Surgical Scalpel Research Articles

Comparing scissors and scalpels to a novel surgical instrument: a biomechanical sectioning study

BackgroundThis study introduces a novel surgical instrument to reduce iatrogenic nerve injuries during procedures such as carpal tunnel and ulnar nerve decompression surgery. These injuries often result from direct damage to surrounding tissues by surgical instruments, whose designs have remained largely unchanged over the past decades. The novel device is a modified surgical forceps that has a deployable surgical scalpel that runs along a groove on the forceps. This design protects important anatomical structures while allowing fast dissection and cutting of fascial layers.MethodsThe process used to develop a novel instrument included computer-aided design (CAD) modeling, 3D printing for prototyping, and the fabrication of an aluminum prototype. Biomechanical testing was performed with the novel device, iris scissors, bandage scissors, and a scalpel on an MTS Static Materials Test System. The peak force to slide-cut, number of cut attempts, and percentage cut on first attempt were compared between the prototype and traditional surgical tools. The materials cut in testing were Ace™ bandage, stockinette, and gauze. Statistical analyses were performed using Welch’s t-tests and Fisher’s exact tests.ResultsCompared to conventional bandage and iris scissors, the novel surgical instrument required significantly less force to cut through an Ace™ bandage, stockinette, and gauze (p < 0.01). The number of cuts required to transect those same materials with the novel device was comparable to that of the scalpel and bandage scissors. Additionally, while there were no differences between the novel device and the other devices for an Ace™ bandage and stockinette, the novel device tended to cut a greater percentage of gauze in one pass than did the iris scissors.ConclusionThe novel surgical instrument designed in this study required less force compared to conventional scissors, demonstrated cutting efficiency similar to that of a scalpel blade, and had more safety features than either instrument. This study highlights the value of collaboration between biomedical engineering and orthopedic surgery departments on innovation in medical technology, through which new technologies with improved design and functionality demonstrate the potential to reduce iatrogenic injuries.

Scalp-Split Technique: A Concept of Bone Splitting and Expansion for Thin Alveolar Ridges to Place Dental Implants.

Bone expansion is when the existing bone at the implant site is split and separated to create a gap to widen it. This article introduces a novel concept of bone expansion for the ultrathin alveolar ridges to place dental implants with zero wastage of existing natural bone in long-term edentulous arches. Instead of using twist drills and piezo surgery kits, the bone is split with a surgical scalpel blade to prevent natural bone wastage. The split helps to expand the bone horizontally by using expanders to accommodate the smaller diameter implants. This technique was applied to 12 individuals to rehabilitate their atrophic edentulous mandibles to facilitate the implant-supported overdentures, and it revealed that all the cases achieved successful osseointegration after placing implants following this method. The scalp-spilt technique is promising for providing implant-retained or implant-supported prostheses over ultrathin edentulous alveolar ridges.

A Clinical Comparison of ErCr:YSGG Laser and Scalpel Techniques in Gingival Depigmentation.

Gingival depigmentation impacts patient self-confidence and quality of life. This study compares the Er,Cr:YSGG laser to the traditional scalpel technique for reducing gingival hyperpigmentation, assessing their effectiveness and other relevant factors. We conducted a double-blind, randomized trial with a split-mouth design. Forty participants were selected from the university's dental clinic and randomly assigned to receive either the Er,Cr:YSGG laser (2780 nm) or surgical scalpel. Pain intensity and smile satisfaction were assessed post-surgery, and treatment duration was evaluated. The Dummett Oral Pigmentation Index (DOPI) was used to determine the initial severity of pigmentation and to track both reduction and potential repigmentation over time. The Gingival Melanosis Record (GMR) was used to evaluate the presence and extent of pigmentation and to monitor recurrence after 1 and 12 months. Both the Er,Cr:YSGG laser and surgical scalpel similarly reduced GMR and DOPI scores over time, without significant differences at 12 months (p > 0.05). A significant examiner variability was noted in GMR scoring (β &#61; -1.2 for Examiner 2; p < 0.001). Power analysis indicated a higher confidence for detecting treatment effects in DOPI (75%) compared to GMR (55%). Patient satisfaction with smile significantly improved (p < 0.001). Treatment type did not influence postoperative pain levels. The Er,Cr:YSGG laser required longer surgery times (p < 0.001). Under the conditions of the present study, both Er,Cr:YSGG laser and surgical scalpel were equally effective in reducing gingival hyperpigmentation. Although lasers offer better bleeding control and require less anesthesia than the scalpel technique, clinicians should also consider surgery duration, cost, and expertise when selecting a treatment method. Future research should focus on long-term outcomes and economic evaluations, utilizing standardized clinical measures.

Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel

BackgroundThis study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers.MethodsThis randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests.ResultsPain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all).ConclusionsIn conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser.Trial registrationThe study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials (www.irct.ir) (registration number: IRCT20220630055326N1).

Ceramic soft tissue trimming bur gingival depigmentation: clinical performance and patient experience. A split mouth randomized controlled trial

BackgroundThe ceramic soft tissue trimming bur (CeraTip™) was initially introduced for use in gingivoplasty but has recently been used for gingival depigmentation. The aim of this study is to compare the efficacy of depigmentation between the novel CeraTip™ and the gold-standard surgical scalpel technique.MethodsEight healthy, nonsmokers with moderate to severe gingival hyperpigmentation in both arches were randomly assigned for CeraTip™ depigmentation in one arch as the test group (TG) and scalpel depigmentation in the opposite arch as the control group (CG). Pigmentation indices were used to assess clinical performance. Treatment time, pain level, and esthetic satisfaction were the parameters of patient experience. The assessments were performed at baseline, one week, one month, and three months.ResultsAt all assessment visits, pigmentation intensity represented by the Dummet oral pigmentation index (DOPI), and pigmentation distribution represented by the Hedin melanin index (MI), were significantly lower than those at baseline (p < 0.001) in both groups. When comparing the two groups, Scalpel depigmentation had better initial clinical outcomes, while CeraTip™ had less visible repigmentation, pain scores, treatment time, and greater esthetic satisfaction. However, none of the differences were statistically significant.ConclusionBoth techniques successfully removed gingival hyperpigmentation with comparable clinical performance. The patients preferred CeraTip™ depigmentation.Trial registrationThe study protocol was registered on 11/09/2023 on the www.clinicaltrials.gov database (NCT06031116) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-Rec012124).

Real-time soft body dissection simulation with parallelized graph-based shape matching on GPU

Background and ObjectiveInteractive soft tissue dissection has been a fundamental procedure in virtual surgery systems. Existing cutting algorithms involve complex topology changes of simulation meshes, which can increase simulation overhead and produce visual artifacts. In this paper, we proposed a novel graph-based shape-matching method that allows for real-time, flexible, progressive, and discontinuous cuts on soft tissue. MethodsWe employed shape-matching constraints within the position-based dynamics (PBD) framework, a widely adopted approach for real-time simulation applications. The soft tissue was effectively modeled using overlapping clusters, each governed by shape-matching constraints. The dissection process was bifurcated into two distinct stages. In the first stage, the surgical scalpel presses the surface of the soft tissue. The soft tissue is cut apart when the surface pressure exceeds a threshold, entering the second stage. To address the discrepancy between the visual mesh and the simulation model during cluster separation, we developed an Aggregate Finding Connected Components (AFCC) algorithm, optimized for GPU computation and integrated with a background grid. This approach also avoids ghost forces and fragmentation artifacts. To control the increase in the number of clusters, we also propose a merging strategy that can run in parallel. ResultsOur simulation outcomes demonstrated that the AFCC dissection algorithm effectively manages cluster separation and expansion with robustness. There were no ghost forces between the cutting surface and unrealistic fragments. Our simulation capability extended to supporting intricate and discontinuous cutting routes. Our dissection simulation maintained real-time performance even with over 100,000 particles constituting the soft tissue. ConclusionsOur real-time and robust surgical dissection simulation technique enables the performance of complex cuts in various surgical scenarios, demonstrating its potential in virtual surgery applications.

Needle‑based gastrocnemius lengthening: a novel ultrasound‑guided noninvasive technique: part II—clinical results

BackgroundIsolated gastrocnemius contracture has been associated with more than 30 lower limb disorders, including plantar heel pain/plantar fasciitis, Achilles tendinosis, equinus foot, adult flatfoot, and metatarsalgia. Although many techniques are available for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques usually require epidural or general anesthesia, exsanguination of the lower extremities and stitches and can damage the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure. The purpose of this study is to evaluate the clinical results of a surgical technique for gastrocnemius lengthening with a needle, as previously described in cadaver specimens.Methods and resultsWe performed a prospective study of ultrasound-guided gastrocnemius tendon lengthening in level II using a needle in 24 cases (19 patients) of gastrocnemius contracture. The study population comprised 12 males and 7 females. Mean age was 41 years (18–64). All but 5 recessions were bilateral and occurred simultaneously. The indication for the procedure was gastrocnemius contracture; although the patients also presented other conditions such as non-insertional Achilles tendinopathy in 6 patients (2 were bilateral), insertional Achilles calcifying enthesitis in 4 (1 was bilateral), metatarsalgia in 4, flexible flat foot in 1 and plantar fasciitis in 5 (2 were bilateral). The inclusion criteria were the failure of a previous conservative protocol, that the Silfverskiöld test was positive, and that the pathology suffered by the patient was within the indications for surgical lengthening of the patients and were described in the scientific literature. The exclusion criteria were that the inclusion criteria were not met, and patients with surgical risk ASA 3 or more and children. In these patients, although possible, it is preferable to perform the procedure in the operating room with monitoring, as well as in children since they could be agitated during the procedure at the office. We used the beveled tip of an Abbocath needle as a surgical scalpel. All patients underwent recession of the gastrocnemius tendon, as in an incomplete Strayer release. We evaluated pre- and postoperative dorsiflexion, outcomes, and procedural pain (based on a visual analog scale and the American Orthopedic Foot and Ankle Society scores), as well as potential complications. No damage was done to the sural bundle.ResultsAnkle dorsiflexion increased on average by 17.89°. The average postoperative visual analog score for pain before surgery was 5.78, 5.53 in the first week, 1.89 at 1 month, and 0.26 at 3 months, decreasing to 0.11 at 9 months. The mean postoperative American Orthopedic Foot and Ankle Society Ankle-Hindfoot score the average was 50.52 before surgery, 43.42 at 1 week, 72.37 at 1 month, 87.37 at 3 months, and 90.79 at 9 months.ConclusionUltrasound-guided needle lengthening of the gastrocnemius tendon is a novel, safe, and effective technique that enables the surgeon to check all the structures clearly, thus minimizing the risk of neurovascular damage. The results are encouraging, and the advantages of this approach include absence of a wound and no need for stitches. Recovery is fast and relatively painless. A specific advantage of ultrasound-guided needle lengthening of the gastrocnemius tendon is the fact that it can be performed in a specialist's office, with a very basic instrument set and local anesthesia, thus reducing expenses.

Diathermy versus Scalpel Skin Incision for Open Inguinal Hernia Surgery: An Interventional Study

Introduction: Inguinal hernia is one of the most encountered surgical-related problems worldwide. For years, there has been debate among surgeons about which type of skin incision to use: cutting with electrocautery or the traditional method of a surgical scalpel. Aim: To compare the skin incisions made with electrocautery versus traditional scalpel incisions in terms of incision time, blood loss, postoperative pain, and scar evaluation. Materials and Methods: A hospital-based prospective interventional study was conducted at the Department of General Surgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, from November 2019 to September 2021. Written informed consent was obtained from 130 consecutive cases scheduled for open inguinal hernia surgery. Patients were alternately assigned to undergo incision with electrocautery (group A) or a conventional steel scalpel (group B), with each group comprising 65 patients. Bilateral hernia cases were treated as separate entities. Data analysis was performed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) software version 24.0, employing the Student’s t-test and Chi-square test. A p-value of &lt;0.05 was considered statistically significant. Results: The age distribution in group A was 49.69±15.74 years and in Group B was 52.81±14.25 years. The time taken for incision in the electrocautery group was much shorter at 12.57±11.55 seconds than in the scalpel group at 20.63±2.99 seconds, with a p-value of &lt;0.001. The average amount of blood loss in group A was 1.02±0.35 mL and in group B was 2.03±0.32 mL, with a significant p-value of &lt;0.001. The postoperative pain, calculated by the Visual Analogue Scale (VAS), showed a significant difference in the early postoperative period at 6 hours after surgery in Group A at 6.58±0.9 compared to group B at 7.05±1, with a p-value of 0.005. However, no significant difference was noted between the two groups at 12, 24, and 48 hours after surgery. There was no significant difference in scar evaluation between group A and group B at 12 weeks, with a p-value of 0.673 for the patient score and 0.189 for the observer score. Conclusion: Electrocautery can be recommended for hernia skin incision due to its advantage of shorter incision time, minimal blood loss, and less early postoperative pain.

Characteristics and electrochemical properties of Al2O3 thin films on surgical scalpel blades

Surface modification techniques play an important role in shaping the physicochemical properties of surgical tools. The article discusses the problem of the destruction of surgical scalpel blades and the methods of depositing thin films on them.

Current practice pattern among anaesthesiologists for difficult airway management: A nationwide cross-sectional survey.

The practice patterns for airway management vary among anaesthesiologists, depending on various setups and geographical divides. This survey assessed practice patterns in unanticipated difficult intubation and cannot intubate or cannot ventilate (CICV) situations/complete ventilation failure among Indian anaesthesiologists'. A validated questionnaire of 22 items related to practice preferences for airway management among anaesthesiologists was sent to Indian Society of Anaesthesiologists members online through Google Forms and distributed manually to delegates in continuing medical education programme. A total of 535 responses were obtained and analysed. In unanticipated difficult laryngoscopy and intubation, the order of preference for alternative airway devices was video laryngoscope (VL, 60.1%), intubating laryngeal mask airway/laryngeal mask airway (23.5%), fibreoptic bronchoscope (13.5%) and optical stylets (1.2%). Advanced difficult airway devices were unavailable in most nursing homes and government non-teaching hospitals. Seventy per cent of respondents experienced CICV situations at least once, most during head and neck surgeries. In CICV situations, the order of choice for the front-of-neck airway access was cricothyroidotomy (CT) by narrow bore cannula (48.9%), tracheostomy by the surgeon (30%), Seldinger CT (12.5%), open surgical CT (5.4%) and scalpel bougie CT (3.2%). The VL was the most preferred airway rescue device in unanticipated difficult intubation, and intravenous catheter cricothyroidotomy was the most selected technique in CICV situations.

Comparison of Diathermy versus Surgical Scalpel for Skin Incisions in Elective General Surgical Procedures

Objective: To compare diathermy versus surgical scalpel in skin incisions in elective general surgical procedures regarding incision time, post-operative pain and surgical site infection.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Study Duration: Department of Surgery, Combined Military Hospital, Peshawar Pakistan, from Feb to Jul 2020.&#x0D; Methodology: A total of 106 patients undergoing general elective procedures aged 20-60 years belonging to either gender were included in the study. They were divided into two equal groups of 53 patients each. Patients with ischemic heart disease, diabetes mellitus, hypertension, and dirty and contaminated procedures were excluded. Group-A patients underwent skin incisions with diathermy, while Group-B patients underwent skin incisions with a surgical blade on a scalpel. The incision time was noted for both groups. All patients were followed for post-operative pain per visual analogue score and development of surgical site infection. &#x0D; Results: Mean incision time in Group-A (Diathermy-Group) was 46.58±8.03 seconds, while in Group-B (Scalpel-Group), it was 54.75±7.91 seconds (p&lt;0.001). The mean post-operative pain score in Group-A (Diathermy Group) was 2.25±0.76, while in Group-B (Scalpel Group), it was 3.58±0.91 (p&lt;0.001). Wound infection was found in 3.77% of patients in Group-A, while in Group- B, it was found in 15.09% (p=0.046).&#x0D; Conclusion: Incision with Diathermy is better than scalpel skin incisions regarding incision time, post-operative pain and postoperative surgical site infection.

Mechanical performance and microstructure of 3Y‐TZP/Al2O3/GNPs medical ceramic surgical scalpel material prepared through SPS–HF dual sintering method

AbstractIn this study, 3 mol% yttria‐stabilized tetragonal zirconia polycrystal (3Y‐TZP)/Al2O3/graphene nanoplatelets (GNPs) medical ceramic materials for manufacturing surgical scalpels were sintered in vacuum in an SPS–625HF furnace. The mechanical performances and microstructures of the composites were investigated, and the influence mechanisms of the sintering temperature and amount of added GNPs were studied. During the sintering process at 1400°C and 30 MPa for 5 min, the added GNPs enhanced the mechanical properties of the 3Y‐TZP/Al2O3 composites. The results showed that the composite with .1 wt.% GNPs had 6.4% (910 ± 11 MPa) higher flexural strength than 3Y‐TZP/Al2O3. The composite with .4 wt.% GNPs had 38.7% (12.95 ± .22 MPa m1/2) greater fracture toughness than 3Y‐TZP/Al2O3. The main toughening mechanisms of 3Y‐TZP/Al2O3/GNPs were crack bridging, crack deflection, crack branching, GNPs bridging, transgranular fracture structures, and phase transformation of t‐ZrO1.95. The two‐stage densification displacement curve appeared at the optimal sintering temperature of the materials, and the 3Y‐TZP/Al2O3/GNPs composites with a two‐stage densification displacement curve had excellent mechanical properties. The added GNPs can inhibit the grain growth during the sintering process, thereby refining the zirconia grains. With the increase in GNPs content, the grain size and flexural strength of the composites decreased gradually. However, higher content of GNPs was beneficial to improve the relative density and thermal diffusivity of 3Y‐TZP/Al2O3/GNPs composite material.

Evaluation of Surgical Scalpel Versus Semiconductor Diode Laser Technique in the Management of Gingival Melanin Hyperpigmentation Along with Crown Lengthening: A Split Mouth Randomized Clinical Comparative Study

Evaluation of Surgical Scalpel Versus Semiconductor Diode Laser Technique in the Management of Gingival Melanin Hyperpigmentation Along with Crown Lengthening: A Split Mouth Randomized Clinical Comparative Study

Properties of Nitride-Coated Surgical Scalpel Blades

Surgical tools are used in many medical treatments and procedures that expose them to a wide range of biological conditions that induce corrosion, abrasion, and wear. A protective layer is often needed to prolong its useful life. Thus, it is essential to use appropriate coating techniques to improve the mechanical properties and chemical stability of the substrate. This work used a custom-built radio frequency-powered magnetron sputtering system for the deposition of titanium-(Ti-) based coatings, which were selected because of their reported biocompatibility and superior mechanical qualities. Titanium nitride (TiN) and titanium aluminum nitride (TiAlN) thin films were deposited on AISI 304 stainless steel substrates and on Indoplas&lt;sup&gt;TM&lt;/sup&gt; sterile scalpel blades. TiN was grown using a Ti target while TiAlN used a Ti-Al combinatorial target. Both films were deposited using a 90:10 admixture of argon (Ar) and nitrogen (N&lt;sub&gt;2&lt;/sub&gt;) gases. The substrate bias was varied into three different potentials: 0, -100, and -200 V Substrate heating of 200&amp;deg;C was applied, and the deposition time was set at 120 min. The optimal parameters and material for surgical tools are found to be TiN deposited at -100 V and TiAlN deposited at -200 V substrate bias as they show the highest resistance to abrasion and corrosion, respectively, and without reducing the sharpness of the blades. This work aims to offer the medical community a practical and inexpensive method of protecting surgical instruments while extending service life.

The Effect of The Topical Application of Eurycoma Longifolia Jack (TA) Root Extract Hydrogel on Vascular Endothelial Growth Factor (VEGF) Expression During Wound Healing in vivo Excisional Wound Model

INTRODUCTION: Medicinal plants are known for their positive impacts on wound healing by stimulating angiogenesis in the skin. Eurycoma longifolia Jack locally known as Tongkat Ali (TA), is a medicinal plant characterised by anti-inflammatory and antioxidant effects. MATERIALS AND METHODS: Excisional wound (15mm × 15mm) in diameter and (2mm) depth was created at the back of 20 male Sprague Dawley rats by incising the marked skin with sterilized surgical scalpel blade then excised the skin by surgical scissors and toothed forceps. The wounded rats were divided into 4 groups, each group contained 5 rats (n=5). Experimental groups were formed as follows: untreated (-ve) control, Hydrocyn® aqua gel (+ve) control, vehicle hydrogel, and TA hydrogel. All the treatments were applied twice daily for 5 days starting on the first day (wounding day). On Day 5 post-wounding, the granulation tissue was harvested from all groups and evaluated by immunohistochemistry assay for Vascular endothelial growth factor (VEGF) expression. RESULTS: VEGF expression in granulation tissue of rat’s skin treated with TA hydrogel and vehicle hydrogel increased significantly compared to that in the untreated (-ve) control group with p-values of 0.040 and 0.029, respectively. Although there was no significant difference in VEGF expression in granulation tissue of rat’s skin treated with the TA group, Hydrocyn® aqua gel (+ve) control, and vehicle hydrogel groups, our study group showed higher expression of VEGF. CONCLUSION: Our study showed that the topical application of TA hydrogel increased the VEGF expression in granulation tissue of rat’s skin, which is an essential growth factor for wound healing. Thus, there is great potential for TA hydrogel to be an effective wound-healing agent for managing cutaneous wounds.

THE EFFECT OF TOPICALLY USING MELATONIN AND ANABASIS ARTICULATE EXTRACT WITH VAGINAL SPONGES ON SOME HORMONES AND ANTIOXIDANT STATUS

This study was conducted in the University of Anbar College of Agriculture in the Department of Animal Production Sheep Field, for the period from 10/15/2021 to 5/7/2022. The aim of this study is to use the melatonin hormone in two different doses and the Anabasis articulate extract in vaginal sponges topically, to understand their effectiveness on the oxidative state and some of the reproductive hormones on the local Iraqi ewes. The study was conducted on twenty local ewes within 4-2.5 years age range and 47 kg weight average. All ewes were treated with vaginal sponges for 14 days, and was randomly divided into four treatment groups: (T1) 20 mg melatonin hormone, (T2) 30mg melatonin hormone, (T3) Anabasis articulate extract at a concentration 3 g and (T4) was left without any treatment and was considered a control treatment. The treatment was applied through a sponge with a hole made in it using a surgical scalpel; that hole position should be away from a pulling thread attached to the sponge to avoid cutting it accidentally and thus not being able to pull the sponge out. The treatment continued from day 0 of pushing the vaginal sponges until day 14 when they were withdrawn. All ewes were injected with eCG hormone at a dose of 500 IU intramuscularly after sponge withdrawal. Also, the experimental ewes were kept with 3 rams for 3 days. Blood samples were collected from the jugular vein and the levels of estrogen, progesterone, antioxidants glutathione peroxides (GPX), and Malone Dialdehyde (MDA) were measured. The experiment treatments showed no significant differences in both estrogen and progesterone hormone levels compared with the control group, which indicates that there was no effect of the sponge materials on the hormones absorption. As for the antioxidants, the study showed the superiority of the experimental treatments in the levels of GSH compared to the control group. Also, the MDA recorded a decrease in its levels in the treated groups compared to the control one. We conclude from this study that placing the hormone melatonin at 20,30 Mg concentration and the Anabasis extract at 3g in vaginal sponges did not affect the hormone’s actions neither its absorption from the sponge, but rather improved the uterus conditions and prevent fluid accumulation around the sponge. It also prevents infections and improves the oxidation state by increasing GSH activity and MDA level reduction.

Mathilde Schott, A Woman's Influence in the Revolution of the Scalpel in the 1890s.

Surgery relies on the scalpel; the surgeon's first instrument in every case. From early knives crafted in the pre-historic era to today, the scalpel has evolved along with medical and surgical fields but maintained its critical role and symbolism of operative intervention. A significant catalyst for change in surgical instrument development in the late 1800s was the evolution of anesthesia and antisepsis. Surgical instruments were affected by harsh sterilization techniques, creating need for a method to maintain surgical scalpel sharpness. Mathilde Schott, an early female biomedical engineering innovator, filed a patent (US431153) in 1890 for a detachable scalpel blade. Schott identified and responded to the needs of surgeons at the turn of the 20th century and created a detachable blade and stabilizing lever. Schott persevered in a society unaccustomed to women leaders, subsequently improving medicine, surgery, and engineering.

Impact of sublethal phenol in freshwater fish Labeo rohita on biochemical and haematological parameters.

Phenol, an aromatic chemical commonly found in domestic and industrial effluents, upon its introduction into aquatic ecosystems adversely affects the indigenous biota, the invertebrates and the vertebrates. With the increased demand for agrochemicals, a large amount of phenol is released directly into the environment as a byproduct. Phenol and its derivatives tend to persist in the environment for longer periods which in turn poses a threat to both humans and the aquatic ecosystem. In our current study, the response of Labeo rohita to sublethal concentrations of phenol was observed and the results did show a regular decrease in biochemical constituents of the targeted organs. Exposure of Labeo rohita to sublethal concentration of phenol (22.32mg/L) for an epoch of 7, 21 and 28days shows a decline in lipid, protein, carbohydrate content and phosphatase activity in target organs such as the gills, muscle, intestine, liver and kidney of the fish. The present study also aims to investigate the toxic effects of phenol with special reference to the haematological parameters of Labeo rohita. At the end of the exposure period, the blood of the fish was collected by cutting the caudal peduncle with a surgical scalpel. And it was observed that the red blood corpuscle count (RBC), white blood corpuscle (WBC), haemoglobin count (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) values showed a decline after exposure to phenol for 7days, while white blood corpuscle (WBC) shows an increased count. At 21days and 28days, all the haematological parameters showed a significant decrease.

Augmented Reality Surgical Navigation System for External Ventricular Drain

Augmented reality surgery systems are playing an increasing role in the operating room, but applying such systems to neurosurgery presents particular challenges. In addition to using augmented reality technology to display the position of the surgical target position in 3D in real time, the application must also display the scalpel entry point and scalpel orientation, with accurate superposition on the patient. To improve the intuitiveness, efficiency, and accuracy of extra-ventricular drain surgery, this paper proposes an augmented reality surgical navigation system which accurately superimposes the surgical target position, scalpel entry point, and scalpel direction on a patient’s head and displays this data on a tablet. The accuracy of the optical measurement system (NDI Polaris Vicra) was first independently tested, and then complemented by the design of functions to help the surgeon quickly identify the surgical target position and determine the preferred entry point. A tablet PC was used to display the superimposed images of the surgical target, entry point, and scalpel on top of the patient, allowing for correct scalpel orientation. Digital imaging and communications in medicine (DICOM) results for the patient’s computed tomography were used to create a phantom and its associated AR model. This model was then imported into the application, which was then executed on the tablet. In the preoperative phase, the technician first spent 5–7 min to superimpose the virtual image of the head and the scalpel. The surgeon then took 2 min to identify the intended target position and entry point position on the tablet, which then dynamically displayed the superimposed image of the head, target position, entry point position, and scalpel (including the scalpel tip and scalpel orientation). Multiple experiments were successfully conducted on the phantom, along with six practical trials of clinical neurosurgical EVD. In the 2D-plane-superposition model, the optical measurement system (NDI Polaris Vicra) provided highly accurate visualization (2.01 ± 1.12 mm). In hospital-based clinical trials, the average technician preparation time was 6 min, while the surgeon required an average of 3.5 min to set the target and entry-point positions and accurately overlay the orientation with an NDI surgical stick. In the preparation phase, the average time required for the DICOM-formatted image processing and program import was 120 ± 30 min. The accuracy of the designed augmented reality optical surgical navigation system met clinical requirements, and can provide a visual and intuitive guide for neurosurgeons. The surgeon can use the tablet application to obtain real-time DICOM-formatted images of the patient, change the position of the surgical entry point, and instantly obtain an updated surgical path and surgical angle. The proposed design can be used as the basis for various augmented reality brain surgery navigation systems in the future.

Contrast-enhanced microCT evaluation of degeneration following partial and full width injuries to the mouse lumbar intervertebral disc

A targeted injury to the mouse intervertebral disc (IVD) is often used to recapitulate the degenerative cascade of the human pathology. Since injuries can vary in magnitude and localization, it is critical to examine the effects of different injuries on IVD degeneration. We thus evaluated the degenerative progression resulting from either a partial- or full-width injury to the mouse lumbar IVD using contrast-enhanced micro-computed tomography and histological analyses. A lateral-retroperitoneal surgical approach was used to access the lumbar IVD, and the injuries to the IVD were produced by either incising one side of the annulus fibrosus or puncturing both sides of the annulus fibrosus. Female C57BL/6J mice of 3–4 months age were used in this study. They were divided into three groups to undergo partial-width, full-width, or sham injuries. The L5/6 and L6/S1 lumbar IVDs were surgically exposed, and then the L6/S1 IVDs were injured using either a surgical scalpel (partial-width) or a 33G needle (full-width), with the L5/6 serving as an internal control. These animals recovered and then euthanized at either 2-, 4-, or 8-weeks after surgery for evaluation. The IVDs were assessed for degeneration using contrast-enhanced microCT (CEµCT) and histological analysis. The high-resolution 3D CEµCT evaluation of the IVD confirmed that the respective injuries were localized within one side of the annulus fibrosus or spanned the full width of the IVD. The full-width injury caused significant deteriorations in the nucleus pulposus, annulus fibrous and at the interfaces after 2 weeks, which was sustained through the 8 weeks, while the partial width injury caused localized disruptions that remained limited to the annulus fibrosus. The use of CEµCT revealed distinct IVD degeneration profiles resulting from partial- and full-width injuries. The partial width injury may serve as an alternative model for IVD degeneration resulting from localized annulus fibrosus injuries.