Simulation of non-Newtonian flow of blood in a modified laparoscopic forceps used in minimally invasive surgery.

During surgeries, blood often oozes out of the operated tissue and this has to be sucked out by the S-I device. Blood is more viscous than saline, the cleaning fluid is used in the S-I process. Therefore, for a more comprehensive CFD flow analysis of the improved forceps is simulated in the present work for different driving pressures. The resulting flow rate of blood is compared among the prospective designs and the S-I device currently in use. The new surgical forceps eliminates re-insertion of dissector with suction-irrigator and is reusable, multi-functional, non-toxic, corrosion resistant, toughened, and cost-effective.

Design and fluid flow simulation of modified laparoscopic forceps.

Laparoscopic surgery has gained prominence in recent decades and employed in minimally invasive surgeries to avoid massive cuts resulting in a reduction in pain, the chance of infection, and duration of stay in the hospital. Maryland forceps, which belongs to the category of grasper instruments, are often used in minimally invasive surgeries to hold, pull, push, manipulate, and perform dissection operations. During laparoscopic surgeries, often blood and other body fluids ooze from the site of surgery. Typically, suction-irrigation (SI) devices are used to periodically clear these fluids to get a better view of the site of surgery. To achieve this, the removal and insertion of multiple instruments are required. This process has to be repeated numerous times, which significantly increases the time needed for surgery. Literature survey and feedback from practicing surgeons suggest that this can be avoided by improving the current design of forceps. In this article, a modified design is proposed by combining the SI feature with the existing form of Maryland forceps. The modified design is first modeled in SolidWorks and then analyzed for fluid flow using ANSYS Fluent. Parametric analysis is performed to obtain the optimal design for the proposed multi-functional instrument, which can potentially improve the overall efficiency of the laparoscopic surgical process.

Control of the buffalo fly Haematobia irritans exigua in India, using the pyrethroids deltamethrin and fenvalerate.

The effectiveness of two pyrethroids, fenvalerate and deltamethrin, against the fly Haematobia irritans exigua de Meijere (Diptera: Muscidae) on buffalo was considered in a field trial. Fenvalerate provided 100% control for 1, 2 and 4 weeks at concentrations of 0.03, 0.04 and 0.05%, respectively. Concentrations of 0.01 and 0.02% were less effective. One hundred percent control of this fly was obtained with deltamethrin for 2, 3 and 6 weeks at concentrations of 0.003, 0.004 and 0.005%, respectively. Deltamethrin concentrations of 0.001% and 0.002% achieved fly control for only 1-2 weeks, respectively.

Assessment of antianginal efficacy of long-acting sustained release isosorbide dinitrate in comparison with short-acting isosorbide dinitrate.

A quadruple blind randomized cross-over study evaluated the therapeutic efficacy of twice a day long acting sustained release isosorbide dinitrate (SRISDN) in comparison with 4 times daily of the short acting isosorbide dinitrate in 18 patients with stable angina pectoris (NYHA class II-III) with a positive exercise treadmill test. The antianginal effect of sustained release isosorbide dinitrate (SRISDN) (exercise duration 472.61 +/- 112.49 sec and anginal episodes per week (1.33 +/- 1.18) was not significantly different (p less than 0.05) when compared to conventional isosorbide dinitrate (exercise duration 468.33 +/- 135.28 sec and anginal episodes per week 1.55 +/- 104). Twice a day long acting sustained release isosorbide dinitrate is as effective as four times a day conventional short acting isosorbide dinitrate. Such a regimen is likely to lead to a better patient compliance and ease of antianginal therapy.

Restenosis after successful coronary angioplasty in single vessel disease.

One hundred and ninety five patients who underwent successful percutaneous transluminal coronary angioplasty (PTCA) for single vessel disease and have been followed up for more than 6 months are being reported. Angiography was done routinely in first 20 patients (Group 1) 8 to 15 weeks (mean 9.6 weeks) after PTCA. Restenosis (loss of 50% of the initial improvement in luminal diameter) was seen in 4 patients (20%). The remaining 175 patients (Group II) have been followed up clinically and subjected to serial exercise testing. Coronary angiography was performed only if symptoms and/or objective evidence of ischemia recurred. In this group, restenosis suspected clinically and confirmed by angiography occurred in 37 patients (21%), 2 to 23 weeks (mean 12.5 weeks) after PTCA. The restenosis rate for the entire patient population was 21%. In general the restenosed lesions were longer and tighter than the lesions before PTCA. A comparison of 41 patients with restenosis with those who did not have clinical restenosis revealed a proximal left anterior descending artery (LAD) involvement (66% vs 31%, p = 0.01), crescendo unstable angina (37% vs 16% p = 0.05), length of pre PTCA stenotic lesion greater than or equal to 1 cm (41% vs 27.5%, p less than 0.05), absence of intimal haziness in immediate post PTCA angiogram (27% vs 16%, p less than 0.05) and residual stenosis greater than or equal to 25%, (34% vs 14% p less than 0.05) in the restenosis group. Repeat PTCA was done in 30 patients with a 96% success rate; 4 patients required coronary artery bypass grafting (CABG). Restenosis after PTCA is a significant problem in our experience.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of factors predisposing to arterial thrombosis in coronary artery disease.

Estimation of antithrombin III, alpha 2 macroglobulin and alpha 1 antitrypsin in patients with stable and unstable angina and acute myocardial infarction (15 cases each) were carried out. Twenty age, sex and weight matched healthy subjects were included as controls. Mean platelet factor 4(PF4) levels measured in 10 cases of each subgroup were significantly elevated in myocardial infarction (MI) (48.4 +/- 15.16 ng/ml) and III unstable angina patients (44.7 +/- 15.9 ng/ml) as compared to controls (25.42 +/- 12.47 ng/ml; P less than 0.01). Mean antithrombin III (AT III) levels were markedly reduced in all patients with MI (39.65 +/- 12.8% of normal pooled plasma) and unstable angina (37.9 +/- 16.6% of normal pooled plasma) and in 9 patients with stable angina. Alpha I antitrypsin and alpha 2 macroglobulin levels in these cases showed no significant difference compared to normals. Reduced AT III in coronary artery disease suggests a prethrombotic tendency in these patients. Raised PF4 levels in acute phase of the disease suggests heightened platelet activation.

Emergency treatment with ketoconazole in disseminated intravascular coagulation due to metastatic prostatic carcinoma.

We report the use of ketoconazole to control disseminated intravascular coagulation due to prostatic carcinoma. Clinical improvement in the condition of the patient was noted in 48 hours and coagulation profile became normal in 10 days.

Synthesis and central nervous system activities of certain fluorine-containing 3-substituted indol-2-ones.

Several fluorine-containing 3- aroylmethyl -3-hydroxyindol-2-ones (4a-g), 3- aroylmethyleneindol -2-ones (5a-g) and 3- aroylmethylindol -2-ones (6a-g) were synthesized from the corresponding fluorine-containing indole-2,3-diones and appropriate ketones. The compounds were characterized by spectral studies. Representative compounds of each series were tested on mice for CNS activities, viz. analgesic and anticonvulsant and the effects were also observed against amphetamine-induced stereotypy, on conditioned avoidance response and on potentiation of pentobarbitone sodium hypnosis. Of the compounds examined, the greatest degree of activity was observed in 3- aroyl - methyleneindol -2-ones with a pronounced unsaturation in the system.