562 Midline Versus Off Midline Extraction Site in Laparoscopic Left Sided Colorectal Resections for Colorectal Malignancy: A Systematic Review and Meta-Analysis

Method

To evaluate comparative outcomes of off-midline and midline extraction sites in laparoscopic left sided colorectal resections.

Method

A systematic search of electronic databases and bibliographic reference lists was conducted, and a combination of free text and controlled vocabulary search was adapted to thesaurus headings, search operators and limits in electronic databases were applied. Studies comparing the outcomes of Off Midline and Midline incisions for specimen extraction in laparoscopic left sided colorectal resections were included. Incisional hernias, surgical site infections, operative time, estimated blood loss, anastomotic leak and length of hospital stay were the evaluated outcome parameters.

Results

We identified 5 comparative studies reporting a total of 1187 patients comparing outcomes of off-midline (n=486) and midline (n=701) incisions for specimen extraction in laparoscopic left colorectal resections. The off-midline approach was associated with lower post operative surgical site infection (OR 0.71, P=0.68), anastomotic leak (OR 0.76,P=0.66), and incisional hernia (MD: 0.65,P=0.64) compared to midline approach, however it was not statistically significant. There was no significant difference in operative time (MD: 0.10, P=0.99), intra-operative blood loss (MD 2.31, P=0.91), and post-operative hospital stay (MD : 0.78, P=0.18) between the two groups.

Conclusions

Off-midline extraction site for left sided colorectal resections have no significant difference in rates of post operative surgical site infection and incisional hernias when compared to midline extraction site. No significant difference was found in operative time, intra-operative blood loss, anastomotic leak and post operative hospital stay in this study. Future higher-level research is required to further evaluate the clinical outcomes.

Pathogenesis-Related Gene Expression in Response to Trachyspermum ammi Supplementation Along With Probiotics in Chicken Salmonellosis and Insights in Drug Therapeutics

Salmonella enterica serovar typhimurium (S. typhimurium) is the leading cause of foodborne illness. Since Salmonella continues to have a detrimental effect on public health, there is an ongoing need to develop more advanced methods for combating Salmonellosis in foods before they reach consumers. In addition, the quest for alternative natural products has recently intensified due to increasingly stringent regulations regarding the use of antibiotics as growth promoters and consumer demand for antibiotic-free poultry products. This study evaluated the effect of Ajwain extract (AJE) on immune response and antioxidant status in broiler chicks challenged with Salmonella typhimurium. The chicks were infected with S. typhimurium and were divided into the different groups, except for the control group (CON). The challenged chicks received different treatments with 3 × 109 colony-forming unit (CFU) AciproTM-WS probiotic (PRO), 200 mg/kg Ajwain extract (AJE), 200 mg/100 kg of enrofloxacin (ENR), and a combination of 3 × 109 CFU AciproTM-WS probiotic and 200 mg/kg Ajwain extract (COM). Five days posttreatment, the tissue samples (liver and spleen) were analyzed. The results showed that basal diet supplemented with Ajwain extract (AJE) and a combination of probiotic and Ajwain extract (COM) significantly (P < 0.0.5) reduced the cytokine expression in broiler chicks challenged with S. typhimurium. Our findings suggest that AJE can clear the bacterial infection, improve antioxidant status, and suppress the inflammation response. Additionally, AJE supplementation significantly mitigated the S. typhimurium-induced increase in the interleukin-6 (IL-6) (liver and spleen), interleukin-8 (IL-8) (liver and spleen), interleukin-17A (IL-17A) (liver and spleen), and inducible nitric oxide (iNOS) (spleen and liver) levels (P < 0.05). We conclude that Ajwain is an efficient feed additive with antioxidant and anti-inflammatory properties. The interaction networks developed in this study provide a novel lead that could be targeted for anti-inflammatory and antioxidant properties.

Genome wide expression analysis of circular RNAs in mammary epithelial cells of cattle revealed difference in milk synthesis

Milk is an excellent source of nutrients for humans. Therefore, in order to enhance the quality and production of milk in cattle, it is interesting to examine the underlying mechanisms. A number of new investigations and research have found that, circRNA; a specific class of non-coding RNAs, is linked with the development of mammary gland and lactation. In the present study, genome wide identification and expression of the circRNAs in mammary epithelial cells of two distinct cattle breeds viz Jersey and Kashmiri at peak lactation was conducted. We reported 1554 and 1286 circRNA in Jersey and Kashmiri cattle, respectively, with 21 circRNAs being differentially expressed in the two breeds. The developmental genes of the established differentially expressed circRNAs were found to be largely enriched in antioxidant activity, progesterone, estradiol, lipid, growth hormone, and drug response. Certain pathways like MAPK, IP3K and immune response pathways were found significantly enriched in KEGG analysis. These results add to our understanding of the controlling mechanisms connected with the lactation process, as well as the function of circRNAs in bovine milk synthesis. Additionally, the comparative analysis of differentially expressed circRNAs showed significant conservation across different species.

Outcome of Mineral Trioxide Aggregate Pulpotomy for Mature Permanent Molars with Symptoms Indicative of Irreversible Pulpitis

Root canal treatment (RCT) is preferred treatment for mature teeth with irreversible pulpitis. But sometimes it is very difficult to perform due to complex pulpal anatomy and the vitality of tooth is completely lost by this procedure. A new hope has been emerged to consider pulpotomy treatment as an effective treatment in mature permanent teeth with irreversible pulpitis as with the new understanding of pulp biology and recent innovation of bioactive material like MTA. The aim of the study was to evaluate the outcome of MTA pulpotomy for mature third molars with symptoms indicative of irreversible pulpitis. This quasi-experimental study was conducted at Department of Conservative Dentistry and Endodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from September 2019 to August 2020. Twenty permanent mandibular third molar teeth with fully developed roots and diagnosed as irreversible pulpitis in 20 patients aged 25-50 years were selected for this study. After informed consent, each tooth was anaesthetized, isolated with dental dam and disinfected with 5% NaOCl before caries excavation; caries was removed, and then, a full pulpotomy was performed. Haemostasis was achieved and MTA (Angelus, Brazil) was placed as the pulpotomy agent over the pulp chamber floor covering the canal orifices and rest of the cavity was sealed with glass-ionomer filling over the set MTA. Clinical and radiographic evaluation was completed at 3 months, 6 months, and 1 year postoperatively. Descriptive statistics were used to assess outcomes. The recall rate ranged from 90% at 3 months to 85% at 1 year, with an overall 100% clinical and radiographic success during the 3 month and 6 month, and 95% success at the end of 1 year. MTA pulpotomy sustained a good success rate over the 1 year follow-up in mature third molar teeth clinically diagnosed with irreversible pulpitis.

Genotyping and antibiotic resistance patterns of Campylobacter fetus subsp.venerealis from cattle farms in India

Bovine genital campylobacteriosis caused by Campylobacter fetus subsp. venerealis (Cfv) is of considerable economic importance to the cattle industry worldwide. Cfv causes syndrome of temporary infertility in female cattle, early embryonic mortality, aberrant oestrus cycles, delayed conception, abortions and poor calving rates. In the present study, a total of 200 samples obtained from vaginal swabs, cervicovaginal mucous (CVM), preputial washes and semen straws were investigated that were obtained from organized cattle farm of MLRI, Manasbal and unorganized sectors. Out of a total of 200 samples, 49 (47·57%) vaginal swabs, 1 (3·33%) preputial wash and 8 (25%) carried out CVM samples were positive for Cfv, whereas none of the semen straws were positive for Cfv. A total of eleven isolates of Cfv were recovered. PFGE (Pulse field gel electrophoresis) analysis revealed four different pulsotypes (I-IV) circulating in the screened farms. A common pulsotype circulating among farms could not be established. Insertion element (ISCfe1), a 233 bp amplicon of Cfv, was sequenced and the sequence was deposited in GenBank (accession no: MK475662).

Picosecond 554 nm yellow-green fiber laser source with average power over 1 W

We demonstrate a source of 554 nm pulses with 2.7 ps pulse duration and 1.41 W average power, at a repetition rate of 300 MHz. The yellow-green pulse train is generated from the second harmonic of a 1.11 μm fiber laser source in periodically-poled stoichiometric LiTaO3. A total fundamental power of 2.52 W was used, giving a conversion efficiency of 56%.

An unbalanced half-cryptic translocation involving the 6q subtelomeric region and 2p25.3 in a child with mental retardation: uses and limitations of fluorescence in situ hybridization

We report on a 5-year-old boy with minor anomalies, growth retardation, and developmental delay carrying an extra chromatin material on the terminal band of the long arm of chromosome 6. To determine the origin of this extra material, whole chromosome fluorescence in situ hybridization (FISH) was used initially. Results showed fully painted 6qs, excluding the possibility of a derivative. However, maternal cytogenetic investigation suggested the presence of a possible half-cryptic balanced translocation that was further assessed using specific subtelomeric FISH probes of chromosome 6. Results showed that the 6q subtelomeric region was translocated on an A-group chromosome that was ultimately characterized, using FISH, as chromosome 2. This illustrates the use of specific subtelomeric regions and the limitations of whole chromosome FISH to identify the origin of a subtle chromosomal abnormality.

Stability of neurological soft signs in chronically hospitalized schizophrenic patients

Neurological soft signs (NSS) have been shown to be more prevalent in chronically ill and in acute or never-mediated patients with schizophrenia. If neurological soft signs are trait-like, then NSS scores should be relatively stable over time and should not be related to changes in patients' psychopathology or medication. Chronically hospitalized patients with schizophrenia were rated two or more times over a 5-year period with standard NSS and psychopathology scales. Total NSS scores were highly correlated over time, and changes in NSS scores at two time points were not significantly related to changes in psychopathology scores. Total NSS scores did not change significantly in a subsample rated when they were first treated with a traditional neuroleptic and later with an atypical neuroleptic. The findings suggest total NSS scores may have some characteristics of a trait-like feature in chronically hospitalized patients with schizophrenia.

Campylobacter jejuni enterocolitis in neonates

Campylobacter jejuni is one of the leading bacterial pathogens causing acute gastroenteritis in children. Only a few cases have been described in the world literature about neonatal enterocolitis due to campylobacter and none from Saudi Arabia. We describe six cases of neonatal enterocolitis due to this organism isolated during the period from September 1989 - January 1991 at Suleimania Children's Hospital, Riyadh, Saudi Arabia. All of the patients presented with diarrhea; duration ranging from 1-20 days. Three patients had blood and two had mucus in their stool. In contrast to the findings of other investigators, five neonates presented with fever. One neonate was treated with erythromycin, another received augmentin, and two received other antibiotics because of suspected sepsis. In one patient, previous antibiotics were discontinued and erythromycin was added and two received no antibiotics. Campylobacter infection should be suspected in any neonate presenting with diarrhea accompanied by mucus and blood in the stool.

Management of severe tracheal stenosis caused by repeated endotracheal intubation in a patient of myasthenia gravis

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. The disease is characterized by exacerbation and remission of the symptoms from time to time. Myasthenic crisis is a serious complication of MG and is defined as weakness from acquired MG that is severe enough to require intubations [1]. Myasthenic crisis may complicate in 15-20% of patient with MG [2], [3]. Most patients require ventilation for a brief period, usually less than two weeks [4]. Repeated intubations may cause tracheal stenosis. The potential risk factors for post-intubation subglottic stenosis include, the underlying disease requiring endotracheal intubations(EI), the age and body weight, the duration and number of EIs, absence of sedation and the occurance of infections, hypotensive or hypoxic events during the period of EI and traumatic EI [5], [6].Key words: Tracheal stenosis, Repeated intubations, Myasthenia gravis.DOI: 10.3329/pulse.v3i1.6550Pulse Vol.3(1) July 2009 p25-26