Cent Of Group Research Articles

Efficacy of Ozone and Other Alternative Intrauterine Therapies in Infectious Repeat Breeder Cows.

The study was undertaken to evaluate the therapeutic efficacy of Ozone, E. Coli LPS, Autologous plasma, Neem oil, and Lugol’s iodine in 100 infectious repeat breeder cows. The animals were divided in 5 different groups viz. Group-I, Group-II, Group-III, Group-IV and Group-V treated with Ozone @ 55µg/ml in 60ml distilled water, E. Coli LPS @100mcg in 30 ml sterile PBS, Autologous plasma @ 30 ml, Neem oil @ 10µg/ml in 30 ml distilled water, Lugol’s iodine 1:25 in 30ml normal saline, intrauterine route in 20 cases, respectively, Group-V of 20 animals was kept as control. AI was done in recovered cases. On follow up, recovery rate in treatment group were found as 75.00, 80.00, 65.00, 75.00 and 50.00 per cent in groups I to V, respectively. The conception rate was found as 68.42, 73.68, 55.00, 63.15 and 53.33 per cent in cows in Group-I to V, respectively. Pregnancy rate was observed that 65.00, 70.00, 50.00, 60.00 and 40.00 per cent cows from groups I to V, respectively. On conclusion, infectious repeat breeder cows treated with E. Coli LPS showed highest recovery rate, conception rate and pregnancy rate than the other treatment groups in this research study.

CASA Based Assessment of Kangayam bull semen processed with different extenders and Conception rate following AI

Semen extenders are the essential components of cryopreservation of semen. Identification of suitable and ready to use semen extender is the need of hour for the rapid propagation of Kangayam cows through artificial insemination. Kangayam bull, aged 5 years was utilized for the study. The semen was collected twice in a week and each time two ejaculates were collected. A total of 24 ejaculates were utilized for this study. After assessing the general macroscopical examination the semen was subjected to computer aided semen analysis (CASA) for assessing the kinematic parameters in fresh diluted semen, pre freeze and post thawed such as sperm motility, progressive individual motility, VAP, VSL, ALH and LIN were analyzed using CASA. Among all the three extenders, the sperm kinematic parameters during fresh diluted, pre freeze and post thawed semen stages were higher in group III (liposome based extender) followed by group I (TEYG) and in group II (soya bean lecithin based extender). Among the three extenders used, the components of liposome based extender was better and it was able to maintain the structural integrity, plasma membrane integrity and motility in the sperms of the frozen thawed semen than the other two extenders (TEYG and soya bean lecithin based extenders). Further the fertility rate was evaluated by the in vivo insemination of 60 Kangayam cows after 12 hours of onset of estrum. The fertility rate observed was 45.00, 40.00 and 65.00 per cent in groups I, II and III, respectively. The overall conception rate recorded in Kangayam cow was 50.00 per cent. Based on the findings, it was concluded that liposome based extender may be used for cryopreservation of Kangayam bull semen in order to maximize the fertility rate.

Cryotolerance of in vitro matured and vitrified bovine oocytes supplemented with L-carnitine and niacin

The study was designed to compare the cryotolerance of in vitro matured bovine oocytes, supplemented with L- carnitine and niacin in maturation media, vitrified using cryoloop technique. Bovine ovaries were collected from the slaughterhouse and cumulus-oocyte complexes (COCs) were retrieved by follicular aspiration. Culture quality COCs were selected and randomly allocated to three different experimental groups. Group I oocytes (control), were subjected to in vitro maturation (IVM) in basic maturation media, while Group II and III oocytes (experimental groups) were matured in media supplemented with L- carnitine (0.6 mg/mL) and niacin (400 μM/mL), respectively. The mean per cent of cumulus cell expansion was 80.92 ±0.02, 79.18 ± 0.03 and 87.95 ±0.02 for Group I, II and III, respectively. A significantly high (p < 0.05) cumulus cell expansion could be observed in niacin treated group than L- carnitine, whereas a difference close to being statistically significant (p = 0.057) was noticed between niacin treated and control groups. The matured oocytes were subjected to cryoloopvitrification using dimethylsulfoxide (15%), ethylene glycol (15%) and sucrose (0.05M) as cryoprotectants. The mean survival rate observed in the study was 67.26 ± 0.05, 76.34 ± 0.05 and 79.68 ± 0.03 per cent for Group I, II and III, respectively. Shrinkage of cytoplasm was the most common type of cryodamage observed in all the three groups followed by cracked zona pellucida, abnormal shape and increased peri vitelline space. The survived oocytes were subjected to in vitro fertilisation with no significant difference between the groups in fertilisation rate. The present study revealed the beneficiary effect of supplementing niacin over L- carnitine in maturation media as it improved the maturation and survival rates of bovine oocytes.

Early diagnosis of pseudopregnancy in goats by ultrasonography and response to treatment using cloprostenol sodium

Pseudopregnancy is a state of temporary infertility in goats characterised by the accumulation of sterile fluid in the uterus in the absence of a foetus with persistent corpus luteum. B-mode ultrasonographic examination of goats on day 60 post-breeding was conducted for differential diagnosis of pregnancy, non-pregnancy and pseudopregnancy. Pseudopregnant does diagnosed on day 60 (day 0) post-breeding (Group I, n=8) were treated with three doses of 125μg of cloprostenol sodium (i/m) 10 days apart and were bred by natural service on induced oestrus after the third dose of treatment. The response to treatment was evaluated and compared with normal cycling does (Group II, n=8) which were mated on spontaneous oestrus. The uterine wall thickness measured ultrasonographically on day 0 in group I and on day 60 post-breeding in pregnant does of group II were 0.63 ± 0.02 and 0.66±0.03 cm, respectively (P >0.05). Serum progesterone concentration estimated on day 0, day of the evacuation of uterine fluid, days 10 and 20 in group I and on day 60 post-breeding in group II were 2.73 ± 0.19, 0.78± 0.19, 1.67 ± 0.10, 1.72 ± 0.19 and 3.64± 0.16 ng/mL, respectively. A statistically significant difference was observed between day 0 in group I and day 60 in group II; within group I, between day 0 and the day of evacuation and between the day of evacuation and day 10. Pregnancy diagnosis on day 60 post-breeding revealed a conception rate of 50 and 75 per cent in groups I and II, respectively (P>0.05).

The value of intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism and varying baseline parathyroid hormone levels.

When applying intraoperative parathyroid hormone monitoring (IOPTH) to patients with primary hyperparathyroidism (PHPT), there are established criteria predicting biochemical cure in patients with basal parathyroid hormone (PTH) levels in the medium range (100-400 pg/ml); however, there is a challenge concerning patients with low (less than 100 pg/ml) or high (more than 400 pg/ml) basal PTH levels. The aim of this study was to investigate the value of the 'Vienna criterion' applied during IOPTH in patients with PHPT and various basal PTH concentrations. Consecutive patients between 1999-2009 with a biochemical diagnosis of PHPT who underwent surgical parathyroidectomy were included. Based on preoperative PTH levels they were divided into three groups: group 1 (low) (<100 pg/ml), group 2 (medium) (100-400 pg/ml) and group 3 (high) (>400 pg/ml) basal PTH. PTH was measured at the start of the operation, when the gland was excised and then at 5, 10 and 15 min after. Calcium and PTH levels were measured at 7 days and 12 months postoperatively. Sensitivity, specificity, positive and negative predictive value, as well as accuracy of IOPTH were calculated for the different groups postoperatively. 675 patients with PHPT were analysed. Sensitivity and specificity were 83.7 per cent and 66.7 per cent in group 1 (n = 187), 90.7 per cent and 69.2 per cent in group 2 (n = 433), and 94.4 per cent and 100 per cent in group 3 (n = 55) to predict cure. Preoperative creatinine (p = 0.002) showed significant statistical difference between the groups but was not related to intraoperative PTH decline. At 12 months follow-up normocalcaemia was documented in 98.9 per cent in group 1, 99.0 per cent group 2, and 98.0 per cent of group 3 patients. Normocalcaemia was predicted intraoperatively by applying the 'Vienna criterion' in 98 to 100 per cent and was confirmed after 12 months follow-up in up to 99.0 per cent of patients. Low specificity and a high false-negative rate in patients with low basal PTH show that other criteria might be better suited for this group.

Pterygium management and comparison of different surgical approaches with supportive treatment in Rural Maharashtra

BACKGROUND: Numerous surgical procedures and changes have been ineffective in preventing the recurrence of pterygium. A prospective clinical observational analysis of 205 individuals with primary pterygium was conducted where patients were treated with various surgical procedures. The patients were observed for two to five years in order to examine the frequency of recurrences and consequences. RESULT: Patients were divided into four groups and treated using a variety of surgical methods. Straightforward excision of pterygium was the treatement of choice in group 1. Excision with conjunctival rotation pedicle graft was used on patients in Group 2. Excision and conjunctival autograft were used to treat Group 3 patients. Patients in Group 4 received excision and a 0.02 percent solution of mitomycin c drops as a postoperative treatment. Age varied from 22 to 58, with a median of 34. All four groups had an equal number of men and women. Hemorrhage, astigmatism, symblepheron, foreign body feeling, and a corneo-scleral ulcer were among complications that were reported. There were 12 percent complications in group 1, 16 percent complications in group 2, 6 percent complications in group 3, and 8 percent complications in group 4. Criteria for recurrence was defined as the regrowth of fibrovascular tissue or the appearance of an aesthetic flaw. It's 30 percent for group 1; 14 percent for group 2, 9 per cent for group 3, and 8 per cent for group 4. CONCLUSION: The least rate of recurrence was noted in patients of Group 4 who had pterygium excision with postoperative mitomycin c instillation, and complications were least common in patients in Group 3 who had pterygium resection with conjunctival autograft..

Targeted use of intraoperative frozen-section analysis lowers the frequency of completion thyroidectomy

BackgroundThe impact of intraoperative frozen section (iFS) analysis on the frequency of completion thyroidectomy for the management of thyroid carcinoma is controversial. Although specialized endocrine centres have published their respective results, there are insufficient data from primary and secondary healthcare levels. The aim of this study was to analyse the utility of iFS analysis.MethodsIn the Prospective Evaluation Study Thyroid Surgery (PETS) 2 study, 22 011 operations for benign and malignant thyroid disease were registered prospectively in 68 European hospitals from 1 July 2010 to 31 December 2012. Group 1 consisted of 569 patients from University Medical Centre (UMC) Mainz, and group 2 comprised 21 442 patients from other PETS 2 participating hospitals. UMC Mainz exercised targeted but liberal use of iFS analysis for suspected malignant nodules. iFS analysis was compared with standard histological examination regarding the correct distinction between benign and malignant disease. The percentage of completion thyroidectomies was assessed for the participating hospitals.ResultsiFS analysis was performed in 35.70 per cent of patients in group 1 versus 21.80 per cent of those in group 2 (risk ratio (RR) 1.6, 95 per cent c.i. 1.5 to 1.8; P < 0.001). Sensitivity of iFS analysis was 75.0 per cent in group 1 versus 63.50 per cent in group 2 (RR 1.2, 1.2 to 1.3; P = 0.040). Completion surgery was necessary in 8.10 per cent of patients in group 1 versus 20.8 per cent of those in group 2 (RR 0.4, 0.2 to 0.7; P = 0.001).ConclusioniFS analysis is a useful tool in determining the appropriate surgical management of thyroid disease. Targeted use of iFS was associated with a significantly higher sensitivity for the detection of malignancy, and with a significantly reduced necessity for completion surgery.

Dental anomalies frequency in submucous cleft palate versus complete cleft palate.

This retrospective study evaluated the prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate. The sample comprised 26 individuals with submucous cleft palate (group S) and 68 individuals with complete cleft palate (group C) aged between 9 and 12 years from a single centre. Panoramic radiographs were evaluated regarding the presence of dental anomalies of number in permanent teeth. Intergroup comparison was performed using chi-square tests (P < 0.05). Tooth agenesis was found in 34.61 and 36.76 per cent of group S and group C, respectively. The most commonly missing teeth were the maxillary second premolar, maxillary lateral incisor, and mandibular second premolar. Supernumerary teeth were found in none and 1.47 per cent of the individuals with submucous and complete cleft palate, respectively. No statistically significant difference was found between groups for the frequency of tooth agenesis and supernumerary teeth. Only dental anomalies of number were evaluated. Individuals with submucous and complete cleft palate showed similar prevalence for tooth agenesis and supernumerary teeth. Dental anomalies frequency seems not to be a discriminator for subphenotypes of cleft palate.

Vascular Perfusion of the Preovulatory Follicle and its Relationship in Pregnancy Establishment during Natural and Induced Estrus in Buffaloes

Background: In buffaloes, little attention has been devoted on the haemodynamics of preovulatory follicle (POF) and serum estradiol profiles and their relationship with conception rate following AI at natural and induced estrus. Methods: Sixty healthy pleuriparous graded Murrah buffaloes were selected and divided into two groups, viz., Group I and II. Group I buffaloes were artificially inseminated twice at an interval of 24 hours during natural estrus. Estrus induction was done using PIVD and PGF2α in group II buffaloes and AI was performed 48 h and 72 h after the withdrawal of PIVD. The blood flow of the preovulatory follicle (POF) and early pregnancy were assessed in both the groups by Doppler ultrasonography.Result: On statistical analysis, the mean (± SE) of spectral indices revealed there was an increased blood flow to the POF during induced estrus (Group II) when compared to natural estrus (Group I). The conception rate observed was 66.67 and 58.33 per cent in group I and II, respectively. It is concluded that increased vascular perfusion to POF resulted in almost similar conception rates in induced and natural estrus following AI in buffaloes.

Quenched fractions in the IllustrisTNG simulations: the roles of AGN feedback, environment, and pre-processing

ABSTRACT We use the IllustrisTNG hydrodynamical simulations to show how the fractions of quenched galaxies vary across different environments and cosmic time, and to quantify the role AGN feedback and pre-processing play in quenching group and cluster satellites. At z = 0, we select galaxies with Mstars = 109−12 M⊙ residing within (≤R200c) massive groups and clusters of total host mass M200c = 1013−15.2 M⊙ in TNG100 and TNG300. The model predicts a quenched fraction of ∼70–90 per cent (on average) for centrals and satellites of mass ≳ 1010.5 M⊙, regardless of host mass, cosmic time (0 ≤ z ≤ 0.5), cluster-centric distance, and time since infall in the z = 0 host. Low-mass central galaxies (≲ 1010 M⊙), on the other hand, are rarely quenched unless they become members of groups (1013–14 M⊙) or clusters (≥1014 M⊙), where the quenched fraction rises to ∼ 80 per cent. Typically, the fraction of low-mass passive galaxies is higher closer to the host centre and for progressively more massive hosts. The population of low-mass satellites accreted more than ∼ 4–6 Gyr ago in massive hosts is almost entirely passive, thus suggesting an upper limit for the time needed for environmental quenching to occur. In fact, about 30 per cent of group and cluster satellites that are quenched at z = 0 were already quenched before falling into their current host, and the bulk of them quenched as early as 4–10 billion years ago. For low-mass galaxies (Mstars ≲ 1010–10.5 M⊙), this is due to pre-processing, whereby current satellites may have been members of other hosts, and hence have undergone environmental processes, before falling into their final host, this mechanism being more common and more effective for the purposes of quenching for satellites found today in more massive hosts. On the other hand, massive galaxies quench on their own and because of AGN feedback, regardless of whether they are centrals or satellites.

Adjuvant intraperitoneal ceftriaxone in the treatment of septic peritonitis in horses

BackgroundIntraperitoneal administration of ceftriaxone maintains therapeutic abdominal concentrations for 24 hours in healthy horses. Therefore, it is a possible treatment for septic peritonitis. The aim of this study was to...

“Death Knell” for Prophylactic Vena Cava Filters? A 20-Year Experience with a Venous Thromboembolism Guideline

The role of prophylactic vena cava filters (pVCFs) in trauma patients remains controversial. After 20 years of data collection and experience, we reviewed our venous thromboembolism guideline for the efficacy of pVCFs in preventing pulmonary embolism (PE). A retrospective cohort study was performed using our Level I trauma center registry from January 1997 thru December 2016. This population was then divided by the presence of pVCFs. Univariate analysis was performed comparing the incidence of PEs, deep vein thrombosis, and mortality between those with and without a pVCF. There were 35,658 patients identified, of whom 2 per cent (n = 847) received pVCFs. The PE rate was 0.4 per cent in both groups. The deep vein thrombosis rate for pVCFs was 3.9 per cent compared with 0.6 per cent in the no-VCF group (P < 0.0001). Given that there was no difference in the rates of PEs between the cohorts, the subset of patients with a PE were analyzed by their risk factors. Only ventilator days > 3 were associated with a higher risk in the no-pVCF group (0.2 vs 1.5%, P = 0.033). pVCFs did not confer benefit reducing PE rate. In addition, despite their intended purpose, pVCFs cannot eliminate PEs in high-risk trauma patients, suggesting a lack of utility for prophylaxis in this population.

Audiovestibular functions in chronic kidney disease in relation to haemodialysis.

Several studies have reported that the audiovestibular system is affected in patients with chronic kidney disease. This study aimed to investigate how the audiovestibular system is affected in patients with various stages of chronic kidney disease. Sixty participants were divided into three groups: group 1 - controls; group 2 - chronic kidney disease patients receiving conservative treatment; and group 3 - chronic kidney disease patients undergoing regular haemodialysis. Assessments included: standard and high-frequency audiometry and otoacoustic emissions testing, oculomotor tests, and combined vestibular-evoked myogenic potentials testing. Fifty per cent of group 2 and 60 per cent of group 3 had bilateral sensorineural hearing loss. High-frequency pure tone audiometry showed reduced detectability and higher thresholds at 12 kHz and 16 kHz in patients than in controls. Otoacoustic emissions, tracking, optokinetic and combined vestibular-evoked myogenic potential tests showed abnormal results in chronic kidney disease cases. Both the auditory and vestibular pathways are affected in different stages of chronic kidney disease. High-frequency pure tone audiometry, otoacoustic emissions and combined vestibular-evoked myogenic potentials could be performed routinely in patients with chronic kidney disease, regardless of the disease stage.

BRAF mutation is not associated with an increased risk of recurrence in patients undergoing resection of colorectal liver metastases.

BRAF mutation is associated with a poor prognosis in patients with metastatic colorectal cancer. For patients with resectable colorectal liver metastases (CRLMs), the prognostic impact of BRAF mutation is unknown and the benefit of surgery debated. This nationwide intergroup (ACHBT, FRENCH, AGEO) study aimed to evaluate the oncological outcome of patients undergoing liver resection for BRAF-mutated CRLMs. The study included patients who underwent resection for BRAF-mutated CRLMs in 24 centres between 2012 and 2016. A case-matched comparison was made with 183 patients who underwent resection of CRLMs with wild-type BRAF during the same interval. Sixty-six patients who underwent resection for BRAF-mutated CRLMs in 24 centres were compared with 183 patients with wild-type BRAF. The 1- and 3-year disease-free survival (DFS) rates were 46 and 19 per cent for the BRAF-mutated group, and 55·4 and 27·8 per cent for the group with wild-type BRAF (P = 0·430). In multivariable analysis, BRAF mutation was not associated with worse DFS (hazard ratio 1·16, 95 per cent c.i. 0·72 to 1·85; P = 0·547). The 1- and 3-year overall survival rates after surgery were 94 and 54 per cent respectively among patients with BRAF mutation, and 95·8 and 82·9 per cent in those with wild-type BRAF (P = 0·004). Median survival after disease progression was 23·0 (95 per cent c.i. 11·0 to 35·0) months among patients with mutated BRAF and 44·3 (35·9 to 52·6) months in those with wild-type BRAF (P = 0·050). Multisite disease progression was more common in the BRAF-mutated group (48 versus 29·8 per cent; P = 0·034). These results support surgical treatment for resectable BRAF-mutated CRLM, as BRAF mutation by itself does not increase the risk of relapse after resection. BRAF mutation is associated with worse survival in patients whose disease relapses after resection of CRLM, as for non-metastatic colorectal cancer.

Contribution of acrB upregulation & OmpC/Ompk36 loss over the presence of blaNDM towards carbapenem resistance development among pathogenic Escherichia coli & Klebsiella spp.

Background & objectives:The global spread of carbapenem-resistant Enterobacteriaceae (CRE) is an emerging clinical problem. Hence, in this study, the plausible role of extended-spectrum beta-lactamases (ESBLs)/carbapenemases, OmpC/Ompk36, acrB and their combinations was explored among CRE.Methods:The minimum inhibitory concentration (MIC) of meropenem, enzyme-phenotypes (ESBLs/IR and metallo-beta-lactamase (MBL)/non-MBL carbapenemase), genotypes (blaTEM, blaSHV and blaCTX-M; blaNDM and blaVIM; blaKPC and blaOXA-48-like variants), acrB and outer membrane protein (OMP) expressions were analyzed with a total of 101 non-duplicate clinical isolates, obtained from various samples of patients visiting two tertiary care units of Eastern India during May 2013 - October 2016. This included Escherichia coli (n=36) and Klebsiella pneumoniae (n=65), categorized into two groups, namely Group I (resistant to all carbapenems; n=93; E. coli=34 and Klebsiella spp.=59) and Group II (non-resistant to all the carbapenems; n=8; E. coli=2 and Klebsiella spp.=6).Results:Though 88.17 per cent of Group I isolates exhibited ESBL property, the presence of carbapenemase activity (70.96%) and that of blaNDM gene (42/66: 63.63%) indicated their contributions towards the emergence of CRE. Further, porin loss and/or efflux pump activation among ESBL/carbapenemase-producing isolates heightened the MIC of meropenem from 64 to 256 mg/l (range exhibited by only ESBL/carbapenemase-producing isolates) to >256 mg/l.Interpretation & conclusions:These findings implied the major contribution of porin loss and/or efflux pump activation over the presence of ESBLs/carbapenemases in imparting carbapenem resistance in pathogenic bacteria.

Is Noncurative Hepatic Resection Justified for Advanced Hepatocellular Carcinoma?

It has been obscure whether or not noncurative hepatic resection (Hx) has a favorable impact on the clinical course in patients with advanced hepatocellular carcinoma (HCC). The aim of this study is to clarify the significance of noncurative Hx for advanced HCC. Among 666 consecutive patients undergoing Hx for HCC in our department, 79 patients underwent noncurative Hx. These patients were classified as Group A (presence of macrovascular invasion [MVI]; n = 29), Group B (residual tumors in the remnant liver; n = 37), Group C (residual tumors in the remnant liver with MVI; n = 7), or Group D (residual tumors in the remnant liver with distant metastasis [with or without MVI]; n = 6). The three-year survival rates were 49.6 per cent in Group A, 30.3 per cent in Group B, 14.3 per cent in Group C, and 0.0 per cent in Group D, respectively (Groups A and B vs Group D, P < 0.05). Moreover, the survival rate was significantly higher in patients with ≤3 tumors than in those with ≥4 tumors (P < 0.05), when Group B was divided into subgroups according to the number of residual tumors in the remnant liver. In conclusion, noncurative Hx might be acceptable for advanced HCC with MVI or ≤3 residual tumors in the remnant liver.

Postoperative Complication Assessments of Different Reconstruction Procedures after Total Pharyngolaryngoesophagectomy: Tubular Gastric Pull-Up versus Whole Gastric Pull-Up

Hypopharynx carcinoma tends to be diagnosed at advanced stage and usually has a poor prognosis because of the high incidence of submucosal spreading and lymphatic metastasis. Total pharyngolaryngoesophagectomy (PLE) is mostly used as a curative intervention for this deadly disease, and a commonly used reconstruction method after PLE is gastric pull-up, which could be further divided into tubular gastric pull-up and whole gastric pull-up procedures. Aiming to achieve a precise guidance on optimal reconstruction method after PLE, the present study evaluated the postoperative complications involving in different gastric pull-up procedures in patients with hypopharynx cancer. A total of 52 consecutive patients with hypopharyngeal cancer who underwent total PLE with gastric pull-up reconstruction in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2014 were analyzed in this study. Of these patients, 28 underwent tubular gastric pull-up reconstruction procedure (Group A), whereas 24 underwent whole gastric pull-up reconstruction procedure (Group B). We compared the postoperative complications between these two groups retrospectively. Postoperative anastomotic fistulas occurred in three patients in Group A (3/28) versus eight patients in Group B (8/24), leading to an incidence rate of 10.71 and 33.33 per cent, respectively. The incidence of intrathoracic stomach syndrome was 21.43 per cent in Group A (6/28) versus 58.33 per cent in Group B (14/24), and the incidence of reflux was 35.71 per cent in Group A (10/28) versus 66.67 per cent in Group B (16/24). All of the above postoperative complications exhibited statistical differences between two groups (P ≤ 0.05). This retrospective observation study suggests that compared with whole gastric pull-up, tubular gastric pull-up is a better reconstruction procedure of choice after PLE, evidenced by reduced incidences of postoperative anastomotic fistula, intrathoracic stomach syndrome, and reflux.

Effect of Citrus maxima juice on fasting blood glucose, lipid profile, liver enzyme and body weight

PurposeThis paper aims to investigate the effect of Citrus maxima juice on fasting blood glucose, lipid profile, liver enzyme and body weight of alloxan-induced diabetic adult wistar rats.Design/methodology/approachThe fruits were thoroughly washed with potable water. They were peeled; the epicarp and seeds were removed. Fruit juice was extracted from the pulp. Animal experiment was carried out using 21 adult male wistar rats weighing about 110-130 g. The rats were categorized into three groups (A-C), with each group consisting of seven rats of similar body weights. Diabetes was induced using alloxan. Rats in Groups A and B were administered 300 mg and 600 mg of C. maxima fruit juice/kg body weight/day, respectively, for 14 days, while Group C rats acted as control and received placebo. Biochemical analysis was performed using standard procedures. Data were analyzed using SPSS, version 21.FindingsBlood glucose of rats in the treated groups decreased significantly (p < 0.05) from 454.7 and 569.7 mg/dl to 149.3 and 297.3 mg/dl, respectively, while the control increased from 257.0 to 46.57 mg/dl. Total cholesterol and triglyceride levels of Group B rats reduced significantly (p < 0.05), while the high-density lipoprotein cholesterol level increased (p < 0.05). Body weight of rats in the treated groups increased significantly (p < 0.05) by 30.1 and 20.2 per cent in Groups A and B, respectively, compared to the control group, which reduced by 0.21 per cent. There was no significant effect on markers of liver damage.Practical implicationsThe rate at which diabetes and other non-communicable diseases increase recently calls for affordable and sustainable management.Social implicationsDiabetes is one of the major health and development challenges of the 21st century, its complications are disabling and life threatening.Originality/valueThe hypoglycemic and hypocholesterolemic properties demonstrated by C. maxima fruit juice suggest its potential contribution in reducing/stabilizing blood glucose level and managing complications of diabetes.

Early and Late Complications in Laparoscopic Gastric Bypass: Comparative Study between Manual and Stapled Anastomosis

The aim of this study is to evaluate the early and late complications of laparoscopic gastric bypass (GBP) with manual versus stapled gastrojejunal anastomosis. Eighty-two patients with morbid obesity and body mass index (35-56 kg/m2) who underwent GBP were divided into two groups: manual gastrojejunal anastomosis (Group 1) and stapled anastomosis (Group 2). Early and late complications were evaluated. No differences were found between both groups in age, sex, body mass index, American Society of Anesthesia classification, and comorbidity. The mean operative time was 184.8 minutes [standard deviation (SD) = 61]; 203.5 minutes (SD = 51.9) in Group 1 and 167.4 minutes (SD = 64.2) in Group 2 (P = 0.001). The average length of stay was 5.9 days (SD = 3.9) in Group 1 and 5 days (SD = 2.1) in Group 2 (P = 0.039). Early complications were recorded in 9.7 per cent of the cases, without any differences between the two groups: 12.2 per cent in Group 1 and 7.3 per cent in Group 2 (P > 0.05). Late complication rate was 8.5 per cent, significantly higher in Group 1 (14.6%) than in Group 2 (2.4%; P < 0.05). However, in the logistic regression analysis these differences were not statistically significant (OR 0.48; 95% CI 0.03-8.37; P = 0.61). In our series, the GBP with stapled gastrojejunal anastomosis has shown lower hospital length of stay and operative time than the hand-sewn anastomosis. We have not found significant differences between both groups in early complications or in the need for reoperation. Fewer late complications were found in the group of stapled anastomosis; however, this has not been confirmed in the logistic regression analysis.

Current Indications for Surgical Treatment of Primary Hyperparathyroidism in the Elderly

This study presents the results of surgery in the elderly for primary hyperparathyroidism (PHPT) from a single institution's experience. We retrospectively analyzed 898 cases of surgically treated PHPT, divided into two groups: 135 elderly patients (A) and 763 patients younger than 65 years (B). PHPT was symptomatic in 68.8 per cent patients in group A and in 81.6 per cent in group B. Unilateral temporary recurrent laryngeal nerve palsy was observed in 0.9 per cent in group A and 0.1 per cent in group B (P > 0.05). No cervical hematomas, mortality or major cardiovascular, neurological, respiratory or metabolic postoperative complications were registered. All the patients evaluated at one year had improvement in the quality of life, with increase of bone mineral density (BMD) in 85.6 per cent and 79.8 per cent of patients in groups A and B, with no significant differences between symptomatic and asymptomatic patients. Parathyroidectomy in elderly PHPT patients is safe, with rate of morbidity similar to what observed in younger individuals. Further investigations are recommended to confirm the role of surgery as an effective approach in elderly PHPT patients.