The Long-Pulse Potassium-Titanyl-Phosphate Laser: Promising Treatment for Resistant Port-Wine Stains.

Port-wine stains (PWSs), or port-wine birthmarks, are congenital vascular malformations that manifest as erythematous to pink patches at birth. At present, lasers are the preferred method for treating PWSs, with pulsed dye laser (PDL) being regarded as the gold standard because of its superior efficacy compared to alternative procedures. Despite the progress made in laser therapy, a subset of patients continue to experience PWSs that cannot be resolved effectively even with PDL. A new long-pulse potassium-titanyl-phosphate (KTP) laser with a trail of sub-pulses (Derma V, Lutronic, Seoul, South Korea) is a promising treatment for PWSs resistant to PDL therapies. This is a case of a female patient with PDL-resistance PWSs that was treated successfully with a long-pulse KTP laser. Long-pulse KTP appears to be not just more effective in treating PDL-resistant PWSs but also less costly as less number of sessions are needed, with no significant side effects reported such as purpura.

Comparison Of Operative Complications Of Direct Trocar Access Versus Veress Needle Insertion Technique For Initial Peritoneal Entry In Patients Undergoing Gynecological Laparoscopic Surgery.

BACKGROUND: Laparoscopy is considered to be a good diagnostic and surgical way to replace open surgeries in all surgical fields. As it is a least invasive method, with advantages for patients and all associated with medical care. There is a significant increase in the use of laparoscopic surgery in gynecology. This study was done to compare the frequency of operative complications of direct trocar access versus Veress needle insertion technique for initial peritoneal entry in patients undergoing gynecological laparoscopic surgery. METHODS: This Randomized Controlled Trial was conducted at the Department of Obstetrics & Gynecology, Lahore General Hospital, Lahore from 26-12-2019 to 25-6-2020. Four hundred consecutive patients were enrolled and divided randomly into two groups by blocked randomization. Direct trocar insertion (DTI) technique was used for initial peritoneal access in group A and Veress needle (VNI) was inserted first for peritoneal access in group B. RESULTS: The mean age of the patients in DTI group was 35.76±8.38 years whereas that in VNI group was 35.85±8.38 years. In DTI group there were 8(4%) patients with extra-peritoneal insufflation and in VNI group there were 19(9.5%) patients with extra-peritoneal insufflation. There were 8(4%) patients in DTI group with Omental injury and VNI group there were 13(6.5%) patients with Omental injury. In DTI group there were 7(3.5%) patients with port-site infection compared to 15(7.5%) in VNI group. CONCLUSIONS: According to findings the rate of complications observed with VNI, DTI can be a preferred procedure for gynecological surgeries.

Feasibility of Smartphone-Delivered Progressive Muscle Relaxation in Persistent Post-Traumatic Headache Patients.

Persistent post-traumatic headache (PPTH) is often the most common injury after mild traumatic brain injury (mTBI), reported by 47-95% of patients. Progressive muscle relaxation (PMR) has level A evidence in preventing migraine and tension headaches. However, research on this behavioral therapy for PPTH, let alone smartphone delivered, is limited. We performed a single-arm study of prospective patients calling our Concussion Center between June 2017 and July 2018. Inclusion criteria were that subjects had to meet International Classification of Headache Disorders, 3rd Edition criteria for PPTH secondary to mTBI, have four or more headache days a month, be age 18-85 years and 3-12 months post-injury, own a smartphone, and not tried headache behavioral therapy within the year. We recorded baseline headache and neuropsychiatric data. Using the RELAXaHEAD smartphone application, which has a headache diary and PMR audio files, participants were instructed to record headache symptoms and practice 20 min of PMR daily. There were three monthly follow-up assessments. There were 49 subjects enrolled. Basic demographics were: 33 (67%) female with mean age 40.1 ± 14.6 [20, 75] years. Of the 49 subjects, 15 (31%) had pre-existing headaches. In 11 (22%) subjects, mTBI was sports related. Subjects reported 17.7 ± 9.3 [4, 31] headache days in the month before enrollment, and 49 (100%) experienced over three concussion symptoms. Participants inputted data in the RELAXaHEAD app on average 18.3 ± 12.0 days [0, 31] the first month. Number of participants who did PMR over four times per week was 12 (24.5%) the first month, 9 (22.5%) the second month, and 6 (15%) the third month. After 3 months, 17 (42.5 %) participants continued doing PMR. Participants cited time constraints, forgetfulness, application glitches, and repetitiveness as obstacles to practicing PMR. It is feasible to get PPTH subjects to practice behavioral therapy through low-cost smartphone-based PMR two times weekly. Future work will assess efficacy and examine how to optimize barriers to PMR.

Significance of Bacillus subtilis strain SJ-101 as a bioinoculant for concurrent plant growth promotion and nickel accumulation in Brassica juncea.

In this study, a nickel (Ni)-tolerant Bacillus subtilis strain SJ-101 was characterized based on the 16SrDNA homology and phylogenetic analysis. The role of this strain ascertained in facilitating Ni accumulation in the Indian mustard plant (Brassica juncea [L]. Czern and Coss) var. Pusa Bold (DIR-50), to elucidate the potential of Ni phytoremediation in combination with metal-tolerant rhizobacteria. The data revealed that the plants exposed to NiCl2 (1750 mg kg(-1)) in soil bioaugmented with strain SJ-101 have accumulated 0.147% Ni vis-à-vis 0.094% accumulation in dry biomass of the plants grown in uninoculated soil. The strain SJ-101 has also exhibited the capability of producing indole acetic acid (IAA) (55 microg ml(-1)), and solubilizing inorganic phosphate (90 microg ml(-1)) in specific culture media. The pot culture experiments clearly demonstrated the beneficial effects of bioinoculant strain SJ-101 with significant increase (p<0.05) in the plant growth attributes in untreated control soil. Furthermore, the protective effect of the strain SJ-101 against Ni phytotoxicity was evident in plants grown in soil treated with NiCl2 in concentration range of 250-1750 mg kg(-1). Thus, it is suggested that the strain SJ-101 owing to its intrinsic abilities of plant growth promotion, and attenuation of soil Ni by biosorption and bioaccumulation, could be exploited for bacteria-assisted phytoaccumulation of this toxic heavy metal from contaminated sites.