Factors affecting quality of life in rectal cancer survivors who have undergone laparoscopic surgery: patient-reported outcomes over 10 years at a single institution.

INTRODUCTION: Colorectal cancer survivors have many problems affecting their quality of life (QOL). Traditional follow-up focuses on the detection of recurrence rather than QOL. Efforts are being made to assess patient-reported outcomes (PROMS) more formally. Such changes may enable patients to consider QOL factors when deciding on treatment. METHODS: Patients who underwent laparoscopic surgery for rectal cancer between 2005 and 2015 at a single institution were identified and sent European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 QOL questionnaires. QOL and the impact of radiotherapy, chemotherapy and formation of end colostomy were assessed. RESULTS: Some 141 patients were identified: 12 died and 118 (83.7%) responded, of whom 101 completed the questionnaires and 17 declined to participate; 11 were lost to follow-up. Mean age was 67 years, median follow-up was 58 months. Median QOL score was 6 (maximum 7) and 4.5% of patients reported a poor QOL score (<4). Significant rectal/perianal pain, sexual dysfunction and urinary symptoms were reported in 3.6%, 10.9% and 2.7% of respondents, respectively. Significant differences between treatment groups were uncommon. All cohorts reported similar QOL, functional and symptom scores. CONCLUSIONS: These results compare favourably with the published data. Future studies may benefit from baseline assessment to better assess treatment impact, prescient in an increasingly elderly and comorbid population. This paper establishes that good PROMs are achievable with laparoscopic surgery for rectal cancer. It identifies limited differences in QOL between treatment modalities. Restoration of intestinal continuity and end colostomy result in similar QOL. This may address common concerns regarding stomata, sexual function and low anterior resection syndrome in this cohort.

Analysis of Material Handling Safety in Construction Sites and Countermeasures for Effective Enhancement.

One of many hazardous workplaces includes the construction sites as they involve several dangerous tasks. Many studies have revealed that material handling equipment is a major cause of accidents at these sites. Though safety measures are being followed and monitored continuously, accident rates are still high as either workers are unaware of hazards or the safety regulations are not being strictly followed. This paper analyses the safety management systems at construction sites through means of questionnaire surveys with employees, specifically referring to safety of material handling equipment. Based on results of the questionnaire surveys, two construction sites were selected for a safety education program targeting worker safety related to material handling equipment. Knowledge levels of the workers were gathered before and after the program and results obtained were subjected to a t-test analysis to mark significance level of the conducted safety education program.

Assessment of Groundwater Quality for Irrigation in Coimbatore South Taluk, Coimbatore District, Tamil Nadu.

The study was conducted to evaluate the suitability of ground water for irrigation purpose at twenty seven locations in Coimbatore South Taluk, Coimbatore District. The analytical result shows that Na and Cl are the dominant cation and anions respectively in the groundwater. The values of TDS and EC exceed the permissible limits at some locations due to increase in ionic concentrations. Based on SAR, RSC, US Salinity diagram and Wilcox diagram it is observed that the water ranges from excellent to good quality in most of the places and can be used for irrigation without any hazard. Gibbs variation diagram indicates that lithology is main controlling factor for water chemistry. However, the high SAR and RSC values at few locations restrict suitability for irrigation purpose.

Public and Private Hospitals in Kuala Lumpur and Selangor, Malaysia: How Do They Fare in Terms of Accessibility for the Physically Disabled?

Public and private hospitals in Kuala Lumpur and Selangor were evaluated in terms of their accessibility for the physically disabled. The research hypotheses for this study included the following: (1) Both types of hospitals are accessible for the physically disabled as measured by specifi c criteria but (2) the degree of accessibility is higher in the case of private hospitals as compared to public hospitals. A total of 23 private hospitals and 11 public hospitals in Kuala Lumpur and Selangor were invited to participate in the study. The 5 private hospitals and 5 public hospitals that agreed were evaluated for adequacy of facilities for the physically-disabled. For this purpose, 13 specifi c criteria were assessed and scored for each hospital. These criteria were also grouped into 5 categories, namely, parking, toilet, door and lift, corridor and ramp. Scores were compared between each hospital and then aggregated and compared for private hospitals versus public hospitals. It was found that none of the 5 private hospitals and 5 public hospitals studied satisfi ed 100% of the criteria evaluated. Looking at each hospital individually, the overall scores range from 32% to 92% for the criteria set. Only 4 of the 10 hospitals in our sample achieved overall scores of 80% or higher in terms of the evaluation criteria we used. With the exception of availability of ramps where public hospitals scored slightly higher ,for most of the individual criterion, private hospitals scored higher than public hospitals. Looking at each criterion across all hospitals, the scores range from 59.2% (adequacy of parking) to 85% (adequacy of corridors). The median score obtained by private hospitals and by public hospitals for all 13 criteria were analysed for any difference. The difference between private hospitals and public hospitals is not statistically signifi cant (Mann-Whitney U = 6.5, p-value = 0.099). There is no signifi cant difference between Kuala Lumpur/Selangor private and public hospitals in terms of accessibility for physically disabled people. However, some hospitals are more accessible for the physically disabled than other hospitals. These fi ndings indicate that there is room for improvement.

A Study on the Role of Mobile Phone Communication in Tuberculosis DOTS Treatment.

BACKGROUND: Every year, a lot of Tuberculosis (TB) patients undergo Directly Observed Treatment Short-course (DOTS) in Salem city, one of the high TB districts in South India. Mobile phone usage among these patients and health workers is common. Mobile phone communication has a great potential in TB treatment. OBJECTIVES: To analyze the mobile phone usage and its effectiveness in TB DOTS treatment. MATERIALS AND METHODS: A cross-sectional survey with 150 TB patients was followed by a focus group discussion with treatment supervisors, DOTS providers, and health workers. RESULTS: Majority of patients use mobile phones to make calls to health workers to clarify their doubts on side effects, food, and symptoms of the disease. TB treatment supervisors effectively use mobile phones to counsel patients to adhere to the treatment regimen. Patients see mobile phones as a useful communication tool in TB treatment though they prefer direct interpersonal communication with health workers. Though the mobile ownership is 68% among the TB patients, many of them are not able to send text messages or read messages in English. CONCLUSION: Mobile phone possession and usage is high among the patients. Patients need to be trained to use mobile phone features such as alarm, voice mail, and interactive voice response. Incentives like free talk time and short message service (SMS) will encourage patients to communicate frequently with health workers, thereby, increasing the chances of better adherence to DOTS. SMS could be made available in the regional languages.

An integrated in vitro and in situ study of kinetics of myosin II from frog skeletal muscle.

A new efficient protocol for extraction and conservation of myosin II from frog skeletal muscle made it possible to preserve the myosin functionality for a week and apply single molecule techniques to the molecular motor that has been best characterized for its mechanical, structural and energetic parameters in situ.With the in vitro motility assay, we estimated the sliding velocity of actin on frog myosin II (VF) and its modulation by pH, myosin density, temperature (range 4-30◦C) and substrate concentration. VF was 8.88 ± 0.26 µms⁻¹ at 30.6◦C and decreased to 1.60 ± 0.09 µms⁻¹ at 4.5◦C. The in vitro mechanical and kinetic parameters were integrated with the in situ parameters of frog muscle myosin working in arrays in each half-sarcomere. By comparing VF with the shortening velocities determined in intact frog muscle fibres under different loads and their dependence on temperature, we found that VF is 40-50% less than the fibre unloaded shortening velocity (V0) at the same temperature and we determined the load that explains the reduced value of VF. With this integrated approach we could define fundamental kinetic steps of the acto-myosin ATPase cycle in situ and their relation with mechanical steps. In particular we found that at 5◦C the rate of ADP release calculated using the step size estimated from in situ experiments accounts for the rate of detachment of motors during steady shortening under low loads.

Hexavalent chromium reduction by free and immobilized cell-free extract of Arthrobacter rhombi-RE.

In the present study, hexavalent chromium (Cr(VI)) reduction potential of chromium reductase associated with the cell-free extracts (CFE) of Arthrobacter rhombi-RE species was evaluated. Arthrobacter rhombi-RE, an efficient Cr(VI) reducing bacterium, was enriched and isolated from a chromium-contaminated site. Chromium reductase activity of Arthrobacter rhombi-RE strain was associated with the cell-free extract and the contribution of extracellular enzymes to Cr(VI) reduction was negligible. NADH enhanced the chromium reductase activity. The enzyme activity was optimal at a pH of 5.5 and a temperature of 30 degrees C. Among the ten electron donors screened, sodium pyruvate was the most effective one followed by NADH and propionic acid. Michaelis-Menten constant, K(m), and maximum reaction rate, V(max), obtained from the Lineweaver-Burk plot were 48 microM and 4.09 nM/mg protein/min, respectively, in presence of NADH as electron donor and 170.5 microM and 4.29 nM/mg protein/min, respectively, in presence of sodium pyruvate as electron donor. Ca(2+) enhanced the enzyme activity while Hg(2+), Cd(2+), Ba(2+), and Zn(2+) inhibited the enzyme activity. Among the various immobilization matrices screened, calcium alginate beads seemed to be the most effective one. Though immobilized enzyme system was able to reduce Cr(VI), the performance was not very encouraging in continuous mode of operation.

Evaluation of physical and chemical parameters of river Kaveri, Tiruchirappalli, Tamil Nadu, India.

The physical, chemical and total heterotrophic bacteriological parameters (THBP) bacterial population were measured at three sampling stations namely Upper Anicut (S1), Chinthamani road bridge (S2) and Grand Anicut (S3) for a period of three month January to March 2007 in the river Kaveri, Tiruchirappalli. The pH ranged from 6.7 to 7.8, the level of solids and total hardness was high in station S2 when compared to other stations. Station 2 registered a minimum level of DO (3.6 mg l(-1)), and the BOD and COD varied from 3.47 to 4.27, 20.67 to 41.47 mg l(-1) respectively. THBP colony count was found to be high in S2 (8.16 x 10(2) CFU ml(-1)) and a lowest level in S1 (2.64 x 10(2)) and S3 (1.80 x 10(2)). It was observed in the present study that in reservoir (anicut) stations factors like pH, TDS, TSS, Hardness and THBP were at lower level than for the water at Chinthamani road bridge (S2), probably due to the mixing of municipal sewage at this point.

Biosorption of chromium species by aquatic weeds: kinetics and mechanism studies.

In this paper, we have presented the results of Cr(VI) and Cr(III) removal from aqueous phase by different aquatic weeds as biosorbents. Batch kinetic and equilibrium experiments were conducted to determine the adsorption kinetic rate constants and maximum adsorption capacities of selected biosorbents. In most of the cases, adsorption followed a second-order kinetics. For Cr(III), maximum adsorption capacity was exhibited by reed mat (7.18mg/g). In case of Cr(VI), mangrove leaves showed maximum removal/reduction capacity (8.87mg/g) followed by water lily (8.44mg/g). There was a significant difference in the concentrations of Cr(VI) and total chromium removed by the biosorbents. In case of Cr(VI) removal, first it was reduced to Cr(III) with the help of tannin, phenolic compounds and other functional groups on the biosorbent and subsequently adsorbed. Acid treatment significantly increased Cr(VI) removal capacity of the biosorbents whereas, alkali treatment reduced the Cr(VI) removal capacities of the biosorbents. FTIR spectrum showed the changes in functional groups during acid treatment and biosorption of Cr(VI) and Cr(III). Aquatic weeds seem to be a promising biosorbent for the removal of chromium ions from water environment.

Reduction of Cr(VI) by a Bacillus sp.

A Bacillus sp. RE was resistant to chromium and reduced Cr(VI) without accumulating chromium inside the cell. When Cr(VI) was 10 and 40 microg ml(-1), >95% of the total Cr(VI) was reduced in 24 and 72 h of growth, respectively, whereas at 80 microg Cr(VI) ml(-1 )only 50% of Cr(VI) was reduced. However growth was not affected; the cell mass was 0.7-0.8 mg ml(-1) in all cases. The cell-free extract showed Cr(VI) reducing enzyme activity which was enhanced (>5 fold) by NADH and NADPH. Like whole cells the enzyme also reduced Cr(VI) with decreasing efficiency on increasing Cr(VI) concentration. The enzyme activity was optimal at pH 6.0 and 30 degrees C. The enzyme was stable up to 30 degrees C and from pH 5.5 to 8, but from pH 4 to 5 the enzyme was severely destabilized. Its Km and Vmax were 14 microM: and 3.8 nmol min(-1) mg(-1) respectively. The enzyme activity was enhanced by Cu2+ and Ni2+ and inhibited by Hg2+.

Kinetics of high strength phenol degradation using Bacillus brevis.

A strain of Bacillus brevis has been isolated and identified based on biochemical results. Phenol biodegradation in a batch reactor was studied using the pure culture of B. brevis. The isolated strain was optimized for various environmental conditions and the biodegradation of phenol was maximum at pH 8.0, 5% (v/v) of inoculum size and without any co-substrate. The kinetics of biodegradation according to Haldane's equation micro = micromaxS/(Ks + S + (S2/Ki)) adequately describes cell growth with kinetic constants in the ranges micromax = 0.026-0.078 h(-1), Ks =2.2-29.31 mg/l, Ki = 868.0-2434.7 mg/l. These values are specific for this organism and we have compared with literature for pure or mixed cultures degrading phenol.

Localization and fate of aluminium in the digestive gland of the freshwater snail Lymnaea stagnalis.

The digestive gland of the freshwater snail Lymnaea stagnalis, exposed to water containing an elevated concentration of aluminium at neutral pH for up to 30 days, followed by a 20 day recovery period, was examined by light and electron microscopy and X-ray microanalysis. Aluminium was localized in the yellow granules present in the digestive and excretory cells and in the green and small granules present in the digestive cells. More aluminium, silicon, phosphorus and sulphur were present in all three granule types from aluminium exposed snails. The number of yellow and green granules from the digestive gland of aluminium exposed snails showed a progressive increase over the experimental period compared to controls. The number and aluminium content of the granules is likely to reflect the role of the digestive gland as a 'sink' for accumulated aluminium. We propose that intracellular monomeric silica is involved in the detoxification of aqueous aluminium which at neutral pH is largely in the form of an insoluble polyhydroxide. The increased amounts of sulphur and phosphorus in the granules are likely to be part of a broad response to metal loading but probably do not play a significant role in the storage and detoxification of aluminium.

Accumulation of aluminium by the freshwater crustacean Asellus aquaticus in neutral water.

This study examined the accumulation of aluminium (Al), mostly as the insoluble (Al(OH)(3)) species, by the freshwater crustacean Asellus aquaticus at neutral pH. Animals were exposed to a range of Al concentrations (5-356 microg l(-1)) in three experiments. The first two were of 30 and 50 days duration, respectively, followed by transfer of the A. aquaticus to water containing no Al for 20 days. The third used live and dead animals in order to investigate the contribution made by surface adsorption of Al to the total accumulated. Significant accumulation of Al in the whole tissues occurred by day 10 in all animals in the 30- and 50- day experiment. Peak concentrations of Al were measured in animals between days 10 and 20 with high concentration factors ranging from 1.4 x 10(4) to 5.5 x 10(3). By day 30, accumulated Al had fallen but was still significantly greater than the control in the 50- day exposure experiment. This 30- day increase followed by decreased accumulation of Al was repeated over the remaining exposure period (i.e. 30-50 days) although rates of uptake and loss and peak tissue levels of Al were higher. Proportionality between environmental (water) and tissue concentrations of Al occurred at day 20 but not at day 45. Significantly more Al was accumulated by dead animals than live animals at all Al exposure concentrations. These results suggest that Al is available to the crustacean at neutral pH and that the cuticle may provide an important site of uptake.

Bioaccumulation of aluminium in the freshwater snail Lymnaea stagnalis at neutral pH.

This study examined the accumulation of aluminium (Al) by the freshwater snail Lymnaea stagnalis at neutral pH, when most Al would be predicted to be in an insoluble form (Al(OH)(3)). Snails were exposed to a range of Al concentrations (38-285 microg l(-1)) for 30 days, followed by 20 days in clean water. Aluminium was measured using atomic absorption spectroscopy. Significant accumulation of Al occurred in the whole soft tissues, gut, digestive gland and kidney at the latest by day 10. High concentration factors were observed, ranging from 4.5 x 10(3) in the whole soft tissues to 6.3 x 10(4) in the kidney, corresponding to actual concentrations of 800 to 7500 microg g(-1), respectively. Proportionality between environmental (water) and tissue concentrations of Al was observed in the gut but not in the other tissues. Following transfer to clean water, rapid loss of Al from the whole soft tissues and gut was seen over the first 10 days. Loss of Al from the digestive gland was much less as a proportion of the total, with approximately 90% of the Al remaining in the tissue. In contrast, significant loss of Al from the kidney occurred between days 20 and 30, even in the continued presence of Al; little further loss occurred following transfer to clean water. Aluminium is clearly available to the snail at neutral pH, the most likely route of entry being the gut. This could facilitate entry of the metal into the food chain. The possible roles of the digestive gland and kidney in the handling of Al are discussed.

Cardiovascular and neuromuscular effects of esmolol during induction of anesthesia.

Sixteen subjects scheduled for surgical procedures under general anesthesia participated in an investigation of the effects of esmolol on the transient hypertension and tachycardia that was observed during endotracheal intubation and on the duration of succinylcholine-induced neuromuscular blockade. In eight subjects, infusion of esmolol was begun five minutes before induction of anesthesia and continued for 12 minutes after induction. In the remaining subjects, an equivalent volume of solvent (D5W) was infused for 12 minutes. Infusion of esmolol significantly attenuated the cardioacceleration observed during intubation without any significant effect on the pressor effects of the procedure. Esmolol delayed the recovery from succinylcholine-induced neuromuscular blockade by less than three minutes. The mechanism of this delay remains to be investigated, although such a delay does not have clinical significance. Esmolol-induced attenuation of the tachycardia seen during intubation may offer a protective effect on the myocardium, especially in elderly subjects and patients with coronary artery disease.