Laparoscopic Paediatric Hernia Repair Using Tuohy Needle - Our Preliminary Experience of 100 Cases

Congenital inguinal hernia repair is one of the most commonly encountered paediatric surgical procedures. With advancements in minimal access surgery, there is an increasing inclination towards the repair of paediatric inguinal hernia (PIH) laparoscopically over an open procedure. Currently, a single port laparoscopic percutaneous extraperitoneal closure, a simple and reliable method, is being used widely. METHODS100 patients with PIH were treated using a single port LPEC technique from August 2014 to July 2018. The study was conducted with a modified LPEC technique using a Tuohy needle. The deep ring was encircled with the help of Tuohy needle under laparoscopic visualization and a suture was passed through it. The needle was then used to encircle the ring from the opposite side and the initial suture was retrieved with the help of a loop, and a purse string was created to obliterate the deep ring with extracorporeal knotting. RESULTS100 congenital hernias were repaired by LPEC method. Mean age was 5.85 ± 2 years. Male to female ratio was 7.3 : 1. 96% of cases were unilateral and 4 % were bilateral preoperatively. PPV was found in 8% of cases intraoperatively. Mean operating time was 22.08 ± 10.2 and 27.6 ± 11.47 minutes for unilateral and bilateral cases respectively. There were no intraoperative complications and no recurrences. Only one patient developed wound infection. CONCLUSIONSLPEC of hernial sac using a Tuohy needle is a safe and effective method for the repair of PIH. It is easy to perform, faster, and offers good cosmesis with cure for imminent contralateral hernias.

Bioactivity guided fractionation of Moringa oleifera Lam. flower targeting Leishmania donovani.

Leishmaniases is a group of diseases caused by the protozoan parasite belonging to the genus Leishmania. At least 20 species of Leishmania are known to infect humans transmitted by female sandflies, Phlebotomus spp. Leishmania donovani causes visceral leishmaniasis, considered most lethal among the common three forms of leishmaniasis. Lack of appropriate vaccines, emergence of drug resistance and side effects of currently used drugs stress the need for better alternative drugs, particularly from natural sources. Here, we conducted in vitro and in vivo experiments to study the efficacy of different parts of Moringa oleifera Lam. against Leishmania donovani promastigotes. The flower extract of M. oliefera (MoF) was found to be the most potent antileishmanial agent when compared to other parts of the plant like leaf, root, bark and stem. It imparted significant reduction in parasite number in infected macrophages. The bioactivity guided fractionation of MoF showed ethyl acetate fraction (MoE) as the most active and gave significant parasite reduction in the infected macrophages. Further, growth kinetics studies revealed loss of L. donovani promastigotes viability in the presence of MoE in both time and dose dependent manner. In vivo experiment in Balb/c mouse model of leishmaniasis supported the in vitro findings with a remarkable reduction of the parasite burden in both liver and spleen.

Differential toxicological endpoints of di(2-ethylhexyl) phthalate (DEHP) exposure in MCF-7 and MDA-MB-231 cell lines: Possible estrogen receptor α (ERα) independent modulations.

Wide spread use of Di-(2-ethylhexyl) phthalate (DEHP) has made it a ubiquitous contaminant in today’s environment, responsible for possible carcinogenic and endocrine disrupting effects. In the present investigation an integrative toxico-proteomic approach was made to study the estrogenic potential of DEHP. In vitro experiments carried out with DEHP (0.1-100 μM) induced proliferations (E-screen assay) in human estrogen receptors-α (ERα) positive MCF-7 and ERα negative MDA-MB-231 breast cancer cells irrespective of their ERα status. Further, DEHP suppressed tamoxifen (a potent anti-breast cancer drug) induced apoptosis in both cell types as shown by flowcytometric cell cycle analysis. Label-free quantitative proteomics analysis of the cell secretome of both the cell lines indicated a wide array of stress related, structural and receptor binding proteins that were affected due to DEHP exposure. The secretome of DEHP treated MCF-7 cells revealed the down regulation of lactotransferrin, an ERα responsive iron transport protein. The results indicated that toxicological effects of DEHP did not follow an ERα signaling pathway. However, the differential effects in MCF-7 and MDA-MB-231 cell lines indicate that ERα might have an indirect modulating effect on DEHP induced toxicity.

Effect of physico-chemical treatments on ripening behavior and post- harvest quality of Amrapali mango (Mangifera indica L.) during storage.

An experiment was done to assess the effect of various physico-chemical treatments on ripening behavior and post harvest quality of mango cv. Amrapali. The experiment was planned under completely randomized design (CRD ) with three replications. The treatment units was five fruits per replication. Total 14 treatments were applied. Out of these, ethrel 750 ppm treated fruits showed better results in respect of specific gravity (0.88), moisture loss (8.45%), decay (2.5%), total soluble solids (TSS, 20.7o brix), sugar content (14.39%) and acidity content (0.32) followed by ethrel 500 ppm; specific gravity (0.90), moisture loss (8.82%), decay (3.5%), TSS (20.7o brix ), sugar content (13.99%) and acidity content (0.36%). The pedicellate fruits and ethrel+bavistin (750+1000 ppm) were also found to be significantly superior over control in respect of specific gravity (0.88 and 0.86), moisture loss (9.10 and 9.33%), decay (4.0 and 5.33%), TSS (20.1 and 20.4o brix), sugar content (12.70 and 12.80%) and acidity content (0.42 and 0.38%), respectively. Based on results of this study, it can be concluded that ethrel 750 ppm was found to be the most suitable treatment in improving physico-chemical traits i.e. ripening, storage, quality and shelf-life for commercial purpose in mango.

Morphometric study of lymphoid cells in mycosis fungoides and its simulators.

The distinction of early stages of mycosis fungoides from benign lymphoid disorders of skin is difficult by conventional histological techniques. We studied 10 cases of mycosis fungoides, 10 cases of large plaque parapsoriasis, 10 cases of other benign lymphoid disorders of skin and 5 cases of lymph nodes. Nuclear area, perimeter of the nucleus, nuclear contour index, cytoplasmic area, form factor and nuclear cytoplasmic ratio as well as DNA-ploidy were determined by image analysis. There were statistically significant difference (P value < 0.05) between all parameters except nuclear cytoplasmic ratio of the lymphoid cells of Mycosis Fungoides and benign lymphoid disorders of skin. Aneuploidy was found in 50% cases of Mycosis Fungoides. Histopathological parameters like epidermotropism pautrier micro-abscess and atypical lymphocytic infiltrate in both epidermis and dermis were more marked in aneuploid than diploid cases. So, the determination of nuclear contour index and DNA-ploidy is of importance to differentiate between Mycosis Fungoides and benign lymphoid disorders of skin.