Surgery for symptomatic hepatic hemangioma: Resection vs. enucleation, an experience over two decades.

Backgrounds/Aims: Hemangiomas are the most common benign liver lesions; however, they are usually asymptomatic and seldom require surgery. Enucleation and resection are the most commonly performed surgical procedures for symptomatic lesions. This study aims to compare the outcomes of these two surgical techniques. Methods: A retrospective analysis of symptomatic hepatic hemangiomas (HH) operated upon between 2000 and 2021. Patients were categorized into the enucleation and resection groups. Demographic profile, intraoperative bleeding, and morbidity (Clavien-Dindo Grade) were compared. Independent t-test and chi-square tests were used for continuous and categorical variables respectively. p-value of < 0.05 was considered significant. Results: Sixteen symptomatic HH patients aged 30 to 66 years underwent surgery (enucleation = 8, resection = 8) and majority were females (n = 10 [62.5%]). Fifteen patients presented with abdominal pain, and one patient had an interval increase in the size of the lesion from 9 to 12 cm. The size of hemangiomas varied from 6 to 23 cm. The median blood loss (enucleation: 350 vs. resection: 600 mL), operative time (enucleation: 5.8 vs. resection: 7.5 hours), and postoperative hospital stay (enucleation: 6.5 vs. resection: 11 days) were greater in the resection group (statistically insignificant). In the resection group, morbidity was significantly higher (62.6% vs. 12.5%, p = 0.05), including one mortality. All patients remained asymptomatic during the follow-up. Conclusions: Enucleation was simpler with less morbidity as compared to resection in our series. However, considering the small number of patients, further studies are needed with comparable groups to confirm the superiority of enucleation over resection.

Dengue seropositivity among blood donors in a tertiary hospital in Kerala, Southern India.

Aim: The aim of this study was to screen blood donors in a tertiary hospital in Kerala for dengue during the period of peak dengue transmission. Materials and Methods: One hundred and seventy-eight continuous serum samples obtained from asymptomatic blood donors during the monsoon season were subjected to ELISA for Dengue NS1 antigen and dengue immunoglobulin M (IgM) antibodies. Results: Dengue IgM antibodies were positive in 20 (11.23%) donors and NS1 antigen was positive in 1 (0.56%) donor. The presence of these markers in asymptomatic blood donors showed that they may have had active or subclinical dengue infection at the time of donation or in the recent past. The presence of NS1 in particular raises the possibility that the donor may have been viremic at the time of donation. Conclusion: The findings of this study suggest the risk of transfusion transmission of dengue during the monsoon in Kerala and strengthen the case for dengue screening among blood donors during this period of high incidence.

Résumé Objectif: L'objectif de cette étude était de dépister la dengue chez les donneurs de sang dans un hôpital tertiaire du Kerala pendant la période de transmission maximale de la dengue. Matériels et méthodes: Cent soixante-dix-huit échantillons de sérum continus provenant de donneurs de sang asymptomatiques pendant la saison de la mousson ont été soumis à un test ELISA pour l'antigène de la dengue NS1 et les anticorps de l'immunoglobuline M de la dengue (IgM). Résultats: les anticorps IgM contre la dengue étaient positifs chez 20 (11,23 %) donneurs et l'antigène NS1 était positif chez 1 (0,56 %) donneur. La présence de ces marqueurs chez les donneurs de sang asymptomatiques a montré qu'ils pouvaient avoir eu une infection active ou subclinique de la dengue au moment du don ou dans un passé récent. La présence de NS1 en particulier soulève la possibilité que le donneur ait pu être virémique au moment du don. Conclusion: Les résultats de cette étude suggèrent le risque de transmission transfusionnelle de la dengue pendant la mousson au Kerala et renforcent les arguments en faveur du dépistage de la dengue chez les donneurs de sang pendant cette période de forte incidence. Mots-clés: Donneurs de sang, dengue, anticorps immunoglobuline M, Kerala, antigène NS1, séropositivité.

Expression of Antimicrobial Peptides and Cytokines in Human Omentum Following Abdominal Surgery.

Introduction Omentum can secrete out biological agents like different growth factors, cytokines, and antimicrobial peptides. The aim of our study was to determine the expression of antimicrobial peptides and cytokines in human omentum tissue and its response to intra-abdominal infection. Methodology Omentum tissue was obtained from 60 patients: control (n=20) and cases (n=40). mRNA expression of antimicrobial peptides (LL-37, HBD-1, HBD-2, HNP1-3) and cytokines (TNF- α, IL-8, IL-10, IL1ß) was evaluated using Real-Time PCR. Protein quantification was done by Immunoblotting and ELISA. Results Significantly higher expression of antimicrobial peptides (LL-37, HBD-1, HBD-2, HNP1-3) and cytokines (TNF- α, IL-8, IL-10, IL1ß) was observed in cases as compared to control at both the transcriptional and translational level (p<0.0001). Conclusion Omentum governs a population of antimicrobial peptides with potent immunologic functions. The expression of antimicrobial peptides and cytokines is inducible and increases with the severity of infection. Omentum is thus an immunologically active and adaptable organ but its complete regulatory mechanism is still elusive.

Evaluation of vertical facial height reduction and severity of temporomandibular joint disorders using Shimbashi number and cephalometric analysis.

Objective: This study was designed to evaluate the correlation between vertical dimension at occlusion (VDO) and various grades of temporomandibular disorders (TMDs) versus controls.Methods: Clinically measured Shimbashi number and radiographic cemento-enamel junction (CEJ-CEJ) measurements on 120 TMD patients and 40 controls were evaluated. Radiographic lateral cephalometric skull images of the patients were subjected to cephalometric analysis. The relationship between Shimbashi number, the cephalometric values, and its correlation with the degree of TMD were evaluated and statistically analyzed.Results: Shimbashi number and radiographic CEJ-CEJ values in the TMD patients were significantly lower than those in the controls. TMD severity appeared to increase with the increase in interincisal angle and the decrease in both Shimbashi number and radiographic CEJ-CEJ value.Conclusion: These findings indicate that radiographic evaluation of cephalograms is a reliable indicator of presence and degree of TMD, and the severity of TMD increases with the degree of reduction in VDO.

Unified approach to stochastic thermodynamics: Application to a quantum heat engine.

In the present study we have developed an alternative formulation for the quantum stochastic thermodynamics based on the c-number Langevin equation for the system-reservoir model. This is analogous to the classical one. Here we have considered both Markovian and non-Markovian dynamics (NMD). Consideration of the NMD is an important issue at the current state of the stochastic thermodynamics. Applying the present formalism, we have carried out a comparative study on the heat absorbed and the change of entropy with time for a linear quantum system and its classical analog for both Markovian and NMD. Here the strength of the thermal noise and its correlation time for the respective cases are the leading quantities to explain any distinguishable feature which may appear with the equilibration kinetics. For another application, we have proposed a formulation with classical look for a quantum stochastic heat engine. Using it we have presented a comparative study on the efficiency and its value at maximum power for a quantum stochastic heat engine and its classical analog. The engines are Carnot like which are coupled with their respective Markovian thermal baths. Here also the noise strength as well as the diffusion constant are the leading quantities to explain any noticeable feature.