A Study of Association of Plasma Procalcitonin with Various Components of Metabolic Syndrome and Insulin Resistance.

The metabolic syndrome is a cluster of risk factors that are associated with increased risk of cardiovascular diseases and Type 2 diabetes mellitus. The aim was to study the association of plasma procalcitonin with various components of metabolic syndrome (abdominal obsesity, dyslipidemia, hypertension and hyperglycemia) and insulin resistance and compare with healthy controls. In addition, we tried to gauge the association of plasma procalcitonin with complications of metabolic syndrome at presentation. MATERIAL: This was a hospital based observational comparative study on 30 cases of metabolic syndrome in hospital wards and OPD of SMS Medical College, Jaipur and 30 accompanying healthy controls. INCLUSION CRITERIA: Age more than 18 years, and newly diagnosed or old cases of metabolic syndrome using the definition given by International Diabetes Federation (2006). EXCLUSION CRITERIA: Individuals with active infection, trauma, surgery, neoplasms, cirrhosis, pancreatitis and autoimmune diseases or taking medications which can alter the biochemical profile. Detailed history was taken, subjects clinically examined and anthropometric measurements were taken. Required investigations were obtained and statistical analysis done. OBSERVATION: Plasma procalcitonin was significantly higher in cases (mean 0.11 ng/ml) compared to controls (mean 0.002 ng/ml). Waist and neck circumference (102.87±5.19 and 42.03±3.08) values were higher in case group compared to control group (79.67 ±7.98 and 37.10±1.35). Plasma procalcitonin significantly (p<0.05) correlated with level of insulin resistance (HOMA IR), waist circumference, neck circumference, S. Triglycerides, S. VLDL, fasting blood glucose and fasting insulin level in the case group when analyzed by linear regression analysis. We also found that out of 30 subjects in cases, 16.7% had history of MI, whereas in control group no subject was reported with MI. In case of history of CVA, 16.7% had CVA in case group, whereas in control group, no patient was reported with CVA., Conclusion: Our findings based on community-based data showed that higher plasma procalcitonin levels in the normal range are associated with increased measures of obesity, components of the metabolic syndrome, and greater risk of having metabolic syndrome and insulin resistance. Because associations only partly depend on BMI, plasma procalcitonin may serve as a new marker for adipocyte dysfunction, chronic low-grade inflammation, or both.

A Prospective Comparative Study of 3-Stitch Mesh Hernioplasty with Conventional Lichtenstein Repair.

Background: Hernioplasty, in which a mesh is used to strengthen a weakness or defect in the inguinal wall, has replaced simple tissue repair. As it is associated with low recurrence, it is considered the gold standard and is one of the most common general surgical procedures. The ideal repair should be rapid, safe and simple to do, requires minimal dissection to create sufficient space, be cost-effective and be accompanied by a brief hospital stay, reduced pain, and fewer recurrences. The aim of the present study was to compare the efficacy of 3-stitch mesh fixation with that of traditional Lichtenstein mesh fixation of inguinal hernia repair. Materials and Methods: Between July 2018 and December 2019, 59 cases of primary, uncomplicated inguinal hernias were surgically treated. Both the classical Lichtenstein technique (group A, n = 30) and the Lichtenstein technique with the three-stitch fixation method (group B, n = 29) were used on patients with inguinal hernias. Between the two groups, the mean operative times, post-surgical pain scores, average hospital stays and postoperative complications including recurrence rates were compared. Results: With a P-value of 0.001, the 3-point fixation group (group B) took 3.41 ± 0.58 min less time to fix the mesh than the Lichtenstein group (group A, 5.52 ± 0.59 min). The pain after surgery was much less for participants who had 3-point mesh fixation than for those who had conventional mesh fixation in the early (1, 3, 7 and 15 days after surgery) and late (1 month and 3 months) postoperative periods, with a P-value of 0.0001. When compared to the classical mesh fixation group, the 3-point mesh fixation group had less urinary retention, seroma and swelling. Both groups had the same number of other complications. Conclusions: The three-point hernioplasty is a simple procedure that is easier to adopt, less time-consuming, causes less trauma and has a lower risk of postoperative discomfort including chronic groin pain.

Deoxygenative reduction of carbon dioxide to methane, toluene, and diphenylmethane with [Et2Al]+ as catalyst.

The strong Lewis acid [Et(2)Al](+) catalyzes the reduction of carbon dioxide with hydrosilanes under mild conditions to methane. In benzene solution, the side products toluene and diphenylmethane are also obtained through Lewis acid catalyzed benzene alkylation by reaction intermediates.

Role of Lignocaine Nebulization as an Adjunct to Airway Blocks for Awake Fiber-Optic Intubation: A Comparative Study.

CONTEXT: Airway management is a crucial skill and area of concern for the anesthesiologist. Awake fiber-optic intubation (AFOI) remains the gold standard in managing difficult airway. Anaesthetizing the airway along with psychological assurance is the mainstay for Preparation of AFOI. Different topical and regional techniques have been developed to subdue reflexes and facilitate AFOI. AIM: This randomized controlled study was performed to evaluate the effectiveness of using lignocaine nebulization in addition to specific airway blocks for AFOI. METHODOLOGY: This was a comparative study conducted in 60 patients with difficult airway (LEMON score >2) and randomly allocated into two groups of 30 each. Group LB and Group NB received nebulization of 2% lignocaine 4 mL and 0.9% normal saline 4 mL, respectively. Both groups were then given airway blocks as bilateral superior laryngeal (2% lignocaine 1-2 mL each) and transtracheal (2% lignocaine 4 mL) block. Two puffs of 10% lignocaine to nose and postnasal space on each side were given in both groups. Fiber-optic bronchoscopy (FOB)-guided tracheal intubation was Performed. Vital parameters, side effects, bronchoscopy-guided intubation time and other parameters as intubation grading scale, patient comfort score, satisfaction score were recorded. Chi-square test and unpaired t-test were used for statistical analysis. RESULTS: Statistically, no significant differences were found in hemodynamic parameters, demographics, intubation time, and intubation grading scale in both groups. However, overall patient comfort and satisfaction score was better in Group LB. CONCLUSION: Upper airway blocks provide adequate anesthesia for awake FOB, but when lignocaine nebulization is added to these blocks, it improves the quality of anesthesia and patient satisfaction.

Organic-inorganic hybrid compounds of Li with bisimidazole derivatives: Li ion binding study and topochemical properties.

The imidazole-based ligands, bis(imidazol-1-yl)methane (Bizm, 1a) and (pyrenyl)bis(imidazol-1-yl) methane (Pbizm,2a) were prepared. With LiClO4, these two compounds formed two novel organic-inorganic hybrid materials: a 3D network polymer Li(Bizm).ClO4 (1b) and a 1D chain polymer Li(Pbizm)2.ClO4 (2b). The intriguing topological and physiochemical characteristics of 1b and 2b are reported on the basis of the X-ray single-crystal structure analysis and Li ion binding studies.

Laparoscopic gastric bypass for gastric outlet obstruction is associated with smoother, faster recovery and shorter hospital stay compared with open surgery.

BACKGROUND/PURPOSE: Laparoscopic gastric bypass for relief of gastric outlet obstruction (GOO) is feasible and safe. However, comparative data to confirm the benefits of the laparoscopic approach remain scarce. METHODS: Between 1998 and 2003, 26 patients underwent 15 laparoscopic (surgeon A) and 12 open (surgeon B) gastrojejunostomies (GJs) for GOO. The indications for surgery included malignant (n = 17) and benign (n = 10) diseases. RESULTS: There were no conversions to open surgery in the laparoscopic group, and no operative mortality occurred in either group. The groups were comparable for age, sex, American Society of Anesthesiology (ASA) score, frequencies of previous abdominal surgery and of malignant or benign disease, and type of GJ fashioned. There were no differences between the laparoscopic and open groups with regard to the operating time (median, 90 vs 111 min; P = 0.113), and patients receiving intraoperative blood transfusion. However, laparoscopic surgery was associated with significantly shorter durations of postoperative intravenous hydration (60 vs 234 h; P = 0.001), opiate analgesia (49 vs 128 h; P = 0.025), and hospital stay (3 vs 15 days; P = 0.005). Operative morbidity occurred more frequently following open surgery (33% vs 13%; P = 0.219). CONCLUSIONS: Laparoscopic GJ for the relief of GOO is associated with a smoother and more rapid postoperative recovery and shorter hospital stay compared with open surgery. In experienced hands, the laparoscopic approach to GJ should become the new gold standard.