Peritonitis – the Eastern experience

Peritonitis is a common emergency encountered by surgeons the world over. This paper aims to provide an overview of the spectrum of peritonitis seen in the East. Studies dealing with the overall spectrum of secondary peritonitis in various countries of this region were identified using Pubmed and Google. These were analyzed for the site and cause of perforation and the mortality. It was observed that perforation of duodenal ulcers was the most the commonly encountered perforations. These are followed by small bowel and appendicular perforations. Colonic perforations were uncommon. The overall mortality ranges between 6–27%

The management of large perforations of duodenal ulcers

BACKGROUND: Duodenal ulcer perforations are a common surgical emergency, but literature is silent on the exact definition, incidence, management and complications of large perforations of duodenal ulcers. METHODS: The case files of 162 patients who underwent emergency laparotomy for duodenal ulcer perforations over a period of three years (2001 – 2003) were retrospectively reviewed and sorted into groups based on the size of the perforations – one group was defined as 'small 'perforations (less than 1 cm in diameter), another 'large' (when the perforation was more than 1 cm but less than 3 cms), and the third, 'giant'(when the perforation exceeded 3 cm). These groups of patients were then compared with each other in regard to the patient particulars, duration of symptoms, surgery performed and the outcome. RESULTS: A total of 40 patients were identified to have duodenal ulcer perforations more than 1 cm in size, thus accounting for nearly 25 % of all duodenal ulcer perforations operated during this period. These patients had a significantly higher incidence of leak, morbidity and mortality when compared to those with smaller perforations. CONCLUSION: There are three distinct types of perforations of duodenal ulcers that are encountered in clinical practice. The first, are the 'small' perforations that are easy to manage and have low morbidity and mortality. The second are the 'large' perforations, that are also not uncommon, and omental patch closure gives the best results even in this subset of patients. The word 'giant' should be reserved for perforations that exceed 3 cms in diameter, and these are extremely uncommon

Tubercular appendicitis – a case report

Tuberculosis of the appendix remains a rarity despite the frequency of intestinal tuberculosis. We report a case of acute appendicitis that underwent appendectomy at our hospital, and the histopathology of the specimen revealed tuberculosis

Graphene Patterned Microchip For Colorectal Cancer Detection

Cancer currently stands as the second-leading cause of death worldwide. Studies reveal colorectal cancer (CRC) to be the 4th leading cause of mortality due to cancer. It is estimated that about 30% of CRC cases are hereditary, of which 5% are attributed by known syndromes, particularly Lynch Syndrome. This pilot study aims to fabricate a DNA-graphene-polypyrrole (DGP) based biosensor to diagnose deficiency of functional MMR proteins present in patients at a scale of less than ng/ ml. We have followed LAB-on-CHIP method. We find that the interactive forces between avidin and graphene are mainly hydrophobic, along with some van der Waals, electrostatic and hydrogen bonding interactions. Different mismatch combinations were performed, to prove the activity of each component on the chip. 30 such combinations were done. Electrochemical impedance spectroscopy was done to confirm the working of the bio sensor by corresponding change in electrical impedance. To assist this real-world system, we have carried out simulation studies as well. In the simulation studies from 0-200ns, we present the progression structures of human MutS protein to biotinylated DNA that has been fixed to simulate the manner of a biosensor, furthermore the mismatch within the DNA has been manually introduced with the aid of computational tools to reveal the interactions of the DNA and the protein. This research additionally permits us in early detection of colorectal cancer and the mapping and expertise of the method related to the area of the mismatch repair

Supersymmetry production cross sections in pp collisions at sqrt{s} = 7 TeV

This document emerged from work that started in January 2012 as a joint effort by the ATLAS, CMS and LPCC supersymmetry (SUSY) working groups to compile state-of-the-art cross section predictions for SUSY particle production at the LHC. We present cross sections for various SUSY processes in pp collisions at $\sqrt{s} =7$ TeV, including an estimate of the theoretical uncertainty due to scale variation and the parton distribution functions. Further results for higher LHC centre-of-mass energies will be collected at https://twiki.cern.ch/twiki/bin/view/LHCPhysics/SUSYCrossSections. For squark and gluino production, which dominate the inclusive SUSY cross section, we employ calculations which include the resummation of soft gluon emission at next-to-leading logarithmic accuracy, matched to next-to-leading order (NLO) SUSY-QCD. In all other cases we rely on NLO SUSY-QCD predictions

Predictors of Daily Mobility of Adults in Peri-Urban South India.

Daily mobility, an important aspect of environmental exposures and health behavior, has mainly been investigated in high-income countries. We aimed to identify the main dimensions of mobility and investigate their individual, contextual, and external predictors among men and women living in a peri-urban area of South India. We used 192 global positioning system (GPS)-recorded mobility tracks from 47 participants (24 women, 23 men) from the Cardiovascular Health effects of Air pollution in Telangana, India (CHAI) project (mean: 4.1 days/person). The mean age was 44 (standard deviation: 14) years. Half of the population was illiterate and 55% was in unskilled manual employment, mostly agriculture-related. Sex was the largest determinant of mobility. During daytime, time spent at home averaged 13.4 (3.7) h for women and 9.4 (4.2) h for men. Women's activity spaces were smaller and more circular than men's. A principal component analysis identified three main mobility dimensions related to the size of the activity space, the mobility in/around the residence, and mobility inside the village, explaining 86% (women) and 61% (men) of the total variability in mobility. Age, socioeconomic status, and urbanicity were associated with all three dimensions. Our results have multiple potential applications for improved assessment of environmental exposures and their effects on health

Higher satisfaction and adherence with glatiramer acetate 40 mg/mL TIW vs 20 mg/mL QD in RRMS.

Abstract Background Patients who perceive their medication to be ineffective or inconvenient are less likely to be adherent to treatment, with potentially significant consequences on long-term clinical outcomes. Many patients with multiple sclerosis (MS) are nonadherent to treatment despite demonstrated efficacy of disease-modifying therapies (DMTs). While glatiramer acetate (GA; Copaxone®, Teva Pharmaceuticals) both 20 mg/mL once daily (GA20) and 40 mg/mL three times weekly (GA40) have demonstrated efficacy in relapsing-remitting MS (RRMS), GA40 has a superior tolerability profile in addition to a more convenient dosing schedule. These characteristics may give rise to greater treatment satisfaction and higher rates of adherence with potentially beneficial effects on clinical outcomes and health-related costs. Methods CONFIDENCE was a Phase 4, interventional, open-label, randomized, 2-arm, parallel-group, global study with a duration of 6 months. Patients (N = 861) were randomly assigned 1:1 to receive GA20 (n = 430) or GA40 (n = 431) during the core phase. The primary endpoint was patient-reported medication satisfaction using the Medication Satisfaction Questionnaire (MSQ). Secondary endpoints included self-reported convenience perception using the Treatment Satisfaction Questionnaire for Medication-9 convenience component, symptomatic changes (Modified Fatigue Impact Scale, MFIS), and Mental Health Inventory (MHI). Treatment adherence was measured by Multiple Sclerosis Treatment Adherence Questionnaire. Results from the core phase were included. Results During the core phase, 857 patients received treatments. Patients on GA40 were statistically significantly more satisfied with their medication than those on GA20 (LSM difference in MSQ, 0.3; 95% CI, 0.2, 0.5; p Conclusions Higher levels of satisfaction, perception of convenience, and adherence were reported by patients on GA40 than those on GA20. Clinical trial registration number This trial was registered with ClinicalTrials.gov (NCT02499900)

What Matters to Us:Impact of Telemedicine During the Pandemic in the Care of Patients With Sarcoma Across Scotland

In Scotland, approximately 350 sarcoma cases are diagnosed per year and treated in one of the five specialist centers. Many patients are required to travel long distances to access specialist care. The COVID-19 pandemic brought a number of rapid changes into the care for patients with cancer, with increasing utilization of telemedicine. We aimed to evaluate how the utilization of telemedicine affects professionals and patients across Scotland and care delivery, at the Beatson West of Scotland Cancer Centre Sarcoma Unit. Between June 8 and August 25, 2020, we invited patients and professional sarcoma multidisciplinary team members to participate in separate online anonymous survey questionnaires, to assess their attitudes toward telemedicine. Data were extracted, and descriptive statistics were performed. Patient satisfaction (n = 64) with telemedicine was high (mean = 9.4/10) and comparable with traditional face-to-face appointments (mean = 9.5/10). Patients were receptive to the use of telemedicine in certain situations, with patients strongly opposed to being told bad news via telemedicine (88%). Providers recommended the use of telemedicine in certain patient populations and reported largely equivalent workloads when compared with traditional consultations. Providers reported that telemedicine should be integrated into regular practice (66%), with patients echoing this indicating a preference for a majority of telemedicine appointments (57%). Telemedicine in sarcoma care is favorable from both clinician and patient perspectives. Utilization of telemedicine for patients with rare cancers such as sarcomas is an innovative approach to the delivery of care, especially considering the time and financial pressures on patients who often live a distance away from specialist centers. Patients and providers are keen to move toward a more flexible, mixed system of care