Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases.

Introduction In this study, we reported a single surgeon experience of total laparoscopic hysterectomy (TLH) in terms of intraoperative and early postoperative outcomes and complications. In addition, we compared our results with published literature for a reevaluation of complications and outcomes. Material and methods This present prospective study was conducted on 50 patients who underwent TLH due to benign causes. Patients diagnosed with abnormal uterine bleeding (AUB), uterine fibroids, and post-menopausal bleeding (PMB) were included in this analysis. Patients were discharged after 24 hours of surgery if there were considered fit for discharge. The patients' age, co-morbidities, size of the uterus, additional procedure along with TLH, and postoperative complications were collected and analyzed. The follow-up period was three months, done on the tenth day after surgery, the thirtieth day, and then at three months. Results The mean age of our patients was 46.42±5.01 years. The major indication of hysterectomy was fibroids diagnosed in 27 (54.0%) patients and AUB in 18 (36.0%) patients. Out of 50, 10 (20.0%) patients had a previous cesarean section, and 4 (8.0%) had a bilateral tubal ligation (BTL). Mean surgery duration was 124.26±44.74 minutes. Mean hospital stay was 2.18±0.39 days. Total complications occurred in five (10.0%) patients, ureteric injury in one (2.0%) patient, port-site infections in 2 (4.0%), and vault infections in 2 (4.0%) patients. Conclusion TLH is a safe procedure and can be performed with minimal complications in patients with benign uterine etiology.

Empirics on heterogeneous links among urbanization, the intensity of electric power consumption, water-based emissions, and economic progress in regional China.

This study investigates the heterogeneous causal linkages between urbanization, the intensity of electric power consumption, water-based pollutant emissions, and GRP in regional China by developing an urbanization-augmented "Stochastic Impacts by Regression on Population, Affluence, and Technology" (STIRPAT) model. A whole country panel of 29 provinces as well as region sub-panels of China, for the period 1999 to 2018, are estimated employing common correlated effects mean group approach (CCEMGA), which offers robustness against heterogeneous characteristics and cross-sectionally dependent series. From the theoretic modeling aspect, the intensity of electric power consumption and urbanization have been introduced as the determinants of water-based pollutant emissions in the STIRPAT modeling framework. Based on empirical results, first, GRP growth has shown appealing behavior in the form of its heterogeneous impacts on water-based pollutant emissions growth in the case of different regions. For instance, its impact is noted to be positive and statistically significant for the western region, which turned positive but statistically insignificant for the intermediate region. And it further turned significantly negative in the case of the eastern region. We call this phenomenon as "development level-based emission mitigation effect." Second, in terms of the impact of GRP growth on urbanization, the "development-based urbanization ladder effect" has been found. Based on heterogeneous causal links, firstly, the existence of a positive bilateral causal link between the intensity of electric power consumption and GRP growth and urbanization and GRP growth has been validated. Secondly, a positive unidirectional causal link emerged from urbanization to the intensity of electric power consumption and water-based pollutant emissions growth. Thirdly, the causal connection between GRP growth and water-based pollutant emissions growth remained very interesting and of mixed nature. Based on empirical findings, useful policies are extended. Graphical abstract.

2D/3D graphene on h-BN interlayer-silicon solar cell with ZnO:Al buffer layer and enormous light captivation using Au/Ag NPs.

In this paper, systematic design and analysis of thin-film graphene-silicon solar cells with the addition of an anti-reflection coating (ARC), hexagonal boron nitride (h-BN) interlayer and decorated with Au/Ag NPs infused in rear ZnO:Al buffer layer is reported. The 3D NPs are located on the top and rear side of the solar cell. Initially, we simulated a reference 2D graphene-silicon solar cell with highest simulated short circuit current density (Jsc) 30mA/ cm2 and power conversion efficiency (PCE) of 10.65%. Using 2D and 3D full vectorial finite element method (FVFEM) simulations, we significantly improved the Jsc by 6.2mA/ cm2 from 30mA/cm2 to 36.21mA/cm2 and PCE from 10.93% to 12.03%. We utilized a patterned graphene sheet with small nanoholes to increase surface and optical conductivity. Plasmonic NPs embedded in a graphene-silicon solar cell to increase plasmonic resonance effects is investigated. The 3D position of the patterned graphene, rear buffer layer stack, size, shape, and periodicity of NPs were well-controlled and analyzed under certain parametric variation conditions. Ag NPs located inside textured ZnO:Al detached to metal contact and small periodic Au NPs decorated beneath a h-BN interlayer lead to highly efficient light confinement and increase photon current generation. The proposed device exhibits 12.03% PCE, maximum light absorption over 80% and high overall quantum efficiency (QE). Furthermore, this structure offers major light trapping advantages, including significant EM light propagation throughout the solar cell structure.

Ovarian dermoid causing pilimiction.

Ovarian dermoid cyst is one of the common problems seen in gynaecology, they make upto 10 - 25% of all ovarian neoplasms and are usually seen in younger age group. Mature cystic teratomas are usually an incidental finding during a clinical examinations, radiographic studies or during abdominal operations performed for other indications. Other presentations include abdominal symptoms from complications of the cyst such as torsion, rupture, infection and malignant transformation. Dermoid cyst in urinary bladder is a very rare condition. Here we are presenting a case report of a female who presented with lower abdominal pain and passage of hair in urine (pilimiction). Upon investigations it was found that patient had right sided dermoid which had penetrated the wall of bladder and expelled its contents in the bladder. This was a very rare presentation and no such case has been reported in Pakistani literature.

Antimicrobial activities of Aerva javanica and Paeonia emodi plants.

Aerva javanica and Paeonia emodi plants extracts were studied for antibacterial activity against Escherichia coli (NCTC 10418), Klebsiella pneumoniae (ATCC 700603), Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella typhi, Staphylococcus epidermidis (NCTC 11047) and Methicillin Resistant Staphylococcus Aureus (MRSA) (NCTC 13143) and antifungal activity against Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger and Fusarium solani. Extracts were obtained by using methanol, n-hexane, chloroform, ethyl acetate and aqueous fraction. The extracts of Paeonia emodi and Aerva javanica showed significant antibacterial activity but only Salmonella typhi was resistant to Aerva javanica. Moreover, the antifungal activity of Aerva javanica was very poor but the fractions of Paeonia emodi showed sufficient inhibition against fungal strains.