Serological and molecular detection of neurocysticercosis among epileptic patients in Nagpur, Maharashtra state (India).

Neurocysticercosis (NCC), one of the most important neuroparasitic diseases in humans, is caused by Cysticercus cellulosae, the metacestode stage of digenetic zoonotic cestode Taenia solium. The present study aims at the detection of anti-cysticercus antibodies in the sera of epileptic patients (n=26) visiting a tertiary care hospital in Nagpur, Maharashtra state, India, by an in-house developed indirect IgG-ELISA and enzyme-linked immunoelectro transfer blot (EITB) assay using different antigens (namely, Whole Cyst Antigen (WCA), Cystic Fluid Antigen (CFA), Scolex Antigen (SA), Excretory-Secretory Antigen (ESA) and Membrane-Body Antigen (MBA)) prepared from T. solium metacestodes to find out the status of NCC. An attempt has also been made for molecular detection of NCC from blood samples of those patients by Polymerase Chain Reaction (PCR) assay targeted at large subunit rRNA gene of T. solium. The IgG ELISA level of anti-cysticercus antibodies against WCA, CFA, SA, ESA and MBA antigens were as follows: 19.23 %, 23.07 %, 38.46 %, 30.76 % and 15.38 %. The seroreactivity to CFA, SA and ESA was found in equal proportions in patients with ring-enhancing lesions. In the EITB assay, the lower and medium molecular weight protein bands of SA and ESA were immunodominant compared to the higher WCA and CFA peptides. PCR positivity could be observed in 34.6 % (9/26) of the patients under study. It is the first report of detecting NCC among epileptic patients of the Nagpur region of Maharashtra state in India using serological and molecular tools.

Application of Levenberg-Marquardt technique for electrical conducting fluid subjected to variable viscosity.

In the present study, design of intelligent numerical computing through backpropagated neural networks (BNNs) is presented for numerical treatment of the fluid mechanics problems governing the dynamics of magnetohydrodynamic fluidic model (MHD-NFM) past a stretching surface embedded in porous medium along with imposed heat source/sink and variable viscosity. The original system model MHD-NFM in terms of PDEs is converted to nonlinear ODEs by introducing the similarity transformations. A reference dataset for BNNs approach is generated with Adams numerical solver for different scenarios of MHD-NFM by variation of parameter of viscosity, parameter of heat source and sink, parameter of permeability, magnetic field parameter, and Prandtl number. To calculate the approximate solution for MHD-NFM for different scenarios, the training, testing, and validation processes are conducted in parallel to adapt neural networks by reducing the mean square error (MSE) function through Levenberg-Marquardt backpropagation. The comparative studies and performance analyses through outcomes of MSE, error histograms, correlation and regression demonstrate the effectiveness of proposed BNNs methodology.

Homozygous Hemoglobin Lepore: A Rare Condition Seen in a Bangladeshi Family.

Hb Lepore is one type of hemoglobin disorder in which there is structurally abnormal hemoglobin (Hb) that results from in-frame fusion between the 5 end of the δ-globin gene and the 3 end of the ß-globin gene, due to misalignment of homologous chromosomes during meiosis..Hb Lepore homozygous patients have clinical features indistinguishable from thalassemia major or intermedia. On 22 March 2018 a severely anaemic 2 year old child was referred to Dhaka Shishu Hospital Thalassaemia Center in Dhaka Shishu Hospital, Dhaka Bangladesh for thalassemia screening. HPLC report showed a very high level of Hb F 80.7% and Hb A2 level 16.16%. HPLC of both mother and father revealed a high A2 level and a hump in the download slope of Hb A2 peak and diagnosed as Hb Lepore. This was confirmed by GAP PCR and DNA analysis of the child and the parents and the child was diagnosed as suffering from homozygous Hb Lepore. Here we discuss Hb Lepore a rare homozygosity in a child seen in a Bangladeshi family.

Analytical evaluation of Oldroyd-B nanoliquid under thermo-solutal Robin conditions and stratifications.

Chilling systems are important in the improved technological thermal mechanisms which are considered continuously in passive along with active heat-transference improvement procedures. Engineers recommended several approaches to upsurge heat transference of thermal structures. The pulsating flow, corrugated tube, magnetic field aspect and nanoliquids are the heat-transference improvement procedures delved continuously. In present research work, we addressed the heat-transference characteristics of non-Newtonian (Oldroyd-B) liquid towards heated stratified surface. Thermally radiative laminar flow is modeled. In addition, we accounted Buongiorno's nanoliquid model which includes Brownian along with thermophoretic diffusions. Modeling is further based on heat source, magnetohydrodynamics, dual stratification, thermal radiation and convective conditions. Mathematical system is simplified through boundary-layer idea. Similarity variables are reported with the aim to simplify complex mathematical system. Homotopy algorithm yields convergent results of non-dimensional expressions. Our study unveils diminution of thermal along with solutal fields when stratification factors are increased.

Modeling and interpretation of peristaltic transport in single wall carbon nanotube flow with entropy optimization and Newtonian heating.

Due to some special characteristics like the effective thermal conductivities, appropriate mechanical features, and superior electrical properties, carbon nanostructures have been known as the proper materials to reach the desired characteristics of fluids. In the recent past fluid flows through peristaltic mechanism subject to carbon nanotubes are utilized to handle the overcome of industrial and physiological materials thermal properties. Due to rich thermal characteristics nanotubes are used into basic industrial materials to improve the required ability of thermal properties of these industrial materials. Thus various kinds of nanoparticles e.g. aluminum, copper, zinc oxides and carbon nanotubes are significantly utilized to increase the thermal abilities of base liquids. Because of the several significant special qualities such as improved thermal conductivities, applicable mechanical structures, and rich electrical properties, CNTs have been acknowledged as the accurate tools to reach the wanted features of fluids, due to such abilities CNTs are high demanding research topic in all domains. Keeping such efficiencies of CNTs in notice, this analysis is prepared for peristalsis of carbon nanotubes through non-uniform asymmetric channel. Flow mechanism is modeled in view of conservation principles under desired assumptions likely porous medium, non-linear mixed convection, heat generation absorption and Newtonian heating. Rate of total entropy is evaluated by using thermodynamics second law. Lubrication approach utilized here to attain the simplified form of the complex flow expressions. The pressure gradient, velocity along axial direction, temperature, effective heat transfer rate and entropy expressions subject to boundary conditions are evaluated numerically via built-in-Shooting procedure. Furthermore these numerical results are used to sketch the variations of all the above mentioned quantities against the pertinent parameters of interest. According to physical discussion temperature reduces for heat absorption case and enhances for heat generation case. Impact of Prandtl number on entropy indicates that entropy is minimum due to less fluid friction (i.e. Prandtl number less than 1).

Evaluating the characteristics of magnetic dipole for shear-thinning Williamson nanofluid with thermal radiation.

Objective A recent evolution in fluid dynamics has been the consideration of nanoliquids which retains exceptional thermal conductivity characteristics and upsurge heat transportation in fluids. Inspired by this, the current attempt develops a nonlinear mathematical model (Williamson fluid) towards moving surface heated convectively. Formulated problem further encompasses thermophoresis, magnetic dipole, heat source, Brownian diffusion, thermal radiation and thermo-solutal convective conditions. Upshots are simulated and unveiled graphically. Drag force along with heat/mass transportation rates is addressed numerically. Method The dimensionless expressions are highly non-linear and exact/analytic computations for such expressions are not possible. Thus we employed numeric (bvp4c) scheme for solution development. Conclusions Temperature of Williamson nanofluid intesifies through larger Nb (Brownian movement) factor and Nt (thermophoretic variable). Moreover, Buongiorno relation has reverse behavior for concentration ϕ(η) of Williamson nanofluid regarding Nt and Nt. Transportation rate of heat dwindles against both Nt and Nb.

A shear-rate-dependent flow generated via magnetically controlled metachronal motion of artificial cilia.

Cilia beating is a naturally occurring phenomenon that can be utilized in fluid transport in designing several biomechanical devices. Inspired by the ubiquity of bio-fluids (which are non-Newtonian), we report the characteristics of shear-rate-dependent viscosities on fluid flow generated by the wavy propulsion of magnetic cilia. We assume that the metachronal waves of these cilia form a two-dimensional wavy channel, which is filled with generalized Newtonian Carreau liquid. Galilean transformation is employed to relate fixed and moving frames. The constitutive equations are reduced under the classical lubrication assumption. The resulting fourth-order nonlinear differential equations are solved via a perturbation approach using the stream function. The effects of four dominant fluid parameters (shear thinning/thickening, power-law index, and zero- and infinite-shear-rate viscosity), magnetic parameter (Hartmann number), and metachronal wave parameters on fluid velocity, pressure rise per wavelength, and trapping phenomenon are shown in graphical results and explained thoroughly. This study could play an advisory role in designing a magnetic micro-bot useful in the biomedical industry.

On the evaluation of stratification based entropy optimized hydromagnetic flow featuring dissipation aspect and Robin conditions.

BACKGROUND AND OBJECTIVE: The scrutiny of nonlinear convected flow aspect has continuously appealed researchers attention because of its ample demands in processes like heat exchangers, building insulation, crystal growth, insulation of nuclear reactor, food processing, solar energy and electronic element chilling etc. Taking into consideration the aforesaid utilizations, we modeled differential type (second-grade) nanoliquid considering non-linear mixed convection. The considered differential type nonlinear model elaborates viscoelasticity (elastic and viscous) characteristics. Furthermore the thermal systems emphases on transportation of heat and irreversibility reduction. Especially, evaluating the systems via thermodynamic second relation is essential with the purpose of finding a standard communication between power input prerequisite and heat transference augmentation. METHOD: Formulated non-dimensional problem is non-linear subject to the assumptions (i.e., Non-linear mixed convection, magnetic field, viscous dissipation, double stratification, Joule heating and convective conditions). Analytic simulations for modeled non-linear systems is not possible. Hence we considered bvp4c scheme for non-linear analysis. CONCLUSIONS: Velocity [Formula: see text] of second grade (non-Newtonian) fluid intensifies for larger estimations of R* and λ* whereas it dwindles for M. Temperature of nanoliquid deteriorates with S1 while (θ(η)) rises against Ec. Entropy generation (EG) and (BN) (Bejan number) significantly affected by physical parameters M, α2 and Br.

Entropy optimized Darcy-Forchheimer nanofluid (Silicon dioxide, Molybdenum disulfide) subject to temperature dependent viscosity.

Background In this research communication, entropy optimized Darcy-Forchheimer flow with magnetohydrodynamic over a stretched surface is considered. Here Molybdenum disulfide (MOS2) and Silicon dioxide (SiO2) are taken as a nanoparticles and Propylene glycol as a continuous phase liquid. Electrically conducting fluid is considered and flow is generated via stretched surface of sheet. The total entropy rate which is depends on four types of irreversibilities i.e., heat transfer, porosity, fluid friction and dissipation) is calculated via second law of thermodynamics. The energy expression is mathematically modeled and discussed subject to heat generation/absorption, dissipation, thermal radiation and Joule heating. Furthermore, temperature dependent viscosity is accounted. Method The nonlinear PDE's (partial differential equations) are first changed to ODE's (ordinary differential equations) through implementation of appropriate similarity variables (transformations). The numerical results of ordinary ones are computed via Built-In-Shooting method. The results for the flow field, temperature, skin friction, Nusselt number and entropy generation are discussed against various sundry flow parameters graphically. Results Salient characteristics of sundry flow parameters on the entropy generation rate, velocity, Bejan number, gradients of velocity, gradient of temperature and temperature are examined and display graphically. The results are computed for both nanoparticles. From obtained results it is observed that temperature field increases versus higher thermal Biot number for both nanoparticles. It is also observed that the thermal field is more in presence of Molybdenum disulfide as compared to Silicon dioxide, because the thermal conductivity of Molybdenum disulfide is higher than Silicon dioxide. Entropy generation and Bejan number show contrast impact versus higher estimations of Brinkman number versus both nanoparticles.

Magnetic field influence in three-dimensional rotating micropolar nanoliquid with convective conditions.

BACKGROUND: Hybrid nanoliquids have several benefits in comparison to orthodox type liquids because of their revised attributes. The enhanced rheological along with thermo-physical attributes, create them additionally apposite for systems featuring solar energy. Thus, in the current analysis, the focus retained to pursue the diversity behave by hybrid nanofluid in comparison with traditional nanofluid considering the scheme of micropolar fluid in the environment of MHD, with rotating porous channel on the exponentially stretched surface. METHODS: For the solution of the generated differential model, a numerical technique BVP-4C is applied. The information extraction is done by the graphical representations of these solutions. RESULTS: The velocity, temperature, and micro-rotation are analyzed deeply under graphical representation. For nanofluid and hybrid nanofluid, we investigated a comprehensive behavior by the variation of skin friction and Nusselt number. As a result of these explorations, we found in depth the higher rate of heat transferring in the scenario of hybrid nanofluid in comparison with nanofluid in the manifestation of porosity and rotation.

Variable characteristics of viscosity and thermal conductivity in peristalsis of magneto-Carreau nanoliquid with heat transfer irreversibilities.

BACKGROUND: Peristaltic is a basic way of fluid transportation in physiology, engineering and nuclear industry. Importance of peristalsis is due to its contraction and compulsion property of symmetric and asymmetric type channel walls. Another beauty of this mechanism is that the channel walls propagates and push the material along the tube/conduit channel walls. This mechanism shows its presence in physiology while food particles are transferred through esophagus and stomach, urine through intestines, spermatoza transportation in reproductive tract. In industry it is found in roller and finger pumps, drug delivery and various nuclear materials e.g. toxic, corrosive, noxious etc. Magnetic field in peristalsis is found helpful in treatment of various treatments using magnets. Actually earth and human body as a whole comprises of magnetic and electric fields. The medical specialists found that unbalances of electromagnetic field in human body is the reason for emotional and physical disturbance. In addition it has significant and potential utilizations in modification of medical, industrial and chemical, procedures for example MRI, evaporation, convection, thermoregulation, MHD throttles, and in various types of tumor treatments. Entropy production work out irreversibility in complex systems which are frequently encountered in industrial mechanisms. In view of that, this methodology is effectually implemented in distinct technological applications covering porous media, propulsion ducts, electronic cooling, turbo-machinery and combustion. METHOD: Modelled flow mechanism is nonlinear and coupled due to considered assumptions (i.e. nanofluid, nonlinear porous channel, mixed convection, variable viscosity and thermal conductivity, activation energy and chemical reaction). Such nonlinear and coupled system is difficult to tackle analytically. Thus to obtain the solution we employed RK algorithm for numerical simulations. RESULTS: Stronger magnetic parameter shows resistive characteristics to the flow field. Nonlinear Darcy medium assists the fluid motion at channel center and resits at walls vicinity. Variable characteristics of thermal conductivity moderate the soak or disperse up heat ability which corresponds to temperature reduction. Thermal slip quantity increase the temperature whereas concentration slip deduct the concentration of Carreau nanomaterial. Entropy and Bejan number shows maximum response for higher dissipation estimations. Brownian and thermopherotic motions aspects has reverse impact on nanomaterial concentration. CONCLUSION: Entropy and Bejan number deduces for higher variable thermal conductivity values. Carreau material variable enhance the entropy of the system as a whole.

Fully developed entropy optimized second order velocity slip MHD nanofluid flow with activation energy.

Hydromagnetic second order velocity slip flow of viscous material with nonlinear mixed convection towards a stretched rotating disk is numerically examined here. Important slip mechanism of Buongiorno's nanofluid model i.e., Brownian motion and thermophoretic diffusion is incorporated in the mathematical modeling. Heat transport aspects are examined via Joule heating, thermal radiation and dissipation. Convective conditions at the stretchable surface of disk is implemented for the heat transport analysis. Chemical reaction subject to activation energy is also considered. Through appropriate transformations and shooting method the outcomes are computed and demonstrated graphically. The flow field, temperature, surface drag force, concentration and Nusselt number are deliberated subject to pertinent parameters. Total entropy rate is obtained. The outcomes show that magnetic field significantly affects the flow field as well as entropy rate.

Entropy optimized MHD nanomaterial flow subject to variable thicked surface.

Here we investigate the irreversibility aspects in magnetohydrodynamics flow of viscous nanofluid by a variable thicked surface. Viscous dissipation, Joule heating and heat generation/absorption in energy expression is considered. Behavior of Brownian diffusion and thermophoresis are also discussed. The nanoliquid is considered electrical conducting under the behavior of magnetic field exerted transverse to the sheet. Using similarity variables the nonlinear PDEs are altered to ordinary one. The obtained system are computed through Newton built in shooting method. Significant behavior of various involving parameters on entropy generation rate, velocity, concentration, Bejan number and temperature are examined. Gradient of velocity and heat transfer rate are numerically computed through tabulated form. Velocity field is augmented versus power index (n). Temperature and velocity profiles have opposite characteristics for larger approximation of Hartmann number. Concentration profile has similar impact against Brownian diffusion variable and Lewis number. Entropy optimization is boost up via rising values of Brinkman and Hartmann numbers. Bejan number is declined for increasing value of Hartmann number.

Transportation of heat generation/absorption and radiative heat flux in homogeneous-heterogeneous catalytic reactions of non-Newtonian fluid (Oldroyd-B model).

BACKGROUND: This study addresses the three-dimensional (3D) stagnation point flow of non-Newtonian material (Oldroyd-B) with magnetohydrodynamics. Furthermore, Ohmic heating and radiative flux are used in the modeling of energy expression. The surface is convectively heated. Equal strengths of diffusions for homogeneous and heterogeneous reactions are counted. Results are computed and presented graphically. Heat transfer rate is numerically discussed through table. METHOD: Here the nonlinear differential system first converted into ordinary differential equation through implementation of appropriate similarity variables. The obtained ordinary system is tackled through homotopy technique for convergent solutions. The outcomes are presented through different graphs and discussed in section six. OUTCOMES: The remarkable results of the present communication which is obtained from the semi analytical method i.e., "homotopy method" is summarized as (i) Opposite impact is noticed for velocity components i.e., (f'(ξ), g(ξ)) for rising fluid parameter and rotation parameter. (ii) The temperature is direct relation with Biot number and radiative variable. (iii) Heat transfer rate is more versus Biot number and radiation variable. (iv) The concentration field shows opposite impact versus homogeneous and heterogeneous parameters.

Mathematical modelling and analysis of gravitational collapse in curved geometry.

BACKGROUND AND OBJECTIVES: In the visible universe, it is believed that mass and energy are interchangeable. However, the physical and chemical processes in the hidden world put the scientist into the thought of matter and energy contents that are responsible for these phenomena. These are regarded as dark matter and dark energy. In this article, we study the effects of spacetime curvature on the gravitational collapse of dark energy in modified gravity, considering the collapse of the spherically symmetric star, which is composed of perfect and homogeneous fluid. We studied the collapse for closed, flat and hyperbolic geometry. METHOD: As a result of mathematical modeling, we achieved highly non-linear differential equations. For the solution, we needed the assumption of physical significance. Specifically, we have taken the dark energy collapse. Then we achieved a simple system and solved for the analytic solutions of the field equations. RESULTS: It is shown that the possible collapse is visibly influenced by spatial curvature. The collapse time is advanced for closed spacetime, delayed for the hypersurface, and the flat space behaves intermediately. We have taken here the equation of state in linear form to discuss the exhibition of fluid profile and a specific necessary criterion for the occurrence of spacetime singularity. CONCLUSION: In this paper, we study the mathematical model of gravitational collapse in modified gravity, which derives the field equations using the principle of least action. The significant outcomes are the influences of the spatial curvature on the collapsing process and the time of formation of spacetime singularity. The matching of boundary and the fundamental continuity of the 1-form and 2-form are discussed.

Exploring the features for flow of Oldroyd-B liquid film subjected to rotating disk with homogeneous/heterogeneous processes.

BACKGROUND AND OBJECTIVE: In the working principle of magnetic devices, the thin film substances are the verified efficient ingredients. Several fields of physics and chemistry has taken advanced studies for the features and utilization of thin film for various aspects. Here, we extracted the features of thin film analysis for time-dependent Oldroyd-B liquid. More specifically, our emphasis is to explore transportation rate of mass/heat by considering mass/energy fluxes. Furthermore, space/temperature dependent heat source/sink are considered. Radiation aspects are taken into account for mathematical modeling of Oldroyd-B liquid. Additionally, Oldroyd-B liquid features are elaborated considering Dufour/Soret aspects. Moreover, the heated surface by convection and chemical aspects remained under consideration while designing the physical model. METHOD: Feasible variables are employed to achieve nonlinear structure. Computational analysis of such a nonlinear structure is too easy. Therefore, we have engaged numerical technique (bvp4c technique) to solve nonlinear system. RESULTS: Thickness of liquid film boosts for larger rotation whereas it dwindles against magnetic parameter. Liquid concentration intensifies for Soret number. Transportation rate of mass for larger rotation parameter. CONCLUSION: Velocity components (Radial, axial, azimuthal) rises via higher ω. Velocity of liquid increase for greater (ß2) while reverse trend is detected for (ß1). Temperature of liquid dwindles for heat sink (A* < 0, B* < 0) parameters while (θ(η)) rises for (A* > 0, B* > 0).

Entropy optimized stretching flow based on non-Newtonian radiative nanoliquid under binary chemical reaction.

BACKGROUND AND OBJECTIVE: Developed electronic mechanisms frequently deal with defies about thermal management from developed phase of heat diminution or generation of available surface area regarding heat exclusion. Such promising defy can be subjugated either by introducing an optimal geometry for chilling equipments or intensifying heat transportation attributes. Nanoliquid in this perspective executes an extraordinary function to address all such matters. Having such usefulness of entropy in view, we formulated the hydromagnetic non-Newtonian nanoliquid in frames of mixed convection. Nanoliquid model comprises Brownian movement and thermophoretic mechanisms. In addition, the novel mass transportation approach featuring binary chemically reacting species is introduced. Energy expression formulation is developed through dissipation phenomenon. Besides, new conditions for Buongiorno model along with radiating flux are considered. METHOD: We obtained highly nonlinear structure. The computations of such structure are not easy. Thus we employed bvp4c scheme to tackle the nonlinear structure. RESULTS: Heat transportation rate boosts subject to higher chemical reaction parameter in comparison to thermophoretic factor and Eckert number. The considered rheological model yields viscous nanoliquid situation when material factors are assumed zero. Entropy owing to habituation of respiring air is more in comparison to its frictional factor and during hefty physical action. Entropy subject to respiring air friction under respiratory region is much higher in comparison to air habituation factor. CONCLUSION: Velocity rises via higher material parameter for thickening situation while opposing trend is witnessed for thinning nature of liquid. Entropy is meaningfully higher owing to breathing air condition rather than frictional impact towards tract. No doubt, entropy have a feasible association with respiratory thermoplasty which assists to handle asthma.

Theoretical and mathematical analysis of entropy generation in fluid flow subject to aluminum and ethylene glycol nanoparticles.

BACKGROUND: Here we have conducted a magnetohydrodynamic (MHD) flow of viscous material with alumina water and ethylene glycol over a stretched surface. The flow is discussed with and without effective Prandtl number. MHD liquid is considered. Electric field is absent. Effect of uniform magnetic field is taken in the vertical direction to the surface. Influence of thermal radiation as well as Joule heating are taken into account for both aluminum oxide-water and aluminum oxide-Ethylene glycol nanofluids. Velocity slip and melting heat effects are considered. METHODS: The nonlinear flow expressions are numerically solved via ND-solve technique (built-in-Shooting). RESULTS: The physical impacts of flow variables like mixed convection parameter, magnetic parameter, Reynold number, Eckert number, melting parameter and heat source/sink parameter are graphically discussed. Moreover, entropy generation (irreversibility) and Bejan number are discussed graphically through various flow variables. Physical quantities like skin friction coefficient and Sherwood and Nusselt numbers are numerically calculated and discussed through Tables. CONCLUSIONS: Impact of magnetic and slip parameters on the velocity field show decreasing behavior for both effective and without effective Prandtl number. Temperature field increases for both effective and without effective Prandtl number for higher values of magnetic and radiative parameters. Entropy number is an increasing function of Reynolds number while Bejan number shows opposite impact against Reynolds number. Moreover, heat transfer rate upsurges versus larger melting and radiative parameter.

Comparative efficacy of Prolene and Prolene-Vicryl composite mesh for experimental ventral hernia repair in dogs.

In this study, efficacy of two hernia mesh implants viz. conventional Prolene and a novel Prolene-Vicryl composite mesh was assessed for experimental ventral hernia repair in dogs. Twelve healthy mongrel dogs were selected and randomly divided into three groups, A, Band C (n=4). In all groups, an experimental laparotomy was performed; thereafter, the posterior rectus sheath and peritoneum were sutured together, while, a 5 × 5 cm defect was created in the rectus muscle belly and anterior rectus sheath. For sublay hernioplasty, the hernia mesh (Prolene: group A; Prolene-Vicryl composite mesh: group B), was implanted over the posterior rectus sheath. In group C (control), mesh was not implanted; instead the laparotomy incision was closed after a herniorrhaphy. Post-operative pain, mesh shrinkage and adhesion formation were assessed as short term complications. Post-operatively, pain at surgical site was significantly less (P<0.001) in group B (composite mesh); mesh shrinkage was also significantly less in group B (21.42%, P<0.05) than in group A (Prolene mesh shrinkage: 58.18%). Group B (composite mesh) also depicted less than 25% adhesions (Mean ± SE: 0.75 ± 0.50 scores, P≤0.013) when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions (n=2), or, only flimsy adhesions (n=2) in group B (composite mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. Conclusively, the Prolene-Vicryl composite mesh proved superior to the Prolene mesh regarding lesser mesh contraction, fewer adhesions and no short-term follow-up complications.

Remote preconditioning and major clinical complications following adult cardiovascular surgery: systematic review and meta-analysis.

BACKGROUND: A number of 'proof-of-concept' trials suggest that remote ischaemic preconditioning (RIPC) reduces surrogate markers of end-organ injury in patients undergoing major cardiovascular surgery. To date, few studies have involved hard clinical outcomes as primary end-points. METHODS: Randomised clinical trials of RIPC in major adult cardiovascular surgery were identified by a systematic review of electronic abstract databases, conference proceedings and article reference lists. Clinical end-points were extracted from trial reports. In addition, trial principal investigators provided unpublished clinical outcome data. RESULTS: In total, 23 trials of RIPC in 2200 patients undergoing major adult cardiovascular surgery were identified. RIPC did not have a significant effect on clinical end-points (death, peri-operative myocardial infarction (MI), renal failure, stroke, mesenteric ischaemia, hospital or critical care length of stay). CONCLUSION: Pooled data from pilot trials cannot confirm that RIPC has any significant effect on clinically relevant end-points. Heterogeneity in study inclusion and exclusion criteria and in the type of preconditioning stimulus limits the potential for extrapolation at present. An effort must be made to clarify the optimal preconditioning stimulus. Following this, large-scale trials in a range of patient populations are required to ascertain the role of this simple, cost-effective intervention in routine practice.