A 'twist' in the tale of a 'simple' laparoscopic cholecystectomy: Duplication of the gall bladder.

The duplication of the gall bladder (GB) is unusual biliary anatomy that can be encountered during cholecystectomy and can create intraoperative confusion if missed on pre-operative imaging. Here, we describe a case of duplication of GB in a young female, which was detected during laparoscopic cholecystectomy as an operative surprise. Laparoscopic cholecystectomy was done successfully with the removal of both the GBs. She was discharged uneventfully and remained symptom-free at a 6-month follow-up.

Computational fluid dynamics-based disease transmission modeling of SARS-CoV-2 Intensive Care Unit.

Covid-19 has become one of the most severe diseases causing acute respiratory problems and has killed millions of people worldwide. It was declared as the ongoing pandemic by the World Health Organization. It is an infectious virus which can be transmitted by sneezing, coughing and exhalation of air by any infected person. There are certain places having high chances of becoming contaminated like hospital rooms. In this context, we studied the transmission of Covid-19 particles in an ICU room. We have considered the combined effect of both of air-conditioning (AC) and ceiling fan in the room. The infected person can transmit the disease when under influence of fan and AC. The work highlights the flow of aerosol particles considering the combined effect as well as the individual effects of fan and AC. The results also emphasized that the aerosol particle flow have a promising application in sanitizing the room.

Application of RP-HPLC method in dissolution testing and statistical evaluation by NASSAM for simultaneous estimation of tertiary combined dosages forms.

A dissolution method with robust high performance liquid chromatographic (HPLC) analysis for immediate release tablet formulation was developed and validated to meet the requirement as per International Conference on Harmonization (ICH) and United States Food and Drug Administration (USFDA) guidelines. The method involved the use of Agilent ZORBAX Eclipse XDB C18 column, and temperature was maintained at 30 °C. After optimization, the mobile phase was selected as phosphate buffer (KH2PO4, 30 mM) : ACN (60:40, v/v) with pH 3.0, and retention time Rt was found as 3.24, 4.16, and 2.55 min for paracetamol (PCM), chlorpheniramine maleate (CPM) and phenylephrine hydrochloride (PH) respectively at 265 nm and at a flow rate of 1 mL/min. The relative standard deviation (%RSD) for 6 replicate measurements was found to be less than 2%. Furthermore net analyte signal standard addition method (NASSAM) with spectrophotometer was performed for standard and liquid oral suspension. On the basis of selectivity, sensitivity and accuracy analysis, it was confirmed that this novel method could be useful for simultaneous estimation of the given drug combinations. Two-way analysis of variance (ANOVA) was applied for evaluating the statistical difference between the assay results obtained via both NASSAM and RP-HPLC methods and ultimately no significant difference was found between both the methods. All the methods and results were acceptable and confirmed that the method was suitable for intended use.

Management of oral submucous fibrosis by different surgical approaches: report of three cases.

Oral submucous fibrosis (OSMF) is an insidious chronic progressive disease of the oral cavity which is considered as a precancerous condition. The suggested aetiological factor is the practice of certain customs/habits of the inhabitants of South East Asia. As the disease progresses, the oral mucosa becomes stiff due to the formation of fibrotic bands in the cheek, ultimately leading to reduced mouth opening and trismus. The early form of the disease can be treated by medicinal means, however, advance form needs surgical excision of the fibrotic tissue bands. The defect created due to the excision needs to be repaired by various grafts including split thickness skin grafting, bilateral nasolabial flaps, palatal island flaps, tongue flaps, buccal fat pad graft and temporalis muscle flap graft. We present the management of trismus following OSMF by various surgical approaches in three cases.