Estimating the mineral density of trabecular bone using Compton scattering.

This study proposes a technique based on Compton scattering to estimate trabecular bone mineral density (TBMD), which is important for understanding bone strength, and hence, is pivotal for estimating the condition of the bone. Bone phantoms (a mixture of paraffin wax and bone powder) with various concentrations of bone ash were prepared to simulate the trabecular bone. These samples were exposed to primary gamma photon flux from a137Cs (222 GBq) radioisotope source one after the other, and the scattered photon flux was detected using an NaI(Tl) detector. The presence of the cortical bone (using aluminum sheets) and fat (tertiary butyl alcohol) around the trabecular bone was also studied to determine whether the TBMD measurements had been affected. The correlation between bone ash contents and the intensity of Compton scattering was high with a coefficient of 0.97. The outcomes suggest that TBMD is independent of the presence of the cortical bone and overlying fat, with a statistical uncertainty of ±0.3% in the count rate. The intensity of Compton scattering increased by only 1.5% when the thickness of the aluminum sheet (simulating the cortical bone) becomes was increased by four times, and by less than 5% when the bone phantom was surrounded by tertiary butyl alcohol.

Characterization of Eggplant Genotypes for Different Resistance Mechanisms Against Leucinodes orbonalis.

Host plant resistance mechanisms play an important role in developing cultivars with resistance to the target pests; information regarding morphological and biochemical factors contributing to the resistance is essential for developing pest-resistant cultivars. As a result, we investigated the contribution of various morphological and biochemical characters in forty-two eggplant genotypes against Leucinodes orbonalis Guenée, in Himachal Pradesh, India. Out of all the phenotypic parameters evaluated, pericarp thickness (r = 0.89) has significantly positive correlation with fruit infestation, whereas trichome density had significantly negative correlation (r = - 0.89). Analysis of the biochemical compounds in the eggplant genotypes revealed that total phenols (r = - 0.71), polyphenol oxidase (r = - 0.63), peroxidases (r = - 0.35), phenylalanine ammonium lyase (r = - 0.71) and solasodine (r = - 0.81) had significantly negative correlation with the per cent fruit infestation by L. orbonalis while the reducing sugars (r = 0.66) and non-reducing sugars (r = 0.62) showed a significantly positive correlation. Molecular characterization by random amplified polymorphic DNA (RAPD) primers also revealed the presence of high genetic diversity among different eggplant genotypes, where 17 polymorphic RAPD primers produced a total of 167 amplicons, among which 144 amplicons were polymorphic and 23 monomorphic bands. PCR-amplified DNA fragment size ranged from 100 to 2500 bp, mean polymorphism was 86.42% and the average PIC value was 0.444. Jaccards coefficient-based dendrogram grouped 40 eggplant genotypes into two major clusters. Results also revealed that the resistant genotypes accumulated higher levels of defensive biochemical enzymes such as phenols, PO, PPO, PAL and solasodine to confer insect resistance. Molecular characterization also revealed that genotypes in the present study were genetically diverse and could be used in future breeding and improvement programmes in this crop. Genotypes, IC411485 and IC090951, in particular, can be used as varied parents in breeding programmes to generate improved lines in terms of resistance to L. orbonalis.

Dissemination and persistence of extended-spectrum cephalosporin-resistance encoding IncI1-blaCTXM-1 plasmid among Escherichia coli in pigs.

This study investigated the ecology, epidemiology and plasmid characteristics of extended-spectrum cephalosporin (ESC)-resistant E. coli in healthy pigs over a period of 4 years (2013-2016) following the withdrawal of ESCs. High carriage rates of ESC-resistant E. coli were demonstrated in 2013 (86.6%) and 2014 (83.3%), compared to 2015 (22%) and 2016 (8.5%). ESC resistance identified among E. coli isolates was attributed to the carriage of an IncI1 ST-3 plasmid (pCTXM1-MU2) encoding blaCTXM-1. Genomic characterisation of selected E. coli isolates (n = 61) identified plasmid movement into multiple commensal E. coli (n = 22 STs). Major STs included ST10, ST5440, ST453, ST2514 and ST23. A subset of the isolates belong to the atypical enteropathogenic E. coli (aEPEC) pathotype that harboured multiple LEE pathogenic islands. pCTXM1-MU2 was similar (99% nt identity) to IncI1-ST3 plasmids reported from Europe, encoded resistance to aminoglycosides, sulphonamides and trimethoprim, and carried colicin Ib. pCTXM1-MU2 appears to be highly stable and readily transferable. This study demonstrates that ESC resistance may persist for a protracted period following removal of direct selection pressure, resulting in the emergence of ESC-resistance in both commensal E. coli and aEPEC isolates of potential significance to human and animal health.

Non-destructive study of wood using the Compton scattering technique.

A simple nondestructive method is presented in this study to characterize woods having different densities, thus estimating the size and depth of inhomogeneities in given wood samples using the Compton scattering technique (CST). This technique uses a collimated beam of 662-keV energy from 137Cs radioactive source, and the scattered flux is detected by an NaI(Tl) detector. To characterize different wood samples on the basis of their densities, both scattering and transmission experiments were performed. The presence of inhomogeneities such as knots in wood was simulated by drilling cylindrical voids of diameter 9mm in the samples and then filling them with a high-density material (aluminum). Furthermore, different sizes of inhomogeneities (Al cylinders) were filled in the wood samples to estimate the depth and size of the inhomogeneity using the CST. A higher linear correlation (R2 ~ 0.96) was found between the scattered intensity and the density of different woods using the CST than that using the transmission (R2 ~ 0.83) method by measuring the density range. An increase of 24.6% in the average scattered intensity was observed at the location where the knot was present, and it was found that an inhomogeneity of the order of ~4mm or more could be detected by the CST.

The anatomy of Rouviere's sulcus as seen during laparoscopic cholecystectomy: A proposed classification.

INTRODUCTION: Although Rouviere's sulcus is being increasingly mentioned as the first landmark to be seen so as to begin dissection during laparoscopic cholecystectomy to prevent bile duct injuries, the anatomy of the sulcus has not been described in clear and simple terms. OBJECTIVES: To define the detailed anatomy of Rouviere sulcus as seen during laparoscopic surgery in simple terms for the surgeons to refer to and begin their dissection from this, always staying above this sulcus in order to eliminate bile duct injury. METHODS: 100 recordings of laparoscopic cholecystectomy were analysed to define the anatomy of the Rouviere's sulcus. RESULTS: Majority of the sulci (71) were seen as a deep sulcus and were labelled as simply the 'sulcus'. This was further seen to be of two types - open (60) or closed (11). Some of the sulci (23) were small and so narrow and shallow as to be labelled as a 'slit'. Rarely, the sulcus was found to be fused and represented by a white fusion line (6 cases), and this was simply labelled as a 'scar'. CONCLUSIONS: The Rouviere's sulcus can now be defined in three simple terms - a deep sulcus, or a slit or a scar. We recommend that as a first step in laparoscopic cholecystectomy, the surgeon must look for this reference point (whether it is in the form of a scar, or a slit or a real sulcus) which will be the plane of the main bile duct, and thus avoid any dissection below this point in order to eliminate any danger to the bile duct during surgery.

A comparison between modified Alvarado score and RIPASA score in the diagnosis of acute appendicitis.

Acute appendicitis is a common but elusive surgical condition and remains a diagnostic dilemma. It has many clinical mimickers and diagnosis is primarily made on clinical grounds, leading to the evolution of clinical scoring systems for pin pointing the right diagnosis. The modified Alvarado and RIPASA scoring systems are two important scoring systems, for diagnosis of acute appendicitis. We prospectively compared the two scoring systems for diagnosing acute appendicitis in 50 patients presenting with right iliac fossa pain. The RIPASA score correctly classified 88 % of patients with histologically confirmed acute appendicitis compared with 48.0 % with modified Alvarado score, indicating that RIPASA score is more superior to Modified Alvarado score in our clinical settings.

Multiple Giant Sebaceous Cysts of Scalp.

Sebaceous cyst is an epidermal cyst often found on the hairy areas of the body such as scalp, trunk and face. Though commonly encountered in surgical practice, its presentation as multiple giant sebaceous cysts over scalp is rare. However, in long standing cases malignant transformation has also been sparingly reported. We report a case of a 52-year-old male presenting with multiple large sized swellings on the scalp, seven in number. These were present since childhood and gradually progressed to the enormous size of largest measuring 10cm x 8cm. Excision of these cysts was undertaken and specimens were sent for histopathological examination which confirmed the nature of these cysts to be sebaceous cysts. No malignant changes were reported in any of the specimens. The patient was followed up and was doing well.

Laryngopyocele: Presenting with pressure symptom.

Laryngocele is a rare, benign dilatation of the laryngeal saccule that may extend internally into the airway or externally through the thyrohyoid membrane. When it is secondarily infected, it is called laryngopyocele, which is even rarer. Many laryngoceles are asymptomatic; sometimes, they may cause a cough, hoarseness, stridor, sore throat and may present as a swelling on one or both sides of the neck. Laryngocele may be associated with supraglottic squamous cell carcinoma. Computed tomography scan is the most effective imaging method for diagnosis. Surgery is the treatment of choice. A case of large mixed laryngopyocele in a 75-year-old male is described together with surgical management and follow-up. A review of the literature is also presented.

Status of Day Care Laparoscopic Appendectomy in Developing Countries.

The practice of laparoscopic appendectomy as an ambulatory surgery is uncommon even in apex institutes, more so in developing countries, despite proven feasibility. To promote this practice in the developing countries like ours, we attempted to find the safety and cost effectiveness in such institutions which have limited resources. Thirty cases of symptomatic appendicitis were tried for same day discharge after laparoscopic appendectomies. The results were encouraging with 87% patients discharged on the same day and 13% on the next day in the early morning. Among the next day discharged cases, only 03% stayed for medical reasons (nausea, vomiting, and pain) while 10% stayed as their attendants declined to leave (social reasons), even though they were medically eligible for discharge from the hospital. There were no significant postoperative complications except tolerable pain in all patients and mild to moderate nausea/vomiting in 80%. There was no readmission. The mean length of hospital stay was 11.20 hrs. At the time of discharge all patients were highly satisfied. We concluded that routine same day discharge is safe and feasible after appendectomies in developing countries, with social decline as the main hurdle which can be improved by proper communication.

Mesenteric fibromatosis presenting as a diagnostic dilemma: a rare differential diagnosis of right iliac fossa mass in an eleven year old-a rare case report.

An eleven-year-old boy presented with a mass in the right iliac fossa for the last 21 days associated with pain, fever, anorexia, and nausea. The patient was thoroughly investigated and contrast-enhanced CT abdomen revealed a well-defined mass in the region of right iliac fossa. Exploratory laparotomy was done and a mass measuring 10 cm in diameter arising from mesentery of proximal ileum and adherent with the wall of ileum was seen. Resection and anastomosis were done. Histopathological examination showed mesenteric fibromatosis. Postoperatively, patient was well and 3-month followup showed normal recovery.

Multiple extramedullary plasmacytoma with lytic bony lesions: a rare case report.

Objective. Multiple extramedullary plasmacytoma lesions involving subcutaneous tissue, breast, mediastinal tissue, spleen, and soft tissue of pelvic region along with multiple bones plasmacytomas without marrow plasmacytosis are a very rare presentation. Design. Case report. Result. A 54-year-old female was found to have multiple small bony lytic lesions, multiple extramedullary soft tissue plasmacytomas, serum M protein >3 g/dL, and elevated ESR. Bone marrow aspirate did not reveal any evidence of multiple myeloma/plasmacytosis. There was no anemia, hypercalcemia, or renal insufficiency. Conclusion. Extramedullary plasmacytoma can involve multiple organs at a time including bones and soft tissue without involving bone marrow.

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds.

Wound dehiscence is a postoperative complication encountered following abdominal surgery. A prospective randomized study was conducted to compare the incidence of wound dehiscence with a delayed absorbable and a nonabsorbable suture material in the mass closure of vertical laparotomy wounds. In one group, 100 patients were analyzed after closure with Prolene®, and in another group, 100 patients were analyzed after closure with Vicryl®. The incision was closed by continuous far and near suture technique using polypropylene (Prolene) suture in one group and a synthetic delayed absorbable polyglactin 910 (Vicryl) suture in the other group. There was significant difference in the incidence of wound dehiscence between the two groups: 6 % with Prolene and 17 % with Vicryl, (χ (2) = 5.944, 1 DF, P value = 0.0148). The overall incidence of wound dehiscence was 11.5 % in this study. The incidence of wound dehiscence in both the study groups was higher than expected as compared to previous literature. There was a significant difference between the two suture materials. In our study, Prolene is a better suture material for closure of vertical laparotomy wounds.

Isolated cystic duct lymph node tuberculosis.

Tuberculosis of the cystic duct lymph node without involvement of gall bladder is exceedingly rare. Cholelithiasis is a usual accompaniment. A case of 65-year-old woman was diagnosed to have cholelithiasis. Laparoscopic cholecystectomy was performed and a prominent cystic lymph node was excised for biopsy. Histopathology surprisingly reported tuberculosis of cystic duct lymph node without affecting the gall bladder. Thereupon, she was treated with antituberculous chemotherapy.