Simulation of non-Newtonian flow of blood in a modified laparoscopic forceps used in minimally invasive surgery.

During surgeries, blood often oozes out of the operated tissue and this has to be sucked out by the S-I device. Blood is more viscous than saline, the cleaning fluid is used in the S-I process. Therefore, for a more comprehensive CFD flow analysis of the improved forceps is simulated in the present work for different driving pressures. The resulting flow rate of blood is compared among the prospective designs and the S-I device currently in use. The new surgical forceps eliminates re-insertion of dissector with suction-irrigator and is reusable, multi-functional, non-toxic, corrosion resistant, toughened, and cost-effective.

Design and fluid flow simulation of modified laparoscopic forceps.

Laparoscopic surgery has gained prominence in recent decades and employed in minimally invasive surgeries to avoid massive cuts resulting in a reduction in pain, the chance of infection, and duration of stay in the hospital. Maryland forceps, which belongs to the category of grasper instruments, are often used in minimally invasive surgeries to hold, pull, push, manipulate, and perform dissection operations. During laparoscopic surgeries, often blood and other body fluids ooze from the site of surgery. Typically, suction-irrigation (SI) devices are used to periodically clear these fluids to get a better view of the site of surgery. To achieve this, the removal and insertion of multiple instruments are required. This process has to be repeated numerous times, which significantly increases the time needed for surgery. Literature survey and feedback from practicing surgeons suggest that this can be avoided by improving the current design of forceps. In this article, a modified design is proposed by combining the SI feature with the existing form of Maryland forceps. The modified design is first modeled in SolidWorks and then analyzed for fluid flow using ANSYS Fluent. Parametric analysis is performed to obtain the optimal design for the proposed multi-functional instrument, which can potentially improve the overall efficiency of the laparoscopic surgical process.

Emergency treatment with ketoconazole in disseminated intravascular coagulation due to metastatic prostatic carcinoma.

We report the use of ketoconazole to control disseminated intravascular coagulation due to prostatic carcinoma. Clinical improvement in the condition of the patient was noted in 48 hours and coagulation profile became normal in 10 days.

Congenital abduction contracture with dislocation of the shoulder in children: report of two cases.

Isolated congenital contracture of the deltoid muscle in children is uncommon. There are no reports in the literature of such cases associated with anterior dislocations of the shoulder. Two young girls with deltoid contracture and associated dislocation of the shoulder are reported.

Immune reactions in human filariasis.

Sera from cases of elephantiasis due to Wuchereria bancrofti infection promoted an intense adhesion of peripheral blood leukocytes to W. bancrofti microfilariae in vitro. A similar adhesion was also seen using sera from some normal persons living for several years in areas where filariasis is endemic. No such adhesion was evident with sera from microfilaria carriers or from normal subjects from nonendemic areas. The adhesion was complement independent and was associated with the immunoglobulin G fraction of serum. 51Cr release studies suggested the occurrence of cell-mediated cytotoxicity to W. bancrofti microfilariae in the presence of elephantiasis serum. Microfilariae of Litomosoides carinii could be isolated free of blood cells, from the blood of infected rats. In the presence of serum, or its immunoglobulin G fraction, from patients with elephantiasis, L. carinii microfilariae adhered to human peripheral blood leukocytes or rat spleen cells.