Mini-incision living donors nephrectomy using anterior muscle-splitting approach with hybrid technique

Significant morbidity is associated with standard open flank living donor nephrectomy. Laparo- scopic donor nephrectomy is criticized for a steep learning curve and a tendency to avoid the right kidney. The anterior muscle-splitting technique uses principles or advantages of an open extraperitoneal approach with minimal morbidity and the advantageous muscle-splitting [instead of cutting] procedure. To compare mini-incision laparoscopic instrument-assisted [MILIA] live donor nephrectomy using a muscle-splitting technique to the standard open-flank donor nephrectomy [ODN] approach for efficacy and safety. MILIA living donor nephrectomies were performed in 119 donors and compared to a cohort of open-flank nephrectomy donors [n=38] from the same center. Both donor groups were matched for body mass index as well as other personal characteristics. The mean donor age was 35 [range: 18-60] years. The right kidney was procured in 28% of cases. The majority of donors were female [58%] and Caucasian [60%]. No differences were observed between MILIA and ODN donors for the age, gender and ethnicity. However, MILIA donors experienced a longer mean_SD operative time [234 +/- 47 vs. 197 +/- 33 min, p<0.0001] but a shorter hospital stay [4 +/- 1 vs. 6 +/- 3 days for the ODN group, p<0.0001] and less intraoperative blood loss [215 +/- 180 vs. 331 +/- 397 mL, p<0.02]. No difference was found in the number of units of blood transfused [0.13 +/- 0.6 vs. 0.34 +/- 1.0 units, p=0.13]. Right-sided kidneys were almost equally harvested in both groups [29% of MILIA donors vs. 26% of ODN donors]. Post-operatively, MILIA donors had a significantly lower mean pain scores at one week and one month after surgery [p<0.001]. They showed significant better post-operative recovery earlier stopping of pain medications and restoration of other preoperative activities. Moreover, they were better satisfied with their scar appearance. Scores on the short form-36 quality of life questionnaire were comparable for both groups. MILIA is a viable option as an alternative for pure laparoscopic donor nephrectomy. MILIA ap- pears to be as safe as open donor nephrectomy and may provide advantages over ODN, such as smaller incision, shorter hospital stay, and less incisional pain. Patient recovery and satisfaction after MILIA are excellent. This technique avoids the possibility of adhesive intestinal obstruction and also improves handling of major complications [e.g., bleeding] of laparoscopic donor nephrectomy. Utilization of this hybrid tech- nique is particularly feasible on smaller [BMI<24 kg/m[2]] and medium-sized [BMI<28 kg/m[2]] donors. We believe that this technique should be adopted by centers that have limited advanced laparoscopic surgical experience and also it could be used selectively for the right donor nephrectomies, even in centers perform- ing hand assisted donor nephrectomies by including a small patch of inferior vena cava for a better quality of right donor kidney during transplantation

Isolation of mycoplasma gallisepticum and mycoplasma synoviae from native, ross and lohmann chickens in hail region of Saudi Arabia

In this study, M gallisepticum and M synoviae were isolated from different breeds of chickens in Flail region of Saudi Arabia. Out of 200 samples [trachea, lungs, air sacs and synovial swabs] taken from native chickens of different ages, 100 pure mycoplasma isolates were recovered. When typed by morphological, biochemical and serological methods, 39 isolates were identified as M synoviae, 31 isolates were identified as M. gallisepticum. of 60 samples from Lohmman layers, 11 pure isolates were obtained and 6 of them were identified as M synoviae, I was M gallisepticum. of 140 samples collected from Ross chickens and breeders, only samples collected from breeders aging 8 14 weeks [40 samples] resulted in positive mycoplasma isolation. Fifteen pure mycoplasma isolates were recovered of which 3 were identified as M gallisepticum, 4 were identified as M synoviae. Tracheal samples and synovial fluids resulted in the highest isolation rates from native and Lohmman chickens, respectively while synovial fluid and tracheal samples resulted in equal rates of Mycoplasma isolation from Ross chickens. Agar media containing tryptone soy agar base resulted in bigger Mycoplasma colonies and nipples

Preliminary study on the production of nitric oxide and expression of nitric oxide synthase by camel macrophages [with one table and one figure]

Nitric Oxide is produced by macrophage when activated or invaded by certain antigens or microbes. In the present study, camel peripheral blood leukocytes were obtained by ficoll cushion. Monocytes were separated and grown to macrophages. The mature macrophages were exposed to E. coli LPS as well as sheep pox virus antigen. Nitric oxide [NO] production, by stimulated macrophages as well as the mRNA specific for production of inducible nitric oxide syntheses [iNOS], were investigated. Production of NO was stimulated by both pox antigen and LPS and was more with the latter. The obtained results indicated the similarity in the tested parameters between camel macrophages and those of other mammals tested so far viz mice

Evaluation of sensitivity and specificity of bovine Gamma-Interferon In-Vitro Assay for Diagnosis of tuberculosis in buffaloes

The sensitivity and specificity of the Bovine Gamma Interferon [IFN-lambda] in-vitro assay [BOVI-GAM] in the diagnosis of bovine tuberculousis in buffaloes as compared to the single intradermal cervical tuberculin test [SICT] and cultural isolation of Mycobacterium bovis were investigated. Thirty buffaloes from a dairy farm, in which tuberculin positive animals had been previously diagnosed, were tested. In the SICT test examined buffaloes 36.7% were positive and 23.3% were doubtful as compared with 53.3% positive and 16.7% doubtful results using the IFN- lambda assay. Two animals were positive to avian tuberculin in the IFN- lambda assay. The prevalence rate reached 60% and 70% using the SICT test and the IFN- lambda assay respectively. The sensitivity of the SICT and the IFN- lambda assay as compared with the cultural isolation of M. bovis were 75% and 95%, respectively, while the specificity were 70% and 80%, respectively. M. bovis was isolated from five buffaloes that were negative to SICT and one buffalo that was negative to the IFN- lambda assay. In conclusion, the present study demonstrated that the IFN- lambda assay is a practical, more sensitive and specific in-vitro diagnostic test than the conventional tuberculin test for detection of bovine tuberculosis in buffaloes

Antibiotic prophylaxis in premature rupture of membranes: maternal and fetal outcome

The purpose of the study was to evaluate the effectiveness of Amoxycilline Clevulinate [Augmentin] as a prophylaxis against maternal and neonatal infections in P.R.O.M. Thirty-Five pregnant patients with gestational ages between 28-34 weeks, with a definitely diagnosed rupture of the fetal membranes were included in the study. They were divided into two groups: First: [20 cases] were given Augmentin 625 mg. tablet /12 hours for 5 days. Second: [15 cases] managed conservatively without antibiotics. Both groups were studied for prolongation of pregnancy, bacteriological examination of post partum endo uterine and neonatal nasopharyngeal swabs. Patients of the study group showed a significant prolongation of pregnancy than the control group. The mean duration of the period from the onset of R.O.M. till delivery was 5 days in the study group and 2.5 days in the controls [P< 0.05]. Bacteriological examination of uterine swabs showed a significant reduction of the incidence of [+ve] cultures in the study group [+ve swabs in 55%] than the control group [+ve swabs in 93%]. Neonatal naso-pharyngeal cultures showed a significant reduction of +ve cultures in the study group [in 40% of patients] than in the control group [80% of patients]. Augmentin therapy in patients with P.R.O.M. can significantly reduce the incidence of both maternal and neonatal infectious morbidity besides allowing for more prolongation of pregnancy giving the chance for better fetal maturation