Novel treatment with double scope technique for disconnected pancreatic duct syndrome with external pancreatic fistula.

Background and study aims External pancreatic fistula in association with disconnected pancreatic duct syndrome is a common sequelae of the percutaneous step-up approach for infected pancreatic necrosis and is associated with significant morbidity. The present study aimed to report the initial outcome of a novel technique of two-scope guided tractogastrostomy for management of this condition. Patients and methods The present study was a retrospective analysis of data from patients with external pancreatic fistula and disconnected pancreatic duct syndrome, who underwent two-scope-guided tractogastrostomy. All the patients had a 24F or larger drain placed in the left retroperitoneum. Transgastric echo endoscopy and sinus tract endoscopy were performed simultaneously to place a stent between the gastric lumen and the sinus tract. Technical success was defined as placement of the stent between the tract and the stomach. Clinical success was defined as successful removal of the percutaneous drain without the occurrence of pancreatic fluid collection, ascites, external fistula, or another intervention 12 weeks after the procedure. Results Three patients underwent two scope-guided tractogastrostomy. Technical and clinical success were achieved in all the patients. No procedure-related side effects or recurrence occurred in any of the patients. Conclusions Two-scope-guided tractogastrostomy for treatment of external pancreatic fistula due to disconnected pancreatic duct syndrome is a feasible technique and can be further evaluated.

Field-scale assessment of soil, water, plant, and soil microbiome in and around Rania-Khan Chandpur Chromium contaminated site, India.

Rania-Khan Chandpur site, (Kanpur Dehat, Uttar Pradesh, India), one of the highly Chromium (Cr) contaminated sites in India due to Chromite Ore Processing Residue (COPR), has been investigated at the field-scale. We found that the area around the COPR dumps was hazardously contaminated with the Cr where its concentrations in the surface water and groundwater were > 40 mgL-1, its maximum contents in the COPRs and in the soils of the adjoining lands were 9.6 wt% and 3.83 wt%, respectively. By exploring the vegetation and microbial distribution across the site, we advocate the appropriateness of Cynodon dactylon, Chrysopogon zizanioides, Cyperus sp., and Typha angustifolia as the most suitable phytoremediation agent because their association with Cr remediating bacterial species (Pseudomonas sp., Clostridium sp. and Bacillus sp.) was strong. Using this remarkable information for the bioremediation projects, this site can be re-vegetated and bioaugmented to remediate Cr in soils, waterlogged ditches, surface water, and in groundwater systems.

NIR-Absorbing 1,1,4,4-Tetracyanobuta-1,3-diene- and Dicyanoquinodimethane-Functionalized Donor-Acceptor Phenothiazine Derivatives: Synthesis and Characterization.

A series of symmetrical and unsymmetrical donor-acceptor type phenothiazine derivatives 1-18 were designed and synthesized via Pd-catalyzed Sonogashira cross-coupling and [2 + 2] cycloaddition-retroelectrocyclization reactions. The incorporation of cyano-based acceptors 1,1,4,4-tetracyanobutadiene (TCBD) and dicyanoquinodimethane (DCNQ) in the phenothiazine derivatives resulted in systematic variation in the photophysical, thermal, and electrochemical properties. The electronic absorption spectra of the phenothiazine derivatives with strong acceptors 2, 3, 5, 6, 8, 9, 11, 12, 14, 15, 17, and 18 show red-shifted absorption as compared to phenothiazine derivatives 1, 4, 7, 10, 13, and 16 in the near-IR region due to a strong intramolecular charge transfer (ICT) transition. The electrochemical analysis of the phenothiazine derivatives 2, 3, 5, 6, 8, 9, 11, 12, 14, 15, 17, and 18 reveals two reduction waves at low potential due to the TCBD and DCNQ acceptors. The mono-TCBD-functionalized phenothiazine 2 shows higher thermal stability compared to other phenothiazine derivatives. The computational studies on phenothiazines 1-18 reveal the LUMO is substantially stabilized as acceptor strength increases, which lowers the HOMO-LUMO gap.

Bioremediation of Organic Pollutants in Soil-Water System: A Review.

Soil-water pollution is of serious concern worldwide. There is a public outcry against the continually rising problems of pollution to ensure the safest and healthiest subsurface environment for living beings. A variety of organic pollutants causes serious soil-water pollution, toxicity and, therefore, the removal of a wide range of organic pollutants from contaminated matrix through the biological process rather than physico-chemical methods is an urgent need to protect the environment and public health. Being an ecofriendly technology, bioremediation can solve the problems of soil-water pollution due to hydrocarbons as it is a low-cost and self-driven process that utilises microorganisms and plants or their enzymes to degrade and detoxify pollutants and thus, promote sustainable development. This paper describes the updates on the bioremediation and phytoremediation techniques which have been recently developed and demonstrated at the plot-scale. Further, this paper provides details of wetland-based treatment of BTEX contaminated soils and water. The knowledge acquired in our study contributes extensively towards understanding the impact of dynamic subsurface conditions on engineered bioremediation techniques.

A holistic review on trend, occurrence, factors affecting pesticide concentration, and ecological risk assessment.

Demographic outbursts and increased food demands invoke excessive use of pesticides in the agricultural field for increasing productivity which leads to the relentless decline of riverine health and its tributaries. These tributaries are connected to a plethora of point and non-point sources that transport pollutants including pesticides into the Ganga river's mainstream. Simultaneous climate change and lack of rainfall significantly increase pesticide concentration in the soil and water matrix of the river basin. This paper is intended to review the paradigm shift of pesticide pollution in the last few decades in the river Ganga and its tributaries. Along with this, a comprehensive review suggests the ecological risk assessment method which facilitates policy development, sustainable riverine ecosystem management, and decision-making. Before 2011, the total mixture of Hexachlorocyclohexane was found at 0.004-0.026 ng/mL in Hooghly, but now, the concentration has increased up to 0.465-4.132 ng/mL. Aftermath of critical review, we observed maximum residual commodities and pesticide contamination reported in Uttar Pradesh > West Bengal > Bihar > Uttara Khand possibly because of agricultural load, increasing settlement, and incompetency of sewage treatment plant in the reclamation of pesticide contamination.

Multiphase flow behavior of diesel in bog, fen, and swamp peats.

Hydrocarbon fate and transport in various categories of peatlands is complicated by the botanical origin, and thus variations in the hydraulic structures and surface chemistry of its peat soils. There has been no systematic evaluation of the role of different peat types on hydrocarbon migration. Thus, two-phase, and three-phase flow experiments were performed for living and partially decomposed peat cores from bog, fen, and swamp peatlands. Numerical simulations of water drainage were performed using HYDRUS-1D, diesel-water and diesel-water-air flow using MATLAB Reservoir Simulation Toolbox (MRST). Five water table (WT) fluctuations were imposed to explore its potential to reduce residual diesel saturation in peat columns. Our results demonstrate a good match of the relative water permeability (krw) - saturation (S) relations estimated using the unsaturated hydraulic conductivity-S relation derived from HYDRUS-1D modeling of two-phase flow, and krw - S from MRST for three-phase flow, for all tested peat columns. Thus, we recommended using two-phase system based krw - S predictions if multiphase data are unavailable for peatland sites' spill management plans. We found the discharge of water and diesel both increase with increasing hydraulic conductivity, while residual water and diesel were within the range of 0.42-0.52 and of 0.04-0.11, respectively. High diesel discharge rates suggest that quick spill-response is required to manage its spread in peatlands. Up to 29% of residual diesel saturation was yielded by the five WT fluctuations, and thus we strongly recommend WT manipulation as a first step towards diesel decontamination progression in peatlands.

Adsorptive behavior of micro(nano)plastics through biochar: Co-existence, consequences, and challenges in contaminated ecosystems.

The abundance of micro(nano)plastics in natural ecosystems is a crucial global challenge, as these small-sized plastic particles originate from land-based and marine-based activities and are widely present in marine, freshwater, and terrestrial ecosystems. Micro(nano)plastics can significantly be reduced through various methods, such as biological, chemical, and physical techniques. Biochar is a low-cost adsorbent and is considered an efficient material and its application is ecologically effective carbon-negative for remediation of organic and inorganic pollutants. Therefore, this review critically discusses the fate and transport of micro(nano)plastics and their interactions with different biochar in aqueous and column porous media. This review outlines the implications of biochar with the co-existence of micro(nano)plastics in efforts to understand their coupled effects on soil physicochemical properties, microbial communities, and plant growth, along with the removal of heavy metals and other toxic contaminants. In batch experiments, biochar synthesized from various biomasses such as corn straw, hardwood, pine and spruce bark, corncob, and Prosopis juliflora had shown high level of removal efficiency (>90 %) for microplastic adsorption under varying environmental conditions viz., pH, temperature, ionic strength, particle size, and dose due to chemical bonding and electrostatic attractions. Increased temperature of the aqueous solutions encouraged higher adsorption, while higher pH and dissolved organic matter and nutrients may show decreased adsorption capacities for micro(nano)plastics using biochar. Compared to other available physical, chemical, and biological methods, biochar-amended sand filters in column experiments have been very efficient in removing micro(nano)plastics. In saturated column porous media, various microplastics could be inhibited using biochar due to decreased electrostatic repulsion, steric hindrance, and competitive sorption due to humic acid, ionic strength, and cations. Finally, this review provides in-depth insights on further investigations and recommendations for overall micro(nano)plastics removal using biochar-based materials.

Augmenting the productivity of tubular solar still using low-cost energy storage materials.

Productivity improvement is one of the high-priority areas in the development of solar stills. The present work describes the use of some low-cost energy storage materials such as sand, gravels, and black granite as potential candidates to improve the productivity of the tubular solar still (TSS). The experimental studies have been carried out at Nagpur (21.1241° N, 79.0023° E) to investigate the effects of these materials on the productivity of the TSS. Three separate TSS experimental setups have been made for each energy storage materials. These include (a) 5 kg of fine sand (0.125-0.25-mm grain size), (b) small gravels (20-30 mm), and (c) black granite (5-mm thickness) placed in the absorber basin of individual TSS setup, separately. The experiments have been performed by varying basin water depth at 0.5 cm, 1 cm, and 2 cm, for each case. The results show that for water depth of 0.5 cm, productivity of TSS-Black granite is enhanced by 10.5% and 34.88% as compared to TSS-Gravel case and TSS-Sand case, respectively. Thermal efficiency and exergy efficiency of TSS-Black granite at 0.5-cm water depth is enhanced by (32.4%, 9.8%) and (92.1%, 21.9%) as compared to TSS-Sand case and TSS-Gravel case, respectively. Furthermore, it has been estimated that the cost of production of freshwater using TSS-Black granite is lowest among all selected combinations.

A comprehensive study on aquatic chemistry, health risk and remediation techniques of cadmium in groundwater.

Cadmium (Cd), a non-essential trace element, it's intrusion in groundwater has ubiquitous implications on the environment and human health. This review is an approach to comprehensively emphasize on i) chemistry and occurrence of Cd in groundwater and its concomitant response on human health ii) sustainable Cd remediation techniques, iii) and associated costs. Current study is depending on meta-analysis of Cd contaminations in groundwater and discusses its distributions around the globe. Literature review primarily comprises from the last three decades online electronic published database, which mainly includes i) research literatures, ii) government reports. On the basis of meta-data, it was concluded that Cd mobility depends on multiple factors: such as pH, redox state, and ionic strength, dissolved organic (DOC) and inorganic carbon (DIC). A substantially high Cd concentration has been reported in Lagos, Nigeria (0.130 mg/L). In India, groundwater is continuing to be contaminated by Cd in the proximity of industrial, agricultural areas, high concentrations (>8.20 mg/L) were reported in Tamil Nadu and Maharashtra. Depending on chemical behavior and ionic radius cadmium disseminate into the food chain and ultimately cause health hazard that can be measured by various index-based assessment tools. Instead of chemical adsorbents, nanoparticles, phytoextraction, and bioremediation techniques can be very useful in the remediation and management of Cd polluted groundwater at a low-cost. For Cd pollution, the development of a comprehensive framework that links the hydro-geological, bio-geochemical processes to public health is important and need to be further studied.

Antinociceptive activity of standardized extract of Bacopa monnieri in different pain models of zebrafish.

ETHNOPHARMACOLOGICAL RELEVANCE: Bacopa monnieri L. (Scrophulariaceae) is commonly known as Brahmi and traditionally used as a neuroprotective herbal medicine. Recently, Bacopa monnieri exhibited significant therapeutic activity against animal model of neuropathic pain. However, the therapeutic potential of methanolic extract of Bacopa monnieri in experimental animal model is yet to establish. AIM OF THE STUDY: The present study was designed to evaluate the anti-nociceptive potential of standardized methanolic extract of Bacopa monnieri in experimental adult zebrafish (Danio rerio) model of pain. MATERIALS AND METHODS: The methanolic extract of Bacopa monnieri (BME) was standardized to bacoside-A using chromatographic method. Subsequently, BME (0.75, 1.25 and 5.0 mg/ml) was evaluated for anti-nociceptive activity using adult zebrafish model. RESULTS: Standardized BME showed antioxidant effect through radical quenching activity in in vitro study. BME at 1.25 mg/ml significantly decreased the nociceptive effect induced by different noxious agents like acetic acid where as BME at 2.5 mg/ml exhibited significant antinociceptive activity against glutamate, formalin, capsaicin, cinnamaldehyde when compared to control and sham group animals. CONCLUSION: BME exerted antinociceptive activity in adult zebrafish. It could be presumed that BME may involve glutamatergic receptor, ASIC and TRP channel activity in its anti-nociceptive effect. BME could be considered as a potential therapeutic option in the management of pain.

Dynamics of microbial populations and diversity in NAPL contaminated peat soil under varying water table conditions.

Despite the risks that hydrocarbon contamination from pipeline leaks or train derailments impose on the health of peatlands in hydrocarbon production areas and transportation corridors, assessing the effect of such contaminations on the health and sustainability of peatlands has received little attention. This study investigates the impacts of hydrocarbons on peat microbial communities. Column experiments were conducted on non-aqueous phase liquid (NAPL) contaminated undisturbed peat core (0-35 cm) under static and fluctuating water table conditions. Water table fluctuations reduced residual NAPL saturation from 8.1-11.3% to 7.7-9.5%. Biodegradation of n-C8 and n-C12 along with oxidation of CH4 together produced high CO2 concentrations in the headspace. Clear patterns in dynamics in the microbial community structure were observed, with a more pronounced population growth. However, a significant loss of microbial richness was observed in contaminated columns. The result indicates that the phylum Proteobacteria benefited most from NAPL; however, their families differed between static and fluctuating water table conditions. This study established strong evidence that peat microbes and water table fluctuation can be an excellent tool for hydrocarbon removal and its control in peatlands.

Leakage of CO2 from geological storage and its impacts on fresh soil-water systems: a review.

Leakage of CO2 from the geological storage is a serious issue for the sustainability of the receiving fresh soil-water systems. Subsurface water quality issues are no longer related to one type of pollution in many regions around the globe. Thus, an effort has been made to review studies performed to investigate supercritical CO2 (scCO2) and CO2 enrich brine migration and it's leakage from geological storage formations. Further, the study also reviewed it's impacts on fresh soil-water systems, soil microbes, and vegetation. The first part of the study discussed scCO2/CO2 enrich brine migration and its leakage from storage formations along with it's impact on pore dynamics of hydrological regimes. Later, a state-of-the-art literature survey has been performed to understand the role of CO2-brine leakage on groundwater dynamics and its quality along with soil microbes and plants. It is observed in the literature survey that most of the studies on CO2-brine migration in storage formations reported significant CO2-brine leakage due to over-pressurization through wells (injections and abandoned), fracture, and faults during CO2 injection. Thus, changes in the groundwater flow and water table dynamics can be the first impact of the CO2-brine leakage. Subsequently, three major alterations may also occur-(i) drop in pH of subsurface water, (ii) enhancement of organic compounds, and (iii) mobilization of metals and metalloids. Geochemical alteration depends on the amount of CO2 leaked and interactions with host rocks. Therefore, such alteration may significantly affect soil microbial dynamics and vegetation in and around CO2 leakage sites. In-depth analysis of the available literature fortifies that a proper subsurface characterization along with the bio-geochemical analysis is extremely important and should be mandatory to predict the more accurate risk of CO2 capture and storage activities on soil-water systems.

Ensemble modelling framework for groundwater level prediction in urban areas of India.

India is facing the worst water crisis in its history and major Indian cities which accommodate about 50% of its population will be among highly groundwater stressed cities by 2020. In past few decades, the urban groundwater resources declined significantly due to over exploitation, urbanization, population growth and climate change. To understand the role of these variables on groundwater level fluctuation, we developed a machine learning based modelling approach considering singular spectrum analysis (SSA), mutual information theory (MI), genetic algorithm (GA), artificial neural network (ANN) and support vector machine (SVM). The developed approach was used to predict the groundwater levels in Bengaluru, a densely populated city with declining groundwater water resources. The input data which consist of groundwater levels, rainfall, temperature, NOI, SOI, NIÑO3 and monthly population growth rate were pre-processed using mutual information theory, genetic algorithm and lag analysis. Later, the optimized input sets were used in ANN and SVM to predict monthly groundwater level fluctuations. The results suggest that the machine learning based approach with data pre-processing predict groundwater levels accurately (R > 85%). It is also evident from the results that the pre-processing techniques enhance the prediction accuracy and results were improved for 66% of the monitored wells. Analysis of various input parameters suggest, inclusion of population growth rate is positively correlated with decrease in groundwater levels. The developed approach in this study for urban groundwater prediction can be useful particularly in cities where lack of pipeline/sewage/drainage lines leakage data hinders physical based modelling.

Complex regional pain syndrome-A forgotten entity.

Complex Regional Pain Syndrome (CRPS) is a painful condition characterized by regional pain that is disproportionate temporality and severity to the usual course of any known cause. The pain is regional which is not in a specific nerve territory or dermatomal distribution. Judicious clinical suspicion and targeted investigations are necessary for correct diagnosis and appropriate treatment. We hereby report a case of a young lady with CRPS who presented to us with unilateral upper limb pain, swelling, discoloration and muscle atrophy without any history of inciting injury.

A rare cause of nodular skin lesions with fever in an immunocompetent individual.

Histoplasmosis is a fungal disease caused by the dimorphic fungus Histoplasma capsulatum. It is endemic to many parts of the world but is rarely seen in India. The fungus usually affects the immunocompromised patients and is rarely reported in immunocompetent hosts. We hereby report a case of the nodular skin lesion with fever lesion that finally turned out to have cutaneous histoplasmosis, from a non-endemic region of northern India and that too in an immunocompetent.

Uncommon cause of persistent hypoxia in a patient with obstructive sleep apnea.

We report a case of hypothyroidism, obstructive sleep apnea (OSA) with persistent daytime hypoxemia. Cause of hypoxemia was two arteriovenous (AV) malformations in the lower lobe of the lung. We must be alert to other causes of hypoxemia in patients of OSA with persistent daytime hypoxemia.

Performance evaluation of duplex constructed wetlands for the treatment of diesel contaminated wastewater.

A duplex constructed wetland (duplex-CW) is a hybrid system that combines a vertical flow (VF) CW as a first stage with a horizontal flow filter (HFF) as a second stage for a more efficient wastewater treatment as compared to traditional constructed wetlands. This study evaluated the potential of the hybrid CW system to treat influent wastewater containing diesel range organic compounds varying from C7 - C40 using a series of 12-week practical and numerical experiments under controlled conditions in a greenhouse (pH was kept at 7.0 ±â€¯0.2, temperature between 20 and 23° C and light intensity between 85 and 100-µmol photons m-2 sec-1 for 16 h d-1). The VF CWs were planted with Phragmites australis and were spiked with different concentrations of NH4+-N (10, 30 and 60 mg/L) and PO43--P (3, 6 and 12 mg/L) to analyse their effects on the degradation of the supplied petroleum hydrocarbons. The removal rate of the diesel range organics considering the different NH4+-N and PO43--P concentrations were simulated using Monod degradation kinetics. The simulated results compared well with the observed database. The results showed that the model can effectively be used to predict biochemical transformation and degradation of diesel range organic compounds along with nutrient amendment in duplex constructed wetlands.

Evaluation of Microleakage with Total Etch, Self Etch and Universal Adhesive Systems in Class V Restorations: An In vitro Study.

INTRODUCTION: Adhesive dentistry is overwhelmingly evolving with respect to the dental surgeon's and patient's perspective. Embracing the concept of minimally invasive dentistry which follows minimum intervention performed to produce good adhesion and tooth coloured restoration, in turn makes the newer generation bonding agents more acceptable and appropriate withstanding the demand for stable restoration. AIM: To study and compare the extent of microleakage between tooth and restoration interface in class V composite resin restorations applying one Total Etch (AdperTM single bond), two Self Etch (AdperTM SE Plus, AdperTM Easy One) and Universal bonding agents using dye penetration method. MATERIALS AND METHODS: A total of 120 freshly orthodontically extracted human maxillary and mandibular premolars were included in the study. Class V cavities were prepared with a cylindrical diamond bur on the facial surface of each tooth, having approximate dimensions of 3 mm × 2.5 mm × 1.5 mm. Teeth were divided into four groups (30 in each group). Group A AdperTM single bond 2 (3M ESPE), Group B AdperTM SE Plus (3M ESPE), Group C AdperTM Easy One (3M ESPE), Group D AdperTM Single Bond Universal (3M ESPE) bonding agents were applied as per the manufacturer's instructions and the cavities were then restored with nanohybrid composite resin (Tetric N Ceram Ivoclar Vivadent). Teeth were then thermocycled for 200 cycles at 5°-55°C with 60 seconds of dwell time. Specimens were subjected to a dye leakage test. Microleakage was evaluated using a stereomicroscope. Data was analysed using Kruskal- Wallis, Dunn and Mann-Whitney test to assess the difference in microleakage among various adhesives. RESULTS: The present study revealed that the microleakage was more at the gingival margin when compared with occlusal and this was found to be statistically significant. At the occlusal margin statistical significant difference was found only between AdperTM Easy one and AdperTM SE Plus, on the other hand at gingival margin no statistical significant difference was found. CONCLUSION: One step self etch agents showed less microleakage than total etches and universal adhesive at occlusal margin. Higher degree of microleakage was observed at gingival margin compared to occlusal margin.

Malignant transformation in a case of megalencephalic leukoencephalopathy with subcortical cysts: An extreme rarity in a rare disorder.

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is an autosomal recessive inherited disorder characterized by macrocephaly, progressive motor disability, seizures, mild cognitive decline, slow progression, and typical magnetic resonance imaging (MRI) findings. Age of onset of symptoms is described from birth to 25 years. Late onset presentation is very rare, only few cases have been reported worldwide. Most important clue for diagnosis is the characteristic MRI changes that include diffuse involvement of subcortical white matter mainly in frontoparietal region with relative sparing of central white matter along with subcortical cysts mostly in anterior temporal region. Cysts are usually benign and slowly progressive. Malignant transformation of cysts has not been reported as yet. We herein report a very unusual and probably the first case of MLC who presented to us in a unique manner with late onset and malignant transformation of cyst in left temporal region leading to rapid neurological decline. This case report highlights a possible life-threatening complication of a previously known slowly progressive disease warranting urgent neurosurgical intervention.

Periodic electroencephalogram discharges in a case of Lafora body disease: An unusual finding.

Lafora body disease (LBD) is a form of progressive myoclonic epilepsy, characterized by seizures, myoclonic jerks, cognitive decline, ataxia, and intracellular polyglucosan inclusion bodies (Lafora bodies) in the neurons, heart, skeletal muscle, liver, and sweat gland duct cells. Electroencephalogram (EEG) findings in LBD may include multiple spikes and wave discharges, photosensitivity, multifocal epileptiform discharges, and progressive slowing in background activity. Periodicity in epileptiform discharges has not been frequently depicted in LBD. We herein report an unusual case of LBD who showed generalized periodic epileptiform discharges in EEG.