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Subcuticular suturing has emerged as a prominent technique for abdominal wall closure, offering notable benefits in cosmetic outcomes, infection reduction, and patient satisfaction. This comprehensive review delves into the evolution and current state of subcuticular suturing, examining its principles, techniques, and advancements. Traditional methods like continuous and interrupted suturing are compared with modern innovations like barbed sutures and knotless techniques. Clinical outcomes, including healing efficacy, complication rates, and cost-effectiveness, are analyzed to highlight the technique's advantages. The review also explores specific applications in various surgical specialities, presenting case studies and clinical trials to substantiate its effectiveness. Despite certain challenges and limitations, the future of subcuticular suturing appears promising with ongoing research and technological advancements. This review aims to thoroughly understand subcuticular suturing, emphasizing its significance in improving surgical outcomes and patient care in abdominal wall closure.
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Radial neck fractures with radial head rotation are very rare and extremely difficult to manage. We present the case of an 11-year-old girl who fell on her outstretched left upper extremity and damaged her left elbow in a road traffic accident. An arthrotomy was performed under a C-Arm fluoroscope, which confirmed the radial head displacement of 180° along with the fracture. The fracture site was reduced and fixed with two Kirschner wires, cutting the wire short at its distal end for a complete closure. Open reduction and internal fixation were followed by casting for five weeks. After two years of follow-up, she had complete pain free range of motion of the affected limb. No post-operative complications have been observed till date. Open reduction and internal fixation with two Kwires is a viable option for such complex injuries. However, further evaluation of outcomes and post-operative complications are required.
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Fixação Interna de Fraturas , Fraturas da Cabeça e do Colo do Rádio , Criança , Feminino , Humanos , Acidentes de Trânsito , Fios Ortopédicos , Lesões no Cotovelo , Articulação do Cotovelo/cirurgia , Articulação do Cotovelo/diagnóstico por imagem , Fixação Interna de Fraturas/métodos , Redução Aberta/métodos , Fraturas da Cabeça e do Colo do Rádio/diagnóstico por imagem , Fraturas da Cabeça e do Colo do Rádio/cirurgia , Amplitude de Movimento Articular , RotaçãoRESUMO
Municipal solid waste management is a major concern in developing economies, requiring collective international efforts to achieve carbon neutrality by diverting waste from disposal facilities. This study aims to highlight the importance of the waste sector as it has the potential to significantly contribute to climate change and its toxicity impact on the local ecosystem. Out of the total municipal solid waste generated, only 78 % is collected, either open dumped or thrown in sanitary landfills. The waste sector's ecological impact value is calculated for the Earth's regions, and it is very high at >50 % in Africa, Asia, Latin America and the Caribbean. This sectoral impact value is mainly responsible for greenhouse gas emissions and degradation of the local ecosystem health. Current businessâasâusual practices attribute 3.42 % of global emissions to the waste sector. Various scenarios are developed based on waste diversion and related emissions modelling, and it is found that scenarios 3 and 4 will support the policymakers of the regions in attaining zero carbon footprints in the waste sector. Our findings conclude that cost-effective nature-based solutions will help lowâincome countries reduce emissions from disposal sites and significantly improve the local ecosystem's health. Developed economies have established robust wasteâhandling policies and implementation frameworks, and there is a need for collaboration and knowledge sharing with developing economies at the regional level to sustain the sector globally.
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The advancement of optoelectronic applications relies heavily on the development of high-performance photodetectors that are self-driven and capable of detecting a wide range of wavelengths. CsPbI3 nanorods (NRs), known for their outstanding optical and electrical properties, offer direct bandgap characteristics, high absorption coefficients, and long carrier diffusion lengths. However, challenges such as stability and limited photoluminescence quantum yield have impeded their widespread application. By integrating PbSe colloidal quantum dots (CQDs) with CsPbI3 NRs, the hybrid nanomaterial harnesses the benefits of each component, resulting in enhanced optoelectronic properties and device performance. In this work, a self-powered and broadband photodetector, ITO/ZnO/CsPbI3:PbSe/CuSCN/Au, is fabricated, in which CsPbI3 NRs are decorated with PbSe QDs as the photoactive layer, ZnO as the electron-transporting layer and CuSCN as the hole-transporting layer. The device performance is further improved through the incorporation of Cs2CO3 into the ZnO layer, resulting in an enhancement of its overall operational characteristics. As a result, a notable responsivity of 9.29 A W-1 and a specific detectivity of 3.17 × 1014 Jones were achieved. Certainly, the TCAD simulations closely correlate with our experimental data, facilitating a comprehensive exploration of the fundamental physical mechanisms responsible for the improved performance of these surface-passivated heterojunction photodetectors. This opens up exciting possibilities for substantial advancements in the realm of next-generation optoelectronic devices.
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Giant fibroadenomas are common in young females and are rarely reported in perimenopausal or menopausal females. These fibroadenomas are observed as single, mobile, small to large, with distinct boundaries. These tumors are hyperplastic and characterized by their aberrant growth in both the epidermal and mesenchymal layers, which can be accompanied by pain in some instances. These tumors have similar clinical resemblances to other epithelial and stromal tumors, such as phyllodes tumors, except for the level of disease severity and malignancy. Treatment of giant fibroadenomas includes surgical resection. Surgical excision is done by complete excision of the fibroadenoma, with the rest of the breast tissue and the nipple-areolar complex preserved. Timely diagnosis can be helpful in the prevention of adverse outcomes. This is a case of a 40-year-old female who presented with a lump in her right breast, for which she underwent a wide local excision. On histopathology, it was found to be a giant fibroadenoma. Her postoperative recovery was uneventful.
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Transition metal (TM) ion doping in II-VI semiconductors can produce exciton magnetic polarons (EMPs) and localized EMPs containing longitudinal optical (LO) phonon coupling, which will be discussed in this paper. TM ion doping in II-VI semiconductors for a dilute magnetic semiconductor show emission via magnetic polarons (MPs) together with hot carrier effects that need to be understood via its optical properties. The high excitation power that is responsible for hot carrier effects suppresses the charge trapping effect in low exciton binding energy (8.12 meV) semiconductors, even at room temperature (RT). The large polaron radius exhibits strong interaction between the carrier and MP, resulting in anharmonicity effects, in which the side-band energy overtone to LO phonons. The photon-like polaritons exhibit polarized spin interactions with LO phonons that show strong spin-phonon polaritons at RT. The temperature-dependent photoluminescence spectra of Ni-doped ZnTe show free excitons (FX) and FXs interacting with 2LO phonon-spin interactions, corresponding to3T1(3F) â1T1(1G) and EMP peaks with ferromagnetically coupled Ni ions at3T1(3F) â1E(1G). In addition, other d-d transitions of single Ni ions (600-900 nm) appear at the low-energy side. RT energy shifts of 14-38 meV are observed due to localized states with density-of-states tails extending far into the bandgap-related spin-induced localization at the valence band. These results show spin-spin magnetic coupling and spin-phonon interactions at RT that open up a more realistic new horizon of optically controlled dilute magnetic semiconductor applications.
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Amyand's hernia (AH) occurs when the appendix becomes part of an inguinal hernia. Amyand's hernias are typically discovered incidentally during surgery due to their variable clinical manifestations and features, such as caecum and appendix forming the sliding component in the present case. Claudius Amyand operated it for the first time in 1735. Due to the simple presentations that these patients typically exhibit, the diagnosis is extremely challenging. The choice between surgical modalities is influenced by the numerous, logically accepted advantages and disadvantages of management modalities, which are subject to debate. That being said, we believe that, in the absence of sepsis or inflammation, open repair using mesh - as long as a clean operating room and competent surgical skill are available - should be the gold standard approach.
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Passion fruits, renowned globally for their polyphenolic content and associated health benefits, have enjoyed growing attention from consumers and producers alike. While global cultivar development progresses, Australia has pioneered several native cultivars tailored for its distinct planting conditions. Despite their cultivation, comprehensive studies on the phenolic profiles and antioxidant capacities of these Australian-native passion fruits are notably lacking. This study aims to investigate and compare the polyphenolic content present in the by-products, which are peel (L), and consumable portions, which are the pulp and seeds (P), of four indigenous cultivars: 'Misty Gem' (MG), 'Flamengo' (FG), 'Sweetheart' (SW), and 'Panama' (SH). Employing LC-ESI-QTOF-MS/MS for profiling, a comprehensive list of polyphenols was curated. Additionally, various antioxidant assays-DPPH, FRAP, ABTS, RPA, FICA, and â¢OH-RSA-were performed to evaluate their antioxidant potential. A total of 61 polyphenols were identified, categorized into phenolic acid (19), flavonoids (33), and other phenolic substances (9). In the antioxidant assays, the SHP sample exhibited the highest â¢OH--RSA activity at 98.64 ± 1.45 mg AAE/g, while the FGL sample demonstrated prominent DPPH, FRAP, and ABTS activities with values of 32.47 ± 1.92 mg TE/g, 62.50 ± 3.70 mg TE/g, and 57.84 ± 1.22 mg AAE/g, respectively. Additionally, TPC and several antioxidant assays had a significant positive correlation, including DPPH, FRAP, and ABTS. The Australian-native passion fruits revealed distinct polyphenolic profiles and diverse antioxidant capacities, establishing a foundation for deeper health benefit analyses. This study accentuates the significance of understanding region-specific cultivars and their potential nutraceutical applications.
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Post-liver transplantation biliary complications remain a serious concern and are associated with reduced patient and graft survival. Among various biliary complications, anastomotic stricture (AS) is the most frequent and challenging one. The frequency of AS after living donor liver transplantation (LDLT) is higher as compared to deceased donor liver transplantation. The management involves endoscopic retrograde cholangiopancreatography and/or percutaneous transhepatic biliary drainage, but refractory cases necessitate surgical revision. We present a case of complex biliary AS in a 63-year-old man after LDLT. The conventional approaches including endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, and cholangioscope-guided interventions remained unsuccessful. An innovative approach using a wire-guided sphincterotome through percutaneous transhepatic route successfully managed the complex post-LDLT AS. This is perhaps the first reported case of novel utilization of sphincterotome through transhepatic route for the management of AS in LDLT, averting major surgical interventions with related morbidity and mortality.
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Food is one of the most necessary needs since human civilization. For Muslims, it is mandatory to consume halal food. From a halal authentication perspective, adulteration of food products is an emerging challenge worldwide. The demand for halal food consumption has resulted in an ever-increasing need for halal product validity. In the market, there are several food products in which actual ingredients and their source are not mentioned on the label and cannot be observed by the naked eye. Commonly nonhalal items include pig derivatives like lard, pork, and gelatin derivatives, dead meats, alcohol, blood, and prohibited animals. Purposely, various conventional and modern methods offer precise approaches to ensure the halalness and wholesomeness of food products. Conventional methods are physiochemical (dielectric) and electrophoresis. At the same time, modern techniques include high-pressure liquid chromatography (HPLC), gas chromatography (GC), electronic nose (E-Nose), polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), differential scanning calorimetry (DSC), nuclear magnetic resonance (NMR), near-infrared (NIR) spectroscopy, and Fourier transform infrared (FTIR) spectroscopy. This review intends to give an extensive and updated overview of conventional and modern analytical methods for ensuring food halal authenticity.
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The use of chemical preservatives in the baking industry is a common practice to extend the shelf life of baked goods However, there is growing interest in natural alternatives due to worries about the security and potential health risks of these chemicals. The purpose of this concurrent review is to investigate the potential of using essential oils and bio-preservatives in place of chemical preservatives in the baking industry. With a focus on their efficiency in extending the shelf life of baked goods, the review includes a thorough analysis of the most recent research on the use of bio-preservatives and essential oils in food preservation. The findings suggest that bio-preservatives and essential oils can be effective in preserving baked goods and may offer a safer and more natural alternative to chemical preservatives. However, further research is needed to fully understand the potential of these natural alternatives and to optimize their use in the baking industry.
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The current study focuses on Punica granatum L. (pomegranate) peel and peel extract and their use as functional foods, food additives, or physiologically active constituents in nutraceutical formulations. The pomegranate peel extract is a good source of bioactive substances needed for the biological activity of the fruit, including phenolic acids, minerals, flavonoids (anthocyanins), and hydrolyzable tannins (gallic acid). The macromolecules found in pomegranate peel and peel extract have been recommended as substitutes for synthetic nutraceuticals, food additives, and chemo-preventive agents because of their well-known ethno-medical significance and chemical properties. Moreover, considering the promises for both their health-promoting activities and chemical properties, the dietary and nutraceutical significance of pomegranate peel and pomegranate peel extract appears to be underestimated. The present review article details their nutritional composition, phytochemical profile, food applications, nutraceutical action, and health benefits.
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Retained surgical sponge is a relatively rare medical condition with potential serious medicolegal implications. The term "gossypiboma" is frequently used to describe this condition. We present a case of a 40-cm-long retained surgical sponge in a 43-year-old woman who presented with unexplained chronic abdominal pain for several years. She had a history of open cholecystectomy, hepaticojejunostomy, and enteroenterostomy. Computed tomography scan revealed a large cotton sponge anchored within the large bowel. Surgical exploration is usually required for the retrieval of gossypiboma. However, it was successfully removed endoscopically using a diathermic needle knife with no immediate complications. The patient was discharged after 48 hours with marked improvement in her abdominal pain. This case emphasizes the emerging role of novel endoscopic interventions, resulting in excellent clinical outcomes, avoiding major surgical interventions, and providing cost-effective benefits.
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The aim of this study was to investigate the effectiveness of continuous cold flow and compression device as against traditional icing regimen and without icing after anterior cruciate ligament (ACL) reconstruction. All patients undergoing ACL reconstruction from June 2021 to August 2021 were enrolled in this study. Patients were randomly allocated to three groups: A control group (n=10) with no ice regimen post-operatively, a second control group (n=10) with ice bag, and a third group (n=10) with continuous cold flow and compression device (physiolab). All patients who had isolated ACL tear evident on magnetic resonance imaging were included. Pain intensity, limb girth, Oxford Knee Score, and 12-item survey form were measured pre- and post-operatively. Significant difference was noted between pain scores in all groups at two- and six-week follow-ups with p-value of 0.004 and 0.01. The test for "between subject effects" showed significant difference (p=0.007) in limb girth between the two groups. Cold and compression device can be used to reduce swelling immediately after ACL reconstruction.
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Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Humanos , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Projetos Piloto , Resultado do Tratamento , Reconstrução do Ligamento Cruzado Anterior/métodos , Articulação do JoelhoRESUMO
Cough-based diagnosis for respiratory diseases (RDs) using artificial intelligence (AI) has attracted considerable attention, yet many existing studies overlook confounding variables in their predictive models. These variables can distort the relationship between cough recordings (input data) and RD status (output variable), leading to biased associations and unrealistic model performance. To address this gap, we propose the Bias-Free Network (RBF-Net), an end-to-end solution that effectively mitigates the impact of confounders in the training data distribution. RBF-Net ensures accurate and unbiased RD diagnosis features, emphasizing its relevance by incorporating a COVID-19 dataset in this study. This approach aims to enhance the reliability of AI-based RD diagnosis models by navigating the challenges posed by confounding variables. A hybrid of a Convolutional Neural Networks (CNN) and Long Short-Term Memory (LSTM) networks is proposed for the feature encoder module of RBF-Net. An additional bias predictor is incorporated in the classification scheme to formulate a conditional Generative Adversarial Network (c-GAN) that helps in decorrelating the impact of confounding variables from RD prediction. The merit of RBF-Net is demonstrated by comparing classification performance with a State-of-The-Art (SoTA) Deep Learning (DL) model (CNN-LSTM) after training on different unbalanced COVID-19 data sets, created by using a large-scale proprietary cough data set. RBF-Net proved its robustness against extremely biased training scenarios by achieving test set accuracies of 84.1%, 84.6%, and 80.5% for the following confounding variables-gender, age, and smoking status, respectively. RBF-Net outperforms the CNN-LSTM model test set accuracies by 5.5%, 7.7%, and 8.2%, respectively.
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The WD40 repeat protein 5 (WDR5) is a nuclear hub that critically influences gene expression by interacting with transcriptional regulators. Utilizing the WDR5 binding motif (WBM) site, WDR5 interacts with the myelocytomatosis (MYC), an oncoprotein transcription factor, and the retinoblastoma-binding protein 5 (RbBP5), a scaffolding element of an epigenetic complex. Given the clinical significance of these protein-protein interactions (PPIs), there is a pressing necessity for a quantitative assessment of these processes. Here, we use biolayer interferometry (BLI) to examine interactions of WDR5 with consensus peptide ligands of MYC and RbBP5. We found that both interactions exhibit relatively weak affinities arising from a fast dissociation process. Remarkably, live-cell imaging identified distinctive WDR5 localizations in the absence and presence of full-length binding partners. Although WDR5 tends to accumulate within nucleoli, WBM-mediated interactions with MYC and RbBP5 require their localization outside nucleoli. We utilize fluorescence resonance energy transfer (FRET) microscopy to confirm these weak interactions through a low FRET efficiency of the MYC-WDR5 and RbBP5-WDR5 complexes in living cells. In addition, we evaluate the impact of peptide and small-molecule inhibitors on these interactions. These outcomes form a fundamental basis for further developments to clarify the multitasking role of the WBM binding site of WDR5.
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Histona-Lisina N-Metiltransferase , Peptídeos , Histona-Lisina N-Metiltransferase/química , Histona-Lisina N-Metiltransferase/genética , Histona-Lisina N-Metiltransferase/metabolismo , Peptídeos/química , Sítios de Ligação , Fatores de TranscriçãoRESUMO
Urinary tract infection is an infectious disease that requires immediate treatment. It can occur in any age group and involves both genders equally. The present study was to check the resistance of some antibiotics and to assess the antibacterial potential of three extracts of three plants against notorious bacteria involved in urinary tract infections. Along with assessing the antibacterial activity of plant extracts, we checked for the anticancer potential of these extracts against the cancer cell lines MCF-7 and A2780. Cancer is the leading cause of mortality in developed countries. Determinations of total flavonoid content, total phenolic content, total alkaloid content, total tannin content, total carotenoid content, and total steroid content were performed. The disk diffusion method was used to analyze the antibacterial activity of plant extracts. Ethanolic extract of Selenicereus undatus showed sensitivity (25-28 mm) against bacteria, whereas chloroform and hexane extracts showed resistance against all bacteria except Staphylococcus (25 mm). Ethanolic extract of Pistacia vera L. showed sensitivity (22-25 mm) against bacteria, whereas chloroform and hexane extracts showed resistance. Ethanolic extract of Olea europaea L. showed sensitivity (8-16 mm) against all bacteria except Staphylococcus, whereas chloroform and hexane extracts showed resistance. Positive controls showed variable zones of inhibition (2-60 mm), and negative control showed 0-1 mm. The antibiotic resistance was much more prominent in the case of hexane and chloroform extracts of all plants, whereas ethanolic extract showed a sensitivity of bacteria against extracts. Both cell lines, MCF-7 and A2780, displayed decreased live cells when treated with plant extracts.
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Olea , Neoplasias Ovarianas , Pistacia , Masculino , Feminino , Humanos , Hexanos , Linhagem Celular Tumoral , Células MCF-7 , Clorofórmio , Antibacterianos/farmacologia , Extratos Vegetais/farmacologia , Staphylococcus , Bactérias , Testes de Sensibilidade MicrobianaRESUMO
Wireless connectivity delay, disruption, or failure can significantly affect the performance of wireless-enabled medical devices, which in turn causes potential risks to the patient. Notably, the challenges related to connectivity provisioning are exacerbated in the fifth-generation (5G)-enabled healthcare use cases where mobility is utilized. In this article, we describe relevant 5G-enabled healthcare use cases involving mobility and identify the connectivity challenges that they face. We then illustrate practical implementation considerations, tradeoffs, and future research directions for enabling reliable 5G healthcare transmissions. This is done through simulation of connected ambulances as an example use-case.
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Near-infrared stimulated emission from a high-quality InN layer under optical pumping was observed with a threshold excitation power density of 0.3 and 4 kW cm-2 at T = 8 and 77 K, respectively. To achieve such a low threshold power density, vicinal GaN substrates were used to reduce the edge-component threading dislocation (ETD) density of the InN film. Cross-sectional transmission electron microscopy images reveal that the annihilation of ETDs can be divided into two steps, and the ETD density can be reduced to approximately 5 × 108 cm-2 near the surface of the 5-µm-thick film. The well-resolved phonon replica of the band-to-band emission in the photoluminescence spectra at 9 K confirm the high quality of the InN film. As a result, the feasibility of InN-based photonic structures and the underlying physics of their growth and emission properties are demonstrated.