Diagnosing chronic rhinosinusitis: a comparative study between diagnostic nasal endoscopy and computed tomographic scan paranasal sinuses

<p class="abstract"><strong>Background:</strong> The term ‘rhinosinusitis’ refers to a heterogenous group of disorders characterized by inflammation of mucosa of the nose and paranasal sinuses. The National Institute of Allergy and Infectious Diseases (NIAID) have recently mentioned that 136 million people of India suffer from chronic rhino sinusitis.</p><p class="abstract"><strong>Methods:</strong> A total 50 patients with symptoms of rhinosinusitis were investigated with both diagnostic nasal endoscopy and CT scan paranasal sinuses and their findings were scored with particular scoring system and compared with each other. </p><p class="abstract"><strong>Results:</strong> Out of 50 patients, 90% patients were diagnosed on CT scan and 84% patients were diagnosed on nasal endoscopy. By considering CT scan as accurate procedure and correlating nasal endoscopy with CT scan, sensitivity was 88.88%, specificity was 60%, positive predictive value was 95.23%, negative predictive value was 37.5%, and p value was 0.004671, which was significant at p&lt;0.05, indicates that CT paranasal sinuses is more accurate than diagnostic nasal endoscopy in diagnosing chronic rhinosinusitis.</p><p class="abstract"><strong>Conclusions:</strong> Both diagnostic nasal endoscopy and CT paranasal sinuses are important pre-operative evaluation tools in detecting pathology and both are complementary to each other. But CT paranasal sinuses are more convenient than endoscopy according to this study.</p>

Critical Aspects Concerning the Development of a Pooling Approach for SARS-CoV-2 Diagnosis Using Large-Scale PCR Testing

The primary approach to controlling the spread of the pandemic SARS-CoV-2 is to diagnose and isolate the infected people quickly. Our paper aimed to investigate the efficiency and the reliability of a hierarchical pooling approach for large-scale PCR testing for SARS-CoV-2 diagnosis. To identify the best conditions for the pooling approach for SARS-CoV-2 diagnosis by RT-qPCR, we investigated four manual methods for both RNA extraction and PCR assessment targeting one or more of the RdRp, N, S, and ORF1a genes, by using two PCR devices and an automated flux for SARS-CoV-2 detection. We determined the most efficient and accurate diagnostic assay, taking into account multiple parameters. The optimal pool size calculation included the prevalence of SARS-CoV-2, the assay sensitivity of 95%, an assay specificity of 100%, and a range of pool sizes of 5 to 15 samples. Our investigation revealed that the most efficient and accurate procedure for detecting the SARS-CoV-2 has a detection limit of 2.5 copies/PCR reaction. This pooling approach proved to be efficient and accurate in detecting SARS-CoV-2 for all samples with individual quantification cycle (Cq) values lower than 35, accounting for more than 94% of all positive specimens. Our data could serve as a comprehensive practical guide for SARS-CoV-2 diagnostic centers planning to address such a pooling strategy.

Phase equilibrium in n-octane/water separation units: vapor pressures, vapor and liquid molar fractions

The present study reports result from research into vapor–liquid–liquid phase equilibrium for n-octane highly diluted in water and water highly diluted in n-octane blends, using a dynamic method implemented in a constant volume CREC-VL-Cell. In the CREC-VL-Cell, a very high level of mixing is achieved, allowing for dispersions to be formed in the liquid phase and good mixing in the gas phase. This VL-Cell and its auxiliary equipment provide an increasing temperature ramp in the 30–110 °C range. It is found that the CREC-VL-Cell is of special value, for studying immiscible or partially miscible blends, such as is the case of n-octane in water. With the data obtained, which includes vapor pressures and temperatures, data analyses involving mass and molar balances, allow establishing overall liquid and vapor molar fractions. The recorded vapor pressures together with the calculated liquid and vapor molar fractions offer valuable data for VL thermodynamic model discrimination. For instance, it can be shown that vapor pressures, vapor and liquid molar fractions, as calculated with the Aspen-Hysys Peng Robinson Equation of State (Hysys-Aspen PR-EoS) provide only a first approximation of the experimental data, with significant discrepancies in the prediction of an n-octane disengagement temperatures. Thus, the determination of combined measured vapor pressures and calculated overall liquid molar fractions in the CREC-VL-Cell, offers a valuable and accurate procedure for thermodynamic model validation and discrimination.

TO FIND OUT THE THERAPEUTIC ROLE OF DIAGNOSTIC LAPAROSCOPY IN CHRONIC ABDOMINAL PAIN AND COMPARING ITS EFFECTIVENESS WITH OPEN PROCEDURES.

Background & Method: All the patients with chronic pain abdomen admitted in general surgery under the Department of surgery Index Medical College and Hospital, Indore. The patient is placed on the operating table with the legs straight or lithotomy position if female. The operating table is tilted head up or down by approximately 15 degree depends on the main area of examination. Compression bandage may be used on leg during the operation to prevent thromboembolism especially if patient is in lithotomy position. Result: Laparoscopy has been proved diagnostic as well as therapeutic in 82% of the cases enrolled in our study. Conclusion: Laparoscopy (diagnostic and therapeutic) is simple, safe, available and diagnostically accurate procedure but it is not non-invasive, non traumatic, nor the first choice for diagnosis. It should be reserved for those situations after non invasive methods fail to make a diagnosis. Keywords: laparoscopy, therapeutic, abdominal & diagnostic.

Effects of Antithrombotic Treatment on Bleeding Complications of EBUS-TBNA

Background and Objectives: The application of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been markedly increased over the past decade. EBUS-TBNA is known to be a very safe and accurate procedure; however, the incidence of bleeding complications in patients who are taking antithrombotic agents (ATAs) is not well established. Materials and Methods: We conducted a retrospective analysis of a prospectively registered EBUS-TBNA cohort in a single tertiary hospital from May 2009 to December 2016. The patients were divided into two groups: an insufficient discontinuation group, defined as having a prescription for ATAs on the procedure day or only interrupting them for a short period of time, and a sufficient discontinuation group, defined as having prescription for ATAs during 30 days prior to the procedure and interrupting them for a sufficient period of time. Results: During the study period, a total of 4271 patients, after excluding 3773 patients who did not take ATAs at all, 498 patients were classified into the insufficient discontinuation group (n = 102) and the sufficient discontinuation group (n = 396). The baseline characteristics of patients and examined lesions between two groups were not significantly different, except insufficient discontinuation group had longer prothrombin times than the sufficient discontinuation group. In the insufficient discontinuation group, the most common reasons for prescriptions of ATAs were ischemic heart disease (48.0%) and cerebral vascular disease (28.4%), and half of the patients were taking two or more ATAs. Eventually, only one bleeding complication in the insufficient discontinuation group (1/102, 1.0%) and one event in the sufficient discontinuation group (1/396, 0.3%) occurred (p = 0.368). Conclusions: EBUS-TBNA is considered a safe procedure in terms of bleeding complications, even in patients with insufficient stopping of ATAs.

Renal Cell Carcinoma Intravascular Spread Into Segmental Branches of the Renal Vein: A Single Institution Case Series

(1) Background: Overall survival of the patients with renal cell carcinoma (RCC) depends mostly on extra-renal extension, documented by the invasion of the pelvicalyceal system, or the perinephric/renal sinus fat or the renal vein/its segmental intraparenchymal branches. Staging may be challenging because of the high inter-observer variability. We have introduced a more accurate procedure to detect the extra-renal extension and, to possibly evaluate the impact of such more laborious approach, we have compared the RCC pathological staging obtained following both standard and modified procedures; (2) Methods: We selected 54 consecutive cases of RCC diagnosed 18 months before and 54 consecutive cases diagnosed 18 months after the introduction of the new method of sampling. Clinico-pathological characteristics have been statistically analyzed; (3) Results: Most of the features analyzed were non statistically significative, except the extra-renal invasion. More precisely, the occurrence of retrograde venous invasion was higher in the cases grossly approached with the more accurate method; (4) Conclusions: Extra-renal extension to intraparenchymal renal vein branches may be underestimated, leading to an inappropriate under-staging. Using more accurate staging procedures, to disclose the occurrence of intra-renal veins tumoral thrombosis, helps to better define the pathological stage, allowing patients to benefit of better fitting treatments.

Study of Input Parameters of Layered Half-Space used for Soil Modelling

This article deals with a problem of soil modeling. That is a necessary part of foundation modeling.The soil modeling can directly influent the resulting deformation of the foundations and therefore deformationof the whole building. The accurate procedure that can simulate the foundation-soil interaction is still unknown.A greater understanding of the issue through experiments and numerical modeling is important for a goodapplication and proper use in practice. To improve this understanding an experimental test of a concrete slabwas performed on special testing equipment. The experiment is complemented by numerical modeling.Numerical models are created in the Ansys software. The article features three cube models and a half-spheremodel. Deformations on all featured models are discussed and compared to the experimental values andsimplified hand calculation. The subsoil model is based on the Boussinesq half-space theory. The soil section isassumed homogeneous and layered. The size of models is assumed as a changing parameter from 10 m to 30 m.A recommended model size was evaluated from the parametric study as a match of deformation from modelsand the experiment. This computed model size is compared with an affected depth described by the standardČSN 731001. Computation was performed using supercomputer Anselm in the National SupercomputingCenter IT4Innovations in the VSB-Technical University of Ostrava.

ARTEMIS, THE 14C AMS FACILITY OF THE LMC14 NATIONAL LABORATORY: A STATUS REPORT ON QUALITY CONTROL AND MICROSAMPLE PROCEDURES

ABSTRACT Quality control procedures have been developed at the Laboratoire de Mesure du Carbone 14 (LMC14) national laboratory throughout the years of operation. Routine procedures are applied to sample preparation depending on their composition and their size. The tuning of the ARTEMIS AMS facility, hosted by the LMC14 laboratory, uses an accurate procedure. A batch of unknown samples is measured with accompanying samples (primary and secondary standards and blanks), which give a powerful set of data to control the quality of each measurement. A homemade database has been created to store the sample information and study the evolution of the accompanying samples. The LMC14 laboratory participated in the Sixth International Radiocarbon Intercomparison, SIRI. The results are presented here, with statistical tests to assess the quality of the preparations and measurements done at the LMC14 national laboratory. To obtain a reliable radiocarbon (14C) age by AMS, 1 mg of sample is required in routine analysis. Recently, the LMC14 developed a new procedure dedicated to microsamples, allowing the size of samples to be reduced and contributing to opening 14C dating to materials that were previously unreachable. This new procedure has been successfully tested on valuable Cultural Heritage samples: lead white mural paintings.