PULP Score vs AAST EGS Grading System in Prediction of Outcome of Perforated Peptic Ulcer Disease: A Retrospective Study

Introduction: Peptic Ulcer Disease (PUD) is the most common diagnosis for upper abdomen pain, and it includes ulcerations and erosion in the Stomach and Duodenum. Complication such as Perforated PUD (PPUD) is only second to bleeding and remains a life-threatening emergency. Aim: To compare the American Association for the Surgery of Trauma– Emergency General Surgery (AAST EGS) scoring system with a widely accepted Peptic Ulcer Perforation (PULP) scoring system for PULP to determine the discriminative capacity and pairwise comparison of both scoring systems. Materials and Methods: This was a retrospective study conducted from September 2018 to August 2020 at Department of General Surgery, PES institute of Medical Science, Kuppam, Andhra Pradesh, India. All the adults diagnosed with perforated PUD were included. Preoperative, Intraoperative, and postoperative data were collected. The scores were generated for PULP and AAST EGS grades and analysed using Statistical Package for Social Sciences (SPSS) version 17.0. Spearman’s rho test evaluated a comparison of each variable with the AAST EGS grade. The pairwise comparison was performed for complication development, patient duration of stay, mortality and described using the Area Under the Receiver Operating Characteristic (AUROC) with 95% confidence intervals. Results: This study included 165 patients in this 87% male with a mean age of 56.89±16.79 years. All the total patients were divided into those <=50 years (n=56,mean age:36.8±9.04 years) and >50 years (n=109,mean age: 67.2±8.4 years) and comparative analysis was performed accordingly. Overall, the patients were categorised into the following AAST EGS grade I (9, 5.5%), grade II (99, 60%), grade III (42, 25.45%), grade IV (15, 9%), there were no patients with grade 5 AAST EGS. The AAST EGS grade was comparatively better them PULP score for postoperative complications, but there is not much difference between the PULP score and AAST EGS score for the patient's duration of stay. AAST EGS grade and the PULP discriminated, patient 30-day mortality similarly, but if Area Under Curve (AUC) >0.8, it is a good predictor. Conclusion: The AAST EGS scoring system and the PULP scoring system do similarly predict mortality and complication. But the presence of many variables with points and tabulation which requires laboratory investigation makes PULP scoring system inconvieninent at bedside.

Green-Synthesized FeSO4 Nanoparticles Exhibit Antibacterial and Cytotoxic Activity by DNA Degradation

OBJECTIVE

The current study reports a green, rapid and one-pot synthesis of FeSO4 nanoparticles using Hibiscus rosasinensis floral extract as a reducing and capping agent. 0.5M of FeSO4 was stirred with the floral extract of H. rosasinensis for around 20 minutes at 37ºC and pH 7.

METHODS

The development of pink color was considered as the endpoint of reduction and the nanoparticles were characterized by UV-Vis spectrum, EDAX, DLS, FTIR, FESEM, and XRD. UV-Vis spectral analysis indicated a peak at 530 nm and EDAX measurement revealed the presence of Fe, S, O and C elements in the nanoparticle sample. The FTIR analysis showed amines, alcohol and alkene groups that act as capping agents for the produced nanoparticles. FESEM and XRD determination presented FeSO4 nanoparticles of 40-60 nm in size. The synthesized nanoparticles were found to have antibacterial activity against 6 pathogenic bacteria with MIC and MBC of 40 mg/mL.

RESULTS

To determine the toxicity at the eukaryotic level, brine shrimp toxicity assay was conducted and 100% mortality was found at concentrations >0.06 mg/mL. Gel shift assay suggested the mechanism of toxicity of FeSO4 NPs by binding and degradation of DNA molecules.

CONCLUSION

From the results, the authors demonstrate the ease of green synthesis of FeSO4 nanoparticles and its bioactivity that may have potential applications as drugs and drug delivery systems against various diseases.

Atomic Layer Deposition of Ultrathin Crystalline Epitaxial Films of V2O5

Ultrathin epitaxial films (10-90 nm thick) of V₂O₅ have been grown on c-Al₂O₃ by atomic layer deposition using vanadyl acetylacetonate as the vanadium precursor along with oxygen plasma. Various process parameters have been optimized for the purpose, and excellent crystalline films could be obtained below 200 °C, without the need for post-heat treatment. With a moderate temperature window, the process yields a growth rate of 0.45 Å/cycle. The films have been characterized by electron microscopy, atomic force microscopy, Raman spectroscopy, and other means. The films exhibit a (001) preferred orientation with respect to c-Al₂O₃ and undergo compressive strain at the initial few monolayer growth to adjust epitaxially with the substrate. Heterojunction diodes based on TiO₂(p)-(n)V₂O₅ as well as a humidity sensor have been fabricated using the V₂O₅ films.