Treatment of Symptomatic Hemorrhoids by Baron’s Band Ligation

Haemorrhoids are a clinical symptom of a change in the normal functional architecture of the inflamed and swollen veins known as the anal cushion. Numerous treatment opportunities are available for this communal issue, but Baron's Gum Ligation (RBL) is the utmost frequently used technique for second- and third-degree haemorrhoids because it treats hemorrhoidal disease without anaesthesia, hospitalization, minimal complications, and ooutpatient discharge is uneventful compared to conventional surgery. Purpose: We conducted this study to evaluate the effectiveness of rubber band ligation in the treatment of second- and third-degree haemorrhoids. Methodology: This prospective study was performed on 76 patients over a six-month period at the Department of General Surgery from January 2021 to June 2021 at Islam Medical College and Teaching Hospital Sialkot. Rubber rubber ligation was used in all patients. A maximum of two haemorrhoids in one session were banded, and third as needed in a check-up done two weeks later. At the end of the fourth week, post-banding assessments were made for the presence and absence of bleeding, pain, and haemorrhoidal prolapse. Results: Of the 76 patients, 60 (78.9%) were male and 16 (21.1%) were female. The M:F ratio was 5.0: 1.0. 37.85 years was the mean age of patients (range 15 to 68). The duration of symptoms in approximately 48 patients (63.2%) was less than one year old, and in 18 (23.7%) patients ranged from 1 to 3 years and 10 (13.2%) patients had symptoms for more than 4 years. Complications occurred in 23 patients, bleeding in three patients, pain in 18 patients, 2 patients have prolapsed. Conclusion: RBL is effective, safe and simple method of symptomatic treatment for 2nd and 3rd degree haemorrhoids in an outpatient setting.

Naja nubiae venom ameliorate hepatorenal toxicity induced by Gentamicin in rats

Background: In developing countries, there is no doubt that acute kidney injury and chronic liver diseases have a major impact on health. Different venom components are gaining renewed interest as potential sources of new pharmacological compounds relevant for human therapeutics. Aim: The present study was designed to evaluate the therapeutic efficacy of the crude venom extract of the Egyptian spitting cobra (Naja nubiae) venom extract against gentamycin–induced nephrotoxicity and hepatotoxicity in rats. Methods: Eighteen male Wistar rats were divided into three groups, control, gentamycin, and venom extract. The hepatorenal toxicity model was induced by gentamycin (80 mg/kg, intraperitoneal) for 8 days. Results: LD50 of venom extract in rats was 0.2mg/kg. The venom extract group showed a significant decrease in the liver enzymes, urea, uric acid, creatinine, malondialdehyde meanwhile glutathione reduced and catalase levels increased. Histological examination of liver and kidney mild protective efficacy with less extensive degenerative changes in the tissues of venom extract grou Conclusion: The results of the present investigation showed that administration of venom extract proved therapeutic efficacy against gentamycin -induced hepatorenal dysfunction by maintain the normal functional status of the liver and kidney and normalized the antioxidant system.

Safety factors as a ‘design’ principle of animal form and function: an historical perspective

ABSTRACT For well over 150 years, factors of safety (also known as safety factors) have been a fundamental engineering concept that expresses how much stronger a system is compared with the intended load. The pioneering work of Robert McNeill Alexander in the early 1980s applied this engineering concept to biomechanics. Over the next decade, evidence from comparative biomechanics supported the idea that safety factors are a fundamental principle of animal form and function. In terms of physiology, Jared Diamond related the maximal capacity of a physiological process to normal functional demands and incorporated evolutionary thinking into the concept of safety factors. It was proposed that evolutionary reasoning is required to understand the magnitudes of biological reserve capacities, an idea called ‘quantitative evolutionary design’. However, the general idea of safety factors as related to organismal form and function is much older. In 1906, Samuel James Meltzer, a physiologist and physician, presented the 5th Harvey Lecture to the New York Academy of Medicine; a lecture entitled ‘The Factors of Safety in Animal Structure and Animal Economy’, which was later published in Science in 1907. The 1907 paper is rarely cited and has never been cited within comparative biomechanics or comparative physiology. The purpose of this Commentary is to highlight Meltzer's historical contribution to the concept of safety factors as a general principle of organismal ‘design’.

Engrafted glial progenitor cells yield long-term integration and sensory improvement in aged mice

Aging causes astrocyte morphological degeneration and functional deficiency, which impairs neuronal functions. Until now, whether age-induced neuronal deficiency could be alleviated by engraftment of glial progenitor cell (GPC) derived astrocytes remained unknown. In the current study, GPCs were generated from embryonic cortical neural stem cells in vitro and transplanted into the brains of aged mice. Their integration and intervention effects in the aged brain were examined 12 months after transplantation. Results indicated that these in-vitro-generated GPC-derived astrocytes possessed normal functional properties. After transplantation they could migrate, differentiate, achieve long-term integration, and maintain much younger morphology in the aged brain. Additionally, these GPC-derived astrocytes established endfeet expressing aquaporin-4 (AQP4) and ameliorate AQP4 polarization in the aged neocortex. More importantly, age-dependent sensory response degeneration was reversed by GPC transplantation. This work demonstrates that rejuvenation of the astrocyte niche is a promising treatment to prevent age-induced degradation of neuronal and behavioral functions.

A Cumulative Approach on Rare Case of Infantile Tremor Syndrome

Infantile Tremor Syndrome (ITS) is categorically determined as a self-limiting clinical presentation which is characterized by anaemia, tremors, pigmentary skin disease, muscular hypotonia, and mental development regression. The presenting tremors are coarse in nature which are either decreased or vanished during sleep and takes 4-6 weeks duration for complete resolution following its natural course. The aetiology for ITS has been hypothesized for various factors like metabolic, infectious, nutritional but remained inconclusive for effective statement. But the precipitation is on the developing deficiency of Vitamin B12 but it remained controversial in terms of different factors. As the aetiology remained undefined, the line of treatment for children with ITS has been considered as per the treatment for undernourished child which included nutritional management with external supplementation of trace elements like iron, magnesium, calcium, vitamin B12 along with other such multivitamins. The administration of tremors is most commonly managed with the administration of propranolol or phenytoin, phenobarbitone, and carbamazepine. An 8 months old male child was brought by parents with complaints of fever since 8 days, decreased appetite and vomiting since 3 days. The course of hospital followed by physiotherapy which helped in regaining the normal functional activity of the baby.

Confocal Laser Endomicroscopy in Oncological Surgery

The therapy of choice in the treatment of abnormalities in the human body, is to attempt a personalized diagnosis and with minimal invasiveness, ideally resulting in total resection (surgery) or turning off (intervention) of the pathology with preservation of normal functional tissue, followed by additional treatments, e [...]

Surgical versus conservative management of tongue lacerations in the acute care setting: A systematic review of the literature

Objective The objective of this study was to determine whether suturing or conservative management of tongue lacerations results in differences in wound healing and functional outcome. The secondary aim was to identify whether antibiotics are required in the treatment of tongue lacerations. Methods Studies published between December 1954 and August 2020 were extracted from MEDLINE via PubMed, Embase via OVID, CINAHL via EBSCO, Web of Science, and the Cochrane Library and evaluated for inclusion based on predetermined inclusion and exclusion criteria by two independent reviewers in accordance with PRISMA guidelines. Results The search yielded a total of 16,111 articles, 124 of which were evaluated by full-text review, resulting in 11 articles included in this systematic review representing 142 unique cases of tongue lacerations. At least 26 lacerations (18.3%) included penetration of the muscle layer of the tongue, and 24 (16.9%) were classified as full-thickness lacerations. Thirty-five of the 142 tongue lacerations (24.6%) were sutured. The remaining lacerations underwent some form of conservative management. The majority of studies reported excellent healing of tongue lacerations regardless of the management method, with minimal scarring and excellent return to normal functional status. No cases of infection were reported. Conclusions Current literature is inconsistent with regards to indications and guidelines for primary repair of tongue lacerations. The majority of tongue lacerations reported in the literature heal with excellent outcomes regardless of management method. Physician judgement along with patient and parental preference based on potential risks of the procedure should be used when deciding whether a tongue laceration requires primary repair. Tongue lacerations in otherwise healthy individuals are at very low risk of infection.

Intrathoracic Renal Ectopia: A Case Report and Review of the Literature

: Renal ectopy is a rare phenomenon, which its diagnosis may be delayed due to an asymptomatic condition. The ectopic kidney may even have a normal functional state; however, because of occurring kidney blockade, the risk for kidney stones and even failure may be raised. In many cases, the diagnosis is completely incidental and is based on the request of radiography and sometimes, CT scan even for other reasons. In the therapeutic approach, in cases of kidney blockage, or urine backing up to the kidney, the surgical intervention is highly recommended by excisional removing the mass. Herein, we described a case of ectopic intrathoracic kidney initially presented with mild respiratory distress that was ultimately diagnosed by CT scanning and removed surgically.

Variants in LAMC3 Causes Occipital Cortical Malformation

Occipital cortical malformation (OCCM) is a disease caused by malformations of cortical development characterized by polymicrogyria and pachygyria of the occipital lobes and childhood-onset seizures. The recessive or complex heterozygous variants of the LAMC3 gene are identified as the cause of OCCM. In the present study, we identified novel complex heterozygous variants (c.470G > A and c.4030 + 1G > A) of the LAMC3 gene in a Chinese female with childhood-onset seizures. Cranial magnetic resonance imaging was normal. Functional experiments confirmed that both variant sites caused premature truncation of the laminin γ3 chain. Bioinformatics analysis predicted 10 genes interacted with LAMC3 with an interaction score of 0.4 (P value = 1.0e–16). The proteins encoded by these genes were mainly located in the basement membrane and extracellular matrix component. Furthermore, the biological processes and molecular functions from gene ontology analysis indicated that laminin γ3 chain and related proteins played an important role in structural support and cellular processes through protein-containing complex binding and signaling receptor binding. KEGG pathway enrichment predicted that the LAMC3 gene variant was most likely to participate in the occurrence and development of OCCM through extracellular matrix receptor interaction and PI3K-Akt signaling pathway.