Outcome of Laproscopic Cholecystectomy in Acute Cholecystitis

Objective: To compare the outcome of early laparoscopic cholecystectomy in acute cholecytitis due to cholelithiasis as compared to interval cholecystectomy in terms of conversion rate, operative time and complications.Study design:  Descriptive studyPlace of study: Department of general surgery, Pakistan Atomic Energy Commission General Hospital, H-11/4 Islamabad.Duration of Study: January 2016 to June 2017.Methodology: Patients were divided into two groups. Group A had acute cholecystitis and were admitted through emergency room or surgical OPD and were operated in the same index admission on earliest possible list thus waiting time for surgery was one to four days approximately. While group B, had all elective cases, without any evidence of acute cholecystitis, mainly booked through OPD. All the patients included in both groups, were studied for initial diagnosis, duration of symptoms, duration of surgery, conversion to open cholecystectomy, per operative and post-operative complications and duration of hospital stay.Results: A total of 360 patients were operated in the hospital for cholelithiasis during the said period. Standard four ports were employed for the surgery. Group A (acute cholecystitis) had total 112 patients while group B (non-acute cholecystitis) had 248 patients. Of these 112 patients in group A, there were 77 males and 35 females.  In group B, there were 112 male and 248 female patients in group B. The mean operating time for group A was 64±13 min. whereas for group B the mean duration was 60± 12 min. The average amount of blood loss during surgery for group A was 45 ml ± 33 ml and for group B was 30ml + 20ml.Conclusion: Early laparoscopic Cholecystectomy, for acute cholecystitis is cost effective, has shorter total length of hospital stay and reduces the risk of repeat cholecystitis

Outcome of Laproscopic Cholecystectomy in Acute Cholecystitis

Objective: To compare the outcome of early laparoscopic cholecystectomy in acute cholecytitis due to cholelithiasis as compared to interval cholecystectomy in terms of conversion rate, operative time and complications.Study design:  Descriptive studyPlace of study: Department of general surgery, Pakistan Atomic Energy Commission General Hospital, H-11/4 Islamabad.Duration of Study: January 2016 to June 2017.Methodology: Patients were divided into two groups. Group A had acute cholecystitis and were admitted through emergency room or surgical OPD and were operated in the same index admission on earliest possible list thus waiting time for surgery was one to four days approximately. While group B, had all elective cases, without any evidence of acute cholecystitis, mainly booked through OPD. All the patients included in both groups, were studied for initial diagnosis, duration of symptoms, duration of surgery, conversion to open cholecystectomy, per operative and post-operative complications and duration of hospital stay.Results: A total of 360 patients were operated in the hospital for cholelithiasis during the said period. Standard four ports were employed for the surgery. Group A (acute cholecystitis) had total 112 patients while group B (non-acute cholecystitis) had 248 patients. Of these 112 patients in group A, there were 77 males and 35 females.  In group B, there were 112 male and 248 female patients in group B. The mean operating time for group A was 64±13 min. whereas for group B the mean duration was 60± 12 min. The average amount of blood loss during surgery for group A was 45 ml ± 33 ml and for group B was 30ml + 20ml.Conclusion: Early laparoscopic Cholecystectomy, for acute cholecystitis is cost effective, has shorter total length of hospital stay and reduces the risk of repeat cholecystitis

Blood, hair and feces as an indicator of environmental exposure of sheep, cow and buffalo to cobalt: a health risk perspectives

Exposure to toxic metals (TMs) such as cobalt (Co) can cause lifelong carcinogenic disorders and mutagenic outcomes. TMs enter ground water and rivers from human activity, anthropogenic contamination, and the ecological environment. The present study was conducted to evaluate the influence of sewage water irrigation on cobalt (Co) toxicity and bioaccumulation in a soil-plant environment and to assess the health risk of grazing livestock via forage consumption. Cobalt is a very necessary element for the growth of plants and animals; however, higher concentrations have toxic impacts. Measurement of Co in plant, soil and water samples was conducted via wet digestion method using an atomic absorption spectrophotometer. The Co pollution severity was examined in soil, forage crops (Sorghum bicolor Kuntze, Sesbania bispinosa (Jacq.) W. Wight, Cynodon dactylon (L.) Pers., Suaeda fruticosa (L.) Forssk. and Tribulus terrestris L.) in blood, hair and feces of sheep, cow and buffalo from district Toba-Tek-Singh, Punjab, Pakistan. Three sites were selected for investigation of Co level in soil and forage samples. Highest concentration of Co was 0.65 and 0.35 mg/kg occurring in S. bicolor at site I. The sheep blood, cow hair and sheep feces samples showed highest concentrations of 0.545, 0.549 and 0.548 mg/kg, respectively at site I and site II. Bioconcentration factor, pollution load index, enrichment factor and daily intake were found to be higher (0.667, 0.124, 0.12 and 0.0007 mg/kg) in soil, S. bicolor, S. fruticosa and in buffalo, respectively, at site I. It was concluded that forage species irrigated with wastewater are safe for consumption of livestock. However, though the general values were lower than the permissible maximum limit, it was observed that the bioaccumulation in the forage species was higher. Therefore, soil and food chain components should be avoided from trace metal contamination, and other means of nonconventional water resources should be employed for forages irrigation

Cadmium (Cd) and copper (Cu) exposure and bioaccumulation arrays in farm ruminants: impact of forage ecotypes, ecological sites and body organs

Copper (Cu) and cadmium (Cd) metal distribution in soil–plant ecosystems and their public health risk impact on ruminants (cows, buffalo, and sheep) are explored in the present investigation. Five different forage crops were selected, and the foraging responses of three types of ruminants (cows, buffalo, and sheep) at three ecological sites were evaluated. The soil of these three ecological sites was metal polluted (due to wastewater irrigation) and was studied to evaluate the metal contamination and pollution load index. For the assessment of Cd and Cu, soil, vegetation, blood, hair, and feces samples were collected and analysed using an atomic absorption spectrophotometer. High consumption of fodder crops (Sorghum bicolor Kuntze, Sesbania bispinosa (Jacq.) W. Wight, Cynodon dactylon (L.) Pers., Suaeda fruticosa (L.) Forssk., and Tribulus terrestris L.) by cows and buffalo at site-III resulted in an increase in daily Cu and Cd intake. The pollution load index was higher at site-II and site-III, indicating a severe health risk scenario for local inhabitants. Cd and Cu were at their maximum levels in fodder crops. A significant increase in the concentrations of Cd and Cu was found in the blood, hair, and feces of cows and buffalo at site-III. Ecological indicators such as the bioaccumulation factor, the pollution load index, and the enrichment factor were found to be higher in buffalo than cows. The Cd level in forages was highest at the site-III Cd level and in the order of S. bispinosa > S. fruticosa > T. terresteris > C. dactylon > S. bicolor. Although these levels were lower than the permissible maximum limit, they were generally higher in the forage crops. Exposure of local inhabitants to the consumption of milk and meat from these cattle showed the serious health risks consequences. This situation can be properly managed by general monitoring of soil and vegetation pollution, avoiding metal contamination in the soil and food chain components, and using treated waste water and other alternate water sources for forage irrigation.King Saud University | Ref. RSP-2021/173Princess Nourah bint Abdulrahman University, Riyadh | Ref. PNURSP2022R186Higher Education Commission of Pakistan | Ref. #2484/1

Quality of reporting of diagnostic accuracy studies on pelvic floor three-dimensional transperineal ultrasound: a systematic review

OBJECTIVE: In recent years, a large number of studies have been published on the clinical relevance of pelvic floor three-dimensional (3D) transperineal ultrasound. Several studies compare sonography with other imaging modalities or clinical examination. The quality of reporting in these studies is not known. The objective of this systematic review was to determine the compliance of diagnostic accuracy studies investigating pelvic floor 3D ultrasound with the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines. METHODS: Published articles on pelvic floor 3D ultrasound were identified by a systematic literature search of MEDLINE, Web of Science and Scopus databases. Prospective and retrospective studies that compared pelvic floor 3D ultrasound with other clinical and imaging diagnostics were included in the analysis. STARD compliance was assessed and quantified by two independent investigators, using 22 of the original 25 STARD checklist items. Items with the qualifier 'if done' (Items 13, 23 and 24) were excluded because they were not applicable to all papers. Each item was scored as reported (score = 1) or not reported (score = 0). Observer variability, the total number of reported STARD items per article and summary scores for each item were calculated. The difference in total score between STARD-adopting and non-adopting journals was tested statistically, as was the effect of year of publication. RESULTS: Forty studies published in 13 scientific journals were included in the analysis. Mean ± SD STARD checklist score of the included articles was 16.0 ± 2.5 out of a maximum of 22 points. The lowest scores (< 50%) were found for reporting of handling of indeterminate results or missing responses, adverse events and the time interval between tests. Interobserver agreement for rating the STARD items was excellent (intraclass correlation coefficient, 0.77). An independent t-test showed no significant mean difference ± SD in total STARD checklist score between STARD-adopting and non-adopting journals (16.4 ± 2.2 vs 15.9 ± 2.6, respectively). Mean ± SD STARD checklist score for articles published in 2003-2009 was lower, but not statistically different, compared with those published in 2010-2015 (15.2 ± 2.5 vs 16.6 ± 2.4, respectively). CONCLUSION: The overall compliance with reporting guidelines of diagnostic accuracy studies on pelvic floor 3D transperineal ultrasound is relatively good compared with other fields of medicine. However, specific checklist items require more attention when reported. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd