess the genetic diversity of imported P. falciparum strains, and the potential for propagating drug resistance genotypes respectively. Results: The majority of imported malaria cases were P. vivax, while P. falciparum and mixed species infections (P. falciparum / P. vivax) were less frequent. The primary origin of P. vivax infection was the Indian subcontinent, while P. falciparum was mostly presented by African expatriates. Imported P. falciparum strains were highly diverse, carrying multiple genotypes, and infections also presented with early- and late-stage gametocytes. We observed a high prevalence of mutations implicated in drug resistance among these strains, including novel SNPs in Pfkelch13. Conclusions: The influx of genetically diverse P. falciparum, with multiple drug resistance markers and a high capacity for gametocyte production, represents a threat for the reestablishment of drug-resistant malaria into GCC countries. This scenario highlights the impact of mass international migration on the reintroduction of malaria to areas with absent or limited local transmission