Detecting a small bowel tumor via wireless capsule endoscopy: a clinical case study.

Tumors of the small intestine account for fewer than 5% of gastrointestinal neoplasms. Approximately 20% of small bowel neoplasms are gastrointestinal stromal cell tumors, a spectrum of mesenchymal tumors of the gastrointestinal tract that range from benign to highly malignant. Diagnosis of gastrointestinal stromal cell tumors is usually incidental, given their rarity and the limitations of traditional endoscopy and radiology studies in visualizing the small intestine. The advent of wireless capsule endoscopy has improved the definitive diagnosis of small bowel disorders. This article outlines the course of diagnosis and treatment for a patient who presented to our hospital with severe anemia and demonstrates the role of capsule endoscopy in identifying the causes of obscure gastrointestinal bleeding.     

Functional imaging of colorectal cancer angiogenesis

Angiogenesis is a key factor in the growth and dissemination of colorectal cancer, with significant implications for its clinical management. Previous trials have provided proof-of-principle that inhibition of angiogenesis has the potential to enhance the effectiveness of treatment for this disease. Characterisation of the angiogenic status of the tumour on an individual patient basis could allow for a more targeted approach to treatment. In vivo imaging techniques that assess tumour microvessel function have the potential to improve the management of treatment for patients with colorectal cancer. This review focuses on MRI and CT assessment of colorectal cancer angiogenesis. We discuss the effects that these two techniques have had in the assessment of this disease, including tumour staging and therapeutic assessment. Their comparability with other imaging techniques, in particular ultrasound, and their limitations are also addressed.     

Sealing materials for post-extraction site: a systematic review and network meta-analysis

Clinical Oral Investigations - By means of a systematic review and network meta-analysis, this study aims to answer the following questions: (a) does the placement of a biomaterial over an...     

Is Fourth Port Really Required in Laparoscopic Cholecystectomy?

Since the advent of four-port laparoscopic cholecystectomy, many modifications regarding port number and size have been tried. The feasibility of three-port technique has been found comparable to the conventional four-port laparoscopic cholecystectomy. To assess the feasibility and safety of three-port laparoscopic cholecystectomy in a prospective study. Between March 2007 and March 2009, fifty patients with cholelithiasis aged between 15 and 56 years underwent three-port cholecystectomy in a prospective study in Government medical college, Srinagar. A single surgeon did all the cases and there was no criterion for the patient selection. These were consecutive fifty surgeries done by the surgeon. The outcome was assessed in terms of intra-operative and post-operative parameters. The mean (range) age was 45 (15–56) years and there were thirty-nine females and eleven males in the study. All the procedures were completed successfully without any conversions to open or any major complications; though three patients needed the addition of a fourth port as in conventional laparoscopic cholecystectomy. The mean (range) operative time was 55 (30–90) min and the average blood loss was 30 ml. The mean (range) hospital stay was 1 (1–3) days. All patients returned to routine work within 1 week of surgery. The mean follow-up was 5 (2–7) months. We conclude, from the results above, that three-port laparoscopic cholecystectomy is safe and feasible. There are only two visible surgical scars, better cosmetic appearance with no increased risk of bile duct injury. It reduces the manpower in the form of a second assistant. Thus, it can be recommended as a safe alternative procedure to conventional four-port laparoscopic cholecystectomy.     

Outcome of pediatric heart transplantation in blood culture positive donors in the United States

Active donor infection at the time of organ procurement poses a potential infection risk and may increase post‐transplant morbidity and mortality in recipients. Our hypothesis was that pediatric heart transplant recipients from blood culture positive donors (BCPD) would have increased morbidity and mortality compared to non‐blood culture positive donors (NBCPD). A retrospective analysis of pediatric heart transplant recipients using the organ procurement and transplant network (OPTN) between 1987 and 2015 was conducted. Recipient as well as donor data were analyzed. Propensity score matching with 1:2 ratios was performed for recipient variables. Post‐transplant morbidity and mortality were compared for recipients of BCPD and NBCPD. Among 9618 heart transplant recipients, 450 (4.7%) were from culture positive donors. Recipients of BCPD had longer duration of listing as Status 1; diagnosis of congenital heart disease or restrictive cardiomyopathy and required support (IV inotropes, Inhaled NO and LVAD) prior to transplant. Post‐transplant survival between the 2 groups was not different. Propensity‐matched recipients had similar length of stay; stroke rate; need for dialysis; pacemaker implantation and treated rejection episodes in the first year post‐transplant. Careful acceptance of BCPD may have the potential to increase availability of donor hearts in the pediatric population.     

Spectrofluorimetric Method for Determination of Duloxetine Hydrochloride in Bulk and Pharmaceutical Dosage Forms

A simple accurate, sensitive and reproducible spectrofluorimetric method was developed for the analysis of duloxetine hydrochloride in pure and pharmaceutical dosage form. Duloxetine hydrochloride showed strong native fluorescence in 0.05 M acetic acid having excitation at 225 nm and emission at 340 nm. Effect of different solvents were thoroughly investigated. The calibration graph was linear in the range from 0.020 to 0.400 μg/ml. The proposed method was statistically validated and successfully applied for analysis of capsule dosage forms. The limit of detection and limit of quantification were found to be 0.003 μg/ml and 0.010 μg/ml, respectively. The percentage recovery was found to be in the range of 98.71% to 99.17%.